[Start of Page 2 of the discussion]

Dear Jonathan and team,

I am just wondering if you can already give some feedback on what came out from the questionnaire work that you carried out in May or an update on this research project in Maputo?

I was prompted to ask because of this post about a project by TU Delft which deals with wastewater reuse in Maputo:
forum.susana.org/forum/categories/40-irr...delft-unesco-ihe-uem

Their project is described here: sustainablewatermz.weblog.tudelft.nl/

I will also ask over in the other thread if there is any overlap or common interest with your project. Just wondering as they both deal with wastewater/sanitation in the same city.

Regards,
Elisabeth

Dear F H Mughal,

Many thanks for your feedback.

I understand your point about the fact that in your urban situation many households will have a connection to a sewerage system. As Julius Makowka mentioned, this is not generally the case in sub-saharan Africa. He gave statistics from Kampala - Maputo is in a similar situation.

The focus of the methodology is risks related to the hazard "faeces". We have not attempted to look at a wide range of diseases related to poor environmental health. This is why we are considering the impacts that solid waste had on excreta/wastewater management systems - and not the other health risks related to solid waste. Neither are we considering mosquito related diseases although if the "stormwater drainage" indicator was scored "high" then it would suggest that this could be an additional problem in the area.

The wastewater/drainage/stormwater management/flooding is a particularly difficult one as often the systems are multi-functional even if they have designed to be separate. This is why we decided to have two indicators - one for drainage of wastewater (in dry weather) and one for wet weather drainage. If I remember correctly, the reason why we chose “storm water drainage” rather than "flooding" was because we are not focusing on larger floods caused by river systems.

Water quantity is a difficult one for people to assess which is why we termed this in terms of the level of service:

1) Household water supply is from a well-maintained piped water system with constant supply
2) Households collect water from a protected standpipe or piped water supply is intermittent/unreliable piped and/or water is purchased from vendors
3) Households abstract water for domestic purposes from surface water/shallow wells

A fair few people have commented on/questioned the vulnerability indicators which are admittedly not so strong insofar as they do not capture individual vulnerability. They are only approximate and cover vulnerability from a communal perspective. Perhaps we should have included proportion of people with HIV aids as an additional one. The ones that you propose would be used more a validation checks to see if the methodology was giving credible results. If the risk indicators (and the aggregate score) are high, then we could see if “number of days absent from school in a month” was also high (if we had the data). We may expect to see higher expenditures on medical bill (although if people cannot afford to pay the medical bills, then this correlation may not be so strong).

Thanks again for your feedback. If you have not already done so, I would encourage you to respond to the questionnaire and send back to us.

best regards,

Jonathan


[End of Page 1 of the discussion]

Dear Elisabeth,

Many thanks for responding to the questionnaire and for encouraging others to also respond. It would be most useful to have as many responses as possible to this survey.

So far we have not had so many responses - so it would be great if a few more people reading this can also offer 10 minutes of their time to respond. I am not sure if it is possible to state the statistical relevance unless we can state what the target population is to be surveyed and then the sample would be related to the total.

I don't think we want to be too explicit about the kind of person who we'd like to fill in your questionnaire on the assumption that most SuSanA people have sufficient knowledge and experience to respond the questions. The answers will inevitably be based on different peoples' specific experiences.

With regards to your question about the wider picture of this research, I think this is already in this thread - see below. But for those who have missed it, I am attached the project brief.

A description of the AHP methodology is on the second tab of the xls. I have copied it here :

"The Analytic hierarchy process (AHP) provides a comprehensive and rational framework for structuring a decision problem, for representing and quantifying its elements, for relating those elements to overall goals, and for evaluating alternative solutions. Once the hierarchy is built, the decision makers systematically evaluate its various elements by comparing them to one another two at a time, with respect to their impact on an element above them in the hierarchy. A set of questions, such as the ones below, is to be answered using your perception of the relative importance of each indicator and your judgments about the elements' relative importance. The AHP converts these evaluations to numerical values that can be processed and compared over the entire range of the problem. A numerical weight or priority  is derived for each element of the hierarchy, allowing diverse and often incommensurable elements to be compared to one another in a rational and consistent way."

