As cases of COVID-19 were rising in India and the country’s political leadership instituted a nationwide lockdown, one of the authors of this article received a timely invitation from a friend – a ...

The impossibility of social distancing among the urban poor: the case of an Indian slum in the times of COVID-19

Lack of access to potable water and good sanitation is still one of the most challenging public health concerns of the twenty-first century despite steady progress over recent decades. Almost a billion people globally lack access to safe water; over two billion live without adequate sanitation facilities. The challenge is even more daunting for Sub-Saharan Africa where coverage levels for both potable water and sanitation remain critically low. The urgent need to address the issue calls for adequate understanding of the socio-economic dimensions. Using the 2008 Ghana Demographic and Health Survey, we investigated the socio-economic and demographic factors associated with access to potable water and improved sanitation facilities. Our generalized linear models reveal that income, education, household size, and region are significant predictors of improved water and sanitation access. Our discussion and conclusion sections highlight the implications of the study results for water policy formulation and implementation in Ghana, and broadly for other developing countries.

Socioeconomic and Demographic Predictors of Potable Water and Sanitation Access in Ghana

Diarrheal disease kills over half a million people each year in sub-Saharan Africa; the majority are children under 5 years. About 58% of diarrhea cases are associated with poor water, sanitation, and hygiene—a critical issue for people living in informal settlements. In Kenya, 60% of Nairobi’s population lives in informal settlements; yet, there is a paucity of research exploring the relationship between water, sanitation and hygiene (WASH) conditions in these settlements and associated health outcomes. The study examines characteristics of women’s WASH behaviors and environments as potential factors associated with household diarrhea in Mathare Valley Informal Settlement in Nairobi using cross-sectional survey data collected from 550 women. Approximately 17% of participants reported that at least one member of the household suffered from diarrhea in the previous 2 weeks—48% of the cases were children under five. Results from a logistic regression exploring factors associated with reports of household diarrhea suggest that women’s sanitation management strategies are associated with recent household diarrhea. Women who use toilets for defecation during the day, but rely on bags, buckets, or open defecation (OD) for urination during the day and for urination and defecation at night have over five time the odds of recent household diarrhea than women who use a toilet for all their sanitation needs. The odds of diarrhea were also higher for participants who walk up to 2 min to reach their toilets/sites for defecation and those who rely on water from taps inside buildings and plots. Odds were 62% lower for participants with clean toilets. Findings suggest that health targets to reduce the prevalence of diarrheal diseases in informal settlements may not be met unless particular attention is paid to the needs of women living in these environments.

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Exploring the complex relationship between women’s sanitation practices and household diarrhea in the slums of Nairobi: a cross-sectional study

Availability of clean water and adequate sanitation facilities are the principal measures for limiting various waterborne diseases. These basic amenities are critical for health and sustainable socio-economic development. This study attempted to assess the status of water and sanitation facilities and practices of the people living in rural areas of Chandigarh including awareness about the waterborne diseases. The community-based cross-sectional study design was adopted having 300 households across 12 villages of city Chandigarh. A standardized interview schedule was used to collect information related to water uses, storage, water treatment options, water conservation practices, personal hygiene, knowledge about waterborne diseases, and government schemes. The interview schedule was administered with the head of the family as a study approach during the door-to-door survey. Households in rural Chandigarh have municipal water supply for drinking as well as other domestic purposes. The mean per capita water usage was 67 ± 13.4 l. Most (68.6%) of the study participants reported that they do not treat water before drinking and store it in plastic bottles or bucket (58%). The survey shows that 97% of the household had functional toilets in their premises, remaining reported lack of finances, and space for construction as major barriers. Regarding personal hygiene, 83% of respondents wash hands with soap and rest used only water or ash. Observations made under the study highlighted the need to create awareness regarding the role of water and sanitation practices on health including knowledge about various government schemes to improve water quality, sanitation, and hygiene practices for better health.

Water uses, treatment, and sanitation practices in rural areas of Chandigarh and its relation with waterborne diseases

According to the United Nations, the world has met the Millennium Development Goal target of halving the proportion of people without access to safe drinking water. However, global figures mask massive disparities between regions and countries, and within countries. For instance, only 64% of the people in sub-Saharan Africa have access to improved water sources. Over 40% of all people globally who lack access to drinking water live in sub-Saharan Africa. Rwanda is used as a case in point in this study. Despite the abundance of water resources in the country, access to improved water sources is limited. Using the Rwandan Demographic and Health Surveys (2000–2010), we examined regional disparities in access to improved water sources. Results from logistic regression models show that overall, access to improved water has declined between 2000 and 2010; except in the western region, where access to water marginally improved. Educated individuals, wealthier and urban dwellers were more likely to have access to improved water sources over time compared to their uneducated, poor and rural counterparts. The persistence of regional disparities in access to improved water over time suggests the need for policy to address insufficient investments in water infrastructure in Rwanda.

