Inequalities in microbial contamination of drinking water supplies in urban areas: the case of Lilongwe, Malawi

Assessing the functionality of a water-vending kiosk network with high-frequency instrumentation in Freetown, Sierra Leone

Access to safe, reliable, and equitable water services in urban settings of low- and middle-income countries remains a critical challenge toward achieving Sustainable Development Goal 6.1, but progress has either slowed or stagnated in recent years. A pilot water kiosk network funded by the United States Millennium Challenge Corporation was implemented by the Sierra Leone Millennium Challenge Coordinating Unit into the intermittent piped water distribution network of Freetown, Sierra Leone, as a private-public partnership to improve water service provision for households without reliable piped water connections and to reduce non-revenue water. This study employs the use of high-frequency instrumentation to monitor, model, and assess the functionality of this water kiosk network over 2,947 kiosk-days. Functionality was defined via functionality levels on a daily basis through monitored stored water levels and modeled water withdrawals. The functionality levels across the kiosk network were found to be 34% operational, 30% offline, and 35% empty. Statistically significant (p < 0.001 ) determinants of functionality were found for several predictors across the defined thresholds. Finally, modeling of water supply, water demand and withdrawal capacity, and water storage was conducted to further explain findings and provide additionally externally relevant support for kiosk operations.

Water-based technologies for improving water quality at the point of use: A review

Water safety concerns are increasing tremendously as a result of the rising population and environmental pollution. As a result, viable water treatment approaches need to be designed to meet the water consumption demands of the population, particularly in developing countries. The recent technological advances in water treatment and purification are well articulated in this review. The efficiency of the materials used for purification and their affordability for people living in rural and remote settlements in various parts of the world have been discussed. Water treatment techniques prior to the rapid advancement of science and technology included a variety of strategies such as coagulation/flocculation, filtration, disinfection, flotation and pH correction. The use of nanotechnology in water treatment and purification has modernized the purification process. Therefore, efficient removal of microbes such as bacteria and viruses are exquisitely accomplished. These technologies may include membrane filtration, ultraviolet irradiation, advanced oxidation ion-exchange and biological filtration technologies. Thus, nanotechnology allows for the fabrication of less expensive systems, allowing even low-income people to benefit from it. Most developing countries find these technologies particularly valuable because access to clean and safe water for drinking and residential needs is critical. This is because access to municipal water supplies is also difficult. This article is categorized under: Toxicology and Regulatory Issues in Nanomedicine > Toxicology of Nanomaterials Diagnostic Tools > In Vivo Nanodiagnostics and Imaging.

Demographic dynamics of waterborne disease and perceived associated WASH factors in Bushenyi and Sheema districts of South-Western Uganda

Water remains a significant player in spreading pathogens, including those associated with neglected tropical diseases. The implications of socio-demographic delineations of water quality, sanitation, and hygiene ("WASH") interventions are on the downswing. This study assessed waterborne diseases and perceived associated WASH factors in the Bushenyi and Sheema districts of South-Western Uganda. This study examines the linear relationship between WASH and identifies the association of specific demographic factors as well as their contributions/correlations to waterborne disease in the study area. A structured qualitative and quantitative data collection approach was adopted in face-to-face questionnaire-guided interviews of 200 respondents on eight surface water usage. Most participants, 65.5%, were females and had a higher score of knowledge of WASH (71%), 68% score on the improper practice of WASH, and 64% score on unsafe water quality. Low score for basic economic status was (57%), report of common diarrhoea was (47%), and a low incidence of waterborne disease outbreaks (27%). The principal component analysis (PCA) depicts the knowledge and practice of WASH to have a strong positive correlation (r = 0.84, p < 0.001; r = 0.82, p < 0.001); also economic status positively correlated with grade of water source, knowledge, and practice of WASH (correlation coefficient = 0.72; 0.99; 0.76 and p-values = 0.001; < 0.001; < 0.001 respectively). Occupation (p = 0.0001, OR = 6.798) was significantly associated with knowledge and practice of WASH, while age (r = -0.21, p < 0.001) was negatively associated with knowledge and practice of WASH. The basic economic status explains why "low economic population groups" in the remote villages may not effectively implement WASH, and diarrhoea was common among the population. Diarrhoea associated with unsafe water quality and improper practice of WASH is common among the study population, and there is a low incidence of waterborne disease outbreaks. Therefore, government, stakeholders, and non-governmental organisations should work together to promote proper practice of WASH conditions to limit the occurrence of diarrhoea and prevent potential waterborne disease outbreaks.

