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Resource recovery and reuse (RRR) of fecal sludge (FS) from onsite sanitation systems describes the concept of turning human waste into valuable end products. However, studies on peoples' perceptions of FS-derived products are still limited. Guided by the knowledge, attitudes and practices framework, and data from a survey of 395 households, focus group discussions and key informant interviews, this article explores how residents in three unplanned settlements of Dar es Salaam, Tanzania view FS RRR (FS-RRR). Results indicate that residents' knowledge about FS-RRR is moderately low. Moreover, residents generally have negative attitudes toward using FS-derived products, except for those not directly consumed, such as biogas or FS-briquettes. Additionally, only a few residents have engaged in any FS-RRR practices. We conclude that to increase local acceptance of FS-RRR will require significant efforts by a multitude of actors, not least to dispel myths linked to human waste, but also to raise awareness and demonstrate the benefits and safety of FS-derived products. The Tanzanian government must take the lead in this process and should start by prioritizing the improvement of fecal sludge management (FSM) to enable such a shift. HIGHLIGHTS The existing knowledge, attitudes and practices on fecal sludge resource recovery and reuse among residents were explored in three selected unplanned settlements.; Low-to-moderate knowledge of resource recovery and negative attitudes have been identified.; Training, awareness campaigns, public participation and private sector involvement are recommended.

The concept of resource recovery, particularly from waste has recently gained much attention and popularity. The aim of this study was to quantify the potential economic and environmental benefits of recovering nutrients and energy from faecal sludge (FS). The empirical data were collected from three unplanned settlements of Dar es Salaam City at Keko, Kipawa and Manzese. Two scenarios were developed to recover nutrients and energy. The estimations of potential amounts of compost and char briquettes were performed by using the resource value mapping (REVAMP) tool. Results from REVAMP indicated daily economic benefits across the study areas ranging between 680 and 950 USD for energy and up to 7,000 USD for nutrients recovered, based on the faecal sludge composition. In general, FS derived compost was found more profitable than FS derived briquettes. The analyzed environmental benefits include saving the estimated to 5 hectares of forest area from being cut when substituting the use of wood charcoal with FS-derived briquettes. Since the composting process resulted to be more profitable option between the two, this study recommends the adoption and scaling up. However, guidelines and standards should be developed for proper practices. Keywords: Faecal sludge; resource recovery; resource value mapping; briquettes; compost; economic benefits; environmental benefits

OBJECTIVE: To identify and examine barriers to midwife-led care in Eastern Africa and how these barriers can be reduced DESIGN: A qualitative inductive study with online focus group discussions and semi-structured interviews using content analysis SETTING: The study examines midwife-led care in Ethiopia, Malawi, Kenya, Somalia, and Uganda -five African countries with an unmet need for midwives and a need to improve maternal and neonatal health outcomes. PARTICIPANTS: Twenty-five participants with a health care profession background and current position as a maternal and child health leader from one of the five study countries. FINDINGS: The findings demonstrate barriers to midwife-led care connected to organisational structures, traditional hierarchies, gender disparities, and inadequate leadership. Societal and gendered norms, organisational traditions, and differences in power and authority between professions are some factors explaining why the barriers persist. A focus on intra- and multisectoral collaborations, the inclusion of midwife leaders, and providing midwives with role models to leverage their empowerment are examples of how to reduce the barriers. KEY CONCLUSIONS: This study provides new knowledge on midwife-led care from the perspectives of health leaders in five African countries. Transforming outdated structures to ensure midwives are empowered to deliver midwife-led care at all healthcare system levels is crucial to moving forward. IMPLICATIONS FOR PRACTISE: This knowledge is important as enhancing the midwife-led care provision is associated with substantially improved maternal and neonatal health outcomes, higher satisfaction of care, and enhanced utilisation of health system resources. Nevertheless, the model of care is not adequately integrated into the five countries' health systems. Future studies are warranted to further explore how reducing barriers to midwife-led care can be adapted at a broader level.

