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Getting the basic rights – the role of water, sanitation and hygiene in maternal and reproductive health: a conceptual framework

OBJECTIVE: To explore linkages between water, sanitation and hygiene (WASH) and maternal and perinatal health via a conceptual approach and a scoping review. METHODS: We developed a conceptual framework iteratively, amalgamating three literature-based lenses. We then searched literature and identifi...

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Autores principales: Campbell, Oona M R, Benova, Lenka, Gon, Giorgia, Afsana, Kaosar, Cumming, Oliver
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4681319/
https://www.ncbi.nlm.nih.gov/pubmed/25430609
http://dx.doi.org/10.1111/tmi.12439
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author Campbell, Oona M R
Benova, Lenka
Gon, Giorgia
Afsana, Kaosar
Cumming, Oliver
author_facet Campbell, Oona M R
Benova, Lenka
Gon, Giorgia
Afsana, Kaosar
Cumming, Oliver
author_sort Campbell, Oona M R
collection PubMed
description OBJECTIVE: To explore linkages between water, sanitation and hygiene (WASH) and maternal and perinatal health via a conceptual approach and a scoping review. METHODS: We developed a conceptual framework iteratively, amalgamating three literature-based lenses. We then searched literature and identified risk factors potentially linked to maternal and perinatal health. We conducted a systematic scoping review for all chemical and biological WASH risk factors identified using text and MeSH terms, limiting results to systematic reviews or meta-analyses. The remaining 10 complex behavioural associations were not reviewed systematically. RESULTS: The main ways poor WASH could lead to adverse outcomes are via two non-exclusive categories: 1. ‘In-water’ associations: (a) Inorganic contaminants, and (b) ‘water-system’ related infections, (c) ‘water-based’ infections, and (d) ‘water borne’ infections. 2. ‘Behaviour’ associations: (e) Behaviours leading to water-washed infections, (f) Water-related insect-vector infections, and (g-i) Behaviours leading to non-infectious diseases/conditions. We added a gender inequality and a life course lens to the above framework to identify whether WASH affected health of mothers in particular, and acted beyond the immediate effects. This framework led us to identifying 77 risk mechanisms (67 chemical or biological factors and 10 complex behavioural factors) linking WASH to maternal and perinatal health outcomes. CONCLUSION: WASH affects the risk of adverse maternal and perinatal health outcomes; these exposures are multiple and overlapping and may be distant from the immediate health outcome. Much of the evidence is weak, based on observational studies and anecdotal evidence, with relatively few systematic reviews. New systematic reviews are required to assess the quality of existing evidence more rigorously, and primary research is required to investigate the magnitude of effects of particular WASH exposures on specific maternal and perinatal outcomes. Whilst major gaps exist, the evidence strongly suggests that poor WASH influences maternal and reproductive health outcomes to the extent that it should be considered in global and national strategies.
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spelling pubmed-46813192015-12-23 Getting the basic rights – the role of water, sanitation and hygiene in maternal and reproductive health: a conceptual framework Campbell, Oona M R Benova, Lenka Gon, Giorgia Afsana, Kaosar Cumming, Oliver Trop Med Int Health Women's Health OBJECTIVE: To explore linkages between water, sanitation and hygiene (WASH) and maternal and perinatal health via a conceptual approach and a scoping review. METHODS: We developed a conceptual framework iteratively, amalgamating three literature-based lenses. We then searched literature and identified risk factors potentially linked to maternal and perinatal health. We conducted a systematic scoping review for all chemical and biological WASH risk factors identified using text and MeSH terms, limiting results to systematic reviews or meta-analyses. The remaining 10 complex behavioural associations were not reviewed systematically. RESULTS: The main ways poor WASH could lead to adverse outcomes are via two non-exclusive categories: 1. ‘In-water’ associations: (a) Inorganic contaminants, and (b) ‘water-system’ related infections, (c) ‘water-based’ infections, and (d) ‘water borne’ infections. 2. ‘Behaviour’ associations: (e) Behaviours leading to water-washed infections, (f) Water-related insect-vector infections, and (g-i) Behaviours leading to non-infectious diseases/conditions. We added a gender inequality and a life course lens to the above framework to identify whether WASH affected health of mothers in particular, and acted beyond the immediate effects. This framework led us to identifying 77 risk mechanisms (67 chemical or biological factors and 10 complex behavioural factors) linking WASH to maternal and perinatal health outcomes. CONCLUSION: WASH affects the risk of adverse maternal and perinatal health outcomes; these exposures are multiple and overlapping and may be distant from the immediate health outcome. Much of the evidence is weak, based on observational studies and anecdotal evidence, with relatively few systematic reviews. New systematic reviews are required to assess the quality of existing evidence more rigorously, and primary research is required to investigate the magnitude of effects of particular WASH exposures on specific maternal and perinatal outcomes. Whilst major gaps exist, the evidence strongly suggests that poor WASH influences maternal and reproductive health outcomes to the extent that it should be considered in global and national strategies. Blackwell Publishing Ltd 2015-03 2014-12-22 /pmc/articles/PMC4681319/ /pubmed/25430609 http://dx.doi.org/10.1111/tmi.12439 Text en © 2014 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
spellingShingle Women's Health
Campbell, Oona M R
Benova, Lenka
Gon, Giorgia
Afsana, Kaosar
Cumming, Oliver
Getting the basic rights – the role of water, sanitation and hygiene in maternal and reproductive health: a conceptual framework
title Getting the basic rights – the role of water, sanitation and hygiene in maternal and reproductive health: a conceptual framework
title_full Getting the basic rights – the role of water, sanitation and hygiene in maternal and reproductive health: a conceptual framework
title_fullStr Getting the basic rights – the role of water, sanitation and hygiene in maternal and reproductive health: a conceptual framework
title_full_unstemmed Getting the basic rights – the role of water, sanitation and hygiene in maternal and reproductive health: a conceptual framework
title_short Getting the basic rights – the role of water, sanitation and hygiene in maternal and reproductive health: a conceptual framework
title_sort getting the basic rights – the role of water, sanitation and hygiene in maternal and reproductive health: a conceptual framework
topic Women's Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4681319/
https://www.ncbi.nlm.nih.gov/pubmed/25430609
http://dx.doi.org/10.1111/tmi.12439
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