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Introduction: In spite of concerted efforts by governmental and non-governmental organizations, water and adequate sanitation are still remained a challenge worldwide. Therefore, this study assessed the availability and utilization of sanitation facilities in Enderta district of Tigray, Ethiopia.Methods: A cross-sectional study was conducted in May 2016. An interview and observation were conducted in a total of 450 households. An interviewer administered questionnaire and observation checklist were used to collect the data. Multivariable logistic regression was done to identify the predictors of availability and utilization of latrine, hand washing, and drinking water.Results: Out of 450 households, only 68.4% had latrine of which only 21.4% had hand washing facility near the toilet. Likewise, only 9.3% washed their hand after toilet. However, all households had access to improved water source. The proper utilization was low in which 53%, 42.4% and 36.2% of households utilize latrine, hand washing, and water properly, respectively. The family size and getting sanitation information from health care providers, health extension workers, and health development army had a positive effect on availability and utilization.Conclusion: Though Community-Led total sanitation and hygiene approach has been implemented in the study area, the availability and proper utilization of latrine, and hand washing are still low. And, only a few were used drinking water properly. The education or information on hygienic practices found to affect the availability and utilization of the sanitation facilities positively. Therefore, strengthening the health extension workers and health development army to provide sustainable education and health information is needed.

In India, most people have been finding it challenging to maintain their quality of life, such as standard housing, access to basic minimum drinking water facilities, sanitation, public hygiene, etc. This study attempts to study the availability of housing and household amenities among social groups and identify the inter-rural−urban differences in basic sanitation facilities. Data from the Census of India, 2011, H-Series household amenities and assets, was used to measure the dissimilarity between inter-rural−urban differences by social groups. The present study aimed to explore the differentials across the region and social groups by the availability of different basic sanitation facilities. Analysis shows striking dissimilarities in rural areas of states such as Madhya Pradesh, Odisha, Jharkhand, Tripura and the union territory of Daman and Diu. Moreover, the intensity of dissimilarities is prominently observed between caste Others and ST in rural areas. However, in the state of Jammu and Kashmir, the dissimilarity in the availability of bathrooms without a roof is observed uniformly across regions and among social groups. Furthermore, the study emphasizes that although dissimilarity may not be visible at an aggregate level, it is very much visible at the sub-aggregate level across regions and between castes. Hence, it is proposed to conduct and collect data based on a holistic approach incorporating people's behaviour, attitudes, cultural norms and biases while providing sanitation facilities and those who are availing them. Such research studies will provide a deeper insight into the root causes of such dissimilarities, which may be due to geographical location, the non-availability of water, cultural practices, biases, etc., or the intersection of all these factors. Identifying hotspots at the micro level will help accelerate the success of government schemes such as the Swachh Bharat Mission.

In low- and middle-income countries, the management of fecal sludge from on-site sanitation systems has received little attention over many decades, resulting in insufficient or missing regulations to guide investments and management options. To address this gap, this report examines existing and emerging guidelines and regulations for fecal sludge management (FSM) along the sanitation service chain (user interface, containment, emptying, transport, treatment, valorization, reuse or disposal). It also draws empirical examples from guidelines across the globe to support policy-makers, planners, and sanitation and health officers, as well as consultants in low- and middle-income countries in the development and design of local and national FSM guidelines and regulations.

This is a conference paper. ; Local Government Areas (LGAs) in Nigeria are primarily responsible for provision of sanitation facilities in public places. Most markets and motor parks however are either without any sanitation facilities or are in dilapidated conditions because of misuse and neglect. This leads to rampant open defecation (OD) in public places. This has deprived many LGAs to attain the ODF status where otherwise every household have constructed some sort of toilets as a result of ongoing CLTS campaign. Under Federal Government of Nigeria-UNICEF WASH programme, efforts have been made to address the challenge through public- private partnership (PPP) arrangements. In selected LGAs of 3 States one hundred (100) WASH facilities are planned for completion in 2018 in markets/motor parks to bring the LGA wide ODF declaration one step closer to reality.

