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People affected by emergencies can face increased risks to health from inadequate water, sanitation and hygiene (WASH) and disease outbreaks. Involving communities affected by the crisis in the response, so that the delivery of facilities and services works for them, is a vital part of Oxfam’s WASH response in emergencies., Listening to different groups and individuals is key to community engagement. Understanding how people view risk and how they cope in a crisis can help to ensure that as far as possible, the WASH response strengthens their existing capacities, enables meaningful participation and focuses on marginalized and less powerful members of a community., This guide shows how community engagement in WASH should be a planned and dynamic process, bringing together the capacities and perspectives of communities and responders., Watch the video "Sanitation in Emergencies - How to Consult the User"

Camps are places of refuge for people fleeing conflict and disaster, but they can be dangerous, especially for women and girls. In their first months, many camps rely on communal sanitation facilities – a quick and cost-effective way of meeting immediate needs and minimizing public health risks until a better solution can be developed., In 2016, the Humanitarian Innovation Fund (HIF) set up a research challenge asking: Does lighting in or around sanitation facilities reduce the risk of gender-based violence (GBV)? During 2017 and 2018, Oxfam and researchers from the Water, Engineering and Development Centre (WEDC) at Loughborough University carried out research to try to answer this question. This report presents the main findings from this research.

Research has shown that humanitarian agencies are failing to properly consult the users of the latrines they build, leading many people – especially women and girls – to stop using those latrines as they find them inaccessible, unsuitable and/or unsafe., To address this, the Oxfam WASH team has developed a series of communications tools that seek to promote best practices in sanitation, and ultimately to provide universal guidance for the benefit of the sector. See www.oxfam.org.uk/sanitweaks, Des études ont démontré que les agences ne consultent pas correctement les utilisateurs ou ne prennent pas suffisamment en compte leurs feedbacks dans la construction des latrines ; ce qui mène à un arrêt d’usage par un grand nombre de personnes – surtout les femmes et les filles – qui trouvent les latrines inaccessibles, inappropriées ou peu sûres. Par conséquent, cela peut augmenter les risques de maladies dans les situations d’urgences., Pour répondre au problème, l’équipe WASH d’Oxfam a développé une série d’outils qui cherche à promouvoir les meilleures pratiques en assainissement et fournit des conseils universels pour l’ensemble du secteur.

Improve your learners' English skills while making the UN Convention on the Rights of the Child relevant and interesting., This popular resource for ages 8-11 was revised and updated in June 2015 to support the English curricula in England, Scotland and Wales., These materials include real-life case studies from Syria, Uganda and Sierra Leone, as well as exciting activities to develop learners' spoken language, reading and writing skills. Prioritise needs and wants Use spoken and emotive language to persuade others Explore the UN Convention on the Rights of the Child Participate in role play Learn about the benefits of water and sanitation Set up a health club to raise awareness about the importance of good hygiene, Oxfam is grateful for the support of Postcode Heroes Trust, funded by players of the People's Postcode Lottery, in the development of these materials.

Beginning on 25 August 2017, over 700,000 Rohingya refugees fled from Myanmar to Bangladesh seeking safety and lifesaving assistance. While safe from the violence they were subjected to in Myanmar, Rohingya women continue to face huge protection risks and challenges in Bangladesh. This briefing paper looks at how the humanitarian response, one year on, is meeting the specific needs of women and girls and what more can and should be done so that women and girls can access services, voice their concerns and hopes for the future and influence the decisions that affect their lives.

Hudaydah's residents are already some of the worst affected in the country by hunger and malnutrition. They now face a rapidly deteriorating humanitarian situation, despite a reported pause in the military advance to the sea port and city, and a recent reduction in the fighting. Most areas have no electricity. Whole neighbourhoods have no water, as pipes have been damaged – raising the fear that cholera could once again grip the city. Dozens of businesses have closed, including those providing milk, oil, margarine and cereals. Thousands have fled their homes because they fear a street war like in Taiz. While all parties fighting refuse to compromise, Yemen's civilians are paying the price. As the Hudaydah offensive moves closer to the sea port and city, world leaders have a choice to put their full backing behind peace to bring an end to this crisis, or oversee a potential humanitarian catastrophe.

