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Building resilience to hazards in the water, sanitation, and hygiene (WASH)

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Building resilience to hazards in the water,

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INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH
https://doi.org/10.1080/09603123.2022.2153809

Building resilience to hazards in the water, sanitation, and

hygiene (WASH) systems: a global review
M. Tshumaa, J. A. Belle a
, A. Ncubea, Y. S. Nyama and I. R. Orimoloyeb
a
DiMTEC, University of the Free State, Bloemfontein, South Africa; bThe University of the West Indies, St. Augustine
Campus, Department of Geography, Faculty of Food and Agriculture, Clayton, Australia

ABSTRACT ARTICLE HISTORY

Building the resilience of communities is essential in achieving Received 11 August 2022
Sustainable Development Goals (SDG). Scientific research is crucial in Accepted 24 November 2022
identifying gaps in the development of WASH systems and the manage­ KEYWORDS
ment of WASH-related hazards . The main purpose of this paper was to Resilience; community
analyze the global research evolution on resilience and Water, Sanitation, participation; WASH; hazard;
and Hygiene (WASH) between the period 2003 and 2021. Bibliometric bibliometric analysis
analysis was done through the analysis of research articles from the Web
of Science and Scopus using R Package software A total of 110 articles
were generated from the Web of Science and Scopus databases. The study
revealed that there was very little research on WASH from 2003 to 2010
and a steady increase from 2011 to 2018 and a sharp increase from 2019
to 2020 with a slight drop in 2021. This paper, therefore, recommends
more focused scientific research on WASH issues in Africa and Southern
Africa in particular.

Introduction
UN (2019) puts forward that access to water, sanitation and hygiene is a basic human right and
essential to the well-being of each person, yet 1.8 billion out of 7.8 billion people across the world
still depend on a source of water that is fecally polluted. Therefore, several people around the globe
do not have access to these necessities (WHO and UNICEF 2017). Water, sanitation, and hygiene
challenges are serious phenomena in Sub – Saharan Africa. Unimproved drinking water and
sanitation services are the world’s second principal killer of infants (WHO and UNICEF 2019).
About 159 million people out of 1.8 billion people with limited access to improve water and
sanitation facilities are marginalized rural populations (UN 2019). Most people still depend on
untreated surface water and practicing open defecation is found in rural areas (Etongo et al. 2018).
Open defecation (that is, short of even basic sanitation like a pit latrine) is largely a rural problem,
with 90% of open defecators dwelling in rural areas (UN 2012). A study in three provinces of
Mozambique exposed that 85% of rural families did not use any developed water source for
drinking, while about 55% of rural households practiced open defecation (UNICEF 2019). This
statistic is a reflection of most rural areas where water and sanitation services are very poor owing to
lack of investment or inadequate budgeting by governments and stakeholders as well as a lack of
community participation (Mavhura et al. 2021).
Some analysis of communicable disease outbreaks UN (2019) in the aftermath of disasters
emphasized the role of WASH in common disease occurrences. Water-related pathogens

CONTACT M. Tshuma mlasttshuma@gmail.com DiMTEC, University of the Free State, 58 Wynand Mouton, Universitas,
Bloemfontein 9300, South Africa
© 2022 Informa UK Limited, trading as Taylor & Francis Group
2 M. TSHUMA ET AL.

(Cholerae Shigella) were accountable for 85% of the 50,000 deaths after the abrupt arrival of 800,000
refugees from Rwanda into the Democratic Republic of Congo in July 1994 (Jones et al. 2020). In
recent times, major outbreaks of cholera for example in Haiti in 2010 and hepatitis E in South
Sudan in 2011 have confirmed the complete requirement for quick and well-organized placement of
WASH interventions in emergencies (Als et al. 2020).
In humanitarian crises such as floods, Water, Sanitation, and Hygiene (WASH) are among the
primary problems predominantly in the severe and early recovery stages, when diarrheal sickness
has been found to account for almost 40% of deaths in temporary campsite occupants and 80% of
deaths in children below two years old (Elijah et al. 2017). Flooding worsens WASH problems by
polluting drinking water and destroying sanitation as well as wastewater facilities (Jones et al. 2020).
Given the magnitude of the WASH-related problems and increased frequency of floods as
a result of Climate Change around the globe, there was a need to assess the global research trends
on this fundamental subject to humankind. There is a gap in the literature on the global research
trends, contributions by countries, authors, journals, and institutions in scientific research on
WASH. To date, there is no recorded quantitative research on the global evolution of research on
WASH. Resultantly, this paper used a Bibliometric analysis to quantitatively analyze the global
research evolution between 2003 and 2021. The paper shows a clear picture of research areas that
still need more focus through the word dynamics and co-occurrence network analysis.

