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Paper: Estimating child health equity potential of improved sanitation – Nepal

Tue, 24Sep2013 Comments off

paper

Conceptual framework for using LiST to estimate the lives saved from WSS interventions  Acharya et al. BMC Public Health 2013 13(Suppl 3):S25   doi:10.1186/1471-2458-13-S3-S25 Anjali Acharya,  Li Liu, Qingfeng Li and Ingrid K Friberg

Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA

Estimating the child health equity potential of improved sanitation in Nepal

Abstract

Background

Access to improved sanitation plays an important role in child health through its impact on diarrheal mortality and malnutrition. Inequities in sanitation coverage translate into health inequities across socio-economic groups. This paper presents the differential impact on child mortality and diarrheal incidence of expanding sanitation coverage across wealth quintiles in Nepal.

Methods

We modeled three scale up coverage scenarios at the national level and at each of the 5 wealth quintiles for improved sanitation in Nepal in the Lives Saved Tool (LiST): equal for all quintiles, realistically pro-poor and ambitiously pro-poor.

Results

The results show that equal improvement in sanitation coverage can save a total of 226 lives (10.7% of expected diarrhea deaths), while a realistically pro-poor program can save 451 child lives (20.5%) and the ambitiously pro-poor program can save 542 lives (24.6%).

Conclusions

Pro-poor policies for expanding sanitation coverage have the ability to reduce population level health inequalities which can translate into reduced child diarrheal mortality.  more….

Paper: Human rights & health systems development: Confronting the politics… Duncan Maru & Paul Farmer

Fri, 20Sep2013 Comments off

paper/article:

Duncan Maru and Paul Farmer

Publication: Health and Human Rights    (From listing of articles/papers Wednesday, August 14, 2013)

Human rights and health systems development: Confronting the politics of exclusion and the economics of inequality

Abstract

The social movements of the last two decades have fostered a rights-based approach to health systems development within the global discourse on national and international health governance. In this piece, we discuss ongoing challenges in the cavernous “implementation gap ”— translating legislative victories for human rights into actual practice and delivery. Using accompaniment as an underlying principle, we focus primarily on constructing effective, equitable, and accountable public sector health systems. Public sector health care delivery is challenged by increasingly exclusive politics and inequitable economic policies that severely limit the participatory power of marginalized people. Finally, we discuss the role of implementation science in closing the delivery gap.
 

Introduction: The right to health

The human rights approach to public health systems development has been a central theme to emerge from the explosive growth in global health awareness and funding in the last two decades.1  The notion that health care systems are both national and international public goods protecting the essential rights of all citizens, while not wholly embraced, has gained traction in global debates about health care financing, governance, and implementation.2 In this piece, we discuss challenges in translating consensus around health as a human right into one particular aspect of the right to health: namely, access to effective health care systems that reach the most vulnerable.

The Universal Declaration of Human Rights was published in 1948,3 marking the start of the modern human rights movement. The poles of civil and political rights versus social and economic rights established during the Cold War era prevailed until the early 1990s, when a relative consensus emerged that the different human rights domains should be integrated. The global movement to combat HIV/AIDS represents the broadest, deepest, most concerted effort to date to forge a link between health and human rights. It is no coincidence that this movement was initiated, expanded, and sustained by individuals from communities bearing the highest burdens of HIV disease.  The movement was successful because it was driven and led by individuals directly affected by the epidemic. This movement both globalized public health and connected it to the rights agenda.4

A major challenge in translating the successes of the HIV/AIDS movement into broader health systems change is deepening the involvement of citizens who would be most impacted by such changes—often the most marginalized populations.  Wealthier citizens tend to be able to rely on for-profit, privatized health services and therefore have little incentive to partner with poorer citizens to advance public sector health systems change.

Herein lies a paradox in health and human rights. At no time in human history has health as a human right been as prominent in international and national health discourse as it is now. Yet we also face ongoing expansion of the politics of exclusion and the economics of inequality, which pose immense challenges to implementing human rights-based advances.  Human rights legislation without effective delivery systems is impotent; effective delivery systems without human rights protections (for example, legislative guarantees) will fail to deliver to the most vulnerable.