Diarrhoeal disease is the second leading cause of death in children under five years old, and is particularly prevalent in emergency situations. Handwashing can reduce the risk of diarrhoeal disease by up to 48%. Oxfam, Unilever’s Lifebuoy soap, and Unilever’s Chief Sustainability Office conducted research with emergency-affected mothers in the Philippines, Pakistan and Nepal in 2014/2015 to better understand what motivates mothers in handwashing and to increase the practice., This set of resources – ‘Mum’s Magic Hands’ – were developed from the research for handwashing promotion in first phase emergencies. Tested in Nepal, Jordan, Uganda, Nigeria and Tanzania, the Field Guide contains background information and tools for assessment, implementation and monitoring. Also available is a manual for training trainers and volunteers, and presentations and visuals for running the MMH programme.

The Mum’s Magic Hands (MMH) programme is a set of promotional activities designed to increase the practice of handwashing with soap in emergencies. It was developed by Oxfam in partnership with Unilever’s Lifebuoy soap and Unilever’s Chief Sustainability Office using the most common emotional motivators (nurture and affiliation) found across three Asian countries. See the MMH Field Guide for rapid implementation of handwashing promotion in emergencies., Key to implementing the MMH programme are community facilitators or volunteers (handwashing ‘champions’). This training guide will help you to train MMH champions using the MMH Storyboard and other resources.

Mum's Magic Hands' programme resources for rapid response include materials to run meetings with groups (storyboards and images of handwashing with soap) and visuals for making posters and stickers to remind target groups of the importance of handwashing with soap., The storyboard presentation includes story scripts and images which can be printed out to tell the MMH story to target groups. It is available in versions for use in Africa, Asia and global (multicultural) contexts., Mums Magic Hands was jointly developed by Oxfam, Unilever's Lifebuoy soap and Unilever's Chief Sustainability Office, using the most common emotional motivators (nurture and affiliation) found across three Asian countries. See the MMH Field Guide for rapid implementation of MMH in emergencies., Latest news on the programme can be found at www.mumsmagichands.org.

Monitoring and evaluation of market-based programmes is essential to assess the impact of humanitarian interventions on the lives of people affected by disaster or crises. It enables organizations to track progress, discover unplanned effects of programmes and adjust accordingly. This briefing in the WASH and Markets in Crisis series proposes a framework of indicators to monitor and evaluate programme delivery, taking into account criteria related to the access to and quality of WASH commodities, efficiency of delivery, and benefits for market actors.

Market analysis and programming requires organizations to take on board new approaches and ways of working. This calls for new staff expertise and partnerships with organizations experienced in working with market systems., This briefing in the WASH and Markets in Crisis series identifies organizational considerations with respect to market-based programming, particularly human resources. It highlights the need for institutional commitment and collaboration with other agencies to ensure coordination for effective humanitarian responses.

Working with water, sanitation and hygiene (WASH) markets requires an understanding of market systems and the interactions between users and these systems. An understanding of the demand for WASH commodities prior to and during emergencies is also important in the design and implementation of humanitarian WASH programmes., This briefing is part of the WASH and Markets in Crisis series. It describes the characteristics of market systems, the impacts of crises on these systems, and introduces the benefits of market-based programming.

Working with water, sanitation and hygiene (WASH) markets in humanitarian emergencies requires an understanding of market systems, and the interactions between users and these systems. Aid responses can significantly affect local markets for WASH supplies and services –and aid that is not market-aware may cost more, put suppliers out of business, raise prices and undermine recovery., This overview, and the WASH and Markets in Crisis series linked to it, describes the impacts of crises on market systems, and introduces the benefits of market-based programming.

Market mapping and analysis, both in pre-crisis contexts and during emergencies, is an important and integral step towards the development and implementation of market-based programmes. This briefing in the WASH and Markets in Crisis series focuses on a five-stage approach that forms the basis of engagement with key stakeholders for the design and implementation of market engagement strategies.

Market-based programming in emergencies which uses, supports or develops local market systems is increasingly used by humanitarian agencies to meet the needs of crisis-affected communities. This briefing in the WASH and Markets in Crisis series describes different types of WASH (Water, Sanitation and Hygiene) market-based programming used in pre-crisis, emergency or post-crisis contexts, giving examples from Oxfam's experiences in Bangladesh, Indonesia and Zimbabwe.

In Asia, access to drinking water is a major issue because of the intrusion of saline groundwater in many areas. Water containing a high concentration of salts is unsuitable for human consumption. The situation is expected to get worse as a result of climate change. This report suggests the development of a ‘road map’ for scalable, low energy-input solutions for small-scale desalination.

