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Aboah M. WASH Levels and Associated Human Health Risks in War-Prone West African Countries: A Global Indicators Study (2015 to 2021). ENVIRONMENTAL HEALTH INSIGHTS 2024; 18:11786302241228427. [PMID: 38362375 PMCID: PMC10868510 DOI: 10.1177/11786302241228427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 01/07/2024] [Indexed: 02/17/2024]
Abstract
Water, Sanitation and Hygiene (WASH) levels have been shown to have impacts on health. However, the knowledge of WASH levels in war-prone West African countries is limited. The study extracted data (2015-2021) from the Joint Monitoring Programme (WHO/UNICEF), World Bank and Demographic and Health Surveys (DHS) to estimate WASH levels in the study countries. Pearson correlation analysis was used to establish the association among the WASH levels. Results showed that women had better access to safe water (56.39%), good sanitation (59.36%) and good hygiene (60.23%) compared to men. The urban population had better access to safe water (57.60%), good sanitation (61.23%), and good hygiene (65.65%) than the rural population. Among the countries under study, Nigeria had the highest access to safe water (36.10%) and good sanitation (24.41%), while Mali had the highest access to good hygiene (27.93%). Pearson correlation analysis showed a strong positive association between safe water and good hygiene (r = .998), safe water and sanitation (r = .996) and hygiene and sanitation (r = .998) at .00 significant levels. Based on the findings, it is recommended that integrated WASH programmes with combined infrastructure development, behaviour change campaigns and community engagement should be encouraged to ensure peaceful and sustainable access to WASH levels.
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Affiliation(s)
- Michael Aboah
- Department of Environmental Science, School of Biological Sciences, University of Cape Coast, Cape Coast, Ghana
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Mbhenyane XG, Tambe AB. The Influence of Household and Community Food Environments on Food Insecurity in Limpopo Province, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:125. [PMID: 38397616 DOI: 10.3390/ijerph21020125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/15/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024]
Abstract
Insufficient access to enough quality food remains a public health challenge in South Africa. This study aimed to report the influence of community and the household environment, food system inventories, and food procurement on household food security. The findings alluded that food insecurity is prevalent among the rural areas in South Africa. Large household sizes and a limited access to and use of water and food storage facilities for food preservation are the major household determinants. A multi-sectoral nutrition-planning approach that accelerates the achievement of the Sustainable Development Goals should be reinforced. We recommend the promotion of food production for consumption in rural communities.
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Affiliation(s)
- Xikombiso Gertrude Mbhenyane
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 8000, South Africa
| | - Ayuk Betrand Tambe
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 8000, South Africa
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Tshuma M, Belle JA, Ncube A, Nyam YS, Orimoloye IR. Building resilience to hazards in the water, sanitation, and hygiene (WASH) systems: a global review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:466-478. [PMID: 36519285 DOI: 10.1080/09603123.2022.2153809] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Building the resilience of communities is essential in achieving Sustainable Development Goals (SDG). Scientific research is crucial in identifying gaps in the development of WASH systems and the management of WASH-related hazards . The main purpose of this paper was to analyze the global research evolution on resilience and Water, Sanitation, and Hygiene (WASH) between the period 2003 and 2021. Bibliometric analysis was done through the analysis of research articles from the Web of Science and Scopus using R Package software A total of 110 articles were generated from the Web of Science and Scopus databases. The study revealed that there was very little research on WASH from 2003 to 2010 and a steady increase from 2011 to 2018 and a sharp increase from 2019 to 2020 with a slight drop in 2021. This paper, therefore, recommends more focused scientific research on WASH issues in Africa and Southern Africa in particular.
