System-wide approaches to mitigate environmental and health impacts of water contamination

There is an urgent need to address the challenges of inadequate safe water and proper sanitation in peri-urban communities in low-income countries. Agencies have tended to focus on a single aspect of the challenge for service delivery, which ultimately fails to capture the full scope of the problem. In this study, 63 household surveys and 15 key informant interviews regarding water and sanitation issues were conducted in a peri-urban area of Dar es Salaam, Tanzania. Results revealed that 87% of households experience water scarcity issues. More than 50% of the homes were surrounded by swampy areas with sewage and stagnant pools, with 40% reporting water source contamination due to seepage and overflowing of sewage collection systems. Key informants reported water scarcity and poor water quality due to poor sanitation practices and a compromised water supply network. We found that a highly integrated approach that invests in cultural, social, political, human, financial, and built community capitals is needed to address these challenges. Community self-efficacy and empowerment will be critical to accomplishing this and protecting public health.