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The Water Institute at UNC to help revolutionize global health care by 2030

Researchers at UNC’s Gillings School of Global Public Health know what they want the world to look like by 2030, and with a new study, they are providing the data to help countries get there. 

In the study "Environmental conditions in health care facilities in low- and middle-income countries: Coverage and inequalities", researchers investigated the states of health care facilities across developing nations in an effort to provide tangible information about the 17 Sustainable Development Goals set forth by the United Nations. The study was a more extensive look into a World Health Organization report from 2015, written by Jamie Bartram, a UNC professor of environmental sciences and engineering and director of The Water Institute at UNC, and his research partner Ryan Cronk, a graduate research assistant with the institute. 

“Our goals were to shed light on the status of water, sanitation, hygiene and environmental conditions in health care facilities in developing countries,” Cronk said.

The Sustainable Development Goals include benchmarks of 17 areas that the U.N. hopes the global community can achieve by 2030. They were made in the image of the Millennium Development Goals — eight goals that all 191 U.N. member states agreed to achieve by 2015. Improving environmental conditions, Cronk said, is vital to achieving the new SDGs.  

The researching team looked broadly at the factors that affect environmental health, including the state of health care facilities, but namely UNICEF's three core issues known as "WASH" — water, sanitation and hygiene conditions . Addressing these issues is vital to preventing the spread of infectious diseases, so the availability of standard precautionary items, such as gloves and medical gowns, was also considered.

By using systematic review of existing statistics, the team searched in global databases for gaps in proper environmental conditions and standard precautionary items in developing countries. 

The research team identified six countries for which this information was not available: Tanzania, Haiti, Senegal, Bangladesh, Nepal and Malawi. Only 2 percent of health care facilities in the six countries reached all of the U.N.’s health care standards.

Cronk was especially surprised by the absence of safe piped water in about 50 percent of facilities studied. Many services, including childbirth and associated procedures, require large amounts of water that must then be unreliably harnessed by other means.

Amy Cooke, teaching associate professor and director of undergraduate studies for environment and ecology, was a Peace Corps volunteer in Tanzania. 

“Having spent much time in the villages, with very little access to sanitation, I am not surprised in the least,” she said. “I’m disheartened but not surprised.”

During Cooke's class “Water Resource Management and Human Rights”, she said she cannot underestimate the importance of access to clean and reliable water. She teaches about these systems in the context of the Sustainable Development Goals as well. Despite dire statistics, Cooke said these goals provide important interim goals the global community can strive to reach.

Since the Millennium Development Goals were announced in 2000, the environmental health community has seen a lot of improvement, Cooke said. Even since the publishing of The Water Institute's studies Cronk said she has seen a variety of actors mobilizing to raise awareness for these environmental health disparities.

Aid to governments has increased, research has become more action-oriented and low and middle income countries have begun integrating these principles into their policy, programming and practice, Cronk said.

At UNC’s own Water Institute, students from a variety of academic disciplines collaborate to produce these studies. This interdisciplinary approach is vital to progress, Cronk said.

“Having people from diverse backgrounds can definitely help to solve these challenges,” Cronk said. “It’s something that can be tackled in a multifaceted way.”

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