Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
ResilientAfrica Network, Kampala P.O. Box 7072, Uganda.
Int J Environ Res Public Health. 2023 Jun 19;20(12):6181. doi: 10.3390/ijerph20126181.
Diarrhea causes 1.6 million deaths annually, including 525,000 children. Further, chronic diarrhea puts children at risk for mineral deficiencies, malnutrition, and stunting which, in turn, can result in cognitive deficits, poor performance in school, and decreased disease immunity in adulthood. Most diarrhea is caused by water contaminated by fecal matter. Interventions to improve clean water and sanitation can save lives; however, challenges persist in informal settlements. In this study, we explored the views of residents of informal settlements regarding water and sanitation in their communities. Focus group interviews were conducted with residents of 6 informal settlements in Kampala, Uganda ( = 165 people), and 6 key informant interviews were conducted with governmental and nongovernmental organizations that work to improve informal settlements or provide services to them. The results from this study demonstrate that, although these informal settlements had many infrastructure "upgrades" such as latrines and toilets, water taps, wells, and garbage collection and drainage systems, the water, sanitation, and hygiene (WASH) system and its components largely failed due to point-of-use charges of water taps and toilets and the difficulty of emptying cesspits. Our results suggest that WASH must be considered a system and that multiple upgrading efforts are needed for WASH systems to work, including road construction and better oversight of fecal sludge disposal.
腹泻每年导致 160 万人死亡，其中包括 52.5 万名儿童。此外，慢性腹泻使儿童面临矿物质缺乏、营养不良和发育迟缓的风险，而这反过来又会导致认知缺陷、学业表现不佳和成年后疾病免疫力下降。大多数腹泻是由粪便污染的水引起的。改善清洁水和卫生设施的干预措施可以拯救生命；然而，在非正规住区仍然存在挑战。在这项研究中，我们探讨了非正规住区居民对其社区内水和卫生设施的看法。在乌干达坎帕拉的 6 个非正规住区进行了居民焦点小组访谈（= 165 人），并对致力于改善非正规住区或向其提供服务的政府和非政府组织进行了 6 次重点访谈。这项研究的结果表明，尽管这些非正规住区有许多基础设施“升级”，如厕所和厕所、水龙头、水井和垃圾收集和排水系统，但由于水龙头和厕所的使用点收费以及化粪池排空困难，水、环境卫生和个人卫生（WASH）系统及其组成部分基本上都失败了。我们的研究结果表明，WASH 必须被视为一个系统，WASH 系统需要进行多项升级工作才能发挥作用，包括道路建设和更好地监督粪便污泥的处理。