There isn't a hypothesis that we are trying to prove or disprove. What we are aiming to do is to use the results to weight the indicators that we are using in the risk assessment framework. As Luiza says in here posting " it is apparent that in actual terms, the indicators contribute to the overall level of risk in varying amounts. The purpose of this questionnaire is therefore to ask you to help define the weighting to be assigned to the indicators according to the perceived level of importance that each indicator plays in the transmission and resultant incidence of disease."

We were looking to see if we could use results from scientific studies to derive this information but it proved to be impossible as there is insufficient evidence that covers the range of indicators that we have included in the methodology. So, this is why we decided to adopt the AHP approach.

With regards to when survey participants can see the results, I would expect that we can report back with a month. If people respond reasonably quickly (this week please) then we can process the results together and that would make it more efficient. We would be happy to acknowledge those who respond to the questionnaire.

best regards,

Jonathan

Depends on the context obviously. The capital of Uganda, a city of around 1.5 million has less than 5% sewer coverage.

Dear Jonathan, Luiza and Philippa,

I have few minor observations for your consideration:

The attachment says: “a rapid participatory risk assessment tool for urban sanitation systems is being developed.” The nature of risk indicators shows that it is more relevant for rural sanitation systems, and for some peri-urban areas that exist at the periphery of a major city, in a developing country. If I were to apply these indicators for Karachi, a major city, none appears applicable, as we have a well-established “sewerage” system, with proper toilets. And, if I were to apply the indicators for a small town or a village (like Shikarpur, my home town), yes, they are applicable. Please look into the nomenclature.

Solid waste collection has been mentioned as a secondary indicator. With solid waste comes the fly breeding – insects, mosquitoes, flies, etc. About 2 months back, I was passing by an un-kept solid waste dump and the wind speed was a bit higher. I was at the down-wind direction, and I felt I inhaled some particle. After 24 hours, I developed massive chest congestion. I had to take strong antibiotic, anti-allergic tablets and cough syrup. I’m still having low-level cough that attacks me at bed time. Where does the fly-breed, or airborne agents, or mosquito intensity, fit in the risk analysis?

The term “storm water drainage” has been used. Typically, the storm water drainage refers to the conveyance of water other than sewage. In addition, the description says: “Flooding of sanitation systems…..” and “Households which are only at risk from flooding in the most extreme storm events.”
Hence, it appears, the appropriate title should be “flooding” and not the storm water drainage.

I would propose addition of “water quantity used per day” under the primary indicators; and “expenses on medical bills per month,” and “number of days absent from school in a month,” under vulnerability indicators

I would join Elisabeth in wishing you good luck in your research!

Regards,

F H Mughal

Dear Jon, Luiza and Philippa,

OK, you convinced me to fill in your questionnaire. I was hesitant at first because it was in Excel and not online like with Surveymonkey. But I realise now this would be too difficult to set up.

I timed it: it took me about 6 minutes, including sending back the Excel file via e-mail.

It was actually quite enjoyable and straight forward to fill it in, so I would like to encourage others to do so as well (but then I am a sucker for questionnaires, I nearly always fill them because I also want people to participate in my questionnaires or surveys).

Perhaps to get a higher response rate, you could:

• Explain what kind of person should fill in your questionnaire, i.e. how much prior knowledge about sanitation is required?
• State how many responses do you think you need to make it statistically viable, and how many responses do you have so far.
• Explain which methodology you would use to analyse this pairing of risk factors and which research hypothesis are you trying to prove or disprove?
• Maybe even attach the PhD proposal or outline to this thread so that people can see the wider picture of this research?
• Indicate the time frame, i.e. when would the survey participants be able to see the results (roughly)?
• Lastly, if you can think of any incentive to filling out the survey, this always helps (my experience with other surveys).

Good luck with your research!