Desludging is considered a key step in urban sanitation improvement. Nevertheless, in most urban unplanned settlements, desludging is performed in an unhygienic manner, risking public health. This study used a combination of qualitative and quantitative methods to analyse the underlying factors for unhygienic desludging in three urban unplanned settlements of Dar es Salaam, Tanzania. Factors for unhygienic desludging were analysed using logistic regression analysis and the Integrated Behavioural Model for Water, Sanitation and Hygiene (IBM-WASH), respectively. It was found that 23.7% of the surveyed houses practised unhygienic desludging. Plot physical inaccessibility, outdated laws that stipulate low penalties and the lack of routine data were found to be key contextual factors. Furthermore, perceived inability to control unhygienic desludging among community members and the lack of feeling of shame among those performing unhygienic desludging are the key psycho-social factors. Technological factors contributing to continued practice of unhygienic desludging can be linked to the weakness in existing desludging technologies and general skepticism about the performance of manual desludging hand pumps. This paper concludes that unhygienic desludging in Dar es Salaam is likely to continue unless such factors are considered and integrated into the city's sanitation improvement plans.

Cities in the developing world face the challenge of safe management of faecal sludge because of rapid population growth that overwhelms the sanitation infrastructure and services. In developing countries, only 50% of faecal sludge (FS) generated is safely managed the remaining portion is haphazardly disposed of in the environment risking public health and environment. In response to the urgent need for safely managed sanitation services, technological options for containment, desludging and transportation of FS are being modified. This paper reviewed current desludging practices and the potential of modified technological options for addressing FSM at containment, desludging, and transportation in Dar es Salaam unplanned urban settlements. The paper reviewed; water seal squat pan, Urine Diversion Dry Toilet (UDDT), split slabs, pre-installed suction hose, and the container-based sanitation (CBS) for containment stage. Others are the hand tools, sludge digger, the excrevator, rammer, and the eVac for desludging; and small pick-up truck and motorized tricycle and transfer stations for transfer and transportation of FS. Based on technical feasibility, social and environmental context of Dar es Salaam, the reviewed modified technology options have the potential of addressing FSM challenges in unplanned urban settlements in Dar es Salaam. However, institutional arrangement particularly the absence of the modified technologies in the menu of recommended technological options affects their upscaling. Paradoxically, most of the technologies have not been vigorously tried in the field to inform policy choice. Improvement of FSM with the application of modified technological options will require improvement in enabling environment for their operation and continuous modification. The major research gaps have also been identified in this review. Keywords : Containment, Desludging, Faecal Sludge Management, Modified technology options Non-sewered sanitation.

Worldwide, every day human beings generate millions of tons of Faecal Sludge (FS), which is rich in water, nutrients, energy, and organic compounds. Yet FS is not being managed in a way that permits us to derive value from its reuse, while at the same time, millions of farmers struggle with depleted soils and lack of water. In most of the developing countries, energy for cooking is mainly derived from cutting of trees, either as wood or charcoal. Resource recovery and reuse from FS can create livelihoods, enhance food security, support green economies, reduce waste and contribute to cost recovery in the sanitation chain. Many studies have reported on the different technologies used for FS treatment, such as dewatering and bio-stabilization. The commonly used dewatering technology is sand drying bed, which occupied a large space and has a low dewatering rate. To enhance the dewatering rate of FS as well as reducing the size of the sand drying bed, the use of chemical conditioners has been done. Despite the fact that they have been used successfully, chemical conditioners are expensive, have health and environmentally hazardous. In recent years, attempts have been made to use local conditioners to tackle the drawbacks experienced from chemical conditioners. Although the feasibility of applying local conditioners for FS dewatering has been studied, its potentials on FS treatment have not been well documented. This review indicates that there is potential for local conditioners linked with dewatering, enhancing of FS resources recovery and in reducing costs of operating and maintaining FS treatment plant. Moreover, local conditioners have the potential in contribution to socio-economic development in Tanzania through renewable energy production, income generation and food- health security, soil and water conservation, eco-sanitation and reduction of environmental degradation. Keywords : Faecal sludge, Local conditioners, Resource recovery, Sanitation, Treatment.

