Formative research for a One Health, animal-inclusive approach to Community-led Total Sanitation in rural Mali

SSRN Electronic Journal · 2026-01-01

Towards Sustainable Shelter Systems in Climate‑Vulnerable Settlements: Performance of Jute‑Based Composite Housing

SSRN Electronic Journal · 2026-01-01

Videography of pathways for enteric pathogen exposure among children in urban informal settlements in Fiji and Indonesia

BMC Public Health · 2026-04-07

Children in urban informal settlements are vulnerable to enteric pathogen exposures due to inadequate availability of clean water, sanitation, and wastewater treatment. These exposures can contribute to diarrhea, malabsorption, and poor growth. Understanding how children interact with their environments – particularly through mouthing behaviors – can help identify high-risk environmental sources, exposure pathways, and opportunities for intervention. The objective of the study is to characterize mouthing behaviors among young children and assess the environmental contexts in which these behaviors occur, in order to identify potential pathogen exposure risk. Two videography campaigns were conducted involving 192 children under five years old (106 in Fiji and 86 in Indonesia), with a mean observation duration of 4.1 h per child. Mouthing behaviors were recorded along with the environmental context (location and presence of risk factors (i.e., near human or animal feces, close to animals, or interacting with environmental water)). All children mouthed objects during observation. Mouthing frequencies were similar across countries: 68.6 contacts/h in Indonesia and 68.2 contacts/h in Fiji. Most frequently mouthed objects were food (25.5 in Indonesia, 16.9 in Fiji), fomites (17.4 and 24.4), and the child’s own hand (17.6 and 20.4 contacts/h). Outdoors, mouthing was common: 98% of Indonesian children and 91% of Fijian children, with frequencies of 58.9 and 50.1 contacts/h, respectively. Indonesian children spent significantly more time outdoors (26.3 vs. 8.2 min/h; p < 0.001). High-risk contexts were observed in 66% of children in Fiji and 93% in Indonesia, with over half mouthing objects while in these settings. Systematically incorporating contextual information on the settings where mouthing occurs, enables a broader understanding of children’s potential pathogen exposure risks through child-environment interactions.

Additional file 1 of Videography of pathways for enteric pathogen exposure among children in urban informal settlements in Fiji and Indonesia

Figshare · 2026-04-07

Supplementary Material 1: Figure S1. Child mouthing: intersection of objects mouthed (number and proportion of children observed and median of mouthing frequency), location, and context. Risky contexts defined as proximity to feces or animals, or interaction with environmental water. Figure displays the three most-commonly mouthed object groups that remain consistent across all intersections; full breakdown of remaining object groups is provided in Tables S10 and S11. Table S1. Pre-consent survey completed prior to the video-observation day. Table S2. Main survey completed during the video-observation day. Table S3. Child characteristics, by campaign and country (a); child behavior change during filming as reported by caregiver and fieldworker (b). Table S4. Caregiver characteristics and reports of child activities. Table S5. Wilcoxon Rank Sum test results comparing age group, mobility group, and sex within countries, and country comparison for children time outdoors; age group, mobility group, sex, and location within countries, and country comparison for all mouthing frequency; and country comparison for frequency of all mouthing during a high-risk context. Table S6. Mouthing frequency (contacts per hour), by country, age, mobility, sex, and campaign. Table S7. Time spent outdoors, by country and age, mobility, sex, and campaign. Table S8. Time spent at outdoor locations by country, sex, age and mobility. Table S9. Summary of Pearson’s Chi-squared test with Yates’ continuity correction (age and sex for each country) for proportion of children engaged in each high-risk context. Table S10. Number of children observed mouthing any object when they were outdoor vs indoor as a proportion of all children, number of children observed mouthing outdoor vs indoor in each context (as a proportion of children observed mouthing in each location), and number of children observed mouthing specific object-groups in each location-context setting (as a proportion of children observed mouthing in each location-context setting). Table S11. Median and interquartile range (IQR) of children all-objects mouthing frequency, mouthing frequency when outdoor vs indoor, mouthing frequency when outdoor vs indoor in a high-risk/other context, and mouthing frequency for each object-groups in each category of location and context.

