Is Benin on track to reach universal household coverage of basic water, sanitation and hygiene services by 2030?

Nicolas Gaffan; Cyriaque Dégbey; Alphonse Kpozèhouen; Yolaine Glèlè Ahanhanzo; Roch Christian Johnson; Roger Salamon

doi:10.1371/journal.pone.0286147

Peer Review History

Original SubmissionOctober 26, 2022
9 Feb 2023 Decision Letter - Alison Parker, Editor PONE-D-22-29273Is Benin on track to reach universal household coverage of basic water, sanitation and hygiene services by 2030?PLOS ONE Dear Dr. GAFFAN, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Both reviewers have provided some detailed and constructive comments which I think should be feasible to address but nevertheless require careful attention. Please submit your revised manuscript by Mar 26 2023 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. 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For additional information about PLOS ONE ethical requirements for human subjects research, please refer to http://journals.plos.org/plosone/s/submission-guidelines#loc-human-subjects-research Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Partly ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: The authors endeavored to study this theme in Benin. The manuscript is very well prepared and the technical quality and presentation of the results is quite good. The results can be useful for decision makers in the country. I suggest that authors consider the modifications below for readability and further improvement of the article. 1. Line 68: what would 7c be? 2. In the third paragraph of the introduction, could you give examples of some vulnerable countries? 3. Write the abbreviation WASH in full in the introduction 4. What is the WASH estimated universal coverage rate for 2030? 5. Please, defines what DHS is. 6. Line 145: what were the missing variables? 7. Rewrite the phrase “The APC is the percentage …….assuming linearity” on line 201. 8. Review the numbering of equations in addition to naming them in the text. 9. Line 230-232: Do you know the reason for this decrease? 10. Wouldn't it be better to review the numbering of the tables? For example, Table 1 and on instead of Table S1? 11. It gets confusing to mention Tables S3-S7. I don't know if it's from table S3 to table S7 or just tables S3 and S7. Make this clear in your text. 12. Line 245-247: Enter the percentage obtained to aggregate the work. 13. "The prevalence of surface water consumption decreased the most between 2006 and 2011-2012 (APC = -14.93%)." Was that at the national or departmental level? 14. Define the acronym UNICEF and all others in the text. 15. I find the conclusion too short 16. Missing abbreviation list 17. I suggest improving the quality of the figures 18. Providing the link of each reference and mentioning the date of access is important. Reviewer #2: In general, this paper is well-written, interesting and useful. This can be evidence for monitoring inequity. The paper is well-planned and easy to read. The methodology appears sound, but I have made suggestions below that would improve or clarify the findings and some inputs for other parts (attached). ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes: JOHNSON HERLICH ROSLEE MENSAH Reviewer #2: No ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. Attachments Attachment Submitted filename: attachment_reviewPONE-D-22-29273.docx https://doi.org/10.1371/journal.pone.0286147.r001
Revision 1
18 Mar 2023 Author Response Dear Editor, We are grateful for the opportunity to submit a revised manuscript. We appreciate the efforts of the reviewers and the editorial team in providing suggestions for improving the quality of the manuscript. We have incorporated the changes into the revised manuscript. All authors have approved the current version of the manuscript. Below are point-by-point responses to the comments. Best regards. GAFFAN Nicolas [Corresponding author] P.-S. - Line numbers in the responses are from the ‘Manuscript.docx’ file (without tracking changes). Point-By-Point Responses Reviewer 1 1. Line 68: what would 7c be? “7c” is one of the targets of the Millennium Development Goals (MDGs). Lines 67-68: It called on states to "halve the proportion of people without sustainable access to safe drinking water and basic sanitation by 2015". 2. In the third paragraph of the introduction, could you give examples of some vulnerable countries? In paragraph 3, we stated that SDG 1 includes a target to ensure universal access to basic services, especially for the poor and vulnerable. Addressing the most vulnerable implies attention to the specific WASH needs found in "special cases" such as refugee camps, detention centres, mass gatherings, pilgrimages, etc. 3. Write the abbreviation WASH in full in the introduction Thank you for your comment. In the revised manuscript, we have defined the acronym WASH as the first use in the introduction. We did the same thing for the other abbreviations/acronyms. Lines 103-105: Besides, estimates in 2020 showed that the world was on track to meet the 2030 Water, Sanitation and Hygiene (WASH) targets, with Sub-Saharan Africa and Oceania most off track. 