In recent years, the concept of resource recovery from waste, particularly faecal sludge (FS) has gained much attention and popularity. The aim of this study is to quantify/estimate the economic and environmental benefits of nutrients and energy that could be recovered from FS. The empirical data come from three unplanned settlements of Dar es Salaam City; Keko, Kipawa and Manzese. Two different FS resource recovery scenarios were assessed, namely nutrients and energy. The resource value mapping (REVAMP) tool was used to quantify benefits of nutrients and energy/solid fuels recovered from FS. The results indicate a daily economic benefit from FS recovery, ranging between 680-950 USD for energy and up to 7,000 USD for nutrients recovered, depending on the composition. The co-composting of FS with organic waste to recover nutrients was found more profitable than FS derived briquettes. The environmental benefits, beyond the disposal of untreated FS into the local environment, include a potential saving of up to 5 hectares of forest area when substituting the use of wood charcoal with FS-derived briquettes for domestic cooking energy needs. Even here, co-composting FS is estimated to be more profitable than FS derived briquettes. The study concludes that to obtain FS derived briquettes with high calorific value, FS should be co-fuelled with other feedstock materials. Guidelines and standards for safe re-use of FS derived products should be developed, adapted and information campaigns and demonstration sites to illustrate the economic and environmental benefits of resource recovery from FS for energy and agricultural purposes should be made available to relevant stakeholders

The use of High Rate Algal Ponds (HRAPs) for the treatment of wastewater and resource recovery has raised interest in recent years. Treatment of wastewater through this technology has proved to have high efficiency in reducing the level of pollution, nutrients, dissolved solids as well as pathogens. HRAPs are more efficient than conventional Wastewater Stabilization Ponds (WSPs) due to their design approach that provides room for high rate bio-chemical processes, which increase the mechanisms of nutrients and pathogens removal as well as the rate of micro-algae production for purposes of resource recovery. This paper reviews the upgrading potential of existing WSPs to HRAPs for resource recovery from products of wastewater for biofuel production, as a plant nutrient or for irrigation purposes and animal feeding. Several results have reported HRAPs to have efficiency in reducing bacterial contamination in excess of 99% while the removal of organic matter of up to 84% for Chemical Oxygen Demand (COD) and 88% for Biochemical Oxygen Demand under normal conditions have been reported. The removal for nitrogen was indicated to vary from 50 t0 98% while that of phosphorus varies from 32 to 99% depending on the culture conditions. It was further noted that, the potential for resource recovery from HRAPs is high in terms of energy and nutrients recovered through algae biomass, particularly for biofuel and animal feed production. Whereas among the dominant algal species of the HRAP Chlorella vulgaris revealed to have suitability in both treatment of wastewater and achieved a higher effluent quality and having nutrients contents essential for lipid extraction for biofuel and as a protein source for animal feeding which is largely attributed by their ability to grow very rapidly and to tolerate varieties of cultural conditions. To date, limited research attention has been given to studying the re-use potential of wastewater for irrigation purposes in Africa. Keywords : High rate algal ponds, Wastewater Treatment, Micro-algae, Resource Recovery.

In this work, a conceptual framework for faecal sludge (FS) management and resource recovery in Dar es Salaam city was developed. Material Flow Analysis (MFA) approach was used to assess and quantify the current materials and nutrients to support on decisions for nutrient recovery and minimize environmental pollution in three unplanned settlements of Manzese, Keko and Kipawa in Dar es Salaam city. Nitrogen and Phosphorus were chosen as indicators for the evaluation of the process. The results showed that about 75% of the Dar es Salaam city population relies on pit latrines and 15% connected to septic tanks, translating to a large amount of faecal sludge being contained onsite. The situational analysis study on faecal sludge management (FSM) showed that the collection, treatment and proper disposal of FS are the major challenges that pose risks to public health. Currently, 57% of faecal sludge generated in Dar es Salaam is disposed to the environment inappropriately. Onsite Sanitation Systems in all study areas are the main polluters, discharging large quantity of nutrients to the environment. About 37.7% of faecal sludge is with large amount of nutrients emptied from onsite sanitation systems discharged to the environment and through seepage to the groundwater. Keywords : Faecal sludge; Material flow analysis; Resource recovery; unplanned settlements.