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Affiliation(s)
- M Tshuma
- DiMTEC, University of the Free State, Bloemfontein, South Africa
| | - J A Belle
- DiMTEC, University of the Free State, Bloemfontein, South Africa
| | - A Ncube
- DiMTEC, University of the Free State, Bloemfontein, South Africa
| | - Y S Nyam
- DiMTEC, University of the Free State, Bloemfontein, South Africa
| | - I R Orimoloye
- Department of Geography, Faculty of Food and Agriculture, The University of the West Indies, St. Augustine Campus, Trinidad and Tobago
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Ahmed KY, Dadi AF, Ogbo FA, Page A, Agho KE, Akalu TY, Baraki AG, Tesema GA, Teshale AB, Alamneh TS, Tessema ZT, Kabthymer RH, Tamirat KS, Ross AG. Population-Modifiable Risk Factors Associated With Childhood Stunting in Sub-Saharan Africa. JAMA Netw Open 2023; 6:e2338321. [PMID: 37851439 PMCID: PMC10585405 DOI: 10.1001/jamanetworkopen.2023.38321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/28/2023] [Indexed: 10/19/2023] Open
Abstract
Importance Identifying modifiable risk factors associated with childhood stunting in sub-Saharan Africa (SSA) is imperative for the development of evidence-based interventions and to achieve the Sustainable Development Goals. Objective To evaluate key modifiable risk factors associated with childhood stunting in SSA. Design, Setting, and Participants This cross-sectional study examined the most recent (2014-2021) Demographic and Health Surveys data for children younger than 5 years from 25 SSA countries. Exposures Modifiable risk factors included history of diarrhea within 2 weeks, consumption of dairy products, maternal body mass index, maternal educational level, antenatal care visits, place of birth, wealth index, type of toilet, and type of cooking fuel. Main Outcomes and Measures Stunting and severe stunting, measured using the height-for-age z score, were the main outcomes. Children who scored below -2.0 SDs or -3.0 SDs were classified as having stunted or severely stunted growth, respectively. Relative risks and 95% CIs were computed using generalized linear latent and mixed models and log-binomial link functions. Population-attributable fractions (PAFs) were calculated using adjusted relative risks and prevalence estimates for key modifiable risk factors. Results This study included 145 900 children from 25 SSA countries. The mean (SD) age of the children was 29.4 (17.3) months, and 50.6% were male. The highest PAFs of severe childhood stunting were observed for mothers lacking a formal education (PAF, 21.9%; 95% CI, 19.0%-24.8%), children lacking consumption of dairy products (PAF, 20.8%; 95% CI, 16.8%-24.9%), unclean cooking fuel (PAF, 9.5%; 95% CI, 2.6%-16.3%), home birth (PAF, 8.3%; 95% CI, 6.3%-10.0%), and low-income household (PAF, 5.8%; 95% CI, 3.4%-8.0%). These 5 modifiable risk factors were associated with 51.6% (95% CI, 40.5%-60.9%) of the severe childhood stunting in SSA. Conclusions and Relevance This cross-sectional study identified 5 modifiable risk factors that were associated with 51.6% of severe childhood stunting in SSA. These factors should be a priority for policy makers when considering future child health interventions to address chronic malnutrition in SSA.
