Effectiveness of Emergency Sanitation Strategies in Disaster Prone Areas of Africa: A Systematic Review

Introduction Gap analyses conducted in emergency Water, Sanitation and Hygiene (WASH) interventions have pinpointed essential obstacles to the effective implementation of sanitation in disaster scenarios. This systematic review aimed to gather and consolidate evidence on the effectiveness of emergency sanitation strategies in areas that experience disasters. Methods We systematically searched for articles in the ReliefWeb, International Organization for Migration (IOM), World Health Organization (WHO), United Nations Office for the Coordination of Humanitarian Affairs (OCHA), Google Scholar, PUBMED, Directory of Open Access Journals (DOAJ), BASE (Bielefeld Academic Search Engine), Web of Science, Scopus, Cochrane Library, Hinari, Medline, and African Index Medicus databases guided by the acceptable best practice developed by the PROSPERO and COCHRANE for systematic search and selection of articles. A search string was applied across these databases, using Boolean operators to differentiate the key terms. In addition, a PRISMA flow diagram was used to elaborate on the number of articles retrieved, retained, excluded and reasons for every action. Studies that evaluated emergency sanitation strategies in disaster areas of Africa, which were interventional in nature were included in this review. A mixed method appraisal tool was used to appraise studies. Results Six articles met the eligibility criteria. Out of the 6 articles, only three reported the challenges faced during implementation of emergency sanitation interventions during an emergency particularly in response to cholera outbreaks. The findings from all the studies have not directly specified the sanitation strategies suitable for specific disaster type. However, the nature of the emergency context (e.g. displaced populations, poor water quality, makeshift facilities) allows to infer suitability for specific disaster types. One study found that 87% of the drinking water sources tested were contaminated with fecal matter, which was likely a major contributor to the continued cholera outbreak. However, emergency sanitation measures introduced in response showed a positive impact (water testing and treatment, chlorine sprayers, waste incineration, water storage tanks and health promotion), reflected by a downward trend in cholera cases, As was seen in the epidemic curve Conclusion This systematic review emphasizes that while emergency sanitation measures in Africa have considerable potential to lessen disease spread during disasters, their effectiveness is frequently hampered by contextual, logistical, behavioral, and infrastructural challenges. The success of these measures is closely linked to prompt execution, cultural relevance, fair distribution of resources, and ongoing community involvement.