In December 2017, South Sudan marked four years of devastating conflict. Only a few months later, it has reached another critical point: more South Sudanese are hungry than ever before., While the February 2018 Integrated Food Security Phase Classification (IPC) does not declare famine, any classification of IPC 3 upwards means people need aid to survive. This means that 6.3 million people are struggling to get enough to eat, and are dependent on humanitarian aid that is increasingly difficult to access., This report examines the impact of the ongoing conflict on hunger through the prism of livelihoods; women’s empowerment; displacement; water, sanitation and hygiene; and the spread of disease. It provides recommendations for the international community and warring parties on what they can do to stop the violence, increase access to humanitarian aid and allow the people of South Sudan to recover.

Oxfam works with partners to connect poor and vulnerable communities to water and sanitation services. This strategy explains how a unified approach, working to support and connect humanitarian and development actors and approaches, will help build real resilience for marginalized populations to keep water and sanitation systems operational, accessible, equitable and affordable.

Since the end of April 2017, Yemen has been experiencing its worst recorded outbreak of suspected cholera in a single year. By mid-August, more than 500,000 cases were recorded. More than two years of war have devastated large parts of Yemen’s infrastructure and left the majority of the population lacking basic services such as clean water or enough to eat. Levels of food insecurity and malnutrition are high, and make people even more vulnerable and susceptible to disease. Governorates with high levels of food insecurity are among those worst affected by cholera. Salaries in the public sector have not been paid for nearly a year, which means that people have less access to what is left of the health sector., The current rainy season is likely to aggravate the spread of cholera and other diseases can easily break out, as a recent increase in meningitis cases shows. And all efforts to contain the multitude of crises have failed so far. Hence, all efforts need to focus on an integrated response, taking into account the links between food insecurity, disease and the need for livelihoods in order to build people’s resilience to further shocks. Significant and urgent scale up in all areas of intervention is needed, and institutional infrastructure needs to be maintained to ensure at least basic service deliveries. But ultimately, Yemen’s crises can only be addressed effectively in an environment of peace, not war.

In the wake of the devastating destruction in Gaza in 2014, the Gaza Reconstruction Mechanism (GRM) was established as a temporary measure to facilitate the entry of construction materials and a range of items classified and treated as ‘dual use’ by Israel. Two and a half years on, vital water sector recovery and development remains hampered and fully controlled by the Government of Israel, demonstrating the extent to which Israeli government policies continue to undermine humanitarian response, cause de-development and exacerbate the separation of the Gaza Strip from the rest of the Occupied Palestinian Territory and the world. This paper analyses the effectiveness of the GRM in improving access to water, health and sanitation services, assesses the roles and responsibilities of a range of actors and identifies urgent steps in relation to the GRM that should be taken to contribute to the development of a just, effective and sustainable water sector in Gaza.

This guide is a compilation of best practices and key lessons learned through Oxfam's experience of community engagement during the 2014 '15 Ebola response in Sierra Leone and Liberia. It aims to inform public health practitioners and programme teams about the design and implementation of community-centred approaches., Key Lessons for Community Engagement in WASH (Water, Sanitation and Hygiene) for Ebola response, 1. A sound understanding of the diversity and varied vulnerabilities within affected communities is vital. Resources must be devoted to understanding community perspectives and advocating for community-focused interventions. Specialists, such as anthropologists and epidemiologists, may be required for information to be collected, documented and used effectively., 2. One-size-fits-all models of community engagement are not the best solution. It is better to recognize the potential capabilities of communities in each situation and provide context-specific support. This allows communities to take action to protect themselves using a 'menu' of different strategies, developed using a community-led approach. To do this effectively, key groups (e.g. male and female leaders, traditional healers, religious leaders, older people, youth and children) need to be identified., 3. Advocacy efforts should be directed at promoting inclusive and representative ideas, concerns, questions and solutions of communities, and ensuring that only useful and practical information is given to communities by humanitarian actors., 4. The information given to communities must be prioritized to ensure that the crisis affected population understands and uses the most effective protective actions (e.g., in the case of Ebola, early isolation and referral, and not touching the dead). The uptake and use of these specific actions must be monitored, and rumours about diseases and treatment processes should be documented in order to track progress., 5. It is important to work with others (from all sectors) to increase the transparency of medical and burial processes, especially where there is a lack of understanding and/or trust in the healthcare system. This can include step-by-step guides for referral or burial management, and showing videos to illustrate what to expect., 6. Support, training and supervision for newly recruited staff are vital to ensure responses are community-centred, effective and accountable., 7. Community engagement supports every other aspect of a response (e.g. testing and treatment, safe burials, etc). Therefore, active coordination and planning with other sectors is crucial at the local and district levels, as well as with national collaborators., 8. Programme managers should actively support and foster regular information exchanges between programme teams within and between organizations (e.g. daily debriefs)., 9. Using fear to encourage changes in behaviour can be counterproductive. It is better to promote self-reliance and self-help among affected populations., 10. Many of the lessons from the Ebola response can be applied to Oxfam's WASH programmes, especially cholera responses. Equally, Oxfam's experience with public health promotion (PHP) and WASH interventions means that it is well placed to support and develop capacity in community engagement and social mobilization., For more detail on these lessons learned from the Ebola response in Sierra Leone, access the full Guide to Community Engagement in WASH

