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Open AccessArticle

System Approaches to Water, Sanitation, and Hygiene: A Systematic Literature Review

Department of Civil, Environmental, and Architectural Engineering, University of Colorado Boulder, Boulder, CO 80309, USA
USAID Sustainable WASH Systems Learning Partnership, United State Agency for International Development, Washington, DC 20004, USA
College of Engineering, George Fox University, Newberg, OR 97132, USA
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(3), 702;
Received: 4 December 2019 / Revised: 9 January 2020 / Accepted: 14 January 2020 / Published: 21 January 2020
(This article belongs to the Special Issue New Directions in Water, Sanitation and Hygiene Research)
Endemic issues of sustainability in the water, sanitation, and hygiene (WASH) sector have led to the rapid expansion of ‘system approaches’ for assessing the multitude of interconnected factors that affect WASH outcomes. However, the sector lacks a systematic analysis and characterization of the knowledge base for systems approaches, in particular how and where they are being implemented and what outcomes have resulted from their application. To address this need, we conducted a wide-ranging systematic literature review of systems approaches for WASH across peer-reviewed, grey, and organizational literature. Our results show a myriad of methods, scopes, and applications within the sector, but an inadequate level of information in the literature to evaluate the utility and efficacy of systems approaches for improving WASH service sustainability. Based on this analysis, we propose four recommendations for improving the evidence base including: diversifying methods that explicitly evaluate interconnections between factors within WASH systems; expanding geopolitical applications; improving reporting on resources required to implement given approaches; and enhancing documentation of effects of systems approaches on WASH services. Overall, these findings provide a robust survey of the existing landscape of systems approaches for WASH and propose a path for future research in this emerging field. View Full-Text
Keywords: WASH; systems approaches; systematic literature review; grey literature WASH; systems approaches; systematic literature review; grey literature
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Valcourt, N.; Javernick-Will, A.; Walters, J.; Linden, K. System Approaches to Water, Sanitation, and Hygiene: A Systematic Literature Review. Int. J. Environ. Res. Public Health 2020, 17, 702.

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