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Affiliation(s)
- Kedir Y. Ahmed
- Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia
| | - Abel F. Dadi
- Charles Darwin University, Menzies School of Health Research, Northern Territory, Australia
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Felix Akpojene Ogbo
- Riverland Academy of Clinical Excellence, Riverland Mallee Coorong Local Health Network, South Australia Health, Government of South Australia, Berri, South Australia, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Penrith, New South Wales, Australia
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Penrith, New South Wales, Australia
| | - Kingsley E. Agho
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Penrith, New South Wales, Australia
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Penrith, New South Wales, Australia
| | - Temesgen Yihunie Akalu
- School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
- Geospatial and Tuberculosis Research Team, Telethon Kids Institute, Perth, Western Australia, Australia
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adhanom Gebreegziabher Baraki
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada
| | - Getayeneh Antehunegn Tesema
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Achamyeleh Birhanu Teshale
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Tesfa Sewunet Alamneh
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Zemenu Tadesse Tessema
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Robel Hussen Kabthymer
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia
- Department of Human Nutrition, School of Public Health, Dilla University, Dilla, Ethiopia
| | - Koku Sisay Tamirat
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- School of Rural Health, Monash University, Warragul, Victoria, Australia
| | - Allen G. Ross
- Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia
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Adhikari S, Hunter E, Vossenberg JVD, Thomas J. A review of latrine front-end characteristics associated with microbial infection risk; reveals a lack of pathogen density data. Int J Hyg Environ Health 2023; 254:114261. [PMID: 37734133 DOI: 10.1016/j.ijheh.2023.114261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/06/2023] [Accepted: 09/09/2023] [Indexed: 09/23/2023]
Abstract
Unsafe sanitation accounts for an estimated 898,000 global deaths annually. The faecal pathogen transmission pathway is complex with several possible routes. Latrine front-end characteristics and usage behaviours are one key transmission pathway for microbial pathogens, however, there has not yet been a synthesis of the available research. This review aims to compare the microbial infection risks with latrine front-end components including any quantified microbial densities within the household latrines. This review was conducted with no restriction on the geographical location of the research. Of 118 studies reviewed, only ten (8%) have quantified the microbial density inside the household latrines compared to 109 (92%) measuring the infection risks. The reported risks were most frequent for specific bacterial (n = 34), and helminths infections (n = 32) compared to diarrhoea (n = 23), combined (n = 15), protozoan (n = 4), and viral (n = 4) infections. The infections risk decreased for using latrines lying at a higher position on the sanitation ladder (for example flush latrines) compared to those lying lower (for example pit latrines). The trend was similar for using floor materials that were easier to clean and less favourable for pathogen survival inside the latrines (for example, concrete as opposed to earth). Faecal coliforms were reported highest on the surface of the squat pan (743 CFU/cm2) of pour-flush latrines and helminths on earth floors of pit latrines (1.5 eggs and larvae per gram of soil). Irrespective of latrine type and its position on the sanitation ladder, a dirty latrine, evidenced by a visible lack of cleanliness, significantly increased the risk for all infections. This study recommends that effective microbial infection risk reduction in latrines can be gained efficiently by ensuring washable surfaces and consistent cleaning practices. Future studies should include more rigorous measurements of microbial densities in various latrine types incorporating the different front-end components and usage behaviours.
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Affiliation(s)
- Sabita Adhikari
- School of Civil Engineering, The University of Sydney, Australia.
| | - Erin Hunter
- Department of Public Health Sciences, College of Behavioural, Social and Health Sciences, Clemson University, United States.
| | - Jack van de Vossenberg
- Water Supply, Sanitation and Environmental Engineering Department, IHE Delft Institute of Water Education, the Netherlands.
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Hoffman DJ, Sommer AD. Does the Lens through Which We View Undernutrition Matter? J Nutr 2023; 152:2634-2635. [PMID: 36302161 DOI: 10.1093/jn/nxac170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/06/2022] [Accepted: 08/06/2022] [Indexed: 02/02/2023] Open
