Water, Sanitation, and Hygiene (WaSH)

Continuity of key water, sanitation, and hygiene (WASH) infrastructure and WASH practices—for example, hand hygiene—are among several critical community preventive and mitigation measures to reduce transmission of infectious diseases, including COVID-19 and other respiratory diseases. WASH guidance for COVID-19 prevention may combine existing WASH standards and new COVID-19 guidance. Many existing WASH tools can also be modified for targeted WASH assessments during the COVID-19 pandemic. We partnered with local organizations to develop and deploy tools to assess WASH conditions and practices and subsequently implement, monitor, and evaluate WASH interventions to mitigate COVID-19 in low- and middle-income countries in Latin America and the Caribbean and Africa, focusing on healthcare, community institution, and household settings and hand hygiene specifically. Employing mixed-methods assessments, we observed gaps in access to hand hygiene materials specifically despite most of those settings having access to improved, often onsite, water supplies. Across countries, adherence to hand hygiene among healthcare providers was about twice as high after patient contact compared to before patient contact. Poor or non-existent management of handwashing stations and alcohol-based hand rub (ABHR) was common, especially in community institutions. Markets and points of entry (internal or external border crossings) represent congregation spaces, critical for COVID-19 mitigation, where globally-recognized WASH standards are needed. Development, evaluation, deployment, and refinement of new and existing standards can help ensure WASH aspects of community mitigation efforts that remain accessible and functional to enable inclusive preventive behaviors.

The unpredictable emergence of Coronavirus 2019 has proven to be challenging for many countries and their preparedness systems. In the heat of the current pandemic, initial interventions have been directed to the medical component of pandemic management, while other parameters such as tracing, retaining, and controlling the infection have been dismantled. It must be remembered that a defective water management system for drinking or personal use cannot only worsen the medical management of an emergency but can also contribute to spreading the disease or other water-borne conditions. This report highlights the significant use of water as a necessity for life and for controlling the pandemic.

Circle of Health International (COHI) conducted this Women's Health Needs Assessment to identify the specific and immediate needs of women, and to provide evidence-based recommendations for short and long-term women's health programming in the Fond Parisien area. These recommendations are based on the results of surveys conducted with 64 women living in the American Refugee Committee (ARC) camp in Fond Parisien. This document highlights the present and future needs of the women living in this IDP camp, and provides specific recommendations to address the unique health needs of women within this population.

This study evaluated the health impact of a public private partnership using microfinance to upgrade slum infrastructure in Ahmedabad, India. The authors show a statistically significant reduction in waterborne illness as a result of the intervention and point to further unmeasured benefits from the upgrade. This is an example of the data driven projects HHI is conducting to lend evidence with operational research on interventions.

Reference: Soc Sci Med. 2010 Sep;71(5):935-40.

As rapid urbanization creates complex environments that concentrate the risks and hazards of man-made and natural disasters, it also presents a vital advantage that must be exploited. Urban humanitarian emergencies by their very nature occur within the geo-political sphere of a governing body, the municipal government, and as such they are the responsibility of that body. It is the duty of the municipal governments to prevent and prepare for and respoond to humanitarian emergencies that may affect their citizens. Preparedness at the city level, therefore, remains a valuable area for development to mitigate the effects of humanitarian crises. Rapid urbanization now allows a greater proportion of the population to fall under a responsible municipal government and an opportunity to promote and advance urban planning around preparedness.

This study seeks to offer a practical examination of resilience in complex urban landscapes for the academic community and humanitarian actors at the local and international levels. Distrito de Aguablanca (Cali, Colombia), a complex settlement area with some 600,000 residents, functions as a case study in human security and resilience that can inform public policy and community level decision making in especially difficult humanitarian environments, with sociopolitical volatility, large populations of internally displaced persons, and high crime and violence rates.

The Syrian refugee crisis represents one of the greatest humanitarian challenges the international community has faced over the recent years, prompting record-high levels of international aid. In view of the complexity of the political and social environment in which these challenges arise and the historical scale of the population affected, innovative and creative programmatic responses are essential to address the short and middle-term needs of refugees and reducing instability in the Middle East region.

This report documents the experiences and attitudes of former underage combatants in eastern Democratic Republic of the Congo (DRC) who went through the reintegration process, the families and communities who received them and the organizations that funded and implemented reintegration programming. Despite increasing attention to the scope and importance of child soldiering globally, there is still limited systematic research on the successes and challenges of reintegration programming for former underage combatants. This project, a collaboration between the Harvard Humanitarian Initiative and Eastern Congo Initiative, used DRC as a case study to examine the community experiences and attitudes around Disarmament, Demobilization and Reintegration (DDR) programming to generate lessons learned for improving future programming for former underage combatants and at-risk youth.

This study highlights the voices of individuals currently affected by the Lord’s Resistance Army to detail the extensive and systematic devastation felt specifically by formerly abducted children and their communities in northeastern Democratic Republic of the Congo. Respondents stressed that the international community must assist with providing essential services through long-term engagement, including life-saving health services; improving water and sanitation access; and providing psychosocial and educational interventions to formerly abducted children and adults. While these communities are facing emergency-level challenges now, the need for solutions that will last into the future.

Humanitarian actors have long used the Sphere Handbook and its minimum standards to guide operational practice. The new revision attempts to update these standards partly to address urban crises that have challenged the humanitarian system. Yet, these indicators have never been based on a substantial body of evidence or data from the varied living standards found in cities or specifically informal settlements. This study aims to contextualize the Sphere standards for urban populations by comparing a sample of the revised key indicators to living standards in three urban informal settlements of Nairobi, Kenya, during a non-crisis period to examine their relevance and applicability, and discuss the implications.

This report provides the summative results from the three-year external impact evaluation of the Disasters and Emergencies Preparedness Programme (DEPP) conducted by a team at the Harvard Humanitarian Initiative (HHI). The DEPP was a £40 million programme funded by the Department for International Development (DFID) that aimed to strengthen skills and capacity and improve the quality and speed of humanitarian response in countries that are at risk of natural disasters or emergencies.

This document provides the annexes of the report. 

This report provides the summative results from the three-year external impact evaluation of the Disasters and Emergencies Preparedness Programme (DEPP) conducted by a team at the Harvard Humanitarian Initiative (HHI). The DEPP was a £40 million programme funded by the Department for International Development (DFID) that aimed to strengthen skills and capacity and improve the quality and speed of humanitarian response in countries that are at risk of natural disasters or emergencies.