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EcoHealth

, Volume 6, Issue 2, pp 180–191 | Cite as

Improving Environmental Sanitation, Health, and Well-Being: A Conceptual Framework for Integral Interventions

  • Hung Nguyen-VietEmail author
  • Jakob Zinsstag
  • Roland Schertenleib
  • Chris Zurbrügg
  • Brigit Obrist
  • Agnès Montangero
  • Narong Surkinkul
  • Doulaye Koné
  • Antoine Morel
  • Guéladio Cissé
  • Thammarat Koottatep
  • Bassirou Bonfoh
  • Marcel Tanner
Original Contribution

Abstract

We introduce a conceptual framework for improving health and environmental sanitation in urban and peri-urban areas using an approach combining health, ecological, and socioeconomic and cultural assessments. The framework takes into account the three main components: i) health status, ii) physical environment, and iii) socioeconomic and cultural environment. Information on each of these three components can be obtained by using standard disciplinary methods and an innovative combination of these methods. In this way, analyses lead to extended characterization of health, ecological, and social risks while allowing the comprehensive identification of critical control points (CCPs) in relation to biomedical, epidemiological, ecological, and socioeconomic and cultural factors. The proposed concept complements the conventional CCP approach by including an actor perspective that considers vulnerability to risk and patterns of resilience. Interventions deriving from the comprehensive analysis consider biomedical, engineering, and social science perspectives, or a combination of them. By this way, the proposed framework jointly addresses health and environmental sanitation improvements, and recovery and reuse of natural resources. Moreover, interventions encompass not only technical solutions but also behavioral, social, and institutional changes which are derived from the identified resilience patterns. The interventions are assessed with regards to their potential to eliminate or reduce specific risk factors and vulnerability, enhance health status, and assure equity. The framework is conceptualized and validated for the context of urban and peri-urban settings in developing countries focusing on waste, such as excreta, wastewater, and solid waste, their influence on food quality, and their related pathogens, nutrients, and chemical pollutants.

Key words

integrated approach health environmental sanitation MFA QMRA social sciences 

Notes

Acknowledgments

We gratefully acknowledge the contributions by Mr. Christoph Lüthi, Dr. Peter Odermatt, Prof. Mitchell Weiss, and Dr. Voranuch Wangsuphachart during the discussions of this framework. This work has been supported by the Swiss National Science Foundation (SNSF) and the Swiss Agency for Development and Cooperation (SCD), through the program of the National Center for Competences in Research (NCCR) North–South.

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Copyright information

© International Association for Ecology and Health 2009

Authors and Affiliations

  • Hung Nguyen-Viet
    • 1
    • 2
    Email author
  • Jakob Zinsstag
    • 1
  • Roland Schertenleib
    • 2
  • Chris Zurbrügg
    • 2
  • Brigit Obrist
    • 1
  • Agnès Montangero
    • 2
  • Narong Surkinkul
    • 3
  • Doulaye Koné
    • 2
  • Antoine Morel
    • 2
    • 3
  • Guéladio Cissé
    • 4
  • Thammarat Koottatep
    • 3
  • Bassirou Bonfoh
    • 4
  • Marcel Tanner
    • 1
  1. 1.Department of Public Health and EpidemiologySwiss Tropical InstituteBaselSwitzerland
  2. 2.Eawag: Swiss Federal Institute of Aquatic Science and TechnologyDepartment for Water and Sanitation in Developing Countries (Sandec)DuebendorfSwitzerland
  3. 3.School of Environment, Resources and DevelopmentAsian Institute of TechnologyKlong LuangThailand
  4. 4.Centre Suisse de Recherche ScientifiqueAbidjanCôte d’Ivoire

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