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The Environmental Health Group (EHG; www.envhealthgroup.org) leads the Sanitation and Hygiene Applied Research for Equity (SHARE) consortium. This £10million grant from the UK Department for International Development seeks to bring together leading research and operational organisations to generate rigorous and relevant research for use in the field of sanitation and hygiene. SHARE works in two regions with historically low levels of sanitation access: sub-Saharan Africa and South Asia and partners with the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR-B), the International Institute for Environment and Development (IIED), Shack/Slum Dwellers International (SDI), and WaterAid. More information on SHARE activities is available at the SHARE website: www.SHAREresearch.org

Researchers of the EHG continue to work on other issues related to water, sanitation, and hygiene. Ousmane Toure has used the Hazard Analysis Critical Control Point (HACCP) approach to develop an intervention to improve the hygiene of weaning food preparation in poor households in Bamako, Mali. Mothers caught on quickly to the measures, involving improved hand hygiene and the reheating of stored food before serving it to the child. Before the intervention, most samples contained gross fecal contamination, but afterwards fecal bacteria were for the most part undetectable. Moreover, these improvements were found three months later to be sustained undiminished.

Collaboration with a group at the Federal University of Bahia in Brazil has focussed on evaluation of the health impact of a $400 million sewerage project covering the whole city of Salvador, population 2.5 million. The provision of sewers was found to be associated with a 22% reduction in diarrhoea overall, and 43% in the high-risk areas. The reduction was associated with neighbourhood coverage, rather than the sanitation of the individual household. It also halved the strength of the association between diarrhoea and poverty.

In 2009, researchers of the EHG were awarded a grant from the Bill and Melinda Gates Foundation to develop innovative strategies for latrine maintenance. The project, titled “New concepts for on-site sanitation based on bio-additives and pit design” and taking place in Tanzania and Vietnam, aims to understand decomposition processes within latrine pits and the influence of sanitation technology factors on decomposition. This understanding will support the development of bio-additives and/or innovative latrine technologies that will extend the life of latrine pits, reducing the economic burden of latrine construction on families and communities. Further information is at www.sanitationventures.com.

EHG also participates in the African SNOWS (Scientists Networked for Outcomes from Water and Sanitation) Consortium, funded by the  Wellcome Trust, which aims to build capacity for research in water supply, sanitation and environmental health in six African universities. The long term objective of the consortium is to build sustainable capacity in research that leads to improved public health by improving water supply, sanitation and hygiene. SNOWS aims to enable African researchers to conduct policy-relevant research on the health impact of environmental interventions, and on how these interventions can be implemented most effectively and taken to scale. www.africansnows.org

The Hygiene Centre continues to collaborate fruitfully with Unilever. By making hand washing central to soap marketing in Africa and Asia, the company is creating large scale and sustainable, solutions to a pressing health problem. The collaboration has also allowed us to learn the techniques of behaviour change from their top marketers. What we have learned has been distilled into resource materials for anyone planning a handwashing promotion programme, downloadable from www.choosesoap.org. Following the success of Global Handwashing Day 2011, the planning has begun in earnest for next year's event. www.hygienecentral.org.uk.

The Malaria Capacity Development Consortium (MCDC) is supported by the Wellcome Trust and the Bill and Melinda Gates Foundation and is designed to help able and motivated African scientists undertake high-quality research that will enhance the research capacity of their home institutions.

The programme will undertake capacity development in African universities that will not only lead to improvements in the malaria control measures available in Africa, but also stimulate research into the development of new ways to control the disease.

IDEAS (Informed Decisions for Actions) is an international research project that aims to improve the evidence base for future maternal and newborn health programmes, ultimately to improve the survival and health of mothers and babies.  IDEAS works in areas with high maternal and newborn mortality: Ethiopia, North-Eastern Nigeria and Uttar Pradesh in Northern India. Using measurement, learning and evaluation to study the impact of innovative maternal and newborn health projects, IDEAS will provide better evidence for policy decisions.

IDEAS is funded between 2010 and 2015 by a grant from the Bill & Melinda Gates Foundation to the London School of Hygiene & Tropical Medicine. 

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