Slum population has been increasing in Bangladesh over the last three decades along with the growth and expansion of cities and towns. But slum facilities are very much unsatisfactory for them due to the lack of proper water supply and sanitation system. Therefore, the major portion of the households use unsafe latrine and deposit their children's excreta into road side drain and open places, which pollutes water sources, groundwater and the general environment. As a result, majority of the population in Bangladesh suffer from different kinds of water and excreta-borne diseases that aggravate their poverty situations. So, the main objective and essential goal of the study is to investigate the water supply system and sanitation facilities in urban slums of Bangladesh. During the study period, data has been collected by questionnaire survey from each slum households (15 slums and 5324 households in RCC). However, the hygienic practice has been found to be significantly low among the all households in slums although they have enough knowledge about it. The study has showed that majority slum households use tube well water for drinking but significant numbers of them are found to use open latrine for defecation. Normally, pit and water seal latrines are found which are partially hygienic. These may cause ground water contamination depending on the soil characteristics and distance between the water sources and latrines. The open disposal of excreta pollutes the nearby water bodies, canals and drains causing severe environmental pollution. Many motivational work and idea marketing from government and NGO sides help to improve their awareness level.

Background: Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce highresolution geospatial estimates of access to drinking water and sanitation facilities. Methods: We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and aggregated results to policy-relevant administrative units. We estimated mutually exclusive and collectively exhaustive subcategories of facilities for drinking water (piped water on or off premises, other improved facilities, unimproved, and surface water) and sanitation facilities (septic or sewer sanitation, other improved, unimproved, and open defecation) with use of ordinal regression. We also estimated the number of diarrhoeal deaths in children younger than 5 years attributed to unsafe facilities and estimated deaths that were averted by increased access to safe facilities in 2017, and analysed geographical inequality in access within LMICs. Findings: Across LMICs, access to both piped water and improved water overall increased between 2000 and 2017, with progress varying spatially. For piped water, the safest water facility type, access increased from 40·0% (95% uncertainty interval [UI] 39·4–40·7) to 50·3% (50·0–50·5), but was lowest in sub-Saharan Africa, where access to piped water was mostly concentrated in urban centres. Access to both sewer or septic sanitation and improved sanitation overall also increased across all LMICs during the study period. For sewer or septic sanitation, access was 46·3% (95% UI 46·1–46·5) in 2017, compared with 28·7% (28·5–29·0) in 2000. Although some units improved access to the safest drinking water or sanitation facilities since 2000, a large absolute number of people continued to not have access in several units with high access to such facilities (>80%) in 2017. More than 253 000 people did not have access to sewer or septic sanitation facilities in the city of Harare, Zimbabwe, despite 88·6% (95% UI 87·2–89·7) access overall. Many units were able to transition from the least safe facilities in 2000 to safe facilities by 2017; for units in which populations primarily practised open defecation in 2000, 686 (95% UI 664–711) of the 1830 (1797–1863) units transitioned to the use of improved sanitation. Geographical disparities in access to improved water across units decreased in 76·1% (95% UI 71·6–80·7) of countries from 2000 to 2017, and in 53·9% (50·6–59·6) of countries for access to improved sanitation, but remained evident subnationally in most countries in 2017. Interpretation: Our estimates, combined with geospatial trends in diarrhoeal burden, identify where efforts to increase access to safe drinking water and sanitation facilities are most needed. By highlighting areas with successful approaches or in need of targeted interventions, our estimates can enable precision public health to effectively progress towards universal access to safe water and sanitation. ; This work was primarily supported by a grant from the Gates Foundation (OPP1132415). LGA has received support from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Finance Code 001), Conselho Nacional de Desenvolvimento Científico e Tecnológico and Fundação de Amparo à Pesquisa do Estado de Minas Gerais. OOA acknowledges the Department of Science and Innovation, National Research Foundation, and DSI/NRF Centre of Excellence for Epidemiological Modelling and Analysis, Stellenbosch, South Africa. SMAl acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. HTA acknowledges Aksum University. MAu and CH are partly supported by a grant from