For health systems development, why does the rights-based view remain relevant today? While much has changed, the underlying forces driving health inequity remain the same. We believe that effective health care systems must guarantee the right to health for our most vulnerable citizens. While this is a sweeping statement, it is important to differentiate this rights-based approach from other approaches that seek merely to reduce population disease, maximize cost-effectiveness, or facilitate rational private investment in health. Our stance is a fundamentally moral one, rooted in the lived experiences of our patients, but it is also deeply pragmatic. To free the world’s poor from the diseases that continue to stalk them, we must build better public sector systems. more….

About the Publication: Health and Human Rights:

Health and Human Rights began publication in 1994 under the editorship of Jonathan Mann. Paul Farmer, co-founder of Partners In Health, assumed the editorship in 2007. Health and Human Rights is an online, open-access publication.

Health and Human Rights provides an inclusive forum for action-oriented dialogue among human rights practitioners. The journal endeavors to increase access to human rights knowledge in the health field by linking an expanded community of readers and contributors. Following the lead of a growing number of open access publications, the full text of Health and Human Rights is freely available to anyone with internet access.

Health and Human Rights focuses rigorous scholarly analysis on the conceptual foundations and challenges of rights discourse and action in relation to health. The journal is dedicated to empowering new voices from the field — highlighting the innovative work of groups and individuals in direct engagement with human rights struggles as they relate to health. We seek to foster engaged scholarship and reflective activism. In doing so, we invite informed action to realize the full spectrum of human rights. more…

This article is important in its own right.  WASHLink believes Hygiene, Sanitation, Water,  & Public Health can not, must not, should not be siloed. If we shall build apart we shall fall together, so while not addressed directly, we  see there is a underlying appeal in this article for such. We encourage you to read on, and explore the invaluable site it is posted on. We can hope this article and other articles found on the Health and Human Rights site  reach the eye of the policy makers and  there minions that execute their edicts. While perhaps trite: we all have  some responsibility  / some role to play in moving this forward.

Urine diversion toilet components – A Technology Review

Sat, 09Jan2010 1 comment

This was first noted/posted  by SuSanA( EN FR ES ) and worthy of    “post duplicating”

GTZ Has published a set of technology reviews the last Quarter of 2009 dealing with “some
technologies commonly used as toilets or as treatment systems in ecosan systems.”

GTZ (Deutsche Gesellschaft für Technische Zusammenarbeit translated- German Agency for Technical Cooperation) is federally owned and “…supports the German Government in achieving its development-policy objectives.” according to its about us web page Thier focus is sustainable development.  Their is site is available in English and Deutsche de

The following comes  from  http://www.gtz.de/en/themen/umwelt-infrastruktur/wasser/9397.htm and the actual documents.

Technology Review 1: Urine diversion components

Technology Review 2: Urine diversion dehydration toilets (UDDTs)

  • Content includes:
    • colored posters in one of the common languages of the  country produced in, viewable on a stands size copy paper.

Technology Review 3: Composting toilets

Technology Review 4: Biogas sanitation

Technologie Review 5: Constructed wetlands

NOTES:

They, GTZ,  suggests the site  http://www.susana.org/lang-en/working-groups for in depth information.  SuSanA (Sustainable Sanitation Alliance) has formed working groups for a range topics centered on sanitation. Their admirable and hopefully achievable goal is to “…provide deliverables  that underline the problems and opportunities …” for these topics.  The working groups break  out as follows:

DRY TOILET 2009 Conference proceedings and presentations

Sun, 27Dec2009 Comments off

The proceedings from the DRY TOILET 2009 conference held by Global Dry Toilet Association of Finland are  available   They are  a great resource and available at  http://huussi.net/tapahtumat/DT2009/full.html

