A GLOWING footprint: Developing an index of wellbeing for low to middle income countries

Our world faces unprecedented, intense and rapid change. As such, it is difficult to fathom how we might monitor related impacts on the wellbeing of population(s) affected. In the past, the world has typically relied upon measures of economic health or wellbeing such as gross domestic product (GDP). As the world ends its commitment to the Millennium Development Goals (MDGs), and embarks on a commitment to the Sustainable Development Goals, questions about where we as a global society should continue our investments in wellbeing and efforts to measure those outcomes are now up for debate. These questions are particularly poignant for those populations most vulnerable to change: low to middle income countries (LMICs). This paper reviews existing “beyond GDP” measures of population wellbeing as a foundation for developing a truly global index of wellbeing (GLOWING) that can be used by LMICs to document change, and measure the impact of policy, across space and over time. The paper describes a proposed index of wellbeing that is simple, meaningful, and built on the use of available secondary data at the ecological level. It is built on the foundation of the innovative Canadian Index of Wellbeing, and hinges on plans for a proof of concept inEast Africafollowed by a scaling up, all of which is founded on the twin pillars of capacity building and empowerment

Social capital, collective action and the water-health nexus in rural Kenya

Access to safe water and adequate sanitation is widely recognised as an important means of protecting public health and human dignity. For example, the introduction of clean water and sewerage disposal (the Sanitary Movement) around the late 19th century in England had significant impacts on disease reduction, especially diarrhoeal diseases and other infectious diseases among marginalised populations. However, similar advancement in water and sanitation coverage has been difficult to achieve in many low and middle-income countries (LMICs) even more than a century and a half later. In recent years, there has been growing emphasis on citizen participation and collective action for initiating and managing community-based water and sanitation related interventions in low resource settings. However, there is limited understanding of the structural and social factors that influence participation in collective action or hinder the success of community based water initiatives. This thesis explores the influence of social capital on water-health linkages, with emphasis on collective action in Usoma, a rural lakeshore community in Western Kenya. The research focused on three broad objectives: first, to develop a framework for understanding the role of social capital in addressing challenges around water-health linkages in LMICs; second, to determine how social capital mediates the relationships between access to water and participation in collective action; and finally, to explore factors that influence individual and community water related practices and collective action. A mixed-method approach – involving a conceptual review, household survey and photovoice – was used in the research. The conceptual review suggests that there are two major pathways linking social capital and health within the context of water. First, social capital enhances the success of water-related behavioural interventions that can improve knowledge, behaviours and practices (KAPS). Second, social capital facilitates collective action towards addressing issues related to access to facilities and/or sustainable management of facilities and water resources. Results from the household survey (n=485) reveal that indicators of social capital such as trust and group membership are primary determinants of collective action. Perceptions of differences in landholding and social status were also negatively associated with collective action. Further, findings from the photovoice interviews (n=8) reveal that access to water, perceptions and practices are shaped by broader structural factors such as power relationships, marginalisation and unemployment. Collective actions to improve access were also constrained by institutional and economic structures, thus (re)enforcing inequalities. This research makes important contributions to knowledge, policy and practice. Theoretically, the research links social capital with ecosocial theory to demonstrate how researchers can connect interactions between environmental risks and (re)actions with broader socio-economic factors to understand environment and health inequalities. The research also developed a framework for understanding how populations literally embody lack of access to safe water and adequate sanitation. This framework can be applied to the embodiment of other environmental risks (e.g., water/air pollution) within similar (or different) context. Methodologically, the research contributes to the conceptualisation and measurement of social capital in a cross-cultural context. The research also provides an effective example of embedded mixed-method design that highlights the strength of mixing quantitative methods with participatory methods such as photovoice. In terms of policy, the research highlights the need for community based water–health interventions to recognise broader policy issues that determine who gets access to water and at what price; as well as micro and macro-level factors that facilitate or constrain social capital, community mobilisation and collective actions

Environmental Associated Emotional Distress and the Dangers of Climate Change for Pastoralist Mental Health

Pastoralists in the Horn of Africa are among the most vulnerable populations to climate change yet little is known about how environmental change shapes their wellbeing and mental health. This paper presents a formative study into the relations between emotion, wellbeing and water security among pastoralist communities in Afar, Ethiopia. It uses focus group and interview data to demonstrate the close relationship between environmental conditions and emotional wellbeing, and shows how current water insecurity leads to extreme worry and fatigue among the studied population, especially in the dry season. In the context of difficulties of translating mental health clinical classifications and diagnostic tools in cross-cultural settings, the paper argues the inductive study of emotion may be a useful approach for studying environmental determined wellbeing outcomes among marginal populations in the light of understanding climate change impacts

Improving community health through marketing exchanges: A participatory action research study on water, sanitation, and hygiene in three Melanesian countries

