Water and sanitation to reduce child mortality : the impact and cost of water and sanitation infrastructure

Using household survey data, this paper estimates the mortality impact of improved water and sanitation access in order to evaluate the potential contribution of water and sanitation investment toward achieving the child mortality targets defined in Millennium Development Goal 4. The authors find that the average mortality reduction achievable by investment in water and sanitation infrastructure is 25 deaths per 1,000 children born across countries, a difference that accounts for about 40 percent of the gap between current child mortality rates and the 2015 target set in the Millennium Development Goals. According to the estimates, full household coverage with water and sanitation infrastructure could lead to a total reduction of 2.2 million child deaths per year in the developing world. Combining this analysis with cost data for water and sanitation infrastructure, the authors estimate that the average cost per life-year saved ranges between 65 and 80 percent of developing countries'annual gross domestic product per capita. The results suggest that investment in water and sanitation is a highly cost-effective policy option, even when only the mortality benefits are taken into consideration. Taking into account the additional expected benefits, such as reduced morbidity, time spending, and environmental hazards, would further increase the benefit-cost ratio.Population Policies,Town Water Supply and Sanitation,Urban Water Supply and Sanitation,Water Supply and Sanitation Governance and Institutions,Wastewater Treatment

Water, sanitation and children's health : evidence from 172 DHS surveys

This paper combines 172 Demography and Health Survey data sets from 70 countries to estimate the effect of water and sanitation on child mortality and morbidity. The results show a robust association between access to water and sanitation technologies and both child morbidity and child mortality. The point estimates imply, depending on the technology level and the sub-region chosen, that water and sanitation infrastructure lowers the odds of children to suffering from diarrhea by 7-17 percent, and reduces the mortality risk for children under the age of five by about 5-20 percent. The effects seem largest for modern sanitation technologies and least significant for basic water supply. The authorsalso find evidence for the Mills-Reincke Multiplier for both water and sanitation access as well as positive health externalities for sanitation investments. The overall magnitude of the estimated effects appears smaller than coefficients reported in meta-studies based on randomized field trials, suggesting limits to the scalability and sustainability of the health benefits associated with water and sanitation interventions.Health Monitoring&Evaluation,Hygiene Promotion and Social Marketing,Town Water Supply and Sanitation,Population Policies,Urban Water Supply and Sanitation

Inter- and Intra-household Linkages Between the Informal and Formal Sector: A Case Study for Urban Burkina Faso

informal labour market, dual economy, poverty, pro-poor growth

Mobile phones for collecting WASH data in low-income countries

Based on our experience using both paper-based and mobile phone data collection methods, we consider the advantages and disadvantages of each in relation to water and sanitation research in low-income countries. We compare the two methods in terms of Usability, Data Quality, Data Monitoring, Data Transfer, Cost, and Ethics and Corruption. We conclude that paper-based surveys are best suited for small sample sizes and/or in locations with unreliable mobile networks. Otherwise, mobile phones are an excellent, increasingly low-cost and easy to manage method for high-quality data collection

Intratumoral chemotherapy in an integumentary squamous cell carcinoma in a cockatiel (Nymphicus hollandicus)

An eight-year-old, female cockatiel (Nymphicus hollandicus) was presented with anorexia, lethargy, a mass at the lower side of the wing and discoloration of the feathers. Physical examination showed an ulcerated nodular integumentary lesion of approximately 4 cm(3) ventromedial on the wing at the side of the propatagium and the humerus. Lateral and ventrodorsal radiographs revealed only hepatomegaly. After a stabilization period, surgical excision of the tumor was performed. Based on histopathological evaluation and bacterial culture of the surgically removed tissue, the lesion was typed as an integumentary squamous cell carcinoma with secondary bacterial infection (Corynebacterium sp). Four weeks postoperative, the tumor had recurred. Chemotherapeutic treatment was started with intratumoral carboplatin (1.5 mg/cm(3)) once a week. Because of further tumor growth after the second administration of carboplatin, resection of the mass was performed before the next infiltration. However, the bird died during anesthesia. Despite increase in tumor size, histopathological and immunohistochemical evaluations showed degeneration of the tumor with intercellular edema and vacuolization of the tumor cells, presumably resulting from carboplatin administration. More research is needed to investigate the efficacy and safety of the intratumoral administration of carboplatin as a treatment option in birds with integumentary squamous cell carcinoma

