The State of Sanitation in Humanitarian Emergencies: A Systematic Review of Global WASH Cluster Needs Assessments Open Access

Wingerter, Conner (2017)

Permanent URL: https://etd.library.emory.edu/concern/etds/6108vb66v?locale=en
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Abstract

Background: Currently, no studies evaluate whether the emergency sanitation sector is meeting sector standards, as described by The Sphere Handbook and UNHCR's Handbook for Emergencies.

Objective: To determine whether the emergency sanitation sector is meeting minimum standards of best practice, and to also ascertain the sector's most common challenges and field recommendations.

Methods: A systematic review was performed of all needs assessments uploaded to the Global WASH Cluster website between June 2011 and October 2016. Both quantitative and qualitative key sanitation data were extracted from assessments, including percent of population with improved sanitation, percent of population with total sanitation, number of persons per latrine, mention of the sanitation needs of special populations, noted challenges, and noted field recommendations. Descriptive statistical analyses were performed using Microsoft Excel to understand the state of sanitation in emergencies globally, and for WHO regions and individual countries.

Results: Seven-hundred and fifty-seven sites from 25 countries met inclusion criteria. Forty-six percent of sites met the Sphere Standard for persons per latrine in the non-acute emergency phase, 67% met the acute emergency phase standard, and 33% failed to meet either standard for persons per latrine. Fifteen percent of sites met the UNHCR Standard for total sanitation coverage for the non-acute emergency phase, 31% met the acute emergency phase standard, and 69% failed to meet either standard for total sanitation coverage. The two most common challenges were open defecation (73% of sites), and damaged latrines (27% of sites). The two most common recommendations were construction of additional latrines (68% of sites), and sanitation promotion or campaign (33% of sites). Specific sanitation needs for children was noted in 7% of sites, and for the elderly was noted in only 2%, compared to women (44%) and the disabled (31%).

Conclusion: The emergency sanitation sector is not meeting sector standards for most acute and non-acute emergencies, with significant sanitation coverage gaps in several countries. In some instances, certain Sphere and UNHCR standards are not being measured at all. Results demonstrate the need to meet sector standards, and to collect additional emergency sanitation data for a more complete analysis.

Table of Contents

INTRODUCTION & BACKGROUND - 1

Standards and Targets for Sanitation in Emergencies - 2

Sanitation Infrastructure in Emergencies - 6

The Global WASH Cluster - 9

METHODOLOGY - 10

Procedure - 12

Methods of Analysis - 15

Protection of Human Subjects - 15

RESULTS - 17

Geographic Representation - 17

Persons per Latrine 19

Total Sanitation Coverage - 21

Improved Sanitation Coverage - 24

Key Sanitation Recommendations - 24

Key Sanitation Challenges - 26

Special Groups - 27

DISCUSSION - 28

CONCLUSION - 33

STUDY STRENGTHS & LIMITATIONS - 34

FINAL RECOMMENDATIONS - 35

REFERENCES - 37

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