Dysfunctional water, sanitation and hygiene (WaSH) systems are mainly determined by poor water governance, exacerbating inequalities and poverty. Multi-stakeholder partnerships provide an approach to more flexible and adaptive governance to explore these problems. In this article, national commitments made to improve WaSH, made through the Sanitation and Water for All (SWA) partnership's Mutual Accountability Mechanism, are examined through qualitative content analysis and guided by the SMART framework to assess the current target-setting. The analysis reveals that there are differences in the participation of the different constituencies regarding the number of stakeholders participating and their performance for measurable and time-bound commitments. This applies especially to research and learning and the private sector. Countries have prioritized commitments related to policy and strategy, efficiency and enabling conditions; further research should understand the linkages of the SWA commitments with other priority-setting processes at the national level. In sum, the commitments leave room for improvement to specify approaches to water governance in more detail and the chance to support the creation of sustainable and resilient systems with more diversified commitments from a wider range of partners. HIGHLIGHTS The importance of more equal participation of all constituencies needs to be underlined, since there are differences in general participation and performance for SMART goals.; Priorities in presenting certain governance components should be explored further to assess national goal-setting thoroughly.; Diversifying commitments could increase the potential of commitments to support creating sustainable and resilient systems.

Sustainable sanitation services are still unavailable to most people in Sub-Saharan Africa (SSA) despite decades of implementing very diverse sanitation projects across the continent. Using a Sustainability Science lens, this chapter identifies through an extended literature review the drivers and shortcomings of business-as-usual sanitation approaches that tend to fail in SSA. As one of the main challenges for the success of sanitation project is the creation of an enabling environment, we attempt to identify some of the critical elements that could support the development of such an environment. Subsequently we identify characteristics and competencies conducive to breaking the cycle of failure and to developing sustainable sanitation systems. We use data from key informant interviews with sanitation implementers, focus group discussions with sanitation facility users and visits to sanitation project sites in Kenya, Tanzania and Uganda. The sanitation approaches explored, although different, are all characterized by their adaptation to the local context, community participation, built-in mechanisms that ensure financial viability, use of technologies that are culturally appropriate and emphasis on environmental sustainability. We offer several policy and practice recommendations for the development of successful sanitation governance structures for national governments, external support agencies and project implementers. The examples discussed in this chapter show promise, but do not guarantee success, as all solutions will require several iterations to adaptate to the local context, as well as financial and governance support, to be scaled up.

In unplanned urban settlements, where onsite sanitation systems are the norm, desludging of faecal sludge (FS) containments is a necessity because of the lack of land space to enable new construction. Poorly designed toilet facilities however may jeopardize the progress towards attainment of safely managed sanitation. This study examined FS characteristics and containment design and their effect on safe desludging with a case of two selected unplanned settlements of Dar es Salaam, Tanzania. The analysis focused on design features for the strength of the containment, access to the containment, and desludging characteristics of the FS. The Desludgeability potential of FS was determined on basis of flow behaviour explained in terms of moisture content and volatile solids. Research results showed that partially lined pits, lack of containment access holes and solid wastes are design and usage features which negatively affect containment strength and potential for safe desludging. The analysis further found that, only 54.8% of containments studied have FS that can be desludged by either mechanized or hand pumps. Pour flush toilets and septic tanks indicated a slightly higher potential for safe desludging compared to traditional pit latrines, however, the difference is not statistically significant (P = 0.180). Thus, safe desludging is a problem across all types of containments. To enhance safe desludging in Dar es Salaam, three key design features and usage ought to be urgently addressed: first, a requirement to ensure that all pits are fully lined inside, second, the mandatory presence of an access hole for FS desludging and third, limitations on solid waste entering the pits.

