Living Conditions and Public Health Challenges in Temporary Camps for Displaced Populations in Shendi Locality, Sudan

Living Conditions and Public Health Challenges in Temporary Camps for Displaced Populations in Shendi Locality, Sudan | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Living Conditions and Public Health Challenges in Temporary Camps for Displaced Populations in Shendi Locality, Sudan Alhaj Saad Mohamed Ahmed, Rowyda Alnile Ahmed Khamees This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6117389/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract Background : Humanitarian aid aims to address the essential needs of displaced populations, especially regarding shelter, water supply, sanitation, and hygiene. This study evaluates the living conditions of displaced populations in Shendi, River Nile State, Sudan, based on the Sphere Guidelines. Methods : A cross-sectional descriptive study was conducted between August and October 2024. Structured face-to-face interviews, a standardized questionnaire (administered to 100 household heads), a checklist-based assessment, and non-structured interviews were employed. Data were analyzed using SPSS software. Results : Most displaced families (52%) live in overcrowded rooms, and 48% are near cooking areas. Food security is critical, with 92% of families relying on grains, while only 6% consume meat and 2% consume dairy. Health coverage is low, with only 52% of women vaccinated against tetanus, and 4% and 2% are vaccinated for meningitis and yellow fever, respectively. While 72% of women gave birth in hospitals, 28% gave birth in camps. Water is accessible to 95% of families, but only 60% consume the recommended daily amount, and 20% face difficulties accessing it. In terms of sanitation, 44% practice open defecation, and 90% dispose of waste openly. Additionally, 96% lack sufficient soap, and 96% face health threats from flies and mosquitoes, with only 32% using mosquito nets. Conclusion: The displaced families face significant challenges, including overcrowding in shelters, poor nutrition, limited access to healthcare and clean water, and inadequate sanitation. These conditions pose serious health risks, especially for children and vulnerable populations. Immediate intervention is necessary to address food security, healthcare, sanitation, and overall living conditions. Living Conditions Public Health Challenges Temporary Camps Displaced Populations Sudan Introduction The ongoing armed conflict in Sudan, characterized by civil wars, internal strife, and political instability, has led to widespread displacement across the country. As a result, millions of individuals have been forced into temporary camps, primarily in regions such as Shendi locality in River Nile State. These camps, housing an estimated 5,950 displaced persons across 35 centers (schools), serve as emergency shelters for displaced populations, where the living conditions are often overcrowded, unsanitary, and severely lacking in essential services. These displaced persons face heightened vulnerabilities due to inadequate access to clean water, sanitation, food, healthcare, and shelter, which intensify the public health challenges they experience. The lack of basic needs in temporary camps significantly raises the risk of infectious diseases, malnutrition, and mental health problems, thus exacerbating the humanitarian crisis in the region (United Nations High Commissioner for Refugees, 2019 ; World Health Organization, 2020 ). Armed conflict often results in the destruction of infrastructure and disruption of local health services, leaving displaced populations without adequate healthcare access. The collapse of essential services such as transportation, communication, and medical facilities makes it increasingly difficult for humanitarian organizations to reach and provide relief to those in need. The exposure to harsh environmental conditions in camps, coupled with inadequate shelter and sanitation facilities, accelerates the spread of diseases, contributing to higher mortality rates and further health deterioration (Sphere Handbook, 2018). This situation highlights the urgent need for effective, coordinated humanitarian interventions that adhere to internationally recognized standards in order to improve the living conditions and health outcomes of displaced populations (United Nations, 2016). Humanitarian organizations such as the United Nations (UN), World Health Organization (WHO), and various non-governmental organizations (NGOs) emphasize the importance of adhering to minimum humanitarian standards during crises. These standards, outlined by organizations like the Sphere Project, cover essential areas such as water, sanitation, shelter, nutrition, and healthcare. Their purpose is to ensure that displaced individuals receive life-saving assistance while maintaining human dignity and upholding fundamental rights. However, the implementation of these standards in emergency settings is often hindered by logistical challenges, resource constraints, and coordination issues among agencies (International Federation of Red Cross and Red Crescent Societies, 2017 ). Despite these challenges, it remains critical to assess how effectively these standards are being applied, especially in the context of displacement camps in Sudan. Previous studies, such as those by El-Din and colleagues (2018) and Alhaj et al. ( 2020 ), have examined displacement camps in Sudan and the broader region. These studies highlighted the critical gaps in meeting humanitarian standards, particularly in water and sanitation, healthcare access, and food security. El-Din's study focused on the displacement camps in Darfur, finding similar challenges with overcrowded shelters and inadequate healthcare services, while Alhaj's research in South Kordofan underscored the impact of poor hygiene practices and insufficient nutrition on the displaced populations, (El-Din et al., 2018 ; Alhaj et al., 2020 ). These studies provide valuable context for understanding the broader challenges faced by displaced populations across Sudan and emphasize the need for improved humanitarian responses in these settings. This study aims to examine the living conditions and public health challenges faced by displaced populations in temporary camps, specifically focusing on the application of humanitarian standards in Shendi locality, River Nile State. It