The Constitution of Nepal 2015 enshrines everyone’s right of access to clean water for drinking and the right to food. The common operationalization of the right to water for drinking is providing access to infrastructure that brings water for drinking and other basic domestic uses near and at homesteads. Challenges to achieving this goal in rural areas include: low functionality of water systems; expansion of informal self supply for multiple uses; widespread de facto productive uses of water systems designed for domestic uses; growing competition for finite water resources; and male elite capture in polycentric decision-making. This paper traces how the Nepali government and nongovernmental organizations in the water, sanitation and hygiene (WASH), irrigation and other sectors have joined forces since the early 2000s to address these challenges by innovating community-led multiple use water services (MUS). The present literature review of these processes complemented by field research supported by the Water for Women Fund focuses on women in vulnerable households. Overcoming sectoral silos, these organizations support what is often seen as the sole responsibility of the WASH sector: targeting infrastructure development to bring sufficient water near and at homesteads of those left behind. Women’s priorities for using this water are respected and supported, which often includes productive uses, also at basic volumes. In line with decentralized federalism, inclusive community-led MUS planning processes build on vulnerable households’ self supply, commonly for multiple uses, and follow their priorities for local incremental infrastructure improvements. Further, community-led MUS builds on community-based arrangements for ‘sharing in’ and ‘sharing out’ the finite water resources in and under communities’ social territories. This realizes the constitutional right to food in line with the Nepal Water Resources Act, 1992, which prioritizes core minimum volumes of water for everyone’s domestic uses and many households’ irrigation. Evidence shows how the alleviation of domestic chores, women’s stronger control over food production for nutrition and income, and more sustainable infrastructure mutually reinforce each other in virtuous circles out of gendered poverty. However, the main challenge remains the inclusion of women and vulnerable households in participatory processes.

Living customary water tenure is the most accepted socio-legal system among the large majority of rural people in sub-Saharan Africa. Based on literature, this report seeks to develop a grounded understanding of the ways in which rural people meet their domestic and productive water needs on homesteads, distant fields or other sites of use, largely outside the ambits of the state. Taking the rural farming or pastoralist community as the unit of analysis, three components are distinguished. The first component deals with the fundamental perceptions of the links between humankind and naturally available water resources as a commons to be shared by all, partially linked to communities’ collective land rights. The second component deals with the sharing of these finite and contested naturally available water resources, especially during dry seasons and droughts. Customary arrangements shape both the ‘sharing in’ of water resources within communities and the ‘sharing out’ with other customary communities or powerful third parties. Since colonial times, communities have been vulnerable to those third parties grabbing water resources and overriding customary uses and governance. The third component deals with infrastructure to store and convey water resources. Since time immemorial, communities have invested in infrastructure for self supply, ranging from micro-scale soil moisture retention techniques to large-scale collective deep wells. As increasingly recognized in both the water, sanitation and hygiene (WASH) and irrigation sectors, this component of self supply is rapidly expanding. In all three components, local diversity is high, with gender, class and other social hierarchies intertwining with social safety nets, neighborliness and moral economies. The study derives two sets of implications for state and non-state policies, laws and interventions. First, state legislation about the sharing of water resources should recognize and protect living customary water tenure, especially through due process in ‘sharing out’ water with powerful third parties. Remarkably, water law, which is dominated by permit systems in sub-Saharan Africa, lags behind other legislation in recognizing customary water tenure (see IWMI Research Report 182). Second, by taking communities’ self supply for multiple uses as a starting point for further water infrastructure development, the WASH, irrigation and other sectors can follow the priorities of communities, including the most vulnerable; identify cost-effective multi-purpose infrastructure; develop local skills; and, hence, contribute more sustainably to achieving more United Nations Sustainable Development Goals (SDGs), in particular SDGs 1, 2, 3, 5, 6 and 13. Further historical and interdisciplinary research to achieve these benefits is recommended.

The Lifesaver Cube (‘the Cube’) is a household water filter developed in collaboration with Oxfam. Dirty water is stored inside the Cube, which resembles a tough five litre jerry can. The small pump on the cap is used to increase the pressure inside the Cube, forcing water through an internal membrane filter which removes bacteria, viruses and other pathogens., More than 2,300 units have been distributed by Oxfam in South Sudan to date. This report summarizes why Oxfam is using the Cube, lessons learned so far, recommendations, and plans for the future.

