Centralized or Onsite Testing? Examining the Costs of Water Quality Monitoring in Rural Africa.

Rural water systems in Africa have room to improve water quality monitoring. However, the most cost-effective approach for microbial water testing remains uncertain. This study compared the cost per test (membrane filtration) of four approaches representing different levels of centralization: (i) one centralized laboratory serving all water systems, (ii) a mobile laboratory serving all systems, (iii) multiple semi-centralized laboratories serving clusters of systems, and (iv) decentralized analysis at each system.

The Impact of Pro-Poor Sanitation Subsidies in Open Defecation-Free Communities: A Randomized, Controlled Trial in Rural Ghana.

Background: According to the World Health Organization/United Nations International Children's Fund Joint Monitoring Program, people practice open defecation globally. After achieving open defecation-free (ODF) status through efforts such as Community-Led Total Sanitation (CLTS), communities (particularly vulnerable households) may revert to open defecation, especially when toilet collapse is common and durable toilets are unaffordable. Accordingly, there is increasing interest in pro-poor sanitation subsidies.

Defining Nutrient Colocation Typologies for Human-Derived Supply and Crop Demand To Advance Resource Recovery.

Resource recovery from human excreta can advance circular economies while improving access to sanitation and renewable agricultural inputs. While national projections of nutrient recovery potential provide motivation for resource recovery sanitation, elucidating generalizable strategies for sustainable implementation requires a deeper understanding of country-specific overlap between supply and demand. For 107 countries, we analyze the colocation of human-derived nutrients (in urine) and crop demands for nitrogen, phosphorus, and potassium.

Navigating Data Uncertainty and Modeling Assumptions in Quantitative Microbial Risk Assessment in an Informal Settlement in Kampala, Uganda.

Decision-makers in developing communities often lack credible data to inform decisions related to water, sanitation, and hygiene. Quantitative microbial risk assessment (QMRA), which quantifies pathogen-related health risks across exposure routes, can be informative; however, the utility of QMRA for decision-making is often undermined by data gaps. This work integrates QMRA, uncertainty and sensitivity analyses, and household surveys in Bwaise, Kampala (Uganda) to characterize the implications of censored data management, identify sources of uncertainty, and incorporate risk perceptions to improve the suitability of QMRA for informal settlements or similar settings.

Re-Envisioning Sanitation As a Human-Derived Resource System.

Sanitation remains a global challenge, both in terms of access to toilet facilities and resource intensity (e.g., energy consumption) of waste treatment.

Navigating Multidimensional Social-Ecological System Trade-Offs across Sanitation Alternatives in an Urban Informal Settlement.

Urban growth in low- and middle-income countries has intensified the need to expand sanitation infrastructure, especially in informal settlements. Sanitation approaches for these settings remain understudied, particularly regarding multidimensional social-ecological outcomes. Guided by a conceptual framework (developed in parallel with this study) re-envisioning sanitation as a human-derived resource system, here we characterize existing and alternative sanitation scenarios in an informal settlement in Kampala, Uganda.

Advancing Sustainable Sanitation and Agriculture through Investments in Human-Derived Nutrient Systems.

The sixth Sustainable Development Goal seeks to achieve universal sanitation, but a lack of progress due to inhibiting factors (e.g., limitations in financial resources, sociocultural conditions, household decision-making) demands innovative approaches to meet this ambitious goal.

Aligning Product Chemistry and Soil Context for Agronomic Reuse of Human-Derived Resources.

Recovering human-derived nutrients from sanitation systems can offset inorganic fertilizer use and improve access to agricultural nutrients in resource-limited settings, but the agronomic value of recovered products depends upon product chemistry and soil context. Products may exacerbate already-compromised soil conditions, offer benefits beyond nutrients, or have reduced efficacy depending on soil characteristics. Using global spatial modeling, we evaluate the soil suitability of seven products (wastewater, sludge, compost, urine, ammonium sulfate, ammonium struvite, potassium struvite) and integrate this information with local recovery potential of each product from sanitation systems that will need to be installed to achieve universal coverage (referred to here as "newly-installed sanitation").

Child soil ingestion in rural Ghana - frequency, caregiver perceptions, relationship with household floor material and associations with child diarrhoea.

Objectives: The objectives of this work were to evaluate (i) the prevalence and frequency of caregiver-reported soil ingestion by children, (ii) whether household flooring material in the bedroom (earth vs. concrete) affected caregiver-reported soil ingestion, (iii) whether caregiver-reported soil ingestion was associated with caregiver-reported diarrhoea and (iv) caregivers' perceptions of their children ingesting soil.

Methods: We conducted 309 household surveys in northern Ghana, including 529 children under five (249 children aged 6-36 months), and measured faecal contamination in soil from 31 households.

Amplifying Progress toward Multiple Development Goals through Resource Recovery from Sanitation.

The United Nations' Sustainable Development Goals (SDGs) recognize that current sanitation gaps must be closed to better serve those without access to safely managed systems (Target 6.2: universal sanitation coverage) and those connected to sewers without wastewater treatment (Target 6.3: halving the proportion of untreated wastewater).