Impact of Indian Total Sanitation Campaign on latrine coverage and use: a cross-sectional study in Orissa three years following programme implementation.

BACKGROUND: Faced with a massive shortfall in meeting sanitation targets, some governments have implemented campaigns that use subsidies focused on latrine construction to overcome income constraints and rapidly expand coverage. In settings like rural India where open defecation is common, this may result in sub-optimal compliance (use), thereby continuing to leave the population exposed to human excreta. METHODS: We conducted a cross-sectional study to investigate latrine coverage and use among 20 villages (447 households, 1933 individuals) in Orissa, India where the Government of India's Total Sanitation Campaign had been implemented at least three years previously. We defined coverage as the proportion of households that had a latrine; for use we identified the proportion of households with at least one reported user and among those, the extent of reported use by each member of the household. RESULTS: Mean latrine coverage among the villages was 72% (compared to <10% in comparable villages in the same district where the Total Sanitation Campaign had not yet been implemented), though three of the villages had less than 50% coverage. Among these households with latrines, more than a third (39%) were not being used by any member of the household. Well over a third (37%) of the members of households with latrines reported never defecating in their latrines. Less than half (47%) of the members of such households reported using their latrines at all times for defecation. Combined with the 28% of households that did not have latrines, it appears that most defecation events in these communities are still practiced in the open. CONCLUSION: A large-scale campaign to implement sanitation has achieved substantial gains in latrine coverage in this population. Nevertheless, gaps in coverage and widespread continuation of open defecation will result in continued exposure to human excreta, reducing the potential for health gains

Toward a kinship perspective on entrepreneurship

This paper develops a theoretical framework for analyzing the role of kinship in entrepreneurship. Kinship, we argue, is a key-ingredient of the social and cultural environment of entrepreneurs, and therefore essential in understanding how and why entrepreneurship happens. Building on qualitative research conducted among Cambodian Chinese entrepreneurs in Phnom Penh, we define kinship as interpersonal ties grounded in relatedness. We distinguish different categories of kinship ties that involve different levels of relatedness and are used for different aspects of entrepreneurship, and we identify different types of reciprocity and trust as the sociocultural dynamics that buttress kinship involvement in entrepreneurship

When Pits Fill Up: Supply and Demand for Safe Pit-Emptying Services in Kisumu, Kenya

Household survey data associated with the paper, "When Pits Fill Up: Supply and Demand for Safe Pit-Emptying Services in Kisumu, Kenya" which sought to determine the degree to which market forces can promote safe fecal sludge removal in low-income neighborhoods of Kisumu, Kenya by comparing household willingness-to-pay for formal pit emptying with the prices charged by service providers

When Pits Fill Up: Supply and Demand for Safe Pit-Emptying Services in Kisumu, Kenya

Household survey data associated with the paper, "When Pits Fill Up: Supply and Demand for Safe Pit-Emptying Services in Kisumu, Kenya" which sought to determine the degree to which market forces can promote safe fecal sludge removal in low-income neighborhoods of Kisumu, Kenya by comparing household willingness-to-pay for formal pit emptying with the prices charged by service providers

Assessment of a low-cost, point-of-use, ultraviolet water disinfection technology.

We describe a point-of-use (POU) ultraviolet (UV) disinfection technology, the UV Tube, which can be made with locally available resources around the world for under $50 US. Laboratory and field studies were conducted to characterize the UV Tube's performance when treating a flowrate of 5 L/min. Based on biological assays with MS2 coliphage, the UV Tube delivered an average fluence of 900+/-80 J/m(2) (95% CI) in water with an absorption coefficient of 0.01 cm(-1). The residence time distribution in the UV Tube was characterized as plug flow with dispersion (Peclet Number = 19.7) and a mean hydraulic residence time of 36 s. Undesirable compounds were leached or produced from UV Tubes constructed with unlined ABS, PVC, or a galvanized steel liner. Lining the PVC pipe with stainless steel, however, prevented production of regulated halogenated organics. A small field study in two rural communities in Baja California Sur demonstrated that the UV Tube reduced E. coli concentrations to less than 1/100 ml in 65 out of 70 samples. Based on these results, we conclude that the UV Tube is a promising technology for treating household drinking water at the point of use

Cross-subsidies for improved sanitation in low income settlements: Assessing the willingness to pay of water utility customers in Kenyan cities

Most residents of the developing world do not have access to safely managed sanitation services, and large financial investments are required to address this need. Here we evaluate surcharges on water/sewerage tariffs as an option for supporting these investments in low-income neighborhoods. We investigated willingness-to-pay (WTP) for a pro-poor sanitation surcharge among customers of two urban water utilities in Kenya. Applying qualitative and quantitative methods, we conducted semi-structured in-depth interviews, focus-group discussions, and a double-bounded contingent valuation method for measuring WTP. We varied scenarios quasi-experimentally to study the effects of messaging and surcharge characteristics and evaluated factors associated with WTP. Our study finds that mean WTP was 290 KES (USD 2.9) per month, about 8% of the average water bill; median WTP was 100 KES (USD 1). In a multivariate analysis, WTP was significantly higher among customers that were younger, wealthier, shared toilets, and had higher water bills. WTP was also higher among customers that trusted the utility and distrusted the county government. Of our randomized scenarios, only the bill type was found to significantly influence WTP; WTP was higher if the surcharge was presented as a proportion of the customers’ last water bill vs a flat amount. Our findings suggest that in a sector that struggles to provide universal access to sanitation services, cross-subsidies may offer a means to support financing of safe sanitation for low-income households. These results indicate there are opportunities for cross-subsidies in urban Kenya that may be relevant for a wider understanding of surcharge payments that support basic services for low-income citizens