Contribution of physical factors to handpump borehole functionality in Africa

Handpumps are the main water supply for rural communities across sub-Saharan Africa. However, studies show that >25 % of handpumps are non-functional at any time. We present results from a systematic field study of handpump borehole functionality. The study was designed to investigate the contribution of physical factors to functionality outcomes, including; hydrogeology, borehole configuration, and handpump components. To achieve this, we deconstructed and examined 145 handpump boreholes in Ethiopia, Uganda and Malawi. Pumping tests showed that 19 % of boreholes were located in aquifers with transmissivity below the minimum required to sustain a handpump. Water levels, measured during the dry season, had a complex relationship with borehole configuration and transmissivity. The handpump cylinder was <10 m below the water table at 38 % of sites, which increases the risk of the handpump running dry during intensive use and/or in areas of low transmissivity. The water column was <20 m at 23 % of sites and screens were <10 m long at 29 % of sites and often sub-optimally positioned in the borehole. Borehole depth had no clear relationship with functionality. Using multinomial regression and four functionality categories (functional; unreliable; low yield; unreliable and low yield) as dependant variables, we found that transmissivity is a significant risk factor for the classification of handpump boreholes as low yield. The configuration of the borehole (e.g. cylinder position, screen/casing configuration and water column) is a statistically significant risk factor for the classification of handpump boreholes as unreliable. Handpump components were in poor overall condition but rising main pipes were a particular problem with 53 % of galvanised pipes corroded and 82 % of uPVC pipes damaged, with implications for handpump performance. Our study highlights the importance of; understanding aquifer properties, investing in borehole siting, construction (including supervision) and commissioning, and improving the quality of components and maintenance of handpumps.

Socio-economic risk factors for severe protein energy malnutrition among children in Mulago Hospital, Kampala

BACKGROUND

Despite Uganda's recent economic success, malnutrition is still an important public health problem and little information is available on socio-economic risk factors for severe protein energy malnutrition.

OBJECTIVE

To determine socio-economic risk factors for severe protein energy malnutrition among children aged 0-60 months.

DESIGN

A case control study.

SETTING

Mulago Referral and Teaching Hospital, Kampala, Uganda.

PATIENTS

Sixty six severely malnourished children (age 0-60 months) were matched, for age and sex, with 66 well nourished controls, and socio-economic, demographic, health facility utilisation and feeding practices were compared between the two groups.

RESULTS

Severe protein energy malnutrition was associated with young age of the caretaker (p = 0.005), living in a mud walled house (OR 2.44, CI 1.13-5.32), lack of breast feeding (OR 3.22, CI 1.31-8.02), failure to complete immunisation (OR 3.68, CI 1.53-9.011), no land ownership (OR 4.62, CI 2.09-10.3), and no ownership of livestock (OR 13.65, CI 3.60-60.84), by the caretaker. The level of formal education of the caretaker was not associated with severe malnutrition.

CONCLUSION

There seems to be a strong association between severe malnutrition and some indicators of poverty, lack of breastfeeding, and failure to complete immunisation. Programmes aimed at poverty alleviation, promotion of breastfeeding and immunisation, will go a long way in preventing malnutrition.