Affiliation(s)
- Daniel J Hoffman
- Program in International Nutrition, Department of Nutritional Sciences, Rutgers, the State University of New Jersey, New Brunswick, NJ, USA.,Center for Childhood Nutrition Research, New Jersey Institute for Food, Nutrition, and Health, Rutgers, the State University of New Jersey, New Brunswick, NJ, USA
| | - Alessandra D Sommer
- Program in International Nutrition, Department of Nutritional Sciences, Rutgers, the State University of New Jersey, New Brunswick, NJ, USA.,Center for Childhood Nutrition Research, New Jersey Institute for Food, Nutrition, and Health, Rutgers, the State University of New Jersey, New Brunswick, NJ, USA
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He Z, Ghose B, Cheng Z. Diarrhea as a Disease of Poverty Among Under-Five Children in Sub-Saharan Africa: A Cross-Sectional Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231202988. [PMID: 37791742 PMCID: PMC10552484 DOI: 10.1177/00469580231202988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 09/03/2023] [Accepted: 09/06/2023] [Indexed: 10/05/2023]
Abstract
The objective of this study was to assess the prevalence of diarrhea among under-five children in low-middle-income countries and identify the sociodemographic factors associated with it. Data of 36 countries in sub-Saharan Africa from demographic and Health Surveys (2006-2018) comprising 251 341 mother-child (singleton) dyads were analyzed to estimate the prevalence and various modifiable and non-modifiable risk factors of diarrhea. Occurrence of diarrhea during the last 2 weeks was the outcome variable which was measured by mothers' observation of the condition. The overall prevalence of having diarrhea during last 2 weeks was 18.44% (19.12% among boys and 17.75% among girls). Boys had higher percentage of having diarrhea than girls in all countries except in Libya. The risk ratios of having diarrhea decreased progressively with higher wealth quintiles; the risks of were respectively 7% [RR = 0.93, 95% CI = 0.91; 0.97], 11% [RR = 0.89, 95% CI = 0.86; 0.92] and 18% [RR = 0.82, 95% CI = 0.78; 0.85] lower for households in the middle, richer and richest households. Rural residency was associated with lower risks [RR = 0.95, 95% CI = 0.93; 0.98] and not having access to improved water [RR = 1.05, 95% CI = 1.03; 1.08] and toilet facilities [RR = 0.04, 95% CI = 1.01; 1.07] were associated with higher risks of diarrhea. Regarding children's characteristics, higher age groups, birth order were associated with higher risks and female sex with lower risks. Children with mothers in the higher age groups and with above secondary level education had lower risks, and primary education had higher risks of diarrhea. Meta-analysis of 36 countries revealed a significantly negative association between wealth quintile and diarrhea (Odds ratio = 0.72, 95% CI = 0.69; 0.74). Findings indicate the presence of a significant wealth gradient in the burden of diarrheal diseases among under-five children in sub-Saharan Africa, and underscores the need for paying special attention to the marginalized communities when designing intervention programs.
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Affiliation(s)
- Zhifei He
- Southwest University of Political Science and Law, Chongqing, China
| | | | - Zhaohui Cheng
- Chongqing Health Statistics Information Center, Chongqing, China
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Achore M, Bisung E. Do perceived inequalities in safe water access manifest in collective action? Evidence from urban Ghana. Health Promot Int 2022; 37:6884542. [PMID: 36482785 DOI: 10.1093/heapro/daac151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Access to safe drinking water is critical in improving health and well-being. It is estimated that >40% of urban households in Ghana do not have access to safe drinking water. Although the willingness and ability of community members to collectively take local initiatives are essential to curtailing inequities in water access in Ghana, the determinant of collective action is less explored. This paper explores determinants of collective action in water-insecure neighbourhoods and examines how perceived inequities in access to water and trust mediate the relationship between lack of access to water and collective action in urban Ghana. The results show that the urban poor OR = 12.047 (p = 0.000) were more likely to participate in water-related collective action compared to wealthy individuals. Primary decision-makers were 1.696 times more likely to participate in collective (p = 0.02). We also found that perceived inequities OR = 0.381 (p = 0.00) significantly predict participation in collective action to address water insecurity. Water service providers should be subjected to a rigid state-level framework that ensures inclusivity, fairness and justice in their distribution systems.