Millions of poor and vulnerable people face hunger and poverty this year and next because of record global temperatures, droughts and erratic rains in 2014 and 2015, compounded by the development of possibly the most powerful El Nino on record. Strong leadership at every level of government and a coordinated international effort are required to avoid the failures of the 2011 Horn of Africa drought, when the international system was slow to respond and widespread suffering ensued. Urgent humanitarian response is required in places already in crisis such as parts of Ethiopia., This paper focuses particularly on other places, where the crisis is currently unfolding, and where there is still the opportunity for rapid action to mitigate the worst impacts of El Nino.

The UK government’s Department for International Development (DFID) wants Payment by Results (PbR) to be a major part of the way it works in future, and other donors look set to follow suit. What does this mean for the WASH (Water, Sanitation and Hygiene) sector, and particularly for NGOs and their partners seeking to implement WASH programmes at scale?, In 2014, DFID launched a WASH Results Programme which aims to reach 4.5 million people by December 2015, supporting achievement of the Millennium Development Goals. The programme is financed on a PbR basis: the three delivering consortia receive payments only upon third-party verification that they have achieved a set of agreed results. Based largely on an internal review of the SWIFT Consortium’s experience of delivering the WASH Results Programme, this learning brief identifies a number of key issues to consider in incorporating the requirements of a PbR contract into the design, implementation, monitoring and evaluation of a WASH programme.

Achieving long-term increases in rural water-supply coverage depends on many factors. A new tool developed for the SWIFT Consortium supports environmental assessment and risk screening activitiesfor rural water supplies in low-income contexts. When conducting a detailed hydrogeological survey is not an option, the SWIFT tool provides simple guidance to help identify and mitigate environmental risks to long-term water availability and quality.

Improving access to water, sanitation and hygiene (WASH) services is a vital element for poverty reduction in sub-Saharan Africa. Long-term increase in coverage depends on many factors, including sound financing, community engagement in the design and implementation of schemes, and the training of village mechanics, local government and entrepreneurs in the upkeep and repair of systems. For a scheme to be sustainable, planning also needs to consider whether there is enough water of suitable quality to meet demand across seasons and between good and bad years. Flooding, land degradation and other environmental risks to water systems also need to be addressed, especially as climate change accelerates., This guide aims to show how organizations implementing WASH programmes, working in partnership with communities, can integrate these concerns into their activities and complement existing approaches such as Water Safety Planning (WSP). The focus of the guide is on groundwater-based, community-managed wells and springs in rural areas ' systems that are potentially most vulnerable to changes in rainfall and in demand due to population growth.

Ebola has had a crippling effect on the economy, health services and education system in Liberia. As schools reopen their doors, it is clear that the lack of clean water, hand washing and sanitation facilities in thousands of schools is a major block to helping children develop and carry out life-changing hygiene practices that will enhance their health. Investing in WASH in schools is a tangible, cost-effective and sustainable way to support Liberia towards a fast recovery with long-lasting health, educational and economic benefits. This briefing summarizes the current challenge of WASH in schools, as well as potential solutions. See the full technical briefing on WASH in Schools in Liberia

BackgroundThe COVID-19 pandemic has highlighted important needs in water, sanitation and hygiene (WASH) services and standard practices for infection prevention and control in sub-Saharan Africa. We assessed the availability of WASH and standard precautions for infection prevention in health facilities across 18 countries in sub-Saharan Africa, as well as inequalities by location (rural/urban) and managing authority (public/private). Data from health facility surveys conducted between 2013 and 2018 in 18 sub-Saharan African countries were used to estimate the access to an improved water source within 500 m, an improved toilet, soap and running water or alcohol-based hand rub, and standard precautions for infection prevention at health facilities. Rural-urban differences and public-private differences in access to services were calculated. We also compared population level access to health facility access to services.ResultOverall, 16,456 health facilities from 18 countries were included. Across countries, an estimated 88 % had an improved water source, 94 % had an improved toilet, 74 % had soap and running water or alcohol-based hand rub, and 17 % had standard precautions for infection prevention available. There was wide variability in access to water, sanitation and hygiene services between rural and urban health facilities and between public and private facilities, with consistently lower access in both rural and public facilities. In both rural and urban areas, access to water, sanitation and hygiene services was ubiquitously better at health facilities than households.ConclusionsAvailability of WASH services in health facilities in sub-Saharan Africa has improved but remains below the global target of 80 % in many countries. Ensuring adequate access to WASH services and enforcing adherence to safety and hygiene practices in health facilities will be essential to minimize the risk of COVID-19 transmission.