The summary  is also avaliable in  – suomi (Finish) and Russian as a pdf

The Suomi version of the  home page is http://www.huussi.net/

Session Presentations

&
Country Focus

1 PROMOTING ECOLOGICAL SANITATION IN ORDER TO
ACHIEVE MDG’S
  • “Composting Toilet – The Bangalore, India experience”
  • Sustainable sanitation in Namibia’s lowest income urban
    areas: “The potential of composting toilets”
  • “To dry or not to dry?-People matter in scaling up dry
    sanitation”
  • “Dry Toilets in Tajikistan”
  • “Sustainable sanitation beyond Taps & Toilet”
  • “Prevalence of Ecological sanitation uptake and associated
    factors in Kabale municipality, Uganda”
India,
Namibia, Finland, Tajikistan, Nepal, Uganda
2 HEALTH AND SAFETY ASPECTS RELATED TO DRY
SANITATION
  • “Toilets and health throughout history”
  • “The public health safety of using human excreta from urine
    diverting toilets for agriculture: The Philippine experience”
  • “Dry Toilet – A boon to rural community”
  • “Ecological sanitation: inactivation of pathogens in faeces
    from dry toilet – grey water disposal”
  • “From pit latrine to a safe and sustainable toilet.”
  • “Possible public health implication of excreta re-use in
    poorly sanitated rural farming communities of Ebonyi state, South-East
    Nigeria”
Philippines, India, Argentina, Belarus, Nigeria
3 IMPLEMENTING ECOLOGICAL SANITATION IN
EMERGENCIES
  • “Sanitation in the disaster cycle – immediate response,
    preparedness and risk reduction”
  • “Provision of Dry Toilets in earthquake hit areas of
    Pakistan – learning from first hand experience”
  • “Eco-toilet for disaster preparedness”
  • “Introducing ecological sanitation in emergency: Some
    lessons learned from a pilot project Bangladesh”
  • “Sanitation in IDP and refugee camps in Chad: the current
    and future challenges”
Pakistan,
Bangladesh, Chad
4a PROSPECTS AND CHALLENGES IN RE-USE OF EXCRETA
  • “Pathogens of concern for developing countries and risk of
    reusing ecosan sludge in agriculture”
  • “Urine from separating toilets for non-edible plants”
  • “From pit latrine to nutrient conservation”
  • “Re-use of human’s urine in market-gardening in
    South-Benin: financial returns analysis”
  • “Biogas generation – a multi-dimensional development
    approach”
Mexico,
Benin, Ethiopia
4b PROSPECTS AND CHALLENGES IN RE-USE OF
EXCRETA continues
  • “Dry toilet compost and separated urine as fertilisers for
    cabbage and potato – a case study from Finland “
  • “Prospects and Challenges in the reuse of human excreta in
    Nakuru Municipality, Kenya”
  • “Use of Faecal Sludge for Agriculture in Tamale Metropolis:
    perception of Farmers, Consumers and Relevant Agencies”
  • “Positive spin offs using mobile urinals and UD toilets in
    Burkina Faso”
  • “Study on the compost produced by compost bins and ecosan
    latrines and survey on knowledge attitudes and practices in usage of
    compost bins and ecosan latrines”
Finland,
Kenya, Ghana, Burkina Faso,

Sri Lanka

5 CHALLENGES IN IMPLEMENTING ECOLOGICAL
SANITATION
  • “Evaluation of social and cultural acceptance of the
    biotoilet system”
  • “Social representattions of hygiene and excretes disposal –
    The case of ecological dry toilets introduction in Quibdo and
    Tumaco-Columbia”
  • “Towards a common goal. The challenges of the sanitation
    sector in Zambia”
  • “Living with the marginalised: Addressing the
    socio-economic and cultural aspects in implementing Oka-Dry Toilets in
    Madimba; case of Lusaka”
  • Sari Huuhtanen*, Finland; Michelo Katambo, Zambia:
  • “The challenge of social change; experiences from Zambia
    dry-sanitation project (ZASP, 2006-2008)”
Mexico,
Columbia, Zambia
6 GENDER ASPECTS
RELATED TO DRY SANITATION
  • “Gender aspects of ecological sanitation with urine
    diverting dry toilets”
  • “Female local latrine builders: Contributing towards
    objectives of International Year of Sanitation, 2008”
  • “Women and ecological sanitation”
  • “Promotion of dry toilets for reducing vulnerability for
    the poor women having Islamic and cultural values in urban slums of
    Bangladesh”
Nepal,
Uganda, Bangladesh
7a TECHNICAL
DEVELOPMENT OF DRY TOILETS
  • “Is the
    Agricultural utilisation of Treated Urine and Faces recommendable?”
  • “Developing low cost composting toilet for developing
    countries”
  • “Solar thermal sanitation of human faeces – an affordable
    solution for
    ensuring sustainability of EcoSan activities”
  • “Feasibility assessment of application of onsite volume
    reduction
    system (OVRS) for source-separated urine”
  • “Urban slum dwellers in Kenya and Bangladesh benefit from
    using Peepoo
    bags which are self-sanitising and biodegradable”
Kenya and
Bangladesh and others
7b TECHICAL
DEVELOPMENT OF DRY TOILETS continues
  • “From the outhouse to indoor dry toilets in Finland”
  • “Estimation of water evaporation rate from composting
    toilet”
  • “Implementation of urine-diverting dry toilets in
    multi-storey apartment buildings in Ethiopia”
  • Dry sanitation in multi-story apartment buildings: “The
    case of Dongsheng, Inner Mongolia, China”
  • “The humanure toilet”
Finland,
Ethiopia, Inner Mongolia, China
8 CAPACITY
BUILDING
  • “Going to scale with urine diversion in Sweden – From
    individual households to municipal systems in 15 years”
  • “The processes of adaption during the introducing urine
    diverting toilets in Kyrgyzstan”
  • “Influence of social, cultural, economic and gender aspects
    in dry toilet as eco-sanitation tool. Case study of Sukuma-nomadic
    community in Malinyi, Tanzania.”
  • “Experiences with ecosan systems to provide sustainable
    sanitation for schools in Kenya and India”
  • “Gold Factory – An experimental art project with dry
    toilets”
Sweden,
Kyrgyzstan, Tanzania,Kenya, India
Side event SUSTAINABLE
SANITATION FOR TOURISM AND RECREATION
  • “Toilet provision in the Cairngorms national park,
    Scotland, UK”
  • “Experience of biotoilet installations on Kizhi island,
    Republic of Karelia, Russia”
  • “Promotion of sustainable development of rural communities
    around especially protected natural areas in Kazakhstan”
  • “Public toilets and care practices in nature parks in
    Finland, current situation and recommendations for improvement”
Scotland,
Republic of Karelia, Russia, Kazakhstan, Finland