Effectiveness of a water-vending kiosk intervention toward household water quality and surveyed water security in Freetown, Sierra Leone

Low-income urban residents of Freetown, Sierra Leone, have limited access to safely managed piped drinking water services. The Government of Sierra Leone, in partnership with the United States Millennium Challenge Corporation, implemented a demonstration project of ten water kiosks providing distributed, stored, treated water among two neighborhoods in Freetown. This study quantifies the impact of the water kiosk intervention by utilizing a quasi-experimental propensity score matched difference-in-differences study design. Results indicate a 0.6 % improvement in household microbial water quality and an 8.2 % improvement in surveyed water security within the treatment group. Furthermore, low functionality and adoption of the water kiosks were observed.

Water journeys: Household water insecurity, health risks, and embodiment in slums and informal settlements

Water insecurity is a critical public-health challenge in Africa's urban informal settlements, where most of the population often lacks access to household taps. In these settings, water fetching is disproportionately performed by women. While water fetching is physically laborious and exposes women to multiple risks, the water-insecurity literature has predominantly focused on household experiences, ignoring women's water-collection journeys. This paper uses the water journey as a window into the embodied dimensions of water insecurity. Combining theoretical insights from embodiment, embodied political ecology of health, and time geographies, we use video-recorded walking interviews to analyze women's everyday water journeys in Ntopwa, an urban informal settlement in Blantyre, Malawi, from initial decision making through exposure to water-fetching risks and household practices regarding use and storage. We identify three principal sources of environmental risk- terrain, built environment, and human behavior-that present challenges for water collectors. Using the walking interview as a heuristic, we show how the seemingly simple practice of water fetching is compounded by complex decision making, constant spatiotemporal trade-offs, and exposure to diverse risks, all of which have embodied health consequences. Based on our findings, we conclude that interventions seeking to improve household water insecurity must consider the embodied effects of water-fetching journeys. This study also provides methodological insights into using walking interviews and videos for water and health research.

Water, sanitation, and hygiene risk factors of acute diarrhea among children under five years in the Gaza Strip

This cross-sectional community household-based study aims to evaluate the water, sanitation, and hygiene facilities in the Gaza Strip and to investigate their associations with the occurrence of acute diarrhea among children under five years. A survey using a structured questionnaire was conducted on 1,857 households with an child under five years from August 2017 to June 2018. About 69.7% of heads of households reported a diarrheal episode among their children during the two months preceding the survey. Multivariable logistic regression showed that sewage water observed around the households was associated with an increased risk of acute diarrhea (AOR = 2.45; P &lt; 0.001; 95% CI: 1.83–3.27). Nevertheless, the allocation of a special water tank for desalinated drinking water at home (AOR = 0.3; P = 0.02; 95% CI: 0.1–0.8), the connection of households to a closed sewerage system (AOR = 0.56; P &lt; 0.001; 95% CI: 0.43–0.73), and handwashing practices before and after eating (AOR = 0.42; P = 0.003; 95% CI: 0.24–0.74 and AOR = 0.50; P = 0.03; 95% CI: 0.26–0.94, respectively), as well as using desalinated water sources for drinking purposes, were inversely associated with the incidence of acute diarrhea among children under five. Further improvements in the existing sewerage system and the intensification of sanitation and hygiene promotion programs at the household levels may reduce the risk of acute diarrhea among children under five years in the Gaza Strip.

