Towards a multi-scale, socio-technical view of the design and evaluation of water, sanitation, and hygiene infrastructure

Abstract

Water, sanitation, and hygiene (WASH) are important prerequisites to human health, yet global investments in this infrastructure do not always deliver the expected benefits. The relationships between WASH and health are complex, and not fully accounting for these complexities in the design and evaluation of interventions may be limiting implementation success. In this dissertation I help the WASH sector reimagine how infrastructure can be engineered and its contributions to health and level of service measured. I propose greater implementation of a multi-scale, socio-technical perspective of infrastructure in the design and evaluation process. I present a diverse collection of research projects, each with a different scope, scale, and/or evaluation technique linked to evidence-based design suggestions. I conclude by reflecting on key conventions underlying WASH infrastructure development – namely, the use of the term community and the application of global technical WASH standards – to further demonstrate the value of a multi-scale, socio-technical approach. Chapter 3 of this dissertation has been accepted for publication but is not the Version of Record. It includes some but not all of the modifications requested in the peer review process and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: http://dx.doi.org/10.1038/s44221-023-00112-6. Use of this Accepted Version is subject to the publisher’s Accepted Manuscript terms of use https://www.springernature.com/gp/open-research/policies/accepted- manuscript-terms