A holistic participatory approach to water and sanitation improvement in disadvantaged urban slums -

Abstract

Safe drinking water, adequate sanitation, and proper hygiene practices constitute preconditions for health improvement and livelihood enhancement in disadvantaged urban areas and contribute to poverty alleviation. The importance of incorporating local knowledge of health and environmental conditions and of household preferences and behavior into decisions on water and sanitation improvement options is well acknowledged. In this context, a poor and deprived urban area was selected as a pilot, whereby a community-based collaborative approach to water and sanitation improvement was tested with the aim of easing environmental burdens through a better understanding of how poor environmental services can exacerbate poverty. A multi-disciplinary research framework combining quantitative and qualitative methodologies was adopted to document the existing conditions, analyze and interpret the social and cultural factors that determine or influence the situation, identify and assess current prevention and intervention strategies, and develop and implement new pilot interventions and evaluate them. Field surveys revealed that the pilot area suffers from water pollution at the building-household level due to deteriorated water and wastewater plumbing systems. A high incidence of diarrhea (33.1 percent), nearly 6.5 folds the national annual incidence, was estimated using household and hospital-dispensary surveys. Statistical modeling estimated the baseline probability of contracting diarrhea in a household in Tebbaneh at 83.5percent, given that there are two members in the household, the age of the female household head is 20, the household is unable to secure 100 USD within one week, there is no wastewater accumulation in the basement, network water is not used for cooking, and the household is not located in Zone 2, to the southwest of Tebbaneh. The annual economic burden of increased morbidity and premature mortality resulting from reported diarrhea alone was estimated to range between 3.4 to 17.1 percent of the total annual a