Understanding and linking resilience, community participation, and WASH systems

Community resilience is simplified by Pfefferbaum et al. (2017) as the ability of a community to
withstand a shock by using available resources and capabilities. This definition is in line with the
one provided by UNDRR (2022) which emphasizes the restoration of essential basic structures and
functions of a community after a hazard. Once a disaster strikes, it, therefore, becomes incorrect to
refer to community resilience but rather to coping capacities. Building resilience necessarily means
being prepared, and fully equipped in terms of policies being implemented, or bringing to bear all
the capacities (social, natural, physical, economic, and human) to counter vulnerability (Jezeer et al.
2019). The absence of one component weakens the ability to prevent, prepare, mitigate and respond
to a disaster including those that are related to WASH. Community participation is generally the
direct involvement or engagement of the average people in the matters of planning, control, and
total development efforts at the grassroots level and has developed into a fundamental portion of
democratic exercise in modern years (David Alelah and Mueke 2017). It has loosely been described
as the inclusion of local community members in programs to resolve their peculiar challenges or to
build their resilience (Etongo et al. 2018). In several countries, constitutions offer basic frameworks
for empowering the urban local authorities, and rural communities (Hove et al. 2019). The concept
of community participation suggests that local people are not supposed propelled to be involved in
programs that touch their livelihoods but should be allowed to be part of the project.
The motivation behind building resilience through community participation is to allow societies
to be in charge of their resources and to enhance their influence in decision-making (Hove et al.
2019). Community participation can be an apparatus for poverty reduction, removing people from
the deprivation of having to live short of access to safe water and sanitation facilities while at the
same time enhancing development for all (Niederberger and Glanville-Wallis 2019). However,
when water is insufficient in quantity and quality, it can fairly serve as a restrictive issue in poverty
mitigation and economic recovery, causing poor health and small productivity, food insecurity, and
reduced economic growth (Madon et al. 2018). Therefore, what we get out of water hinges largely
upon everything done in terms of its management and use (Krieken et al. 2017).
The WASH concept incorporates all the people, constituent parts, and purposes that are
required to provide critical WASH amenities. The WASH principle comprises all the players
which are the people and institutions as well as all the factors which include infrastructure, finances,
policies, and environmental conditions that influence and move the system (Nicholson 2020).
 INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 3

Worldwide, improved access to safe drinking water remains a dream despite the Millennium
Development Goal objective for clean water being met in 2010, with 663 million people relying
on unimproved water sources (Ashole Alto et al. 2020). Rural areas constitute a bigger percentage of
all people without access to clean and safe drinking water and improved sanitation facilities with 8
out of 10 people depending on unimproved water sources living in rural areas. A total of 159 million
people use unsafe water drawn from lakes, dams, and rivers (Mackinnon et al. 2019).
Out of all-natural hazards, floods have the highest destruction possibility globally and affect the
largest number of people (UN 2015). During flood incidences in less economically developed
nations, years of investments in infrastructure are effectively washed away, extremely cripple
economic fortune, and cause serious loss of life and outbreak of epidemics (Johannessen et al.
2014). Concerning the context, flood flows can be a challenge or even cause a disaster. Floods are
a challenge when the extent and effects of the incident surpass the capability of affected commu­
nities to manage or they become a disaster when a flood incident causes a severe interruption of the
functioning of a community and bring about extensive human, material, economic, and/or envir­
onmental damages, which surpass the aptitude of the impacted society to bounce back with their
resources (UNISDR 2017).
In flood-prone areas especially rural areas, floodwater causes usual water sources to become
inaccessible leading to a lack of access to potable water (WHO 2020). Where communities still
rely on both protected and unprotected traditionally dug wells, flood water enters these wells and
contaminates the water sources (Momberg et al. 2017). In less developed countries that are prone
to flooding, serious damage to sanitation facilities mainly the collapse of toilets as well as the
collapse and clogging of hand pumps have been recorded (Mackinnon et al. 2019). Communities
in flood-prone areas lose non-food household items, bridges and roads are washed away, crops
and food stocks are destroyed, livestock is lost and communication is seriously disrupted (Ohwo
2019).

