{Reference Type}: Journal Article
{Title}: The effect of improving solid waste collection on waste disposal behaviour and exposure to environmental risk factors in urban low-income communities in Pakistan.
{Author}: Schmidt WP;Haider I;Hussain M;Safdar M;Mustafa F;Massey T;Angelo G;Williams M;Gower R;Hasan Z;Sharma Waddington H;Anjum N;Biran A;
{Journal}: Trop Med Int Health
{Volume}: 27
{Issue}: 7
{Year}: 07 2022
{Factor}: 3.918
{DOI}: 10.1111/tmi.13787
{Abstract}: To estimate the effect of improving waste collection services on waste disposal behaviour and exposure to environmental risk factors in urban, low-income communities in Pakistan.<BR>We enrolled six low-income communities in Islamabad (Pakistan), four of which received an intervention consisting of a door-to-door low-cost waste collection service with centralised waste processing and recycling sites. Intervention communities underwent community-level and household-level mobilisation. The effect of the intervention on waste disposal behaviour, exposure to waste and synanthropic fly counts was measured using two cross-sectional surveys in 180 households per community.<BR>Intervention communities had less favourable socio-economic indicators and poorer access to waste disposal services at baseline than control communities. Use of any waste collection service increased from 5% to 49% in the intervention communities (difference 44%, 95% CI 41%, 48%), but the increase was largely confined to two communities where post-intervention coverage exceeded 80% and 90%, respectively. An increase in the use of waste collection services was also found in the two control communities (from 21% to 67%, difference 47%, 95% CI 41%, 53%). Fly counts decreased by about 60% in the intervention communities (rate ratio 0.4, 95% CI 0.3, 0.4) but not in the control communities (rate ratio 1.52, 95% CI 1.1, 2.2). The decrease in fly counts was largely confined to the two high-coverage intervention communities.<BR>Introduction of a low-cost waste collection service has the potential for high uptake in low-income communities and for decreasing the exposure to waste and synanthropic flies at household level. Intervention success was constrained by low uptake in half of the intervention communities.