January 2001

In this month�s update, we are introducing a new page on our web site: "EHP Activities." By clicking on appropriate links, you will get information on where EHP is working and what it is doing. You will find summary descriptions of the activities as well as links to available reports related to the activities. To see this new feature "EHP Activities," which will be updated monthly, please click here

EHP�s E-Newsletter Debuts!

The first issue of "What�s New at EHP," a monthly e-newsletter of the Environmental Health Project, came out in January. The e-newsletter is intended to keep EHP staff, partners, clients, and colleagues informed of EHP happenings and activities, new EHP publications and reports, and upcoming meetings and conferences related to environmental health. To subscribe, please send an email to [email protected]

Improving Effectiveness of National Malaria Control Programs

Historically, vector control has been a mainstay of national malaria control programs, but increasing resistance to insecticides, high costs, and wasteful practices have limited its effectiveness. Effective vector control depends on using the right mix of interventions to fit local conditions and vector ecology. Working with national malaria control programs in Nepal, Eritrea, and Mozambique, EHP is focusing on capacity building in collection, analysis, and use of data to strategically target control measures at the local level. For example, improved mapping of malaria cases in Maputo, the capital of Mozambique, has helped local officials target their efforts in neighborhoods with the greatest number of cases. National malaria control program officials have requested USAID to expand EHP�s assistance to cover the Maputo metropolitan area and Mozambique�s other five provincial capitals. The case maps for Maputo have also revealed areas of intense transmission where modest efforts at vector control may have a substantial impact on malaria incidence; further investigations are planned for the coming year. For more information, please contact Gene Brantly [email protected]

Urban Congolese Create Healthier Neighborhoods

EHP is working with NGOs and the University of Kinshasa, School of Public Health to build the capacity of community groups involved in improving environmental conditions and health in urban areas of the Democratic Republic of Congo. In one city, local groups and an international NGO have teamed to overcome severe daily water shortages that affect the population of 800,000 people. In Kinshasa, EHP, community groups and NGOs are working together to reduce flooding and improve conditions in public markets. Each project combines community participation, entrepreneurial business, infrastructure construction, and education to improve child health. For information on this activity, please contact Chris McGahey [email protected]

EHP recently carried out six case studies on the decentralization of water supply and sanitation services in Latin America. The case studies--focusing on small towns and rural communities--were developed around three themes. These themes, while distinct, represent three aspects of one major issue � the effect of reform and decentralization on the less advantaged elements of the population.

The three themes are as follows:

-Role of small and medium-sized municipalities in service provision: Each case study under this theme describes a different management model for providing services. The case studies were implemented in El Salvador, Colombia, and Paraguay.

-Institutional arrangements to provide backup support to rural systems: Case studies carried out in Honduras and Nicaragua under this theme address the question of which institutional models can provide backup support to rural communities after the systems are operational.

-Effective regulation of municipal services: This study provides an overview of the regulatory trends, defines the issues that need to be addressed to establish a regulatory structure, and includes a brief summary of eight experiences with regulatory reform in the region.

These case studies are available in English, and will shortly be available in Spanish. The report can be viewed on the publications page. Please contact [email protected] if you wish to be notified when the Spanish version is completed.

A baseline survey of blood-lead levels was conducted in Lima by the General Directorate of Environmental Health (DIGESA). USAID/Peru supported the study with technical assistance from EHP. The baseline study, conducted in 1998-99, included 2,510 children, aged 6 months to 9 years, and 874 post-partum women living in Lima and the Province of Callao. The mean blood-lead level in children was found to be 9.9 ug/dL. Certain areas of El Callao, however, showed alarmingly high levels of lead exposure. Preliminary information gathered at the time of the study suggested that exposure to lead originated from a large depository of mineral concentrates located in the area where the highest levels were identified. Children�s hand-mouth habits, combined with dusty playground areas, limited water supplies, and poor handwashing practices, contributed to children consuming significant amounts of lead from the dust and soil.