Materials and methods

A bibliometric methodology was used by performing a bibliometric analysis using the R Package to
meet the aim of this paper (Guo et al. 2021; Donthu et al. 2021). The bibliometric analysis allows for
the management of a huge volume of scientific data as well as yields a high research effect through
quantitative analysis and statistics (Ellegaard and Wallin 2015). “Bibliometric” originates from the
Latin and Greek words “Biblio” and “metrics”, respectively, pointing to the application of mathe­
matics to the study of bibliography. The bibliometric approach has become a cornerstone in the
library and information science field. This study used keywords to generate the bibliography of
published research on resilience, community participation, and WASH from Web of Science and
Scopus databases. From the Web of Science and Scopus databases the following selected keywords
“community participation”, “water and sanitation and hygiene”, “resilience”, “WASH hazards”, and
“WASH disasters” were used. The generated data were analyzed using the R Package bibliometric
software to obtain clear and concise results (Dervis 2019; Guo et al. 2019). The information
downloaded from the Web of Science and Scopus databases included authors, sources, keywords
plus, author’s keywords, period, author appearances, documents per author, author per document,
co-authors per document, and collaboration index. In total, there are 110 original documents on
resilience and WASH that were downloaded and analyzed as shown in Table 1. It is also revealed
that 518 authors have published on WASH.

Results
In this study, annual research on building resilience in WASH was analyzed from January 2003 to
July 2021 using R Programming software. The generated information included authors, titles, years
4 M. TSHUMA ET AL.

Table 1. Data information on WASH studies from 2003 to 2021.

Description Results
Documents 110
Sources (Journals, Books, Etc.) 78
Keywords Plus (Id) 955
Author’s Keywords (De) 286
Period 2003–2021 (July)
Average Citations Per Documents 10,64
Authors 518
Author Appearances 616
Authors of Single-Authored Documents 11
Authors of Multi-Authored Documents 507
Single-Authored Documents 13
Documents Per Author 0,212
Authors Per Document 4,71
Co-Authors Per Documents 5,6
Collaboration Index 5,23

of publication, institutions, journals, and citations on WASH research. Figure 1 indicates the
categories of document types that are available in WASH studies.
Out of the 110 documents that are available on the subject for the period 2003 to 2021, articles
constitute the biggest number with a total of 78. This high number shows the contribution of
academia and academic institutions to research. Another document type with a higher number is
the reviews with 15, as well as 6 conference papers, 4 book chapters, 3 editorials, 3 notes, and 1 short
survey. This also shows a gap where research focus is needed in areas with very few papers.
Figure 1 shows annual scientific production from 2003 to 2021. The Graph shows that not a lot of
research was done on resilience and WASH globally between the period 2003 and 2009. This may be
because a lot of attention was on water management research and other hazards that had more
severe consequences. There was a small increase in annual scientific production from 2009 to 2017
and a drastic increase from the year 2017 to 2019. The notable increase from 2009 could be a result
of increased focus on the subject under study. There was exponential growth in WASH research
between 2016 and 2020. During this period, local and international NGOs, governments, and other

