Sanitation value chain (SVC) is related to a sanitation system which includes social, cultural, financial and technical systems as well as values of inhabitants and societies. SVC has some new frames added in the sanitation regime. SVC aims to bring better hygiene, resource recycling, well-being, etc. to inhabitants in society. Some methods to promote SVC, however, may cause a sort of trade-off problems. In this study, the relation between income increase and fixation of stratification in society which sometimes related to a gender problem, inequality on the time of the introduction of SVC which is an ethical problem to ensure the equity of inhabitants in society, and independence on and subordination to global economy in SVC operation are discussed and some solutions of these problems are explained. Since SVC should be heading to sustainable society, some measures to keep its continuity are also discussed such that the stability of SVC in developing stage of a society is under inhabitants’ decision making which is under the control of human nature.

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Globally, the most common cause of death of children is infectious diseases, particularly in low- and middle-income countries. In China, infectious diseases, especially diarrhea, are still some of the most serious public health problems, simultaneously suggesting that effective hand washing may help prevent these diseases. However, its effectiveness has remained unclear in terms of the difficulty in measuring children’s hand-washing behavior. The aim of the present study was to develop a hand washing checklist that is handy and suitable for children, to comprehensively evaluate their hand washing practice. In this study, 269 students aged 7–13 years and their mothers completed measures of knowledge, attitude and practices (KAP) level of sanitation and hygiene and demographics. In addition, this study tested participants’ and washing skills following both the World Health Organization (WHO) checklist and new checklist (modified based on the WHO checklist). Two cameras were used to record the whole progress of hand washing test. The present study showed that knowledge and attitude had no correlations with hand washing test. None of the children perfectly completed all steps of the WHO checklist. Given this, after simplifying the WHO checklist, the completion rate has significantly improved. The findings of this study also demonstrated that social economic status plays a significant role in shaping students’ hand washing behaviors along with the striking factor that children’s age, and gender differences had a significant correlation with their hand washing behaviors.

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Previous studies have argued that unimproved sanitation and poor water quality have an impact on important health outcomes, especially diarrhea in children. To solve these problems, the installation of sanitation facilities has often been implemented. However, few follow-up studies have been conducted after the installation of sanitation facilities in hunter-gatherer societies. The current status of the sanitation facilities, water quality, child health, and the relationships between water quality and diarrhea in children in a hunter-gatherer, semi-sedentary village was studied through field investigations. The village of approximately 91 residents was located in the Eastern Region of Cameroon. For this study, the following were conducted: i) interviews with participants on the usage and value of sanitation facilities; ii) an observational survey of sanitation facilities; iii) water quality testing; iv) interviews regarding diarrhea in children; and v) anthropometric measurements of children. The results revealed that more than half the participants defecating outside of sanitation facilities, although they had a positive perception of them. Furthermore, there were problems with each sanitation facility in the village in terms of structure, accessibility, privacy, and hygiene. In addition, all drinking water (from the village water source and that stored in houses) tested positive for total coliforms, and approximately 50% of the children in participants had symptoms of diarrhea. There was, however, no clear association between the total coliform count and diarrhea in children suggesting that children might have been infected through other routes. Despite limitations regarding age estimation and participant numbers, the nutritional status of the participating children was generally good. Appropriate ways to introduce sanitation facilities to the local population, taking into account the values and culture of people living in hunter-gatherer societies, needs to be explored. Furthermore, improving sanitation facilities and access to safe water, and investigating other factors related to diarrhea incidence are needed.

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