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Affiliation(s)
- Meshack Achore
- Department of Kinesiology and Health Sciences, Columbus State University, 4225 University Avenue, Columbus, GA 31907, USA
| | - Elijah Bisung
- School of Kinesiology and Health Studies, Queen's University, 26 Division Street, Kingston, ON k7l 2n9, Canada
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Clarke K, Rivas AC, Milletich S, Sabo-Attwood T, Coker ES. Prenatal Exposure to Ambient PM 2.5 and Early Childhood Growth Impairment Risk in East Africa. TOXICS 2022; 10:705. [PMID: 36422914 PMCID: PMC9699051 DOI: 10.3390/toxics10110705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 11/08/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
Height for age is an important and widely used population-level indicator of children's health. Morbidity trends show that stunting in young children is a significant public health concern. Recent studies point to environmental factors as an understudied area of child growth failure in Africa. Data on child measurements of height-for-age and confounders were obtained from fifteen waves of the Demographic and Health Surveys (DHS) for six countries in East Africa. Monthly ambient PM2.5 concentration data was retrieved from the Atmospheric Composition Analysis Group (ACAG) global surface PM2.5 estimates and spatially integrated with DHS data. Generalized additive models with linear and logistic regression were used to estimate the exposure-response relationship between prenatal PM2.5 and height-for-age and stunting among children under five in East Africa (EA). Fully adjusted models showed that for each 10 µg/m3 increase in PM2.5 concentration there is a 0.069 (CI: 0.097, 0.041) standard deviation decrease in height-for-age and 9% higher odds of being stunted. Our study identified ambient PM2.5 as an environmental risk factor for lower height-for-age among young children in EA. This underscores the need to address emissions of harmful air pollutants in EA as adverse health effects are attributable to ambient PM2.5 air pollution.
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Determinants of diarrhoeal disease in children living in low-income households in a periurban community in Cape Town, South Africa. SOUTH AFRICAN JOURNAL OF CHILD HEALTH 2022. [DOI: 10.7196/sajch.2022.v16.i3.1876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background. Water, sanitation and hygiene are critically important in reducing morbidity and mortality from childhood diarrhoeal disease and malnutrition in low-income settings.Objectives. To assess the association of diarrhoeal disease with factors relating to domestic hygiene, the environment, sociodemographic status and anthropometry in children <2 years of age.Methods. This was a case-control study conducted in a periurban community 35 km from the centre of Cape Town, South Africa. The study included 100 children with diarrhoeal disease and 100 age-matched controls without diarrhoea, who were recruited at primary healthcare clinics. Sociodemographic status, environmental factors and domestic hygiene were assessed using a structured questionnaire; anthropometry was assessed using the World Health Organization’s child growth standards. Univariate and multivariate logistic regression analyses were performed to identify the factors associated with diarrhoea. Results. The results of the univariate logistic regression showed significant susceptibility to diarrhoea in study cases compared with controls when the caregiver was ≥25 years old (odds ratio (OR) 1.82; 95% confidence interval (CI) 1.02 - 3.23; p=0.042); when children were in day care or cared for by a family member or a relative than when cared for by their mother (OR 1.97; 95% CI 1.06 - 3.65; p=0.032); and when the mothers were employed rather than at home (OR 2.23; 95% CI 1.21 - 4.12; p=0.01). Multivariate logistic regression analysis was used to identify predictors of diarrhoea, which entailed relaxing the inclusion criteria for the univariate analysis variables (p<0.25). The predictors significantly associated with diarrhoea were household problems relating to rat infestation (OR 2.44; 95% CI 1.13 - 5.28; p=0.027); maternal employment (OR 2.47; 95% CI 1.28 - 4.76; p=0.007); and children in day care or cared for by a relative (OR 2.34; 95% CI 1.21 - 4.54; p=0.01). Significantly more of the mothers who were employed than those who were unemployed had children in day care or cared for by a relative.Conclusion. Practices relating to employment, childcare and the domestic environment were significant predictors of diarrhoea. Effective policy implementation on water, sanitation and domestic hygiene could prevent diarrhoeal disease and reduce its impact on children’s growth, especially during the annual diarrhoeal surge season in this and similar periurban communities.