The report summarizes activities undertaken to investigate the sources, the results of those efforts and proposed next steps. This new EHP Activity report is in Spanish, with an abstract in English. (The file is 4, 205 KB.) To access the report, click here.

The Water Supply and Sanitation Collaborative Council (WSSCC) held its Fifth Global Forum in Iguacu, Brazil, in early December 2000. Preliminary activities leading to the Forum included a planning meeting in Montreal (early September) and e-conferences (September and October). EHP staff participated in the Montreal meeting, facilitated the e-conferences, and attended the Iguacu Forum which culminated in the draft Iguacu Action Program (IAP). Advocacy will be a major plank for the IAP and will focus on hygiene promotion, environmental sanitation, institutional management options and public private partnerships, and community-based, participatory and social marketing approaches.

EHP plans to partner with other Collaborative Council members and substantially contribute to reaching Vision 21 in the areas of hygiene promotion, sanitation partnership, and monitoring and indicators. For more information please send an inquiry to [email protected]

The Global Water Supply and Sanitation Assessment 2000 report was launched by WHO/UNICEF at the Water Supply and Sanitation Collaborative Council (WSSCC) meeting in Iguacu, Brazil. The Assessment 2000 is the result of an improved methodology for collection and analysis of national water supply and sanitation coverage data. The data in the Assessment came from nationally representative household surveys and focuses on consumer-based coverage and consumer use of services rather than hardware construction. The Assessment estimates that 2.4 billion people worldwide still do not have acceptable means of sanitation, while 1.1 billion people do not have an improved water supply. Of note is a change in the terminology related to coverage data in the Assessment report. Based on lack of information on the "safety" of the water served to the population or the "adequacy" of sanitation facilities, the terms "safe" and "adequate" have been replaced with "improved" in the report.

EHP staff attended the PAHO regional meeting of the Americas in Porto Alegre where the Assessment 2000 data related to the Americas was extensively used in the presentations. The PAHO meeting highlighted urban-rural inequities in water supply and sanitation coverage in the Americas as well as inequities in coverage and diarrhea prevalence based on income levels. The Assessment 2000 Report is available from the WHO. Click here to view the complete report.

In January 2001, a two-day meeting on "The Web and Beyond: Harnessing the Potential of IT for Improving Health" was held in Washington DC by the Population and Health Materials Working Group. This Working Group is composed of representatives from USAID-funded projects and cooperating agencies. Staff from the EHP Information Unit attended the meeting. The purpose of the meeting was to share information on lessons learned related to using the Internet and other communication technologies for health information and training. Case studies from the field and working sessions on a range of IT issues were discussed as well as discussions on future challenges facing the use of information technology in development. For detailed information on discussions and presentations from the conference, click here.

New at Info Services

Environmental Health Updates:

• January 19, 2001
• January 5, 2001
• December 21, 2000
• December 8, 2000

Malaria Bulletins:

• January 5 - 18, 2001
• December 4 - January 4, 2001
• November 20 - December 3, 2000

Virtual Library additions:

• DFID Better Health for Poor People

New at Publications:  Activity Report 104, Estudio para Determinar las Fuentes de Exposici�n a Plomo en la Provincia Constitucional del Callao, Per�  (This file is 4,205 KB.)

New at Linked Sites: NETWAS Group Africa

Previous Issues of "What's New?"

The main topics or countries discussed are given in parentheses.

November 2000 at EHP (Nicaragua, Dominican Republic, Madagascar, SANICONN)
September 2000 at EHP (Nepal/Regional, EHP and E-conferences)
July 2000 at EHP (Nicaragua, Malaria Vaccine Development, "Water for the World")
May/June 2000 at EHP (Nicaragua, International Consultation on Indoor Air Pollution)
April 2000 at EHP (Nicaragua, Madagascar, Mozambique)
March 2000 at EHP (Benin, South Africa, Eritrea, Madagascar)
February 2000 at EHP (Nicaragua, Paraguay, Ukraine, Mozambique and Eritrea)
January 2000 at EHP (Nicaragua, EHP Lessons Learned)

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