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Introduction: Accurate information on context and implementation of public health interventions is necessary to replicate, adapt, and scale effective interventions and to interpret evaluations. Reporting the context and implementation of water, sanitation, and hygiene (WASH) interventions has been inconsistent and incomplete., Methods: To improve the reporting of WASH interventions, we developed the Template for Intervention Description and Replication for WASH (TIDieR-WASH) checklist and guide, by adapting and expanding the original TIDieR guide. We performed a scoping review of existing implementation reporting guidelines, and of current implementation reporting in WASH evaluations, to develop a list of candidate items to include in this checklist. We then used a 4-stages of review by international experts to reach consensus., Results: The resulting 14-item checklist comprises: a ) name, b ) theory of change, c ) prior evidence, d ) location and setting, e ) context, f ) suitability, g ) implementers, h ) recipients, i ) targeting, j ) activities, k ) intervention dose, l ) fidelity, m ) costs, and n ) materials. Definitions, explanations, examples, and instructions for use are reported in this article., Discussion: The checklist can be applied to all types of evaluations of WASH interventions, including direct service provision, behavior change, and systems strengthening interventions. We deliberately developed this guidance document to be accessible and relevant to practitioners and researchers. Adoption of this checklist will support transparent reporting of WASH implementation for research and practice. As with other sectors that have used TIDieR checklists, clear implementation reporting can assist with evidence synthesis, adaptation, and policy guidance. https://doi.org/10.1289/EHP14780.

Sanitation is intended to reduce the spread and burden of diseases transmitted from excreta. Pathogen reduction from excreta before sludge or effluent discharge to the environment would seem a logical and useful performance indicator for sanitation systems. However, the relative magnitudes of pathogen release from common sanitation technologies are not well understood. We, therefore, investigated the feasibility of performance measurement of different sanitation technologies in Tamil Nadu, India in reducing the release of the pathogen indicator Escherichia coli (E. coli). After conducting users' surveys and technical assessments of the locally prevalent sanitation systems, we classified them into 7 distinct categories (based on both observed physical characteristic and usage) within a widely-accepted physical typology. Faecal sludge and wastewater samples were collected and analysed for E. coli and total solids from 136 household systems, 24 community systems, and 23 sanitary sewer oveflows. We estimated the average volumetric release rates of wastewater and faecal sludge from the different sanitation technologies. Average daily per capita E. coli release was computed, and used as one indicator of the public health performance of technologies. We found that on-site installations described by owners as "septic systems" included diverse forms of tanks and pits of uncertain performance. We observed a statistically significant difference in the average daily per capita E. coli release from different sanitation technologies (p = 0.00001). Pathogen release from the studied on-site sanitation technologies varied by as much as 5 orders of magnitude from "lined pits" (5.4 Log10 E. coli per person per day) to "overflowing sanitary sewers" and "direct discharge pipes" (10.3-10.5 Log10 E. coli per person per day). Other technologies lay between these extremes, and their performances in E. coli removal also varied significantly, in both statistical and practical terms. Our results suggest that although faecal sludge management along the sanitation service chain is important, sanitation planners of the observed systems (and probably elsewhere) should direct higher priority to proper management of the liquid effluents from these systems to minimize public health hazards. We conclude that (i) the work demonstrates a new and promising approach for estimating the public health performance of differing sanitation technologies, (ii) if E.coli is accepted as an indicator of the public health hazard of releases from sanitation systems, our results strongly suggest that safe containment of excreta for an extended period substantially reduces pathogen numbers and the risk of pathogen release into the environment; and (iii) there are some simple but little-used technical improvements to design and construction of on-site sanitation systems which could significantly reduce the release of pathogens to the environment., (Copyright © 2022 The Authors. Published by Elsevier GmbH.. All rights reserved.)

Background: Three large new trials of unprecedented scale and cost, which included novel factorial designs, have found no effect of basic water, sanitation and hygiene (WASH) interventions on childhood stunting, and only mixed effects on childhood diarrhea. Arriving at the inception of the United Nations' Sustainable Development Goals, and the bold new target of safely managed water, sanitation and hygiene for all by 2030, these results warrant the attention of researchers, policy-makers and practitioners., Main Body: Here we report the conclusions of an expert meeting convened by the World Health Organization and the Bill and Melinda Gates Foundation to discuss these findings, and present five key consensus messages as a basis for wider discussion and debate in the WASH and nutrition sectors. We judge these trials to have high internal validity, constituting good evidence that these specific interventions had no effect on childhood linear growth, and mixed effects on childhood diarrhea. These results suggest that, in settings such as these, more comprehensive or ambitious WASH interventions may be needed to achieve a major impact on child health., Conclusion: These results are important because such basic interventions are often deployed in low-income rural settings with the expectation of improving child health, although this is rarely the sole justification. Our view is that these three new trials do not show that WASH in general cannot influence child linear growth, but they do demonstrate that these specific interventions had no influence in settings where stunting remains an important public health challenge. We support a call for transformative WASH, in so much as it encapsulates the guiding principle that - in any context - a comprehensive package of WASH interventions is needed that is tailored to address the local exposure landscape and enteric disease burden.

Improvements of water, sanitation, and hygiene (WASH) infrastructure and appropriate health-seeking behavior are necessary for achieving sustained control, elimination, or eradication of many neglected tropical diseases (NTDs). Indeed, the global strategies to fight NTDs include provision of WASH, but few programs have specific WASH targets and approaches. Collaboration between disease control programs and stakeholders in WASH is a critical next step. A group of stakeholders from the NTD control, child health, and WASH sectors convened in late 2012 to discuss opportunities for, and barriers to, collaboration. The group agreed on a common vision, namely "Disease-free communities that have adequate and equitable access to water and sanitation, and that practice good hygiene." Four key areas of collaboration were identified, including (i) advocacy, policy, and communication; (ii) capacity building and training; (iii) mapping, data collection, and monitoring; and (iv) research. We discuss strategic opportunities and ways forward for enhanced collaboration between the WASH and the NTD sectors.

Most water supply programmes in Cambodia have focused on providing access to bacteriologically safe water, an approach which has led to an increasing reliance on ground water, especially in rural areas. However, there have been very few data collected on the chemical quality of the nation's drinking water sources, and few water supply programmes have the capacity to assess chemical quality. The study was designed to address this data gap by conducting a low-cost, rapid assessment of drinking water sources nationwide to determine whether there were any chemicals of concern in Cambodian water supply sources. Results of the assessment confirm that there are several parameters of health and aesthetic concern; dissolved arsenic is the most significant. Elevated arsenic levels (some exceeding 500 microgl(-1)) were detected in aquifers of moderate depth in several highly populated areas, confirming that further investigation of the occurrence of arsenic contamination in Cambodia is warranted. Other chemicals of health concern include nitrate, nitrite, fluoride and manganese. Additionally, many ground water sources are negatively impacted by parameters of aesthetic concern, such as iron, manganese, hardness and total dissolved solids. Elevated levels of these parameters have caused consumers to reject newly installed water supplies, often in favour of surface water sources that are bacteriologically unsafe.