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Interplay of Water–Energy Security and Food Consumption Patterns towards Achieving Nutrition Security in Katsina State, North-Western Nigeria. SUSTAINABILITY 2022. [DOI: 10.3390/su14084478] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Everyone has the right to secure water, energy, and food supplies. These essential resources are stressed in many countries. With the current population growth rate and urbanisation, especially in sub-Saharan Africa, there is a need for more food, water, and energy to sustain the increasing population. The aim of this study was to assess the inter-relationship among water and energy in various urban and rural households to support food and nutrition security. Considering the social-economic peculiarities of the region, a specific framework and questionnaire were developed for the study. A survey involving 1785 questionnaires was conducted. Urban and rural stratification methods were used in selecting settlements across the regions. The household’s nutritional status was measured in relation to protein-rich foods as well as vegetable and fruit consumption. In addition to the Person’s correlation coefficient, which was applied to measure the association between two categories of food consumption, the chi-squared test of interdependence to determine the effect of the urban–rural dichotomy on resource utilisation was calculated. The findings indicate a high risk of undernourishment associated with insufficient sources of water and energy, as well as inappropriate sanitation facilities, especially in rural communities.
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Govender I, Rangiah S, Kaswa R, Nzaumvila D. Malnutrition in children under the age of 5 years in a primary health care setting. S Afr Fam Pract (2004) 2021; 63:e1-e6. [PMID: 34677078 PMCID: PMC8517826 DOI: 10.4102/safp.v63i1.5337] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/24/2021] [Accepted: 08/24/2021] [Indexed: 02/03/2023] Open
Abstract
In this study, we outlined the types of malnutrition amongst children, the causes of malnutrition intervention at the primary health care level and some recommendations to alleviate childhood malnutrition in South Africa.
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Affiliation(s)
- Indiran Govender
- Department of Family Medicine, Sefako Makgatho Health Sciences University, Ga-Rankuwa.
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Ntambara J, Chu M. The risk to child nutrition during and after COVID-19 pandemic: what to expect and how to respond. Public Health Nutr 2021; 24:3530-3536. [PMID: 33845938 PMCID: PMC8144817 DOI: 10.1017/s1368980021001610] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 04/01/2021] [Accepted: 04/07/2021] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The current study aimed to address the key areas of concern for child nutrition, both during and after the COVID-19 pandemic, and proposes strategic responses to reduce child undernutrition in the short and long term. DESIGN A descriptive literature review was performed. The search of the literature was conducted through using electronic databases including PubMed, Web of Science, Google Scholar and Cochrane library. SETTING A wide range of published articles focused on child malnutrition were reviewed. PARTICIPANTS The study was focused on children especially those under 5 years. RESULTS The current study proposes strategic responses to reduce child undernutrition. These responses include strengthening access to community-based nutrition services that support the early detection and treatment of undernourished children and emergency food distribution, including fortified foods with vitamins and minerals, to vulnerable households, particularly those with children under 5 years. Moreover, counseling and promotion programmes should be reinforced to revitalise community nutrition education in areas such as gestation, exclusive breast-feeding and complementary feeding, and hygienic practices involving handwashing, proper sanitation and other basic behavioural changes. CONCLUSIONS The COVID-19 pandemic has affected many countries especially those in the regions of South Asia and sub-Saharan Africa in which there has been an ongoing burden of child undernutrition. However, malnutrition is preventable and can be eliminated through a multisectoral strategic approach. The effective execution of a multisectoral approach towards preventing childhood malnutrition will require not only a financial investment but also the collective efforts from different ministries of the governments, UN-affiliated agencies and non-governmental organisations.