4. What is the WASH estimated universal coverage rate for 2030? Projections of people's access to WASH in 2030 globally and by region are available in the report "Progress on household drinking water, sanitation and hygiene 2000-2020: five years into the SDGs" by WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene. According to estimates, 81% and 67% coverage of safely managed water and sanitation services are projected globally by 2030. Additionally, the world is expected to reach 94%, 90% and 78% coverage of basic WASH services by 2030, which will not achieve universal access. 5. Please, defines what DHS is Thank you for your comment. In the revised manuscript, we have defined DHS at the first use. Line 130: DHS: Demographic and Health Survey 6. Line 145: what were the missing variables? In the study, the level of access to basic hygiene services was assessed using two variables: the availability of hand hygiene facilities and the availability of water and soap. These last two variables are not available in the HOUSEHOLD dataset of the DHS-I in 1996. 7. Rewrite the phrase “The APC is the percentage … assuming linearity” on line 201. Lines 195-197: We rewrite this as: “The APC refers to the average increase or decrease expressed as a percentage of a given parameter between two successive units of time (usually the year) over a given period, assuming linearity”. 8. Review the numbering of equations in addition to naming them in the text. Thank you for your comment. The manuscript has been revised according to your suggestion. Lines 202 and 208: The first equation has been numbered (a) and the second (b). (a) and (b) were stated in the text. 9. Lines 230-232: Do you know the reason for this decrease? There are several reasons for this finding: reinforcement of the application of laws promoting sex equality, strengthening the schooling of girls, increasing the rate of employment among women, and which gives them greater financial autonomy. 10. Wouldn't it be better to review the numbering of the tables? For example, Table 1 and on instead of Table S1? Thank you for your comment. We have adopted this style of numbering as these tables have been presented in supplementary materials. The tables in the body of the manuscript were numbered: Table 1 and Table 2. 11. It gets confusing to mention Tables S3-S7. I don't know if it's from table S3 to table S7 or just tables S3 and S7. Make this clear in your text. In the revised manuscript, we replace “Tables S3-S7” with “Tables S3 to S7” (line 239), and “Tables S8-S12” with “Tables S8 to S12” (line 263). 12. Lines 245-247: Enter the percentage obtained to aggregate the work. Thank you for your comment. In the revised manuscript, we have completed the percentages. 13. "The prevalence of surface water consumption decreased the most between 2006 and 2011-2012 (APC = -14.93%)." Was that at the national or departmental level? It was at the national level. 14. Define the acronym UNICEF and all others in the text. In the revised manuscript, we have defined UNICEF as the first use in the introduction. We did the same thing for the other acronyms Line 337: UNICEF is United Nations Children’s Fund. 15. I find the conclusion too short In the revised manuscript, the conclusion has been strengthened in response to the research question and policy implications (Lines 407-420). 16. Missing abbreviation list Thank you for your suggestion. According to the instructions to the authors, the list of abbreviations is not required. 17. I suggest improving the quality of the figures In the revised manuscript, the figures have been improved. In particular, we used the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool to ensure that the figures met PLOS requirements. We renamed the files "Figure 1.tif" and "Figure 2.tif" as "Figure S1.tif" and "Figure S2.tif", respectively. 18. Providing the link of each reference and mentioning the date of access is important. Thank you for your suggestion. The list of references has been reviewed by the authors and omissions have been corrected where necessary. Reviewer 2 1. Abstract The objective state 'make projection for 2030', but in conclusion, the Author has not clearly stated the projection result. The Author needs to add a statement to improve the conclusion. Thank you for your suggestion. There is a shortage of clarity in the answer to the research question in the conclusion. In the revised manuscript, the abstract has been strengthened in this sense (Lines 53-56). 2a. Methods Sampling (line 151), I feel like there is missing information at ‘each department’. Add words/sentence that can connect with each department. Lines 149-150: A rewording was made: “The departments were stratified into urban and rural, except for the Littoral, an entirely urban stratum”. 2b. Methods In the introduction section, the authors have explained the differences in standard definitions of the WASH indicators in the MDGs and SDGs. The Author added reference information about the standard definition of WASH in table 1. Thank you for your comment. 