Figure 1. Annual scientific outputs on WASH studies between 2003 and 2021.
 INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 5

organizations started paying attention to WASH and WASH-related hazards. For example, the Bill
and Melinda Gates Foundation spent US$ 34 Million to fund projects and research on WASH
between 2016 and 2020 Widespread adoption and efforts to achieve Millennium Development
Goals (MDGs) from 2000 to 2015 as well as the Sustainable Development Goals (SDGs) from 2016
to 2030 also explains the increase in the annual scientific production in resilience and WASH
studies. As the efforts to achieve the SDGs gather pace, there is likely to be more scientific research
in the coming years. With the Climate Change predicament around the globe, there has been an
increase in the frequency of flood hazards and disasters which has prompted an increase in the
research that is being done.
The citation analysis which also exposes the number of times that a specific study has been
quoted in some research papers was also carried out for the period 2003 to 2021 and it is the most
used approach for literature analysis and has proven to be reliable. The illustration in Figure 1
shows that there is a notable increase in publications during the reviewed period. The increasing
problem of WASH across the globe has attracted the attention of researchers and thus citations have
increased. In 2021, there is a drop in the number of scientific research as shown in Figure 1, mainly
because the generated data for 2021 was only for about 7 months thus there is a possibility that more
papers could have been produced in the last half of the year 2021. The growth in scientific research
according to Lee (2019) indicates that WASH is receiving increased attention. The increase in
annual scientific outputs is also a result of deliberate efforts by organizations such as UNICEF, the
World Bank, the Bill and Melinda Gates Foundation, and many other International Non –
Governmental Organisations interested in improving WASH.

Source relevance and impact of WASH studies

The published documents with many citations are considerably extra dominant than those with few
citations. Table 2 shows the top 20 source impact on WASH studies in the period under review
across the globe. The Table unpacks the influence of journals that have published on the subject, the
H – Index (Cumulative impact of an author’s scholarly output and performance), G – Index
(Author level metric), M – Index (Variant of the H-Index), Total Citation as well as the Number
of Productions in a particular year. From the table, the Journal of Water Sanitation and Hygiene for
Development has the most research impact as proposed by Hirsh with an H-Index of 5 as well as

Table 2. Top-20 source impact on WASH studies between 2003 and 2021.
Source h_index g_index m_index TC NP PY_start
JOURNAL OF WATER SANITATION AND HYGIENE FOR DEVELOPMENT 5 7 0,7 56 12 2015
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC 3 6 0,8 36 6 2018
HEALTH
PLOS NEGLECTED TROPICAL DISEASES 3 4 0,3 111 4 2013
PLOS ONE 3 4 0,4 58 4 2015
ENVIRONMENTAL HEALTH PERSPECTIVES 2 3 0,7 19 3 2019
AMERICAN JOURNAL OF CLINICAL NUTRITION 1 2 0,3 12 2 2019
AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE 2 2 0,7 19 2 2019
BMC PUBLIC HEALTH 1 2 0,1 50 2 2013
BMJ OPEN 2 2 0,2 155 2 2013
ENVIRONMENTAL HEALTH INSIGHTS 1 1 0,5 3 2 2020
INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION 1 2 0,1 29 2 2014
JOURNAL OF WATER AND HEALTH 1 1 0,3 2 2 2019
WATER RESOURCES MANAGEMENT 1 2 0,1 31 2 2013
AFRICAN GEOGRAPHICAL REVIEW 1 1 0,3 2 1 2019
ANNALS OF THE NEW YORK ACADEMY OF SCIENCES 1 1 0,1 212 1 2014
ANNUAL RESEARCH AND REVIEW IN BIOLOGY 0 0 0,0 0 1 2016
ARABIAN JOURNAL FOR SCIENCE AND ENGINEERING 1 1 0,2 3 1 2016
ASABE 2020 ANNUAL INTERNATIONAL MEETING 0 0 0,0 0 1 2020
ASIAN PACIFIC JOURNAL OF TROPICAL BIOMEDICINE 1 1 0,2 2 1 2017
BMC PEDIATRICS 0 0 0,0 0 1 2021
6 M. TSHUMA ET AL.

a total citation score of 5. The second most influential journals are the International Journal of
Environmental Research and Public Health, PLOS Neglected Tropical Diseases, and PLOS One all
with an H-Index of 3 and total citation scores of 36, 111, and 58, respectively. The least influential
journals on resilience and WASH studies are Annual Research and Review in Biology, ASABE 2020
International Meeting, and BMC Pediatrics all with 0 H-Index and 0 total citation score.