Water insecurity and urban poverty in the Global South: Implications for health and human biology

OBJECTIVES

Over half of the world's population (4 billion people) experience severe water scarcity at least one month per year, while half a billion people experience severe water scarcity throughout the year. Despite progress from national and global interventions, a staggering proportion of the Global South remains water insecure. Rapid urban growth and associated demographic changes, climate change, and governance failure have also fostered the growth and expansion of urban informal settlements and slums where widespread poverty and environmental hazards exacerbate the impact of water insecurity on health. This article reflects on the interactions between water insecurity and urban poverty in the Global South across four categories of health outcomes: gastrointestinal diseases, mosquito-borne diseases, injuries, and mental illness. These examples highlight the mechanisms through which urban poverty exacerbates the adverse health effects of water insecurity.

METHODS

The four selected health outcomes were chosen a priori to represent two communicable conditions with well-developed literatures, and two noncommunicable conditions with newer literatures that have emerged over the last decade. We conducted a narrative literature review of scholarly and gray literature appearing between January 2000 and April 2019 using several online scholarly databases.

RESULTS

Gastrointestinal diseases, mosquito-borne diseases, injuries, and mental illness all exemplified the relationship between water insecurity and urban poverty through human biological pathways. For each of the four health categories, we identified frontiers for human biology research contributions to the water-poverty-health nexus.

CONCLUSIONS

We discuss our findings in the context of three crosscutting themes that merit innovative research approaches: stressor interactions and trade-offs, exposure thresholds, and intervention efficacy. We reiterate that the global burden of disease associated with water insecurity cannot be addressed in isolation from efforts to alleviate extreme poverty.

Interdisciplinary Critical Geographies of Water: Capturing the Mutual Shaping of Society and Hydrological Flows

In light of recent calls for an increased commitment to interdisciplinary endeavors, this paper reflects on the implications of a critical geography of water that crosses social and natural sciences. Questions on how to best research the relationship between water and society have been raised both in the field of critical geographies of water and sociohydrology. Yet, there has been little crossover between these disciplinary perspectives. This, we argue, may be partly explained by the fact that interdisciplinary research is both advocated and antagonized. On the one hand, interdisciplinarity is argued to deliver more in terms of effectively informing policy processes and developing theoretical perspectives that can reform and regenerate knowledge. On the other hand, natural and social sciences are often presented as ontologically, epistemologically, and methodologically incompatible. Drawing on our own research experience and expertise, this paper focuses on the multiple ways in which critical geographies of water and sociohydrology are convergent, compatible, and complementary. We reflect on the existing theoretical instruments to engage in interdisciplinary research and question some of the assumptions on the methodological and epistemological incompatibility between natural and social sciences. We then propose that an interdisciplinary resource geography can further understandings of how power and the non-human co-constitute the social world and hydrological flows and advance conceptualizations of water as socionatures.

Water Infrastructure Always In-The-Making: Distributing Water and Authority through the Water Supply Network in Moamba, Mozambique

Using the concept of sociotechnical tinkering, this paper provides detailed empirical observations about the everyday practices of design, construction, operation, maintenance and use of a piped water supply network in a small town in Mozambique. We use these to show that the form, materiality, and functioning of this water infrastructure are constantly changing as result of interactions with its physical environment as well as in response to experimentation and improvisation by engineers, construction workers, operators and water users. Sociotechnical tinkering not just (re)distributes water, but also provides an avenue through which powers to control water flows can be wielded and exercised. In this sense, empirical attention to sociotechnical tinkering provides a useful entry-point for rethinking the distribution of control, authority and responsibility in water governance, or more broadly the relations between power and infrastructure. This, in turn, may yield new inspirations for identifying pragmatic possibilities for progressive water politics.

