Emergency Water, Sanitation, and Hygiene Interventions in Low and Middle-income Countries
sanitation, and hygiene (WASH) interventions are used in low and middle-income countries
to help reduce the risk of disease by providing safe water, reducing open defecation,
and promoting hygiene practices. Specifically, in emergencies WASH interventions are
used in nearly all contexts ranging from natural disasters, to disease outbreaks, and
conflicts. Over the last several ... read moreyears, the number of people affected by emergencies is
increasing while the gap between needs and funding is widening. To address these growing
needs, emergency responders need confidence in choosing effective WASH interventions and
increased understanding to improve impact and cost-effectiveness. Unfortunately, there
is a lack of robust evidence on the efficacy and effectiveness of these interventions
because of the difficulty in conducting high-quality research in emergency contexts.
Herein, I present four projects which increase the evidence of emergency WASH
interventions: 1) a systematic review of WASH and the impact on people living with HIV
and AIDS, 2) an evaluation of a chlorine Dispenser project through four case studies in
emergencies, 3) a systematic review of WASH interventions in disease outbreaks, and
finally 4) a systematic review of short-term WASH interventions in emergency response.
The impact of emergency WASH interventions was identified through primary evaluations
(Dispensers) and secondary data analysis (three different systematic reviews, two of
which included grey literature). Across all four projects, seven common themes were
identified: 1) weak overall evidence, despite inclusion of non-experimental studies and
grey literature; 2) impact of WASH on disease reduction is assumed, rather than
consistently documented; 3) most evaluated WASH interventions focus on the water
component; 4) significance of grey literature contributing to the evidence base; 5)
sustainability of emergency interventions; 6) how and when interventions are carried out
influences the success of interventions; and lastly, 7) social aspects like taste and
smell preferences or community trust are important considerations for emergency WASH
interventions. Overwhelmingly, WASH interventions benefit affected populations; however,
the manner of implementation and depth of community engagement of affected populations
greatly influence the effectiveness of the
Thesis (Ph.D.)--Tufts University, 2017.
Submitted to the Dept. of Civil Engineering.
Advisor: Daniele Lantagne.
Committee: Miriam Aschkenasy, Jarrod Goentzel, and David Gute.
Keywords: Environmental engineering, Environmental health, and Public health.read less