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The WHO and UNICEF position paper Implications of recent WASH and nutrition studies for WASH policy and practice summarized three high-quality studies in the WASH sector that resulted in little or no impact on reducing childhood diarrhea and stunting. The paper aimed to contextualize the findings and distill the implications for future WASH investments.


The report highlighted that oftentimes fecal contamination of produce is not considered when designing and implementing interventions despite prior evidence that this is a dominant exposure pathway in many settings. The paper cites SaniPath as the source of this important piece of evidence.

The evidence generated through SaniPath's work is increasing awareness about this major exposure pathway and contributing to influential position papers such as this one. The data generated from deployments is encouraging policies and practices to address food safety issues that arise from fecal contamination along the value chain.

In September of 2019, SaniPath researchers participated in a workshop supported by the Bill & Melinda Gates Foundation held at Emory University in Atlanta, Georgia. The workshop brought together an interdisciplinary group of exposure assessment researchers in the WASH sector. The objectives of the workshop were four-fold:

  1. Identify criteria under which to compare various exposure assessment approaches

  2. Discuss lessons in exposure science from other sectors of environmental health to explore potential application to enteric pathogen exposure assessments

  3. Critically review existing and emerging enteric pathogen exposure assessment approaches

  4. Determine and define research priorities to help move the field of enteric pathogen exposure science forward

The takeaways from the workshop are described in a publication by Goddard, et al. (2020). In the paper, the SaniPath Tool is cited as an example of an exposure assessment tool that measures the important interaction between environmental contamination and behavioral drivers.



Sanitation Challenge for Ghana Participants (Photo Credit: sanitationchallenge4ghana.org)

The Sanitation Challenge for Ghana is a program established to promote innovation and partnerships between Metropolitan, Municipal, and District Assemblies (MMDAs) and private and non-state sector actors to improve liquid waste management in low-income urban households in Ghanaian cities with populations over 15,000. The Challenge was first launched in 2015 by the Government of Ghana and is supported by IMC Worldwide (UK Department of International Development), IRC Ghana, and WASHealth Solutions. The Challenge consisted of two stages in which MMDAs submitted their work to be evaluated alongside their peers. Stage 1 consisted of 139 MMDAs with 17 being invited to participate in the second and final stage of judging. Private and non-state actors were eligible for entry if they had or will be partnering with at least one of the 17 Stage 2 MMDAs on a project related to liquid waste management. SaniPath partners were selected for recognition at both stages of the Challenge and include Accra Metropolitan Assembly, Kumasi Metropolitan Assembly, and Training, Research, and Networking for Development (TREND). Accra Metropolitan Assembly and Kumasi Metropolitan Assembly were recognized during Stage 1 with honorary prizes as Metropolitan Assemblies who are conducting essential work to improve liquid waste management in their respective cities.

Kumasi Metropolitan Assembly receiving the 1st prize worth £400k for innovations in liquid waste management. Photo credit

During Stage 2, Kumasi Metropolitan Assembly was selected as the 1st prize recipient of £400k for their innovative work on addressing liquid waste management to transform livelihoods in the urban center of Kumasi. The following quote was provided by Sanitation Challenge for Ghana on the work Kumasi Metropolitan Assembly had conducted over the challenge period:

Kumasi Metropolitan Assembly – 1st winner, £400,000 for its innovative partnership with the private sector, use of aquaculture, skilled and knowledgeable staff and strong support and leadership commitment from the Mayor. Overall, the Assembly showed an outstanding commitment to all parts of the sanitation value chain. – Sanitation Challenge for Ghana

SaniPath partner TREND receiving the Special Prize for private partners (photo credit: Habib Yakubu)

TREND was also recognized during Stage 2 of the challenge as a private partner to MMDAs whose work aims to improve liquid waste management across urban centers. TREND has facilitated trainings and managed the deployment of two SaniPath Exposure assessments, both in Accra and Kumasi, in late 2018. TREND was awarded $10,000 for their work as a SaniPath Training Hub and the capacity building and data collection work performed alongside Kumasi Metropolitan Assembly.

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