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Affiliation(s)
- James Ntambara
- Department of Epidemiology, School of Public Health, Nantong University, 9 Seyuan Road, Nantong, JS, People’s Republic of China
| | - Minjie Chu
- Department of Epidemiology, School of Public Health, Nantong University, 9 Seyuan Road, Nantong, JS, People’s Republic of China
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Khan AY, Fatima K, Ali M. Sanitation ladder and undernutrition among under-five children in Pakistan. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:38749-38763. [PMID: 33740192 DOI: 10.1007/s11356-021-13492-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/11/2021] [Indexed: 05/28/2023]
Abstract
While the state of sanitation in Pakistan has improved in the last decade, a significant proportion of its population is still using inadequate sanitation or no toilet facility at all. Open defecation has decreased over the years; however, it has been replaced by poor quality sanitation in rural areas that might still cause diarrhoea and undernutrition. The research regarding inadequate sanitation in Pakistan, especially in terms of the sanitation ladder, remains limited. The present research thus fills this research gap by assessing the impact of different types of sanitation on the prevalence of stunting and underweight (moderate as well as severe) among under-five children in Pakistan using the nationally representative micro survey, Pakistan Demographic and Health Survey (2017-18). The sanitation ladder comprises of piped to sewer (highest level, base) followed by flush to septic tank, flush to pit latrine, other improved, unimproved sanitation, and open defecation. In order to estimate the adjusted and unadjusted odds ratios of the determinants, this research uses logistic regressions are used to estimate adjusted and unadjusted odds ratios of the determinants. We show that toilets connected to piped sewerage network are rare in the rural areas of Pakistan and a large segment of the rural population is still practicing open defecation. The logistic regressions show that piped sewerage network and flush to septic tanks are associated with lowest odds (both adjusted and unadjusted) of stunting and underweight among under-five children. In multivariate regressions, pit latrines are associated with even higher adjusted odds of severe and moderate and severe stunting as well as underweight among under-five children, showing that poor quality pit latrines may bring the source of faecal contamination to the doorstep of the households. Therefore, interventions targeting reduction in open defecation should promote good quality toilets for sustainable long-term improvements in child health.
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Affiliation(s)
- Asfand Yar Khan
- Department of Economics, School of Social Sciences and Humanities (S3H), National University of Sciences and Technology, Islamabad, H-12, Pakistan
| | - Kaneez Fatima
- Department of Economics, School of Social Sciences and Humanities (S3H), National University of Sciences and Technology, Islamabad, H-12, Pakistan
| | - Muhammad Ali
- Department of Economics, School of Social Sciences and Humanities (S3H), National University of Sciences and Technology, Islamabad, H-12, Pakistan.
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Robinson J, Howland O. Visible and invisible risks: Exploring washing and hygiene practices with women living on low income in Kenya. Glob Public Health 2021; 17:1002-1015. [PMID: 33635181 DOI: 10.1080/17441692.2021.1887314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Shifting environmental conditions and poor or insufficient hygiene facilitates the transmission of bacteria and viruses between and within species of animals; between humans; and between humans and animals. Taking a One Health perspective, we used interviews to explore with 20 women living on low income in Kenya: their gendered hygiene practices and daily contact with animals; how and why they access water and sanitation facilities for themselves, their families, and any livestock; and their understandings of (zoonotic) health risks and disease transmission within their local environments. The women described how they worked every day to keep bodies and homes clean by washing bodies, surfaces and clothes. Women's hygiene practices focussed on removing visible dirt partly because of concerns for health but also to support their families' social standing in their community. While they were less aware of any 'invisible' risks to health through contact with animals or other hazards present in their daily living environments, most exercised care to source and manage water for drinking. Contaminated water was recognised as a risk to health suggesting that in this case, women accepted that there were 'invisible risks' to health, even in clear water, and took steps to mitigate them.