Country scientific production

In terms of countries that have contributed to the research on WASH studies, the USA has the
highest frequency with a score of 104 as shown in the top 20 Country scientific production table
below. Other countries with the highest scientific production are Australia and UK with 53 and 48,
respectively. Countries with the least scientific production are the Netherlands with a frequency of
4, Spain with a frequency of 4, and China with a frequency of 3. Zimbabwe is in 6th place with a total
of 5 articles. Few African countries have published and this is attributed to a biased focus that has
been over the years towards other problems affecting Africa like Neglected Tropical Diseases.
Table 3 also illustrates the top 20 corresponding author’s countries in the domain of WASH studies.
Considering the single and multiple-country publications, the diagram above clearly depicts that the USA
has the largest single-country publication of 10 articles and multiple-country publications of 13, followed
by the United Kingdom with both single-country publications and multiple country publications pegged
at 6 and Australia having both single country publication and multiple country publication of 5. Rwanda
is among the countries with the least corresponding authors without a single country publication and
only multiple country publications of 1. Mozambique has a single country publication of 1 without any
multiple country publications. Zimbabwe features among countries with the second-highest correspond­
ing authors after Ethiopia in the African continent, it has a single-country production of 3 and multiple-
country production of 2.
The USA is the most cited country with total citations of 474 followed by Australia with 216 total
citations and the UK with 189 total citations. Zimbabwe is among the countries with a higher number of
total citations with 48. The countries with the least number of total citations are Korea and Mozambique
both without any citations. The list of countries contributing to the subject is dominated by more
economically developed countries showing their commitment and developing interest in WASH studies.
In Africa, fewer countries are publishing on the subject under study yet more WASH problems are found
in the continent. All this shows that there is still an extensive opening to be occupied in Africa in terms of

Table 3. Top-20 corresponding author’s country between 2003 and 2021.

Country Articles Freq SCP (Single Country Publication) MCP (Multiple Country Publication) MCP_Ratio
USA 23 0,24 10 13 0,6
UNITED KINGDOM 12 0,13 6 6 0,5
AUSTRALIA 10 0,11 5 5 0,5
INDIA 8 0,09 2 6 0,8
ETHIOPIA 6 0,06 5 1 0,2
ZIMBABWE 5 0,05 3 2 0,4
BANGLADESH 4 0,04 1 3 0,8
INDONESIA 4 0,04 2 2 0,5
KENYA 3 0,03 0 3 1,0
SOUTH AFRICA 3 0,03 2 1 0,3
CANADA 2 0,02 0 2 1,0
NIGERIA 2 0,02 2 0 0,0
PERU 2 0,02 1 1 0,5
SPAIN 2 0,02 2 0 0,0
THAILAND 2 0,02 1 1 0,5
CHINA 1 0,01 0 1 1,0
GREECE 1 0,01 0 1 1,0
KOREA 1 0,01 0 1 1,0
MOZAMBIQUE 1 0,01 1 0 0,0
RWANDA 1 0,01 0 1 1,0
 INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 7

research on WASH. The lack of financial resources could explain the reason why there are fewer scientific
studies in Africa.

