In this IDS Working Paper, Robert Chambers (CLTS Knowledge Hub, IDS) and Gregor von Medeazza (UNICEF) argue for a more inclusive framework for thinking about and dealing with undernutrition. One concept is FTIs (faecally-transmitted infections). This is designed to avoid the reductionisms of faecal-oral infections, waterborne diseases, and the focus on the diarrhoeas to the neglect of less dramatic and less measurable FTIs especially environmental enteropathy. A second concept is the 5 As – availability and access which both have oral associations, and absorption, antibodies and allopath
Although the lack of access to appropriate sanitation, hygiene and water services is not the root cause of violence, it can lead to increased vulnerabilities to violence of varying forms, with incidences reported from a wide range of contexts.
Handwashing is a vital part of good sanitation and hygiene. When Community-Led Total Sanitation (CLTS) and its aim of ODF (open defecation free) communities are fully understood and put into practice it is clear that handwashing is implicit in the approach. Without addressing handwashing and other hygiene practices, communities can never become fully ODF since CLTS aims to cut all faecal-oral contamination routes. However, in practice, the degree to which handwashing is integrated into triggering and follow up, depends on the quality of facilitation.
Sustainability of latrines is a key issue in CLTS. Sandy or rocky soils, seasonal flooding and termites can present challenges to communities who have taken sanitation into their own hands as a result of CLTS and are building latrines. The CLTS Handbook identifies the need for participatory design approaches during follow-up sessions with triggered communities. Sanitation marketing programmes have also applied participatory design through engaging users and sanitation suppliers to create innovative sanitation technologies.
Sanitation and Hygiene in Africa: Where do We Stand? (IWA Publishing 2013, eds Piers Cross and Yolande Coombes) takes stock of progress made by African countries through the AfricaSan process since 2008 and the progress needed to meet the MDG on sanitation by 2015 and beyond. This book addresses priorities which have been identified by African countries as the key elements which need to be addressed in order to accelerate progress.