Control of schistosomiasis transmission in small holder irrigation scheme

Overall goals

The Small Holder Irrigation Project was intended to bring engineers and health practitioners together for control of schistosomiasis in newly established irrigation schemes. The engineers were influenced to design structures that minimized stagnation of water and allow periodic drying of canal and night storage dams to desiccate snails while health practitioners ensured that there were appropriately located toilets in the irrigation plots and at homesteads to reduce contamination of the environment. Boreholes were provided to provide safe water. Agriculturalists were influenced to design cropping regimes that allowed periodic drying of certain parts of the irrigation schemes – the so-called block irrigation system

Tackling infection to benefit Africa (TIBA) – Collaboration with  colleagues in 9 countries; Uganda, Sudan, Kenya, Tanzania, Rwanda, Zimbabwe, South Africa, Botswana and Ghana

Water sanitation and hygiene (WASH) behaviours and practices in rural South Africa.

Research Question
The main research question for the proposed study is “How are WASH behaviours and practices influenced by psychosocial, contextual and institutional factors in Ingwavuma, uMkhanyakude district?” To find answers to this main question several sub-questions have been posed:
1. What is the population’s access to and utilization of improved WASH facilities in Ingwavuma and hand washing behaviours?
2. How do institutional factors influence WASH in Ingwavuma?
3. How does psychosocial and contextual factors influence WASH?
4. What is the appropriate WASH intervention framework for Ingwavuma community?

Key UK Colleagues and Partners

University of Edinburgh
Hydraulics Research, UK

International Partners

The suggested proposal will join an established project which is a collaboration with colleague’s in the context of an NIHR grant called TIBA (Tackling Infections to Benefit Africa). The project involves 9 African countries including South Africa.
The proposal will consider the impact of the irrigation scheme to control schistosomiasis on children and women’s mental health and wellbeing. The above projects are already established. Our plan will be to use my expertise in mental health and wellbeing to assess impact of such an intervention on family wellbeing. Collaboration in the 1990s was in the context of controlling schistosomiasis in small holder irrigation schemes using environmental and engineering methods. This involved designing irrigation with appropriate disease mitigation structures and providing safe water for farmers.

Sustainable development goals

• SDG 2 - Zero hunger
• SDG 3 - Good health and well-being
• SDG 5 - Gender equality
• SDG 6 - Clean water and sanitation
• SDG 13 - Climate action
• SDG 17 - Partnerships for the goals

Funding source

TIBA funds were obtained in a competitive manner by responding to an NIHR call
Smallholder irrigation project funds were provided by Hydraulics Research, the Ministry of Health for Zimbabwe and the Ministry of Agriculture for Zimbabwe.

Project origin

For the small holder irrigation project, the ministry of Africulture, Zimbabwe secured funding from Hydraulics Research to implement a small holder irrigation project. We (health specialists) persuaded the engineers and agriculturalists to take into account health concerns during design and operations of the project. We also offered to monitor the situation of schistosomiasis over years to see if the designs were effective.

Evidence of need

TIBA partnership arose from many years of individual collaborations on vector borne diseases. The University of Edinburgh identified 8 other African partners and developed the proposal jointly.
For the small holder irrigation project, the ministry of Africulture, Zimbabwe secured funding from Hydraulics Research to implement a small holder irrigation project. Health specialists raised the issue of health concerns with engineers and agriculturalists during the design and operations of the project. Monitoring of schistosomiasis over time is planned.

Project areas

Surveillance, diagnosis and treatment of infectious diseases.

Project activities

The Small holder irrigation project ended in late 1990. A grant to evaluate the effectiveness of the designs, was awarded 10 years later (in 2000)  from British Overseas Development Agency. TIBA started in 2017 and we hosted an Annual General Meeting in May 2018 which brought together all the 9 participating countries, stakeholders and funding agencies. This was hosted in Durban South Africa.

Changes

The Small holder irrigation project changed the lives of poor marginalized communities by making them more productive in a healthier environment
TIBA is making an impact at policy level and at the community level by contributing to national, regional and international policies and guidelines and reducing population risk to neglected tropical diseases.

Next steps

Discussions as to how to incorporate assessment of wellbeing in the current project are ongoing.
The use of global wellbeing questionnaires such as Strength and Difficulties Questionnaires’ before and after intervention will be a way forward.
The number of cases of schistosomiasis before and after the intervention.
Measurement of Quality of life for children and mothers.

Challenges

n/a

Mitigating challenges

The ecohealth (ecoproblem) approach is used, which puts health/problem in the centre to address that in the context of the total environment including social/cultural/political. The major challenge associated with this approach is limited funding as the approach requires genuine engagement with communities and stakeholders who may have divergent expectations.

Partnership principles

• strategic
• harmonised
• effective
• respectful
• organised
• responsible
• flexible

Project gains

• leadership
• teamwork
• academic
• patient
• resilience