Word cloud and co-occurrence network on WASH studies

Figure 2a is a word cloud that epitomizes the top 50 most used keywords on WASH studies. The word
cloud identifies the topics of published papers and the more usually used phrases in publications through
the surveyed period of 2003 to 2021. The word cloud in Figure 2a shows the principal terms and/or words
used in the published research on WASH studies. The word cloud reveals that sanitation, water, WASH,
and hygiene feature more in the studies that have been carried out on WASH. It is, therefore, easier to
distinguish inside the word cloud on publication and work productivity in various areas of integration as
well as determine the more dominant words used through the period under review.
Further, in Figure 2b above, the co-occurrence network in WASH studies is clearly illustrated.
The co-occurrence network depicts the linkages between words and/or terms that were used in the
WASH studies during the period 2003 to 2021.
There is also an indication that there was a low annual growth of key terms on the subject from 2003 to
2010. From 2011 to 2021 the occurrence of words like sanitation and hygiene in scientific studies grew
exponentially. Many other terms used in the WASH studies have their annual occurrence in research also
increasing steadily, with the annual occurrence of the term water also growing drastically from 2015 to
2021. Hierarchical relationships amongst different topics that are linked to resilience and WASH studies
also come out clearly, measuring the output using the hierarchical clustering of key headings under study.
Summarily there is an indication that many different topics that were used during the period under
review have some relationship and all feed into the broader subject of sustainable development.

Discussion
Table 4 shows part of the literature on WASH, with specific information on the authors, year of
publication, identified WASH variables, and recommendations. The table also reveals that more needs
to be done in Africa concerning WASH as few scientific pieces of research have been done. As clearly
known and illustrated by literature, several countries have adopted the United Nations SDGs and
incorporated them into their national plans. The integration of the Global Goals into national develop­
ment plans may seem to automatically transfer the SDGs on resilience into national plans but in earnest,
there is a need for the implementation of the plans (Ohwo 2019). For countries that have embarked on
scientific research, the implementation of these plans is likely to bear positive results in building
community resilience whilst promoting sustainable development.

Building resilience to WASH-related hazards

The hazards related to WASH are still very high in Africa and many WASH deaths have been recorded in
different countries over the years (Momberg et al., 2021). Africa is not only facing WASH-related hazards
but numerous other hazards that range from climate-related hazards to civil emergencies (Mackinnon
et al. 2019). Over the years, more focus in Africa has been on natural hazards like drought and floods that
are more frequent in many countries. Thus many types of research were focused on these hazards. Lately,
the WASH issues have been amplified by different players such as UNICEF, Bill and Melinda Gates
Foundation, World Bank, and many other Non-Governmental Organisations such as Plan International
(Momberg et al., 2021). There is a need for a shift in scientific research to deliberately focus on WASH to
reduce the massive impacts of WASH-related hazards felt across Africa. When scientific research has
been done, community resilience to WASH-related hazards can be built using various approaches.
Through the WASH resilience approach, there is the assurance of integrated water supply, sanitation
systems, hygiene education services, and practices that meets the needs of children, families, and
communities (Nicholson 2020). Climate-resilient WASH systems and approaches in the face of
8 M. TSHUMA ET AL.

Figure 2a. Word cloud on WASH studies.

Figure 2b. Co-occurrence network on WASH studies.

