Venis Robbie A, Taylor Virginia, Sumayani Paulina, Laizer Marie, Anderson Troy, Basu Onita D
Department of Civil and Environmental Engineering, Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada.
Sprott School of Business, Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada; Tanzania Education and Micro Business Opportunity (TEMBO) Trust, P.O. Box 95, Longido, Longido District, Arusha Region, Tanzania.
Soc Sci Med. 2022 May;301:114966. doi: 10.1016/j.socscimed.2022.114966. Epub 2022 Apr 8.
Rural communities in sub-Saharan Africa (SSA) are disproportionately burdened by a pervasive lack of access to safe drinking water. Widespread programmatic failure in the water, sanitation, and hygiene (WaSH) sector has resulted in particularly slow progress in alleviating these challenges in the region. Drawing from decolonial and participatory methodological scholarship, this research demonstrates how geographically and demographically specific, locally controlled, and long-term educational programming can improve health and wellness outcomes when associated with a technological intervention. Specifically, consultations between January 2015 and August 2018 were followed by an iterative and community-driven program development process between January and July 2019. Fifty Maasai women were subsequently recruited to participate and were provided with a point-of-use water treatment technology in August 2019. These women engaged in a series of three 14-week WaSH education programs over an 18-month evaluation period. Results showed that 38% of participants reported regular diarrhea at baseline, decreasing to 8%, 0%, and 3% immediately after each of the three WaSH education programs were provided at 3, 12, and 18 months. Interim measurements taken between WaSH programs showed 35% of participants (at 6 months) and 5% of participants (at 15 months) reporting regular diarrhea. A trend of improvement was thus observed over the study period, though the increase in reported diarrhea at 6 months demonstrates the need for long-term commitment on the part of WASH practitioners when engaging with end users to achieve sustained change. Further, this research highlights the importance of participatory program development and pedagogical approaches in WaSH interventions, where local control of study objective determination and implementation, combined with consistent and long-term engagement, can facilitate sustained technology use and associated reductions in diarrhea.
撒哈拉以南非洲（SSA）的农村社区因普遍缺乏安全饮用水而负担过重。水、环境卫生和个人卫生（WaSH）部门广泛的项目失败导致该地区在缓解这些挑战方面进展特别缓慢。本研究借鉴了去殖民化和参与性方法的学术成果，展示了地理和人口特定、地方控制且长期的教育项目在与技术干预相结合时如何改善健康和福祉结果。具体而言，2015年1月至2018年8月进行了磋商，随后在2019年1月至7月进行了一个由社区驱动的迭代项目开发过程。随后招募了50名马赛族妇女参与，并于2019年8月为她们提供了一种家庭用水处理技术。这些妇女在18个月的评估期内参加了一系列为期14周的三次WaSH教育项目。结果显示，38%的参与者在基线时报告经常腹泻，在3个月、12个月和18个月分别提供三次WaSH教育项目后，这一比例立即降至8%、0%和3%。在WaSH项目之间进行的中期测量显示，35%的参与者（在6个月时）和5%的参与者（在15个月时）报告经常腹泻。因此，在研究期间观察到了改善趋势，尽管在6个月时报告腹泻的人数增加表明，WaSH从业者在与最终用户接触以实现持续变化时需要长期投入。此外，本研究强调了参与性项目开发和教学方法在WaSH干预中的重要性，在这种干预中，对研究目标确定和实施的地方控制，加上持续和长期的参与，可以促进技术的持续使用以及腹泻相关病例的减少。