Ideas That Work demonstrates how water, sanitation and personal hygiene (WASH) needs of women survivors of disaster can be addressed to minimise risk to violence that they may otherwise face., It provides a compilation of practical experiences that have attempted to reduce risk to violence against women (VAW) in the provision of WASH facilities in the early response phase of an emergency., Ideas That Work has been developed for use both by WASH engineers as well as emergency personnel dealing with social processes for a more holistic approach to WASH programmes and addresses twin components: delivery of efficient engineering solutions and effective processes for social renegotiation., The result is WASH infrastructure that addresses women’s needs in a manner that is dignified and promotes prevention of violence.

Background Baseline mapping of soil-transmitted helminth (STH) infections among school age children (SAC) in 2008–2009 found high or moderate prevalence in 13 of the 14 districts in Sierra Leone. Following these surveys, mass drug administration (MDA) of mebendazole/albendazole was conducted biannually at national level targeting pre-school children (PSC) aged 12–59 months and intermittently at sub-national level targeting SAC. In addition, MDA with ivermectin and albendazole for eliminating lymphatic filariasis (LF) has been conducted nationwide since 2010 targeting individuals over 5 years of age. Each MDA achieved high coverage, except in 2014 when all but one round of MDA for PSC was cancelled due to the Ebola emergency. The objective of the current study was to determine the prevalence and intensity of STH infections among SAC after a decade of these deworming campaigns. Methods Seventy-three schools in 14 districts were purposefully selected, including 39 schools from the baseline surveys, with approximately two sites from each of low, moderate and high prevalence categories at baseline per district. Fresh stool samples were collected from 3632 children aged 9–14 years (male 51%, female 49%) and examined using the Kato Katz technique. Results The prevalence of STH infections in Sierra Leone decreased in 2016 compared to 2008: Ascaris lumbricoides 4.4% (95% confidence interval [CI]: 3.7–5.1%) versus 6.6% (95% CI: 0–25%), Trichuris trichiura 0.7% (95% CI: 0.5–1.1%) versus 1.8% (95% CI: 0–30.2%), hookworm 14.9% (95% CI: 13.8–16.1) versus 38.5% (95% CI: 5.4–95.1%), and any STH 18.3% (95% CI:17.0–19.5%) versus 48.3% (CI: 5.4–96.3%), respectively. In 2016, no district had high hookworm prevalence and four districts had moderate prevalence, compared with eight and four districts respectively in 2008. In 2016, the arithmetic mean hookworm egg count in all children examined was light: 45.5 eggs per gram (EPG) of faeces, (95% CI:\ 35.96–55.07 EPG); three (0.08%) children had heavy infections and nine (0.25%) children had moderate infections. Conclusions Sierra Leone has made considerable progress toward controlling STH as a public health problem among SAC. As LF MDA phases out (between 2017 and 2021), transition of deworming to other platforms and water and sanitation strategies need to be strengthened to maintain STH control and ultimately interrupt transmission. Electronic supplementary material The online version of this article (10.1186/s40249-019-0553-5) contains supplementary material, which is available to authorized users.

Background Provision of safe water, sanitation, and hygiene (WASH) to affected populations in humanitarian emergencies is necessary for dignity and communicable disease control. Additional evidence on WASH interventions is needed in humanitarian settings. Between 2008 and 2019, we completed six multi-country, mixed-methods effectiveness studies in humanitarian response on six different WASH interventions. In each evaluation, we conducted: key informant interviews; water point observations and water quality testing; household surveys with recipients, including survey and water quality testing; focus group discussions; and/or, secondary data analysis. The research questions were: “What is the effectiveness of [intervention] in reducing the risk of diarrhea/cholera transmission; and, what programmatic factors lead to higher effectiveness?” Discussion In all six multi-country, mixed-methods evaluations, policy-relevant outcomes were obtained. We found, in our individual research results, that: interventions could reduce the risk of disease in humanitarian contexts; this reduction of risk did not always occur, as there were large ranges in effectiveness; and, implementation factors were crucial to intervention effectiveness. When collaboratively reviewing our research process across evaluations, we found strategies for successfully conducting this research included: 1) working with partners to identify and evaluate programs; 2) rapidly obtaining approvals to deploy; and, 3) conducting research methodologies consistently. Personal connections, in-person communication, trust, and experience working together were key factors for success in identifying partners for evaluation. Successes in evaluation deployment occurred with flexibility, patience, commitment of adequate time, and understanding of processes; although we note access and security concerns in insecure contexts precluded deployment. Consistent and robust protocols, flexibility, and a consistent researcher on the ground in each context allowed for methodological consistency and high-quality results. Conclusions In conclusion, we have found multi-country, mixed-methods results to be one crucial piece of the WASH evidence base in humanitarian contexts. This is particularly because evaluations of reductions in risk from real-world programming are policy-relevant, and are directly used to improve programming. In future, we need to flexibly work with donors, agencies, institutions, responders, local governments, local responders, and beneficiaries to design safe and ethical research protocols to answer questions related to WASH interventions effectiveness in humanitarian response, and, improve WASH programming.