Table 4. Part of literature on WASH.
Year of WASH variables
S/N Author (s) publication Title Region Country methodology identified Recommendation (s)
1 Zemichael 2020 Evidence of Households’ Water, Sanitation and Africa Ethiopia Baseline and Water, sanitation, Local health office need to strengthen the
et al. Hygiene (WASH) Education program in Rural Endline and hygiene WASH education program
Dembiya, Northwest Ethiopia Surveys education, rural,
household
2 Adams 2021 Water, Sanitation, and Hygiene (WASH) Europe United Desktop Review WASH insecurity, There is a need to centralize the WASH
et al. insecurity will exacerbate the toll of COVID- Kingdom COVID-19, women needs of women and girls in COVID-19
19 on women and girls in low-income and girls, low- interventions
countries. income countries
3 Justin Im 2020 Can existing improvements in Water, Asia India Cox Regression WASH The major infrastructural investment that
et al. Sanitation, and Hygiene (WASH) in urban Models improvements, improves WASH is key to enhancing
slums reduce the burden of Typhoid fever in Urban slums, Typhoid control
these settings? Typhoid fever
4 Koppelaar 2018 Framework for WASH Sector Data Europe Switzerland Data WASH, WASH Adoption of the modeling methodology
et al. improvements in Data-Poor Environments, Integration mapping, Poor opens avenues for improving the WASH
Applied to Accra, Ghana Framework Environments sector in Developing countries
and
Modelling
5 Mackinnon 2019 21st Century research in urban WASH and Europe United Literature Urban WASH, health, Recommended a broader focus of WASH
et al. health in Sub-Saharan Africa: Methods and Kingdom Review Sub- Saharan research and interviews in urban Africa to
outcomes in the transition Africa, better reflect the demographic and
health transitions happening.
6 Bennion 2021 Association between WASH-related behaviors Europe Switzerland Logistic WASH-related Parental involvement is pertinent in
et al. and knowledge of childhood Diarrhoea in Regression behaviors, lowering morbidity and mortality among
Tanzania Knowledge, children
Diarrhoea,
Children
7 Chatterley 2018 Institutional WASH in the SDGs: Data gaps and Europe United Case Studies Institutional WASH, Can be used for monitoring WASH in other
et al. opportunities for national monitoring Kingdom SDGs, monitoring settings such as workplaces and prisons
and evaluation,
schools, health
care
8 Raihan 2017 Examining the relationship between Asia Bangladesh Structural Socio-economic Translate findings to contribute to policy
et al. socioeconomic status, WASH practices, and Equation status, WASH formulation in terms of justifying the
wasting Model (SEM) practices, wasting inclusion of WASH components in
nutrition and livelihood-improving
INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH

strategies
(Continued)
9
 10
M. TSHUMA ET AL.

Table 4. (Continued).
Year of WASH variables
S/N Author (s) publication Title Region Country methodology identified Recommendation (s)
9 Momberg 2020 Water, Sanitation, and Hygiene (WASH) in Sub- Europe United PRISMA WASH, nutritional Targeted research on the governance of
et al. Saharan Africa and associations with Kingdom Statement status, children WASH is imperative to address the
undernutrition and governance in children under five, burden of child undernutrition
under five years of age: a systematic review governance
10 Mourad 2019 Assessing Students’ knowledge of WASH- Africa Rwanda SPSS WASH education, The provision of water and sanitation
et al. related diseases WASH-related infrastructure should go with the
diseases, provision of health education on how to
Assessment avoid waterborne diseases
 INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 11

Climate Change backed by enough research are key to building resilience to WASH (Als et al. 2020).
WASH-resilient systems that are adaptive to the potential shocks and processes of Climate Change are
therefore key in the provision of sustainable WASH in African countries (McQuade et al., 2020).

Conclusions
There is an upward trend in scientific research that is being done on building resilience, community
participation, and WASH. However, in developing countries, more focus is still needed as the countries
also battle the impacts of climate change. Developing countries still lag when it comes to improved
WASH hence more research is still required to come up with solutions to the current WASH problems.
This study carried out a systematic analysis of the bibliography using the R Programming Software to
establish the evolvement of research on resilience and WASH studies. A total of 110 articles were
generated from the Web of Science and Scopus databases for the period between 2003 and 2021. This
study revealed that for the period from 2003 to 2021 USA, Australia and UK were leading in scientific
production. The Journal of Water Sanitation and Hygiene for Development had the highest source
impacts on resilience and WASH studies. It was also revealed that the London School of Hygiene and
Tropical Studies had the highest affiliations that have researched WASH studies between 2003 and 2021.
Since many developing countries especially in Sub-Saharan Africa still reeling under serious water,
sanitation, and hygiene challenges and are now recording an increased frequency of floods as a result of
climate change phenomena, this study presents an opportunity for more researchers and policy shifts
that prompt a more focus on research on the subject. With the increased interest and popularity of the
subject advanced by the Sendai Framework for Disaster Risk Reduction as well as the Sustainable
Development Goals, there is also hope for increased scientific production on the subject.

Disclosure statement
No potential conflict of interest was reported by the author(s).

Funding
The author(s) reported there is no funding associated with the work featured in this article.

ORCID
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