2c. Methods Table 1: The Author needs to add an explanation of how to create variables 'improved water' and 'improved sanitation' according to Benin DHS and references Footnotes to Table 2: Following your suggestion, we have made some clarifying additions to the definition of an improved water source and an improved sanitation facility: • Improved water: Piped supplies (tap water in the dwelling, yard or plot, public standposts) and non-piped supplies (boreholes/tubewells, protected wells and springs, rainwater, packaged water, including, bottled water and sachet water, delivered water, including tanker trucks and small carts) • Improved sanitation: Networked sanitation (flush and pour flush toilets connected to sewers) and on-site sanitation (flush and pour flush toilets or latrines connected to septic tanks or pits, ventilated improved pit la-trines, pit latrines with slabs, composting toilets, including twin pit latrines and container-based systems) 2d. Methods Table 1 (lines 196-197): did this study conduct reanalyses following the operational definition written in table 1? Table 1 provides details on the sampling for the selected demographic and health surveys. During the data analysis, the sampling design of the individual surveys was taken under consideration, via the 'svy' command in Stata 15. 2e. Methods In lines 195-198, the Author needs to add information describing tables S1 and S2. Line 223: Table S1 (supporting information) presents the basic characteristics of households. Lines 235-236: Table S2 (supporting information) shows the level of household access to water, sanitation and hygiene in Benin. 2f. Methods Table S3, mention p value, is there a subgroup as reference? Thank you for your suggestion. In Table S3, “p” is the p-value from the chi-square test of the association between household characteristics and access to basic water services (by survey). We have additional information in the footnote to facilitate the reading of the tables. 3a. Results Benin DHS, which were carried out based on a sample with complex design. It is better to present the data displays with a 95% confidence interval. Thank you for your suggestion. For the data presented in Tables S1 to S7, the 95% confidence intervals were completed (supporting information). The 95% confidence intervals have also been added in the body of the manuscript. 3b. Results In line 243, the Author needs to add the meaning of the p-value in tables S1 and S2. Thank you for your suggestion. We have additional information in the footnote to facilitate the reading of the tables (Tables S1 to S7). 3c. Results Line 264; although it has summarized tables S8-S12, it would be more communicative to add the word ‘Table S3’ before ‘the overall’ (line 265). Thank you for your suggestion. 3d. Results Line 270; what is the meaning of minus value? The Author needs to give a brief explanation. A negative value indicates a decrease on average over the period considered, while a positive value suggests an increase. We were done in the "Data Analysis" subsection of the "Methods" section on how to interpret the APC. Line 197-199: A negative value indicates a decrease on average over the period considered, while a positive value suggests an increase. 3e. Results Projection of access to WASH by 2030, add number of table that is being discussed in the text of the result. Thank you for your suggestion. We began the subsection with the sentence: Lines 288-289: “Tables S13 to S17 set out projections of household access to WASH services. Notably, projections at the national level are presented in Figures S1 and S2 (supporting information).” 4a. Discussion Lines 311-315 are the justification of the study. I suggest these four sentences move to the end of the introduction. Thank you for your suggestion. We argue for bringing it back to the end of the discussion just before the study's strengths and limitations (Lines 393-404). 4b. Discussion Line 318, add '(Table S2)' after 63,68% to clarify this. In the "Results" section, this result had already been presented by specifying Table 2. This is the proportion of households with access to basic water services. Line 235-237: “Table S2 (supporting information) shows the level of household access to water, sanitation and hygiene in Benin. Household access to basic water services was 50.54% in 2001 and 63.98% in 2017-2018”. 4c. Discussion Line 319-320 – which table was referred to? State the number of tables It is Table S2 (supporting information). The percentage of households with basic sanitation services increased 2.5 times, from 5.39% to 13.29% between 2001 and 2017-2018 (lines 246-247). The percentage of households with basic hygiene services increased 4.8 times, from 2.12% to 10.11% between 2001 and 2017-2018 (Lines 257-258). 4d. Discussion The SDGs' slogan is no one leave behind and interconnection between SDGs’ goals. This paper will be interesting if it discusses connection with the goal#10- inequity that affects the achievement of the 2030 target in Benin. This paper can be evidence-based for monitoring inequity in Benin when discussing the characteristics of being able to raise which subgroups are disadvantaged so that interventions can address these sub groups with the proper programs to reduce the gap between subgroups. Then these will increase the achievement of WASH targets. Thank you for your suggestion. It will certainly be studied in the future. Goal 10 will not be addressed here. 4e. Discussion The Author can add discussion abour policy recommendations for Benin's government based on this study. In the revised manuscript, in the conclusion, we have added policy recommendations for the government of Benin (Lines 407-420). 