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This paper explores the physical, social, and environmental dimensions of how climate change impacts affect drinking water safety in a rural context in developing countries. Climate impacts, such as contamination or the reduced availability of preferred drinking water sources due to climate-related hazards, threaten water safety in rural areas and these impacts will likely worsen as climate change accelerates. We qualitatively examined these impacts in a community in rural Vanuatu using three approaches side-by-side: adaptation, vulnerability, and resilience. We employed a mixed methods case study methodology that combined semi-structured interviews, technological and environmental surveys, and observations. We demonstrate the influence of physical infrastructure design, social structures mediating water access, and the availability of multiple sustainable water resources on water safety with respect to climate impacts. We also show how the initial problematization of how climate affects water safety can influence subsequent actions to address, or overlook, issues of infrastructure design and maintenance, social equity, and natural resource management for water access. Improvements to rural drinking water safety management in the context of climate change should take a pluralistic approach, informed by different conceptualizations of climate impacts, to account for the varied causal pathways of reduced water safety for different members of a community.

Objectives:To measure the role of water, sanitation and hygiene (WASH) practices on recovery from stunting and assess the role of timing of stunting on the reversal of this phenomenonDesign:Data from the MAL-ED multi-country birth cohort study was used for the current analysis. Generalised linear mixed-effects models were used to estimate the probability of reversal of stunting with WASH practice and timing of stunting as the exposures of interest.Setting:Seven different countries across three continents.Participants:A total of 612 children Results:We found that not WASH practice but timing of stunting had statistically significant association with recovery from stunting. In comparison with the children who were stunted at 6 months, children who were stunted at 12 months had 1·9 times (β = 0·63, P = 0·03) more chance of recovery at 24 months of age. And, children who were stunted at 18 months of age even had higher odds (adjusted OR = 3·01, β = 1·10, P < 0·001) of recovery than children who were stunted at 6 months. Additionally, mother’s height (β = 0·59, P = 0·04) and household income (β = 0·02, P < 0·05) showed statistically significant associations with the outcome.Conclusions:The study provided evidence for the role of timing of stunting on the recovery from the phenomenon. This novel finding indicates that the programmes to promote linear growth should be directed at the earliest possible timepoints in the course of life.

Emergency water trucking to drought-affected populations, particularly in the Horn of Africa, has become cyclical intervention as rainfall patterns in these areas has become increasingly unpredictable. In addition to being expensive and unsustainable, cyclical water trucking is coming under increased scrutiny as it increasingly appears to have negative impacts on pastoralist livelihoods, existing coping mechanisms in times of water scarcity, and inflation in the price of water., This technical brief presents information on assessing the appropriateness of water trucking interventions, setup of emergency water trucking in drought, and alternatives to water trucking. It is intended to assist field staff and managers on the most appropriate option for emergency water provision in drought, and to give practical case studies demonstrating their setup and associated challenges. This guide is meant to be utilized in the initial stages of drought to select and appropriately implement (and responsibly exit from) the most suitable form of emergency water provision.

This paper is Oxfam's essential guide for WASH (Water, Sanitation and Hygiene) staff and partners. It describes the processes and standards that Oxfam WASH programmes should follow if they are to be carried out effectively, consistently and in a way which treats affected communities with respect., All WASH staff members are expected to understand and follow these Minimum Requirements. However, it is recognised that in acute emergencies it is preferable to start work on the basics immediately, and build up a comprehensive, quality programme in the following days and weeks. There will, therefore, be some programmes in which certain individual requirements are not appropriate or relevant; in such cases staff members responsible should be able to justify why she/he did things differently, or how the minimum requirement was achieved over time.