Development and implementation of an animal-inclusive Community-led Total Sanitation program for rural Mali

SSRN Electronic Journal · 2026-01-01

Associations Between Floor Material and E. coli Contamination in Rural Bangladeshi Households

SSRN Electronic Journal · 2025-01-01

User experiences with Food Storage in a Meatsafe (Mesh-Covered Food Storage Cabinets) in an Informal Settlement in Dhaka, Bangladesh

Research Square · 2025-12-12

Who has sheds? Exploring practices and determinants of overnight housing for backyard poultry in rural Bangladesh to inform an intervention to limit exposure to poultry and poultry feces

PLOS Global Public Health · 2025-07-22 · 1 citations

Backyard poultry-rearing contributes to income and food security for rural households in low- and middle-income countries. However, poultry are often kept inside the household dwelling at night, posing health risks to the people raising them. Housing poultry separately from the dwelling overnight is a potential intervention to limit exposure to poultry. The aim of this study was to describe practices and determinants of overnight poultry housing in rural Bangladesh as formative research for an intervention to separate young children from poultry and poultry feces. We conducted 19 transect walks in villages across Bangladesh to document overnight housing practices among backyard poultry raisers. We then conducted 27 semi-structured interviews to explore poultry-raising practices, including housing types and materials identified during transect walks. We found overnight poultry housing both inside and separate from the dwelling and found that most poultry raisers who kept their birds separate from the dwelling overnight did so in courtyard sheds. There was a preference and willingness to house birds outside, provided a shed was available, although overnight housing practices fluctuated. Having a shed was a function of household resources, including availability and access to materials and skilled labor, available physical space, area- and village-wide trends, and the preferences and concerns of poultry raisers. We recommend that future studies measuring human exposure to poultry and poultry feces assess exposure prospectively and at regular intervals to capture variations in housing practice, and include assessments of poultry housing hygiene practices. The promotion of sheds for overnight poultry housing may be an acceptable intervention approach in this setting, though programs will need to make recommendations for housing that address the risk of zoonotic disease transmission and accommodate the preferences and constraints of poultry raisers over a one-size-fits-all approach.

Evaluation of a multicomponent child development intervention delivered through the government health system: a feasibility study

BMJ Global Health · 2025-07-01

INTRODUCTION: Small efficacy trials have demonstrated that multicomponent interventions can improve early child development. We evaluated the large-scale delivery of a multicomponent intervention delivered by government health workers throughout a rural subdistrict in northwestern Bangladesh. METHODS: We evaluated a group-based, multicomponent intervention with a curriculum covering responsive parenting, caregivers' mental health, lead exposure prevention strategies at the household level, water, sanitation, hygiene and nutrition. Group sessions were held throughout a rural subdistrict of Bangladesh (August 2019-March 2020). A longitudinal sample of caregivers (n=517) of children 6-24 months was assessed at baseline and endline (primary cohort), and 1179 additional caregivers were assessed only at endline (supplementary cross-sectional). Outcomes were the variety of child play activities and materials, number of books, caregiver depressive symptoms and nutrition and lead knowledge. For primary analyses, we used difference-in-difference. RESULTS: Over half (n=276, 53%) of the cohort participants attended any of the 16 intervention sessions and of these, 83% (228) attended 2+. Caregivers attending 2+ sessions, compared with ≤1 session, had more play materials (adjusted mean difference: 0.58; 95% CI: 0.30, 0.85) and were more likely to have any children's books (adjusted prevalence difference (aPD): 0.26; 95% CI: 0.18, 0.34), to have heard of lead (aPD: 0.13; 95% CI: 0.07, 0.19) or to know how to avoid harm from lead (unadjusted PD: 0.13; 95% CI: 0.08, 0.17). These findings were similar to those from the supplementary cross-sectional analysis. There were no differences in caregiver depressive symptoms in either analysis. More child play activities and nutrition knowledge were associated with attendance in the cross-sectional sample. CONCLUSIONS: A multicomponent child development intervention delivered by government health workers increased the presence of children's toys and books and caregiver knowledge of lead in families who attended two or more sessions. Further adaptation and alternative delivery methods are likely to improve the reach and the breadth of impacts. TRIAL REGISTRATION NUMBER: NCT04111016.