Increasing private sanitation investments: the Urban Affordable Clean Toilets (U-ACT) project

The goal of the Urban Affordable Clean Toilets (U-ACT) project was to determine the effectiveness of subsidies, extended payback periods, and targeting in stimulating households’ investment in non-sewered sanitation systems. Between 2010 and 2013 we implemented a randomized controlled trial (RCT) with 1,200 households in 40 slums in Kampala. Vouchers, which allowed house owners to purchase a Ventilated Improved Pit (VIP) at different price levels and with different payback options were randomly offered to tenants and house owners. Our results indicate that increasing the payback period and adequate targeting are almost as effective in increasing take-up rates as halving VIP prices. Overall, the U-ACT project resulted in the construction of over 150 VIP latrines for over 1,500 people in Kampala slums

How the Direction of Screws Affects the Primary Stability of a Posterior Malleolus Osteosynthesis under Torsional Loading: A Biomechanical Study

Insufficient fixation of a posterior malleolus fracture (PM) can lead to posttraumatic complications such as osteoarthritis and chronic pain. The purpose of this biomechanical study was to test the hypothesis of whether the direction of PM screw fixation has an impact on the primary stability of osteosynthesis of a PM under torsional loading. PM fractures of 7 pairs human cadaveric lower leg specimens were stabilized with posterior to anterior (p.a.) or anterior to posterior (a.p.) screw fixation. Stability of the osteosynthesis was biomechanically tested using cyclic external torsional loading levels, in 2 Nm steps from 2 Nm up to 12 Nm, under constant monitoring with 3D ultrasonic marker (Zebris). The primary stability does not differ between both stabilizations ( p = 0.378) with a medium effect size (η 2 p = 0.065). The movement of the PM tends to be marginally greater for the osteosynthesis with a.p. screws than with p.a. screws. Whether a.p. screws or the alternative p.a. screw fixation is performed does not seem to have an influence on the primary stability of the osteosynthesis of the PM fixation under torsional loading. Although osteosynthesis from posterior seems to be more stable, the biomechanical results in the torsional test show quite equivalent stabilities. If there is no significant dislocation of the PM, a.p. screw fixation could be a minimally invasive but stable surgical strategy

The Influence of Radio-Frequency Transmit Field Inhomogeneities on the Accuracy of G-ratio Weighted Imaging

G-ratio weighted imaging is a non-invasive, in-vivo MRI-based technique that aims at estimating an aggregated measure of relative myelination of axons across the entire brain white matter. The MR g-ratio and its constituents (axonal and myelin volume fraction) are more specific to the tissue microstructure than conventional MRI metrics targeting either the myelin or axonal compartment. To calculate the MR g-ratio, an MRI-based myelin-mapping technique is combined with an axon-sensitive MR technique (such as diffusion MRI). Correction for radio-frequency transmit (B1+) field inhomogeneities is crucial for myelin mapping techniques such as magnetization transfer saturation. Here we assessed the effect of B1+ correction on g-ratio weighted imaging. To this end, the B1+ field was measured and the B1+ corrected MR g-ratio was used as the reference in a Bland-Altman analysis. We found a substantial bias (≈-89%) and error (≈37%) relative to the dynamic range of g-ratio values in the white matter if the B1+ correction was not applied. Moreover, we tested the efficiency of a data-driven B1+ correction approach that was applied retrospectively without additional reference measurements. We found that it reduced the bias and error in the MR g-ratio by a factor of three. The data-driven correction is readily available in the open-source hMRI toolbox (www.hmri.info) which is embedded in the statistical parameter mapping (SPM) framework