Struvite from Urine in Nepal: STUN

Fri, 04Sep2009 Comments off

Bastian collector moringa reactorII

source source http://www.eawag.ch/organisation/abteilungen/sandec/publikationen/stun
The STUN project, operated in co-operation with UN-HABITAT Nepal, examines the feasibility of converting source-separated urine into a dry fertilizer product called ‘struvite’. Struvite (often called MAP for magnesium ammonium phosphate: MgNH4PO4.6H2O) is a safe, bioavailable fertilizer which can be precipitated from urine with only the addition of magnesium.

Working in the Kathmandu Valley, with the community of Siddhipur, the STUN project has assessed the social,

mapit

see map

economic, and technical feasibility of producing struvite at the community level. By producing struvite from urine, we hope to promote improved sanitation, local food security, and nutrient independence as Nepal must import all of its fertilizer at prices which are not always affordable for subsistence farmers.

The following reports are available for download:

E Tilley, K Udert, B Etter, R Khadka, E John. (2009). Struvite Recovery in Kathamandu: A business model for increased food security
Fertilizer.
(award winning poster from the Alliance for Global Sustainability 2009 Annual Meeting)

Etter, B. (2009).  Process optimization of low-cost struvite recovery. Masters thesis submitted to EPFL.

Etter, B. (2009). Struvite recovery from urine at community scale in Nepal. Intermediate report. Eawag: Swiss Federal Insitute of Aquatic Science and Technology, Dübendorf, Switzerland. (technical optimization)

Gantenbein, B. and Khadka, R. (2009). Struvite Recovery from Urine at Community Scale in Nepal: Final Project Report Phase 1. Eawag: Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland. (social assessment)

Kashekya, E.J. (2009). Struvite production from source separated urine in Nepal: The reuse potential of the effluent. MSc Thesis MWI-SE 2009/01. UNESCO-IHE and Eawag, Delft, The Netherlands.

Further reading:

Tilley, E., Gantenbein, B., Khadka, R., Zurbrügg, C. and Udert, K.M. (2009). Social and economic feasibility of struvite recovery from uine at the community level in Nepal. In: International Conference on Nutrient Recovery from Wastewater Streams. K. Ashley, D. Mavinic and F. Koch (eds). IWA Publishing, London, pp 169-178.

For more information (in Switzerland) please contact struvite.nepal@eawag.ch

For more information on:

UN-Habitat

www.unhabitat.org

phosphorus depletion:

http://phosphorusfutures.net

www.phosphaterecovery.com

www.ceep-phosphates.org

Urine separation and reuse:

www.novaquatis.eawag.ch/index_EN

www.ecosanres.com

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