Exploring Links Between WASH Efforts and Population Density

Research Overview

Researchers at the London School of Hygiene and Tropical Medicine (LSHTM) and Georgia Tech, in partnership with implementers from Water and Sanitation for the Urban Poor (WSUP), are evaluating the health impact of an intervention that is increasing access to improved sanitation in peri-urban settlements in Maputo, Mozambique.

Project Location

Maputo, Mozambique

Research Objectives

The main aims of this research are to answer three key research questions

1. Do sanitation improvements affect low-income populations differently based on population density?
2. If so, why?
3. What are the policy implications and recommendations?

Study Approach

The research team led by LSHTM and Georgia Tech is exploring the links between shared sanitation, population density and disease transmission in the peri-urban settlements of Maputo, Mozambique. In response to the high population density in these neighborhoods, WSUP began building shared sanitation facilities that provide access to water and pour-flush toilets for community groups varying in size from 10 to 80 people. LSHTM and Georgia Tech’s Maputo Sanitation (MapSan) study is a controlled, before-and-after trial to estimate the health impacts of WSUP’s shared sanitation intervention on children under five. The intervention group consists of those living in compounds where shared sanitation facilities have been constructed, and the control group consists of those using existing shared unimproved latrines with poor sanitary conditions. Baseline and endline data collection include collection of child stool samples, child salivary samples, tap water samples, and household fly counts. After baseline data collection, single-dose albendazole will be offered to both intervention and control groups in compliance with the Mozambique National Deworming Campaign. Based on the collected data, the research team will evaluate outcomes including: combined prevalence of selected enteric infections, soil-transmitted helminth reinfection in children following baseline deworming, and prevalence of reported diarrheal disease.

Research into Action

This research will help to guide future investments in sanitation infrastructure, especially in high-density populations. As the first controlled trial for an urban shared sanitation intervention, MapSan will provide critical information on how health effects from sanitation interventions differ based on levels of population density.  The research team is partnering with the Government of Mozambique and other local and international institutions, which will facilitate use of the study results at both a local and national level.

The researchers published the study protocol in BMJ Open in June 2015.

Research Partners

London School of Hygiene and Tropical Medicine
Georgia Tech
University of Florida
University of North Carolina at Chapel Hill
Water and Sanitation for the Urban Poor

Project Status