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Affiliation(s)
- Jude Robinson
- School of Social and Political Sciences, University of Glasgow, Glasgow, UK
| | - Olivia Howland
- Zoonotic and Emerging Diseases Group, University of Liverpool, Liverpool, UK.,International Livestock Research Institute (ILRI), Nairobi, Kenya
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Gwenzi W. Dangerous liaisons? As the COVID-19 wave hits Africa with potential for novel transmission dynamics: a perspective. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2021; 30:1353-1366. [PMID: 33425657 PMCID: PMC7778499 DOI: 10.1007/s10389-020-01467-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 12/15/2020] [Indexed: 01/31/2023]
Affiliation(s)
- Willis Gwenzi
- Biosystems and Environmental Engineering Research Group, Department of Soil Science and Agricultural Engineering, Faculty of Agriculture, University of Zimbabwe, P.O. Box MP 167, Mount Pleasant, Harare, Zimbabwe
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A SEM Approach to the Direct and Indirect Links between WaSH Services and Access to Food in Countries in Protracted Crises: The Case of Western Bahr-el-Ghazal State, South Sudan. SUSTAINABILITY 2020. [DOI: 10.3390/su12229631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
As highlighted by the 2030 Agenda, access to food is a crucially important aspect of sustainable development. In this context, the association between WaSH services and access to food still needs to be clearly understood. This study investigates the direct and indirect impact of the WaSH environment of households on access to food, and the role of mediation variables and insecurity due to war and conflicts in South Sudan. We considered a statistically representative sample of 1382 households and used two structural equation models based on primary data. A basic model estimates association between household WaSH environment and food security directly and indirectly through the household livelihood-based coping capacity and poverty perception. Its extended version includes the indirect effect of insecurity due to war and conflicts. Results are theoretically coherent and demonstrate the relevance of the household WaSH environment for food security. The indirect effect of the absence of insecurity due to conflicts and war on food security adds to the basic model a statistically significant total indirect effect. From a policy perspective, the study suggests reinforcement of the capacity of the public sector for delivering WaSH services and the need for multi-sectoral solutions linking humanitarian, development, and peace approaches.
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Momberg DJ, Mahlangu P, Ngandu BC, May J, Norris SA, Said-Mohamed R. Intersectoral (in)activity: towards an understanding of public sector department links between water, sanitation and hygiene (WASH) and childhood undernutrition in South Africa. Health Policy Plan 2020; 35:829-841. [PMID: 32535623 DOI: 10.1093/heapol/czaa028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2020] [Indexed: 12/20/2022] Open
Abstract
Associations between different forms of malnutrition and environmental conditions, including water, sanitation and hygiene (WASH), contribute to poor child health, nutritional status and physical growth. The primary responsibility for the provision of water and sanitation, as a basic service and human right, lies with the State, as such, a number of stakeholders are involved. Despite relatively high levels of WASH infrastructure coverage in South Africa, enteric infections and stunting remain high for a middle-income country. The aim of this study is to elucidate the landscape of WASH in South Africa in relation to nutritional status of children under the age of 5 years in the South African, Gauteng and City of Johannesburg contexts. The authors detailed the national and provincial public sector departments and through purposive sampling proceeded to map the various departments and associated policies that are responsible for the provision of WASH facilities, as well the nutritional status of children. Of the six policies identified for review, three mentioned WASH, nutrition and children; however, none explicitly linked WASH to nutritional status in children. An in-depth review and analysis of these three crucial policy documents was conducted. Finally, a set of expert interviews were conducted and a consensus development conference convened, with experts at the intersection between WASH and nutritional status. The authors found that the public sector would benefit from better integration of the concept of WASH into their policy, planning and implementation frameworks. The WASH sector should emphasize the role in which WASH plans consider the impact of WASH on the nutritional status of children. The various public sector departments involved in WASH service provision, and other WASH stakeholders, including community-based organizations, non-governmental organizations and intergovernmental organizations, should be involved in the decision-making of the nutrition sector.
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Affiliation(s)
- D J Momberg
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Johannesburg, South Africa.,DSI-NRF Centre of Excellence in Food Security, University of the Western Cape, South Africa
| | - P Mahlangu
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Johannesburg, South Africa.,Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
| | - B C Ngandu
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Johannesburg, South Africa
| | - J May
- DSI-NRF Centre of Excellence in Food Security, University of the Western Cape, South Africa
| | - S A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Johannesburg, South Africa.,DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, Johannesburg, South Africa
| | - R Said-Mohamed
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Johannesburg, South Africa.,DSI-NRF Centre of Excellence in Food Security, University of the Western Cape, South Africa.,DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, Johannesburg, South Africa
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