Evidence on the Effectiveness of Water, Sanitation, and Hygiene (WASH) Interventions on Health Outcomes in Humanitarian Crises: A Systematic Review

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Water, sanitation, and hygiene (WASH) professionals operating in humanitarian response must deliver interventions ranging from safe and sufficient drinking water provision to efficient wastewater and excreta removal methods in extremely unstable and insecure contexts (e.g., temporary sites with shifting water tables). This review examined the quantity and quality of evidence on WASH interventions on health outcomes in humanitarian crises, as well as evaluated current evidence on the effectiveness of WASH interventions on health outcomes in these contexts. Of nearly 4000 papers initially retrieved, only 6 measured a statistically significant change in health outcome as a result of a WASH intervention. Of these, only half (3 studies) were graded as providing high quality evidence; 2 studies provided moderate and 1 study low quality evidence. Detailed analysis of study type and design, as well as methods and results, are provided for each of these studies. The current evidence base on the impact of WASH interventions on health outcomes in humanitarian crises is extremely limited, and numerous methodological constraints limit the ability to determine associative, let alone causal, relationships.

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