Vietnam is one of the countries most vulnerable to climate change impacts, especially from extreme weather events such as storms and floods. Thus, climate change adaptation is crucial, especially for natural resource-dependent farmers. Based on a qualitative research approach using a feminist political ecology lens, this article investigates gendered patterns of rural agrarian livelihoods and climate adaptation in the province of Th&aacute, i B&igrave, nh. In doing so, we identify differentiated rights and responsibilities between female and male farmers, leading to unequal opportunities and immobility for females, making them more vulnerable to climate impacts and threatening to reduce their capacity to adapt. This research also shows that demands on farmers to contribute to perpetual increases in agricultural output by the state poses a challenge, since farming livelihoods in Vietnam are increasingly becoming feminised, as a result of urbanisation and devaluation of farming. Past and present national strategies and provincial implementation plans linked to climate change do not consider the burden affecting rural female farmers, instead the focus lies on addressing technical solutions to adaptation. With little attention being paid to an increasingly female workforce, existing gender inequalities may be exacerbated, threatening the future existence of rural livelihoods and the viability of Vietnam&rsquo, s expansion into global markets.

The African continent has been severely affected by the HIV and AIDS pandemic and as a consequence, development is being obstructed. Agriculture and food production systems are changing as a result of the burden of the pandemic. Many farming families are experiencing trauma from morbidity and mortality as well as facing labour losses and exhaustion. To further exacerbate the situation, climate variability and change reduce the available water supply for domestic and productive uses. This article describes how these multiple stressors play out in Nyanza province in Western Kenya and explores livelihood responses to water stress in Onjiko location, Nyanza. In this community, widows and divorced women affected by HIV and AIDS have become agents of positive change. Data from local surveys (2007), mapping of seasonal calendars (September 2009) and numerous focus group meetings and interviews with women in Onjiko (October 2008, January 2010, January 2011), reveal that despite a negative fall-back position, widows are improving their households’ water and food security. This adaptation and even mitigation to some of the experienced climate impacts are emerging from their new activities in a setting of changing conditions. In the capacity of main livelihood providers, widows are gaining increased decision making and bargaining power. As such they can invest in sustainable innovations like rain water harvesting systems and agroforestry. Throughout, they work together in formalized groups of collective action that capitalize on the pooling of natural and human resources as well as planned financial management during hardship periods.

Exposure, sensitivity and adaptive capacity are essential, albeit theoretically vague, components of climate vulnerability. This has triggered debate surrounding how these factors can be translated into, and understood in, an empirical context subject to present and future harm. In this article, which draws on extensive fieldwork in the Lake Victoria Basin of Kenya and Tanzania, we illustrate how exposure, sensitivity and adaptive capacity play out in the context of climate vulnerability and discuss how they interact in situ. Using a mixed methods approach including survey data, rainfall data and a suite of participatory methods, such as focus groups and interactive mapping of seasonal calendars, we identify how climate-induced stressors affect smallholder farmers’ well-being and natural resources. Drawing on the seasonal calendar as a heuristic, and climate vulnerability terminology, we illustrate when, where and how these climate-induced stressors converge to constrain farmers’ livelihoods. Our analysis indicates that farmers in the basin face a highly uncertain future with discernible, but differentiated, adaptation deficits due to recurring, and potentially worsening, patterns of hardship.

Agricultural productivity in East African smallholder systems is notoriously low and food production faces multiple challenges, including soil degradation, decreasing land availability, poor market integration, disease burdens and climate change impacts. However, recent evidence from an in-depth study from two sites in Kenya and Uganda shows signs of new social dynamics as a response to these multiple stressors. This paper focuses on the emergence of local social institutions for collective action, in which particularly women farmers organize themselves. Although previous research on collective action has largely focused on common-pool resource management, we argue that collective action is one potential pathway to livelihood and sustainability improvements also in a setting of private land ownership. Trust building, awareness raising and actions to improve livelihood security through risk sharing and pooling of labour and other limited assets have given people more time and resources available for divers...