Environmental Health Work: Innovations

Bangladesh: Assessing sustainability of sanitation approaches

The Manoff Group recently directed a major study for The World Bank Water and Sanitation Programme (WSP) in Bangladesh on the sustainability of various sanitation program approaches, including Community-Led Total Sanitation (CLTS) and three others. Activities took place in 50 unions (districts) that had been declared Open Defecation-Free (ODF) four to five years earlier to assess whether they had maintained ODF status.

Research methods included a 3,000 household survey, several qualitative methods, and observation of latrines and open defecation sites. The report introduces important new sanitation findings with applications not only to Bangladesh, but internationally.

(photo: Better-quality latrine in Bangladesh)


Romania: Reducing child lead poisoning

In the mid-1990s, The Manoff Group participated in an activity of the USAID-funded Environmental Health Project to address extremely serious air pollution and child lead-poisoning problems in Zlatna, Romania, home of a large copper smelter and refinery. With local partners, we organized in-depth formative research, including focus group discussions with eight- to ten-year-olds, and developed community participation and communication activities. The community cleaned up children's play areas and embraced many actions at home that reduced lead exposure.

These actions resulted in a reduction of children's blood-lead levels by more than 30%. In less than two years, the population's knowledge of how to avoid exposure increased from 17% to 78%. A significant portion of families adopted new behaviors to protect themselves and their families from environmental lead: washing hands before meals and before entering the house, cutting fingernails three or more times per week, and washing toys.


The Ripple Effect: Monitoring and evaluating innovative water delivery and storage


The Manoff Group is responsible for the qualitative research portion of a largely qualitative real-time assessment of a Gates Foundation project: a private sector/NGO pairing of IDEO, a leading design firm, with Acumen, an NGO that funds and assists social entrepreneurs, to help grantees in India and Kenya design and test innovations in water delivery and storage to bring potable water to 500,000 poor Indians and East Africans.

The analysis focuses on the contribution of the partnership in achieving the project’s goals. The Manoff Group is using individual in-depth interviews, observation, participant observation, and other methods. Research is taking place in India in Hyderabad, Ahmedabad, Bangalore, and Rajastan; and in Kenya in Nairobi and Kisumu (western Kenya).


West Bank/Gaza: Unconventional approaches to improve child health

The Manoff Group led an EHP activity in West Bank and Gaza to improve child health by reducing incidence of diarrhea and other water-borne diseases, aimed at reaching 442,785 beneficiaries throughout the West Bank and Gaza.

Formative Research Reveals Potential Improved Practices

A series of Trials of Improved Practices (TIPs) were conducted based upon an initial round of formative research into motivations and barriers to improved hygiene-related practices, and were used to define feasible best practice messages that could lead to improved health. A series of counseling and reminder materials for hand washing, home management of diarrhea, and home-based water disinfection were developed and pre-tested based upon results from TIPs.

Reaching water tanker drivers to improve water quality

Research also revealed that water contamination was occurring in the tankers, so we focused on tanker drivers to achieve behavior change in their water handling and tanker cleaning practices, in collaboration with the Palestinian Water Authority (PWA). A best practices training for a total of 50 water tanker drivers focused on water tanker drivers’ behavior handling water at the source and during delivery to the house, examined the drivers’ role in preserving the quality of the water, suggested methods for drivers to better maintain their vehicles, and promoted drivers' chlorinating the water delivered in their tankers, if necessary.

(Photo: Tanker driver with his truck.)

Child-to-child activities to engage students

The project implemented Child-to-Child activities with over 1,000 students focused on hygiene behaviors that mirrored activities underway in the wider community at selected schools in the West Bank and Gaza. Sanitation infrastructure work was completed at 22 schools throughout the project area to support improved hygiene practices.