Interdisciplinary research on environmental sanitation and health: Conceptual framework development and field test

We developed a conceptual framework for improving health and environmental sanitation using an approach that combines health, ecological, and socio-economic assessments. The framework has three main components: health status, physical environment, and socio-economic environment. Information on each of these three components can be obtained using standard disciplinary methods and an innovative combination of these methods. Analyses based on this framework lead to extended characterisation of health, ecological, and social risks, while enabling comprehensive identification of critical control points. Interventions based on comprehensive analysis take account of biomedical, engineering, and social-science perspectives or a combination of them. Moreover, such interventions encompass not only technical solutions but also behavioural and social changes which are derived from the resilience patterns identified during the analysis. The framework was conceptualised and validated for the context of urban and peri-urban settings in developing countries, focusing on different types of waste such as excreta, wastewater, and solid waste, as well as their influence on food quality and their related pathogens, nutrients, and chemical pollutants. We tested the framework in a case study in northern Vietnam, where we conducted a combined assessment of the impacts of human excreta and wastewater reuse in agriculture on health, the environment, and society. The aim was to propose sustainable and adapted interventions for improving health and environmental sanitation. Impact on health was assessed based on epidemiological and microbial risk analyses. Environmental impact was assessed for both sanitation and agriculture systems, with a focus on nutrient flows. Perceptions and behaviour regarding health risks were evaluated, along with people’s ability to prevent health risks. Our contribution will present results from this case study and insights regarding interventions proposed.