Elisabeth

Please can we have a few minutes of your time to fill in your responses to this questionnaire. many thanks. Jonathan

Dear all, we would really appreciate your response to this questionnaire as it supports the sanitation system risk assessment methodology that we have developed and piloted in Maputo as part of the SPLASH funded research. best regards, Jonathan

Dear All

As part of a doctorate project at Unversity College London, which is closely alligned to the SPLASH funded research led by IWA entitled Sustainable and resilient sanitation service chains in Maputo province, Mozambique, a rapid participatory risk assessment tool for urban sanitation systems is being developed

The tool asks communities to assess the level of risk in their neighborhood according to a risk framework and indicators of risk. You will see (Introduction page in the attachment) that there are 5 different categories of risk indicator that form the basis of this questionnaire.

However, it is apparent that in actual terms, the indicators contribute to the overall level of risk in varying amounts. The purpose of this questionnaire is therefore to ask you to help define the weighting to be assigned to the indicators according to the perceived level of importance that each indicator plays in the transmission and resultant incidence of disease.
 
We would be very grateful if you could fill in the questionnaire, which contains 4 worksheets (woksheets 4.1-4.4). On each sheet, a number of factors contributing to risk are paired. For each of these pairs, please indicate which you think has a higher risk to human health, and by how much relative to the other factor.

Please email me back the questionnaire.

Thanks a lot.

Luiza Campos
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

What is your perception of the relative degree of various health risk factors associated with sanitation systems and practices?

As part of my PhD studies at Unversity College London, which are closely alligned to the SPLASH funded research led by IWA entitled Sustainable and resilient sanitation service chains in Maputo province, Mozambique, I am developing a rapid participatory risk assessment tool for urban sanitation systems.

The tool asks communities to assess the level of risk in their neighborhood according to the following risk framework and indicators of risk. There are 5 different categories of risk indicator that form the basis of this questionnaire: primary sanitation systems, secondary sanitation systems, proximity to the hazard, transmission pathways and vulnerability.

The indicators contribute to the overall level of risk in varying amounts. There is limited data on this subject and therefore I am ask you to help define the weighting to be assigned to the indicators according to the perceived level of importance that each indicator plays in the transmission and resultant incidence of disease.
 
I would be very grateful if you could fill in the questionnaire, It should only take five minutes. It contains 4 worksheets. On each sheet, a number of factors contributing to risk are paired. For each of these pairs, please indicate which you think has a higher risk to human health, and by how much relative to the other factor.

Many thanks - and I'll let you know the results when they are analysed.

PLEASE EMAIL ME BACK THE QUESTIONNAIRE TO THE ADDRESS BELOW

This email address is being protected from spambots. You need JavaScript enabled to view it.

Dear all,

You will find some further information about the SPLASH* funded research in Maputo on Sanitation System Risk Assessment at
www.susana.org/docs_ccbk/susana_download...orkshop-15102013.pdf and also in the attached.

We have also recently applied the methodology in Kampala (see forum.susana.org/forum/categories/59-wg-...-sanitation-planning) and it has been well received. As described in the attached, there are two components;

i) a municipal system risk assessment and ii) a community level risk assessment.

They are quite different but both are based on the principles of being rapid, participatory and based on local stakeholder knowledge.

It is proving to be advantageous compared with conventional approaches as it helps to promote awareness of health risk associated with sanitation as part of the process. The approach is quite powerful as it makes the link between sanitation systems and their failure, the resultant hazardous events that arise as a result of these failure, and consequent the impact on exposed populations, who are more likely to be affected the more vulnerable they are. It is a simple but powerful concept and methodology which I believe has alot of value to disseminate more widely.

The next step is to use this as the basis for developing realistic risk reduction plans and this is something we are working on. We are in communication with WHO about the relevance that this has in relation to the development of a standardised approach for sanitation safety planning.

best regards,

Jonathan

IWA Programme Manager - Urban Sanitation Initiative

* More information about the SPLASH programm here on the forum:
forum.susana.org/forum/categories/97-ena...roon-mozambique#6381

Done! All the best!