5. Conclusion Rewrite more clearly to answer the research question related to the projection result. Thank you for your suggestion. In the revised manuscript, the conclusion has been strengthened in this sense. 6a. Tables; make the title of the table and text. Example text: 'Level of household access to water' title of table S3: 'access to basic drinking water services'. Thank you for your suggestion. The authors have reviewed the titles of all tables and modified them where necessary. 6b. Table presentation – to be self-reported. Add a footnote about the p-value – what you want to explain from the p-value so that the table is easier to read. Thank you for your suggestion. We have additional information in the footnote to facilitate the reading of the tables 6c. In each table, add in lowest row for total Benin, ‘n’ and ‘%’ in each column. Thank you for your suggestion. Under your comment, we have added a final line that shows the total for Benin. 6d. In table S1-S7, it is better to add the year after DHS II ‘(2001)’, DHS III ‘(2006)’, DHS IV ‘(2011-2012)’, DHS V ‘(2017-2018)’ Thank you for your suggestion. In the individual tables, the survey years have been added. Other comments 1. For studies reporting research involving human participants, PLOS ONE requires authors to confirm that this specific study was reviewed and approved by an institutional review board (ethics committee) before the study began. Please provide the specific name of the ethics committee/IRB that approved your study, or explain why you did not seek approval in this case The study included DHS-II, DHS-III, DHS-IV, and DHS-V in Benin. Depending on the survey, data collection was subject to ethical approval by the internal ethics committee of Macro International or ICF International. Additionally, depending on the survey, an ad hoc ethics committee established by the Ministry of Health or the National Committee for Ethics in Health Research also provided ethical authorization. 2. We note your current Data Availability statement is: "No - some restrictions will apply" "Data are available after a request sent via the DHS Program website at https://dhsprogram.com/." The dataset we have used is available free of charge, upon request, and without restriction on the DHS program website (‘https://dhsprogram.com/data/available-datasets.cfm’). In addition to the above comments, all spelling and grammatical errors have been corrected. Also, minor inputs have been made to improve the quality of the work. We have placed all the supplementary materials in a .zip file. We hope that the esteemed reviewers will be able to see that the revised manuscript has taken constructive criticism into account. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0286147.r002
10 May 2023 Decision Letter - Alison Parker, Editor Is Benin on track to reach universal household coverage of basic water, sanitation and hygiene services by 2030? PONE-D-22-29273R1 Dear Dr. GAFFAN, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Alison Parker Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed Reviewer #2: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: (No Response) Reviewer #2: The Author has already revised the first draft paper based on the reviewer’s inputs. In general, paper is better sound, and the tables are self-reported with footnote. But I have 2 inputs for conclusion and note (in supporting information file). Conclusion (line 410-423): The conclusion has been revised but according to it to be too long. Some parts are more appropriate to be included in the method or become a footnote in relevant tables. The author needs to revise again the conclusion to be more concise and answer the objectives of this study. Whether the Benin projection results are on the tract in line with the 2030 target or still far from target. Recommendations should be more operational and addressed to whom? Which departments are progressing, and which departments need more attention and effort to support the achievement of Benin 2030 and for which indicator? Note (in supporting information file): This note will be more concise when included in the methods, if there is no word count restriction. ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No ******** https://doi.org/10.1371/journal.pone.0286147.r003
Formally Accepted
18 May 2023 Acceptance Letter - Alison Parker, Editor PONE-D-22-29273R1 Is Benin on track to reach universal household coverage of basic water, sanitation and hygiene services by 2030? Dear Dr. GAFFAN: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Alison Parker Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0286147.r004

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