the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. AAz acknowledges funding from the Gates Foundation (OPP1171700). ABad is supported by the Public Health Agency of Canada. TWB was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research; the EU; the Wellcome Trust; and from National Institute of Child Health and Human Development of National Institutes of Health (NIH; R01-HD084233), National Institute on Aging of NIH (P01AG041710), National Institute of Allergy and Infectious Diseases of NIH (R01-AI124389 and R01-AI112339), as well as Fogarty International Center of NIH (D43-TW009775). DABen was supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR, or the UK Department of Health and Social Care. GBB is supported by Sistema Nacional de Investigación (SNI) de la Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT) of Panamá. FCar acknowledges UID/ MULTI/04378/2019 and UID/QUI/50006/2019 support with funding from FCT/Ministério da Ciência, Tecnologia e Ensino Superior through national funds. VMC acknowledges her grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006. JDN acknowledges support from the Alexander von Humboldt Foundation. DBD acknowledges support from the Gates Foundation. KD is supported by a Wellcome Trust grant (number 201900/Z/16/Z) as part of his International Intermediate Fellowship. AGo acknowledges Sistema Nacional de Investigadores de Panamá (SNI), Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT). CH is partly supported by a grant co-funded by European Fund for Regional Development through the Operational Program for Competitiveness (project ID P_40_382). SMSI is funded by a Fellowship from National Heart Foundation of Australia and Deakin University. MJ and the Serbian part of this GBD contribution was co-funded through grant OI175014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. JK is a recipient of the 2020 Benjamin V Cohen Peace Fellowship from Ball State University Center for Peace and Conflict Studies. YJK's work was supported by the Research Management Centre, Xiamen University Malaysia, grants number XMUMRF/2018-C2/ ITCM/0001. KKr is supported by a DST PURSE grant and UGC Center of Advanced Study awarded to the Department of Anthropology, Panjab University, Chandigarh, India. BL acknowledges support from the NIHR Oxford Biomedical Research Centre and the British Heart Foundation Centre of Research Excellence, Oxford. PTNM acknowledges the Council for the Development of Social Science Research in Africa. ANA acknowledges Debre Markos University for its support in-terms of office and internet access while reviewing this paper. AMSam received a fellowship from the Egyptian Fulbright Mission programme. MMS-M acknowledges the support of the Ministry of Education, Science and Technological Development of the Republic of Serbia (contract number 175087). AShi acknowledges the support of Health Data Research UK. MRS acknowledges the Clinical Research Development Center of Imam Reza Hospital, Kermanshah university of Medical sciences for their wise advice. JBS is part of Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. RT-S was supported in part by grant PI17/00719 from Instituto de Salud Carlos III–FEDER. BU acknowledges Manipal Academy of Higher Education, Manipal. TWij acknowledges the Migraine Foundation Australia and the Department of Medicine, Faculty of Medicine, University of Rajarata, Saliyapura, Anuradhapuraya, Sri Lanka. CSW was supported by the South African Medical Research Council. SBZ received a scholarship from the Australian Government research training program in support of his academic career. ; publishedVersion

The effect of poor and unhygienic water on health is a pandemic problem across many nations. As per the estimations, approximately 37.7 million Indians are suffering from waterborne diseases annually, diarrhea is observed to be worst illness that is causing huge child mortality. The bad sanitation and hygiene also affects poor productivity which in turn cripples the economy. The economic burden due to poor sanitation and unhygienic drinking water is estimated at $600 million a year. 700 million people residing in rural India comprise more than about 1.42 million habitations spread over 15 diverse ecological regions. In fact, providing drinking water to such a large population is an enormous challenge. Hence, in this very context, a study have been undertaken so as to study and visualize the global water consumption and improved sanitation facilities to know about Indias predicament in comparison to other countries. Certain powerful statistical tools like principal component analysis and itemized cluster analysis were employed to realize the study objectives. The countries were identified in certain important groups lying in similar situation with respect to sanitation and hygiene drinking water facilities. Most importantly the a (chronbach alpha) and β (factor saturation) are very fair to the clusters identified, whereby, affirming that the study variables, i.e. both urban and rural populations with respect to sanitation facilities and availability of hygiene drinking water could strongly characterize the countries under study.