It is now well accepted that despite source water being safe, water can be contaminated during transportation and storage and the hygienic handling of water during transport, storage and use is an important aspect of hygiene promotion in all WASH interventions, In an emergency, it may not always be possible to ensure that the source water is clean (within the existing budget or time constraints) and household treatment of water is an important response option. As with the introduction of any hardware, this will only succeed if the users are considered in the selection, operation and maintenance of the treatment option and intensive hygiene promotion will be required to encourage correct and consistent use.

It is now well known that handwashing with soap has a greater impact on morbidity from diarrhoeal disease than any other single intervention. Why then, do NGOs focus so many of their activities and so much more money on supplying clean water and sanitation facilities? Why are these recognised as core activities while handwashing is considered a bolt-on activity? And why do NGOs always include water quality and latrine use as important indicators of success in logframes and monitoring strategies but rarely include handwashing, even though it is known to be a better success indicator?, This paper seeks to answer these important questions.

Responding appropriately to women’s menstrual hygiene needs in emergencies is an essential component of water, sanitation and hygiene promotion programmes. It can help to address: gender equality in considering the different needs of women and men; women’s participation in the sensitive dialogue that is necessary to address this issue; and women’s specific concerns with dignity and privacy., Unfortunately, not enough attention has been paid to menstrual hygiene in many WASH or girls’ education programmes. But whenever women’s menstrual needs are not met, women are faced with numerous difficulties. Each month they have to cope with several days of reduced mobility, shame, physical discomfort, disruption of essential daily activities, as well as health risks., This paper explains the key considerations of this topic and offers practical advice.

Children under five years can represent up to 20% of the population. In some cases children under 18 years may represent over 50% of the population. They are thus major stakeholders in all humanitarian programmes., This briefing describes the practical issues that need to be considered when involving children in humanitarian WASH programmes.

An Oxfam ‘hygiene kit’ is designed to promote hygiene within the family, and may also include certain items considered to restore dignity such as shampoo for women. A hygiene kit should enable storage of safe drinking water at household level, good practice around drinking water use all family members able to practice handwashing at key times, the washing of self and clothing, management of babies and young children’s faeces dedicated water containers for anal cleansing (if used) management of menstruation practice of reasonable food hygiene

This technical briefing note looks at the criteria for selecting ‘Pipeline Extension from Wellhead to Hand Pumps in Villages’ in all settings (e.g. early recovery, recovery, rehabilitation, development) except first phase response, including its construction, operation and maintenance.

It is now well known that handwashing with soap has a greater impact on morbidity from diarrhoeal disease than any other single intervention., This technical briefing note looks at the relevance of handwashing in disease prevention, as well as the practicalities and promotion of handwashing in developing countries.

This practical field guide brings together lessons learned from Oxfam's past interventions in the prevention and control of cholera, and other related guidance. The aim is to provide a quick, step-by-step guide to inform cholera outbreak interventions and ensure public health programmes that are rapid, community-based, well-tailored, and gender and diversity aware. They will enable both public health teams and programme managers to undertake necessary preparations to prevent cholera outbreaks from occurring and to respond effectively when they have occurred. They have been specifically designed to fit the cholera outbreak curve, depicting key activities in each critical phase before, during and after an outbreak. They can also be adapted to suit other water- and sanitation-related outbreaks, such as Typhoid, Hepatitis E, and dysentery, as well as other WASH-related diarrhoeal outbreaks. This is a pilot publication, and the team are looking for comments and suggestions on both the content and structure of the manual. Please send any feedback to policyandpractice@oxfam.org.uk, with "Cholera guidelines" in the subject line.

Large-scale urban WASH (Water, Sanitation and Hygiene) programming requires different approaches to those normally employed in Oxfam emergency response activities. This paper examines the lessons learned from the WASH response to the Haiti earthquake in January 2010. The paper also gives practical case studies of some of the success and failures from the WASH activities, undertaken in a very high-density urban/peri-urban context.

This manual is part of a series of guides devised by the Oxfam Public Health Engineering Team to help provide a reliable water supply for populations affected by conflict or natural disaster. Wherever possible, water supplies in emergency conditions should be obtained from underground sources by exploitation of springs, tubewells, or dug wells. No filtration will then be needed. However, if sources are not available or cannot be developed, the use of surface water from streams, rivers, lakes or ponds becomes necessary. Usually these surface sources are polluted. The level of faecal contamination can be measured by use of the Oxfam/Delagua Water Test Kit (see Section C). Where a serious level of faecal pollution exists, it is essential firstly to try to reduce the cause of contamination, and secondly to treat the water to make it suitable for human consumption. The Filtration equipment provides a simple, long-term physical and biological treatment system that requires no chemicals (except small amounts of chlorine required during filter cleaning) and needs only simple regular maintenance.