Sani path mole presentation 2012

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Assessing sanitation pathways for better WASH service delivery

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Sani path mole presentation 2012

  1. 1. Assessment of Fecal Exposure Pathways in Low-Income Urban Settings Mole 23rd Conference August 24, 2012
  2. 2. Study GoalsThis project consists of an in-depth, multi-disciplinaryassessment of exposure to human fecal contamination in low-income neighborhoods of Accra.• Address the scarcity of data available to sanitation policy makers and implementers – Identify and describe: • Sources and movement of human fecal contamination in low-income urban environment • Behavior of adults and children that leads to exposure to various fecal contamination pathways – Use new certified tools and approaches to determine which exposure pathways pose the greatest risk
  3. 3. Multiple Fecal Exposure Pathways Hands Flies Food Soil Drinking Water Surface Water Slide courtesy of Dr. Karen Levy
  4. 4. Which Pathway Poses the Greatest Risk?? Household
  5. 5. Study Phases• 4 year study made up of 2 phases• Phase 1: – 15 months (Sept 2011- Dec 2012) • First of its kind • 4 study neighborhoods • Multi-disciplinary approach to assess human behavior and environmental contamination in urban Accra• Phase 1.5: – Jan 2013 – June 2013: Data analysis and development of rapid assessment tools• Phase 2: (July 2013- June 2014)- Extend and validate results of phase 1 and apply rapid assessment tools in a new context
  6. 6. Environmental Sampling and Behavior Observation
  7. 7. Environmental sampling progress to date Sample type Number collected Swabs 158 Handrinse 260 Particulate (Sand, soil and 191 sediments) Septage 3 Food 93 Stored HH and school water 125 ,sachet water Piped water and Ocean Water 90 Flies 48 Drains 76 Total samples 1044
  8. 8. E. Coli resultsType N % positivePiped water 66 33.3%Drinking water (HH and schools) 117 46.2%Sea water 18 100%Drain water 55 96%Flood water 19 73.7%Produce 97 83.5%Soil, sand, sediment 183 90.7%Swabs 142 67%Flies 32 100%Sewage 3 100%Hand rinses 238 86.5%Sachet rinses 36 22.2%Total 938
  9. 9. Behavioral study progress to date• 16 Focus Group Discussions• 12 Key Informant Interviews• 39 Child behavior observations• 11 Beach observations• 25 Nurseries and 27 Primary School observations• 32 Public Latrine observations• 15 Drain observation• 146 Latrine exit interviews
  10. 10. Household Conditions Survey (n=89) Respondent status 69.6% F in HH Tenancy 57% own Compound or HH 68.8% compound Business in HH 53.1% yes Drinking water source 75.6% sachet Latrine in HH 9 with access Number of HH sharing latrine 4 share with other HH Where ppl 5-12 yrs defecate 41.8% public latrine Where youngest child defecates 44.8% diaper/nappy Child age <2 years average Child feces disposal 58.4% rubbish Other HHs leave child feces on ground 64.4% no Child had diarrhea (2 wks) 50.6% yes Ever de-wormed child 41.2% yes Latrine type 88.9% none Animals in compound 64% yesChildren Under 5 Observations• 39 children observed• Behavior events per child: 16.1(6-28)• 40 caregivers observed• Behavior events per caregiver: 3.4(1-10)
  11. 11. Upcoming study activities• 600 Household Surveys linked with environmental sampling in all 4 communities starting next week• Agricultural focused study starting in mid – September, 2012• Full data analysis for development of rapid assessment tools and planning for phase 2

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