The paradox of water accessibility: understanding the temporal and spatial dimensions of access to improved water sources in Rwanda

Background: Access to improved drinking water, sanitation and hygiene is one of the prime concerns around the globe. This study aimed at assessing water and sanitation hygiene-related attitude and practices, and quality of water in urban slums of south Delhi, India. Methodology: This pilot cross sectional study was performed during July 2013 across four urban slums of South Delhi. A convenient sample of 40 participants was enrolled. A modified version of previously validated questionnaire was used to gather information on socio-demographics, existing water and sanitation facilities and water treatment practices. Water quality testing was additionally performed using hydrogen sulphide (H2S) vials. Results: Average age of participants was 36 years (SD=10). 83% of the participants perceived gastrointestinal tract infection as the most important health problem. 75% of the participants did not use any method for drinking water treatment. 45% of the participants consumed water from privately-owned tube well/ bore well. Water shortage lasted two days or more (50%) at a stretch with severe scarcity occurring twice a year (40%). Females aged 15 years and above were largely responsible (93%) for fetching water from water source. 45% of the participants had toilets within their households. 53% of drinking water samples collected from storage containers showed positive bacteriological contamination. Discussion: There is an urgent need to develop family centered educational programs that would enhance awareness about water treatment methods that are cost effective and easily accessible.

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Water and sanitation hygiene knowledge attitude practice in urban slum settings.

Globally, 23.1 million missing female births have been documented, resulting in an imbalanced sex ratio at birth (SRB) between the late 1990s and 2017, with India accounting for almost half of this missing women population. While the country is progressively taking measures to enhance women's position in society and implementing policies toward augmenting the value of a girl child, some deeply rooted cultural and social beliefs propel a strong son preference, resulting in active daughter discrimination. The continuance of patriarchal norms and inequitable gender roles, resulting in son preference, fertility decrease, and reduction in preferred family sizes, and technical breakthroughs that allow for the identification of the sex of the fetus, is all connected to distortions in the sex ratio at birth. Son preference is a well-documented phenomenon in India, and its implications for skewed gender ratios, female feticide, and higher child mortality rates for girls have piqued researchers' and policymakers' interest. The fundamental factors of son preference as an ideology are less widely investigated. With this objective, an extensive secondary review was conducted of the socio-cultural norms and biases leading to increased prenatal sex selection in India despite the laws against it. The study findings suggest that it is imperative to emphasize the necessity for consistent and collective efforts from all stakeholders: changing the social perception of the value of girls requires collective effort and the equal participation of all stakeholders, including civil society organizations and the local community.

Cultural and Social Bias Leading to Prenatal Sex Selection: India Perspective

Background: Gender Violence stigmatises women for life, rendering them powerless to take control of their health. Because of the culture of silence and unequal power-sharing in our society between married couples, women become more prone to gender violence. This study was done to understand the knowledge of gender violence, attitudes towards gender violence and the practice of gender violence among married females. Material & Methods: A cross-sectional study was conducted among 218 married females in the age group of 18-49 years. A structured questionnaire was prepared and shared through different social media platforms. Data were analysed using IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp. Result: Almost half of the participants (74.8%) had knowledge of gender-based violence. Among the participants, 34 (15.6%) of the women experienced physical violence from their husbands, whereas only 24 (11.0%) of women reported violence to the authority. Among the participants, 75 (34.4%) women said that they are not in favour of reporting to the police or the authority if they experience violence at home by their husbands or in-laws. 

Knowledge, attitude and practice on gender violence amongst married women in India

An ethnographic study of folk dentists was conducted in Delhi. Ten case studies of folk dentists and their patients were analysed for various domains of content analysis (CA). Data were collected through mixed method of data collection with some basic research questions guide for the folk dentists and patients during the COVID-19 partial lockdown period in Delhi. The CA for primary cases, secondary cases and for patients was analysed for various domains. Results reveal various aspects of their practices and issues on roadside assets in clinic, health and hygiene, family traditions, pride in work, income/economics, duration of their practices and uncertainties. Similarly, patients were analysed for their views on cheap services, health and hygiene, easily approachable folk experiences and quality of services. The researchers illuminated the policy issues of folk or traditional dentists practicing in a metropolitan city and their patients’ perspectives for their dental public health concerns and have made some recommendations to their salient voice.

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Folk Dentists Voicing their Plight-An Ethnographic Exploration

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Mehak Segan

Papers

Water and sanitation hygiene knowledge attitude practice in urban slum settings.

Cultural and Social Bias Leading to Prenatal Sex Selection: India Perspective

Knowledge, attitude and practice on gender violence amongst married women in India

Folk Dentists Voicing their Plight-An Ethnographic Exploration

An Ethnographic/Epidemiological Study of Folk Dentists Plight in Present Scenario