Lessons learned from conducting six multi-country mixed-methods effectiveness research studies on water, sanitation, and hygiene (WASH) interventions in humanitarian response.
| Title: | Lessons learned from conducting six multi-country mixed-methods effectiveness research studies on water, sanitation, and hygiene (WASH) interventions in humanitarian response. |
|---|---|
| Authors: | Lantagne D; Tufts University School of Engineering, Medford, MA, USA. daniele.lantagne@tufts.edu.; Lehmann L; Innovations for Poverty Action, New Haven, CT, USA.; IDinsight, Manila, Philippines.; Yates T; Tufts University School of Engineering, Medford, MA, USA.; Gallandat K; Tufts University School of Engineering, Medford, MA, USA.; London School of Hygiene and Tropical Medicine, London, UK.; Sikder M; Tufts University School of Engineering, Medford, MA, USA.; Johns Hopkins University, Center for Humanitarian Health, Baltimore, MD, USA.; Domini M; Tufts University School of Engineering, Medford, MA, USA.; Brescia University, Brescia, Italy.; String G; Tufts University School of Engineering, Medford, MA, USA. |
| Source: | BMC public health [BMC Public Health] 2021 Mar 22; Vol. 21 (1), pp. 560. Date of Electronic Publication: 2021 Mar 22. |
| Publication Type: | Journal Article; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: BioMed Central Country of Publication: England NLM ID: 100968562 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2458 (Electronic) Linking ISSN: 14712458 NLM ISO Abbreviation: BMC Public Health Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: London : BioMed Central, [2001- |
| MeSH Terms: | Sanitation* ; Water*; Humans ; Hygiene ; Water Quality ; Water Supply |
| Abstract: | Background: Provision of safe water, sanitation, and hygiene (WASH) to affected populations in humanitarian emergencies is necessary for dignity and communicable disease control. Additional evidence on WASH interventions is needed in humanitarian settings. Between 2008 and 2019, we completed six multi-country, mixed-methods effectiveness studies in humanitarian response on six different WASH interventions. In each evaluation, we conducted: key informant interviews; water point observations and water quality testing; household surveys with recipients, including survey and water quality testing; focus group discussions; and/or, secondary data analysis. The research questions were: "What is the effectiveness of [intervention] in reducing the risk of diarrhea/cholera transmission; and, what programmatic factors lead to higher effectiveness?"; Discussion: In all six multi-country, mixed-methods evaluations, policy-relevant outcomes were obtained. We found, in our individual research results, that: interventions could reduce the risk of disease in humanitarian contexts; this reduction of risk did not always occur, as there were large ranges in effectiveness; and, implementation factors were crucial to intervention effectiveness. When collaboratively reviewing our research process across evaluations, we found strategies for successfully conducting this research included: 1) working with partners to identify and evaluate programs; 2) rapidly obtaining approvals to deploy; and, 3) conducting research methodologies consistently. Personal connections, in-person communication, trust, and experience working together were key factors for success in identifying partners for evaluation. Successes in evaluation deployment occurred with flexibility, patience, commitment of adequate time, and understanding of processes; although we note access and security concerns in insecure contexts precluded deployment. Consistent and robust protocols, flexibility, and a consistent researcher on the ground in each context allowed for methodological consistency and high-quality results.; Conclusions: In conclusion, we have found multi-country, mixed-methods results to be one crucial piece of the WASH evidence base in humanitarian contexts. This is particularly because evaluations of reductions in risk from real-world programming are policy-relevant, and are directly used to improve programming. In future, we need to flexibly work with donors, agencies, institutions, responders, local governments, local responders, and beneficiaries to design safe and ethical research protocols to answer questions related to WASH interventions effectiveness in humanitarian response, and, improve WASH programming. |
| References: | Lancet. 1996 Sep 28;348(9031):840. (PMID: 8826807); Environ Sci Technol. 2018 Dec 18;52(24):14402-14410. (PMID: 30423253); Confl Health. 2018 Apr 23;12:17. (PMID: 29713372); J R Soc Interface. 2014 Dec 6;11(101):20140950. (PMID: 25401184); Environ Sci Technol. 2015 Apr 21;49(8):5115-22. (PMID: 25764353); Cochrane Database Syst Rev. 2015 Oct 20;(10):CD004794. (PMID: 26488938); Emerg Infect Dis. 2007 Jan;13(1):1-5. (PMID: 17370508); Environ Sci Technol. 2020 Apr 21;54(8):5041-5050. (PMID: 32216293); PLoS Negl Trop Dis. 2020 Aug 31;14(8):e0008661. (PMID: 32866145); Environ Sci Technol. 2012 Oct 16;46(20):11352-60. (PMID: 22963031); Disasters. 2004 Jun;28(2):99. (PMID: 20958782); Prehosp Disaster Med. 2016 Dec;31(6):635-642. (PMID: 27641075); Water Res. 2020 Mar 1;170:115288. (PMID: 31783191) |
| Grant Information: | Part of Invited Series United States TW FIC NIH HHS |
| Contributed Indexing: | Keywords: Effectiveness research; Ethics; Humanitarian response; Operational research; Water, sanitation and hygiene |
| Substance Nomenclature: | 059QF0KO0R (Water) |
| Entry Date(s): | Date Created: 20210323 Date Completed: 20210521 Latest Revision: 20240331 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC7983375 |
| DOI: | 10.1186/s12889-021-10597-z |
| PMID: | 33752646 |
| Database: | MEDLINE |
Journal Article; Research Support, Non-U.S. Gov't