Diseases related to poor water, sanitation and hygiene (WaSH) are major causes of mortality and morbidity. While pursuing marketing approaches to WaSH to improve health outcomes is often narrowly associated with monetary exchange, marketing theory recognises four broad marketing exchange archetypes: market-based, non-market-based, command-based and culturally determined. This diversity reflects the need for parameters broader than monetary exchange when improving WaSH. This study applied a participatory action research process to investigate how impoverished communities in Melanesian urban and peri-urban informal settlements attempt to meet their WaSH needs through marketing exchange. Exchanges of all four archetypes were present, often in combination. Motivations for participating in the marketing exchanges were based on social relationships alongside WaSH needs, health aspirations and financial circumstances. By leveraging these motivations and pre-existing, self-determined marketing exchanges, WaSH practitioners may be able to foster WaSH marketing exchanges consistent with local context and capabilities, in turn improving community physical, mental and social health

Analyzing Stakeholder Water Source Preference Based upon Social Capital: a Case Study of the Fajr Jam Gas Refinery in Iran

Gas refineries are among the most water-intensive industries in the world. The Fajr Jam gas refinery is one such example, located in the southern Iran. The indiscriminate use of aquifer resources for this highly profitable industry creates tragedy of the commons effects, causing significant environmental controversy and threatening the long-term water security of the region. It behooves decision makers, therefore, to examine a broad range of adaptive water management strategies for this industry. The implementation of such strategies requires understanding the preferences and potential conflicts that may emerge among competing stakeholder interests. This quantitative social scientific study examines stakeholder preferences among water management options through the lens of social capital. Elite stakeholder representatives (including agricultural organizations, governmental organizations, the Water, and Power Authority, Department of Health, Bureau of Water and Wastewater) were canvassed through a survey instrument using paired comparisons. Data were analyzed using Expert Choice software and an analytic hierarchy process technique. The results show that accountability is the main criterion for selecting the best water sources and ranked first with the Eigenvector 0.62. Also, the results show that the least important criterion was social cohesion with the Eigenvalue 0.033. The criteria of partnership and trust ranked as two and three with Eigenvalues 0.215 and 0.133, respectively. The results indicate that the construction of salt water transmission from the sea (A = 0.240) is the preferred option among other alternatives, and this is confirmed by sensitivity analysis

Promoting safe and inclusive water and sanitation services for students with physical disabilities in primary schools: a concept mapping study in Ghana

Improving water, sanitation, and hygiene (WASH) services in schools is crucial to providing inclusive environments for all children to thrive. Particularly for children with disabilities, the school environment can serve as a barrier to their access to and use of WASH facilities. This paper examines strategies and programs needed to promote safe and inclusive WASH services for students with physical disabilities in primary schools in Ghana. We recruited 22 stakeholders from the Upper West Region of Ghana to complete an online concept mapping exercise. Participants identified eight themes for promoting safe and inclusive access to WASH services for students with physical disabilities. These themes included ‘building special schools,’ ‘guidance services,’ ‘ensuring non-discrimination and fair treatment,’ ‘additional programs for PWDs,’ ‘local government interventions,’ ‘public sensitization,’ ‘teacher training,’ and ‘supervision.’ These findings can assist stakeholders in identifying strategies and prioritising programs in the short run to improve WASH among students with physical disabilities. HIGHLIGHTS This study aims to improve WASH services in primary schools in Ghana for students with disabilities.; Twenty-two stakeholders generated eight themes to promote inclusive access to WASH facilities.; The GO-zone tool was used to analyze the ease and importance of different strategies.; Results suggest prioritizing strategies that are both easy to implement and important.; These findings can help stakeholders improve WASH services for students with disabilities.

Examining the health and wellbeing of women sanitation workers in Ghana and Kenya

About 3.6 billion people worldwide lack access to safely managed sanitation service. To bridge service gaps, informal sanitation businesses have emerged as alternative service providers to meet the sanitation needs of unserved populations. Informal sanitation workers include persons who empty septic tanks, clean toilets, sewers, and manage public toilets. They provide a fundamental public service particularly in areas where access to municipal sanitation service is limited. Through qualitative methodologies, this paper explores the lived experiences and associated health risks of women working in the informal sanitation sector in urban Ghana and Kenya. Our findings show that female informal sanitation workers were exposed to injuries and infections, stigma and discrimination, emotional and psychological distress, sexual harassment, and unhealthy coping strategies. Distinctively, younger female participants were more likely to experience sexual harassment. Because of social stigma, many of the women developed unsafe work practices such as refusal to wear PPE and working at night. By paying close attention to the embodied effects of informal sanitation work, we can better comprehend the daily politics, lived experiences, and urban social infrastructure regimes that have a significant impact on the quality of life of informal sanitation workers. The results are also crucial for developing programs for women's empowerment and labour and social protection policies, especially in lowincome settings where gender norms interact with income disparities and other sociopolitical issues to affect women's participation in the labor market