Moving Towards Transformational WASH: Authors' Response

Publisher: The Lancet Global Health, vol. 7, issue 11
Nov 01, 2019
Authors
Amy J. Pickering, Benjamin F. Arnold, Andrew J. Prendergast, Clair Null, Peter J. Winch, Sammy M. Njenga, Mahbubur Rahman, Robert Ntozini, Jade Benjamin-Chung, Christine P. Stewart, John M. Colford, Jr., Stephen Luby, and Jean H. Humphrey
The authors agree with Karen Levy and Joseph Eisenberg that observational studies of water, sanitation, and hygiene (WASH) interventions with carefully designed counterfactuals can play a valuable role in generating evidence on effectiveness, particularly in urban settings. Randomised controlled trials for community-level WASH infrastructure interventions are not always feasible in urban settings, because of the political and logistical constraints of defining treatment and control groups; strong observational designs could help fill the gap. With increasing urbanisation in Asia and Africa, WASH intervention studies in low-income urban communities will be crucial for informing strategies to meet Sustainable Development Goal (SDG) target 6.1: to achieve universal and equitable access to safe and affordable drinking water for all.