A spectrum of methods for a spectrum of risk: Generating evidence to understand and reduce urban risk in sub-Saharan Africa

Many African towns and cities face a range of hazards, which can best be described as representing a "spectrum of risk" of events that can cause death, illness or injury, and impoverishment. Yet despite the growing numbers of people living in African urban centres, the extent and relative severity of these different risks is poorly understood. This paper provides a rationale for using a spectrum of methods to address this spectrum of risk, and demonstrates the utility of mixed-methods approaches in planning for resilience. It describes activities undertaken in a wide-ranging multi-country programme of research, which use multiple approaches to gather empirical data on risk, in order to build a stronger evidence base and provide a more solid base for planning and investment. It concludes that methods need to be chosen in regard to social, political economic, biophysical and hydrogeological context, while also recognising the different levels of complexity and institutional capacity in different urban centres. The paper concludes that as well as the importance of taking individual contexts into account, there are underlying methodological principles - based on multidisciplinary expertise and multi-faceted and collaborative research endeavours - that can inform a range of related approaches to understanding urban risk in sub-Saharan Africa and break the cycle of risk accumulation.

Sociohydrology: Scientific Challenges in Addressing the Sustainable Development Goals

The Sustainable Development Goals (SDGs) of the United Nations Agenda 2030 represent an ambitious blueprint to reduce inequalities globally and achieve a sustainable future for all mankind. Meeting the SDGs for water requires an integrated approach to managing and allocating water resources, by involving all actors and stakeholders, and considering how water resources link different sectors of society. To date, water management practice is dominated by technocratic, scenario-based approaches that may work well in the short term but can result in unintended consequences in the long term due to limited accounting of dynamic feedbacks between the natural, technical, and social dimensions of human-water systems. The discipline of sociohydrology has an important role to play in informing policy by developing a generalizable understanding of phenomena that arise from interactions between water and human systems. To explain these phenomena, sociohydrology must address several scientific challenges to strengthen the field and broaden its scope. These include engagement with social scientists to accommodate social heterogeneity, power relations, trust, cultural beliefs, and cognitive biases, which strongly influence the way in which people alter, and adapt to, changing hydrological regimes. It also requires development of new methods to formulate and test alternative hypotheses for the explanation of emergent phenomena generated by feedbacks between water and society. Advancing sociohydrology in these ways therefore represents a major contribution toward meeting the targets set by the SDGs, the societal grand challenge of our time.

Understanding the impacts of intermittent supply on the drinking water microbiome

Increasing access to piped water in low-income and middle-income countries combined with the many factors that threaten our drinking water supply infrastructure mean that intermittent water supply (IWS) will remain a common practice around the world. Common features of IWS include water stagnation, pipe drainage, intrusion, backflow, first flush events, and household storage. IWS has been shown to cause degradation as measured by traditional microbial water quality indicators. In this review, we build on new insights into the microbial ecology of continuous water supply systems revealed by sequencing methods to speculate about how intermittent supply conditions may further influence the drinking water microbiome, and identify priorities for future research.

Household drinking water safety among the population of Gaza Strip, Palestine: knowledge, attitudes, practices, and satisfaction

A descriptive cross-sectional study employing a structured questionnaire was employed to assess knowledge, attitude, practice, and satisfaction (KAPS) of Gaza's community on issues related to household drinking water safety. The results showed that of 1,857 household heads, 1,621 (87.3%) were males, with the majority (967, 52.1%) having a university educational level. Of surveyed households, 744 (40.1%) consisted of 5–7 persons and 885 (47.7%) of the households resided in refugee camps. Mean percentages for KAPS were 82 ± 15.5%, 64.9 ± 39.7%, 53.2 ± 14.1%, and 37.3 ± 26.56%, respectively. There were statistically significant associations between some sociodemographic variables and mean percentage of KAPS scores. Educational level was the only variable significantly associated (p &lt; 0.05) with all mean KAPS scores. There was a significant positive linear correlation between knowledge-attitude (r = 0.362, p &lt; 0.05), but a significant negative linear correlation between knowledge-practice (r = −0.070, p &lt; 0.05) was also observed. Therefore, the Local Government Authority (LGA) should arrange community awareness campaigns on the importance of safety and hygiene measures of drinking water storage. Furthermore, and due to the poor financial capabilities of the LGA in Gaza, it is highly recommended that LGA contact relevant international donors in order to support programs aiming at improving household water supply.