Policy, and

We are problem solvers focused on the sustainable management of water for health and human development. We contribute to improving access to safe water, sanitation, and hygiene for all.

News Briefs


Updated Peer-Reviewed Literature on CLTS Available Now

Written as part of a situational assessment process in support of the ‘Testing CLTS Approaches for Scalability’ grant, this 2012 report details findings from a review of literature focused on Community-led Total Sanitation (CLTS) and the role of local actors. Contained within the report are a series of conclusions about CLTS, in addition to identifying knowledge gaps common to both sets of literature, drawn out by comparing the various stages of CLTS implementation in a more systematic and rigorous manner than the existing body of evidence.

CLTS Triggering in Ghana 
Photo/Video by Diana Mrazikova

New CLTS Video Available Now

new video from Plan International and the Water Institute at UNC offers a preview of five exciting lessons on sanitation policy and practice, based on findings from operational research on community-led total sanitation (CLTS). These lessons relate to CLTS planning at the national and local levels, its place in national sanitation systems, and the importance of involving local actors. In particular, government officials, teachers, and natural leaders can play important roles in improving access to basic sanitation, and their involvement can ensure sustainable outcomes over time.


Routledge Handbook of Water and Health

A new handbook on global water and health edited by Water Institute Director Jamie Bartram and public health graduate student Rachel Baum on is now available. Written by a team of expert authors from around the world for interdisciplinary teaching for advanced undergraduate and postgraduate students, “Routledge Handbook of Water and Health” covers both developing and developed country concerns. Sections include hazards, exposure, interventions, intervention implementation, distal influences, policies and implementation, investigative tools, and historic cases.


Best of UNICEF 2015

A study led by The Water Institute at UNC was just named one of the Best of UNICEF Research studies for 2015, based on research that excels at generating knowledge to inform action, shaping policy agendas, and shifting discourse to improve the lives of children everywhere. Only twelve studies were selected by UNICEF for this recognition. “Fecal contamination of drinking-water in low- and middle-income countries: A systematic review and meta-analysis” was selected as a top example of quality research and evidence gathering on children.

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Featured Publications

Private, hand-dug shallow wells in the study site.Private, hand-dug shallow wells in the study site.

Coping Costs of Poor Water Supply

As the disease burden of poor access to water and sanitation declines globally, the non-health costs––mainly the time spent collecting water—will likely grow in importance in sector investment analyses. Measuring these “coping costs” (which also include usage fees and capital costs for storage and treatment) among 387 households in rural Kenya found a median monthly cost of around US$20 (or 12% of cash income). The results suggest more attention should be directed to the non-health benefits of improved water supply as the sector defines and implements new sustainable development goals.




Example of Collapsed Sea Barrier  Photo by Mark ElliotExample of Collapsed Sea Barrier
Photo by Mark Elliot

WaSH Coverage and Climatic Change in PICs

Pacific Island Countries (PICs) have some of the lowest rates of sanitation and drinking water access due to physical isolation and limited resources. Expected climate change impacts will add increased variability in rainfall and rising sea levels. In the Journal of WaSH for Development, we propose an integrated water resource management (IWRM) approach to respond to these challenges. Holistically grasping the relationship among all activities in a catchment offers the best platform from which planners can generate adaptive, sustainable solutions to improve WASH in these vulnerable communities.

Men Digging Pit Latrine  Photo by Vidya VenkataramananMen Digging Pit Latrine
Photo by Vidya Venkataramanan

CLTS in Haiti

Plan International supports Community-led Total Sanitation (CLTS) implementation in two departments in Haiti. In this learning brief and underlying country report, we present the roles of local actors in Plan International’s program activities and highlights considerations for scalability, planning, implementation, and evaluation. Plan International Haiti can lead the effort to determine the viability of CLTS in Haiti by targeting the approach to smaller, more cohesive communities, helping to build the supply chain for sanitation hardware, involving a variety of local actors in the post-triggering stage, and by providing training for multipurpose community health agents to carry out CLTS implementation.

Latrines with Broken Slabs  Photo by Ashley WilliamsLatrines with Broken Slabs
Photo by Ashley Williams

Unsafe Return of Human Excreta

Sanitation facilities are often assumed to create a barrier between humans and excreta; however, this may not be the case if excreta is insufficiently contained or improperly disposed of. Thus, we conducted a literature review of peer-reviewed studies and grey literature to identify pathways of human excreta leaking unsafely into the environment. The fate of collected fecal sludge and the extent of wastewater treatment was not well documented. Future sanitation research should specifically document the location of fecal disposal to aid in characterizing public health risks.

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