will evaluate the extent to which these standards are met in the areas of water, sanitation, healthcare, and shelter, and assess their impact on the health and well-being of displaced persons. The study will also explore the barriers and challenges that hinder the effective implementation of these standards and provide recommendations for improving humanitarian responses. The choice of Shendi locality in River Nile State is particularly significant due to its vulnerability to the effects of ongoing conflict and the large number of internally displaced persons (IDPs) in the region. The region is one of the many parts of Sudan affected by displacement due to armed conflict, and the situation in Shendi represents the broader crisis faced by many displaced populations across Sudan. The camp populations in Shendi are often forced to live in overcrowded conditions with limited access to clean water, adequate sanitation, and healthcare services, making it a critical area for studying the public health implications of displacement and the challenges of meeting humanitarian standards. By focusing on Shendi, this study not only addresses the specific challenges faced by the displaced populations in this region but also provides insights that can be applied to similar contexts of displacement in other conflict-affected areas of Sudan and beyond. The region’s context allows for a deeper understanding of the real-world implications of humanitarian standards in emergency settings, particularly when resources are scarce, and coordination among various agencies is weak. This makes Shendi an important case study for identifying gaps in the implementation of humanitarian aid and exploring ways to improve future responses to displacement crises. This study aims to evaluate the living conditions and public health challenges faced by displaced populations in temporary camps in Shendi locality, River Nile State, Sudan, with a specific focus on the implementation of humanitarian standards. The research will assess the effectiveness of these standards in improving health and well-being within the camps and identify the gaps and barriers that hinder their full implementation. By addressing these objectives, the study will contribute to a better understanding of the real-world challenges in applying humanitarian standards in emergency displacement contexts. The findings will offer insights into how improving the adherence to these standards can mitigate public health risks and enhance the overall quality of life for displaced individuals in Shendi and similar regions. Materials and Methods Study design Cross-sectional descriptive and household based study was conducted on the displaced shelters in the temporary camps in Shendilocality; between August to October 2024 for the purpose of observe theLiving Conditions and Public Health Challenges in Temporary Camps for Displaced Populations. Study area The study was conducted in Shendi locality, located in the River Nile State of Sudan, which has become a major destination for displaced populations fleeing conflict zones in other parts of Sudan. Due to ongoing crises, many individuals and families have sought refuge in temporary camps within this area, which currently house a significant population of 5,950 displaced individuals. A significant reason for selecting Shendi as the study location is its high concentration of displaced populations, providing an ideal setting to assess the living conditions and public health challenges faced by these individuals. The community residing in the area obtains their water through a public network with a distribution point within the camps. However, the flow rates are low, and water is typically collected using common plastic containers and stored accordingly. Regarding sanitation, most of the temporary camps are former schools, equipped with a sewage system such as siphons. However, they face challenges such as improper disposal of solid waste and unhealthy behaviors among the residents. Sample and Sampling Techniques The study sample comprised 100 households, systematically and randomly selected from a total of 750 households across 35 temporary shelter camps in Shendi locality, River Nile State. The sample size was determined by selecting 10% of the households, which equated to 75 households. This was subsequently increased to 100 households to address potential sampling biases and ensure robustness in the findings. It is important to note that the majority of households shared similar housing characteristics, particularly in terms of quality and overcrowding, as most shelters exhibited comparable living conditions. The selection process followed a systematic random sampling technique, with a sampling interval of every 7th household. This approach ensured a representative sample from the overall population in the camps. The camps included all the temporary shelter schools in the area. The methodology for gathering data involved several techniques aimed at obtaining a comprehensive understanding of the living conditions and public health standards within the camps: ❖ Interviews with Camp Administrators : An unstructured interview was conducted with the camp administrator to gather detailed information on the size of the displaced population, the area of the camp, and the availability of facilities. The interview also explored the suitability of the camp as a shelter and the implementation of sanitation and public health programs within the camp. This provided essential contextual information necessary for understanding the challenges faced by displaced populations and the resources available to address these challenges. ❖ Household Survey Using a Questionnaire : A structured questionnaire was developed and administered to the head of each selected household (100 households in total). The questionnaire aimed to assess the living conditions of the displaced families and gather information related to basic humanitarian needs. The questions focused on various aspects of the household's situation, including: Demographic information (age, gender, education level, occupation). Water source and storage capacity (availability of clean water, methods of water storage, etc.). Human and solid waste management (methods of disposal, availability of facilities for waste management). Personal hygiene practices (availability of soap, handwashing habits, sanitation practices). Vector control (use of mosquito nets, control measures for vectors such as flies and mosquitoes). ❖ Checklist for Direct Observation : A checklist was designed to allow direct observation of environmental factors around the camp that could impact the health of displaced populations. The checklist focused on key items related to the camp's sanitation and hygiene standards, including: Cleanliness of water storage containers : Observing whether water containers were covered, clean, and properly stored to prevent contamination. Distance of water storage from potential sources of contamination : Notes were taken on the distance between water sources and sanitation facilities or waste disposal areas. Solid waste management : Observations were made regarding the availability of solid waste containers, their proper maintenance, and methods of disposal. Liquid waste management : Special attention was given to how liquid waste, especially children's feces, was disposed of and whether it met the necessary standards. Personal hygiene practices : The checklist noted any evidence of personal hygiene practices within households and whether proper sanitation protocols were followed. Food preservation : The checklist included observations regarding how food was stored and protected to prevent contamination. Mosquito net usage : The checklist also recorded the availability and use of mosquito nets, as part of the efforts to control vector-borne diseases. ❖ Interview Description An unstructured interview was conducted with the camp official to gain a deeper understanding of the camp's management dynamics, the effectiveness of the sanitation and public health programs being implemented, and the overall support systems in place for displaced populations. The interview provided valuable insights into the distribution of food and non-food supplies, the organizations supporting the camp, and how households respond to sanitation programs. It also highlighted the challenges faced by the camp authorities in ensuring the health and safety of the displaced population. ❖ Data Entry and Preparation Data Coding : All responses from the questionnaires and checklists were coded numerically to ensure that the data could be efficiently analyzed. For categorical variables (e.g., yes/no responses, education level, type of waste disposal), numerical values were assigned (e.g., "1" for Yes, "2" for No). For continuous variables (e.g., number of family members, quantity of water used), raw data were entered directly. Data Cleaning : The data were reviewed for any inconsistencies, missing values, or outliers. Missing data were handled by using imputation techniques or excluding certain cases based on the pattern of missingness. Outliers were identified using descriptive statistics and visual inspection of histograms. ❖ Data Analysis To analyze the data collected from the questionnaires, checklist observations, and interviews, the Statistical Package for Social Sciences (SPSS) version 22 was used. SPSS is a widely utilized software for statistical analysis, particularly in the field of social sciences, as it provides a robust platform for managing, analyzing, and interpreting data. • Descriptive Analysis of Survey Data Descriptive statistics were applied to analyze the demographic and health data gathered from the households in the camps. This involved calculating frequencies and percentages for categorical variables like age, gender, education level, and occupation, as well as continuous variables like family size and income. The analysis provided insights into the socio-economic profile of the displaced population, with key findings such as: A predominance of female-headed households. A significant portion of the population falls within lower income brackets. Education levels For health and nutrition standards, descriptive statistics were used to highlight discrepancies in vaccination status and nutritional intake, emphasizing critical gaps such as: Percentage of women and children remaining unvaccinated, posing a public health risk. Insufficient availability of nutritious food, with most households relying on legumes, while meat and milk consumption was minimal. Water Supply Analysis For the analysis of water supply, both descriptive and comparative analysis was conducted: Water Source Water Quantity Water Storage and Hygiene Hygiene and Sanitation Analysis The analysis of hygiene and sanitation was based on the frequency and practices related to waste disposal, handwashing, and access to soap: A significant gap in soap availability sanitation, Solid waste disposal • Observational Data Analysis Direct observation data focused on assessing sanitation and hygiene practices in the households: The presence of toilets close to food preparation areas A large percentage households regularly remove waste mosquito control • Integration of Qualitative Data (Interviews) The qualitative data from unstructured interviews with camp officials were analyzed thematically to supplement the quantitative findings. Key themes from the interviews included: Camp Management : Officials highlighted the challenges in managing overcrowded shelters and providing adequate sanitation facilities. Public Health Programs : Limited access to vaccinations and health services was a recurrent issue, which corresponds with the low vaccination rates found in the survey data. Water and Hygiene Programs : The absence of basic hygiene materials, such as soap, and the inadequate provision of water, were identified as major barriers to maintaining public health. ❖ Results Interpretation After analyzing the data using SPSS, the results were interpreted to assess the compliance with humanitarian standards in the displacement camps and identify areas of improvement in the living conditions and health outcomes of displaced populations. Accepted Standards Based on Sphere Guidelines 1. Space Allocation per Person (Shelter) Sphere Standard : At least 3.5 m² per person in emergency shelters. Accepted : Shelters with less than 3.5 m² per person are considered overcrowded and may result in insufficient ventilation, safety concerns, and increased health risks. 2. Room Occupancy Sphere Standard : A maximum of 8 persons per room. Accepted : Rooms with more than 8 persons per room (such as those accommodating up to 24 persons) violate this standard and can cause overcrowding, reduced privacy, and health issues. 3. Sanitation Facilities (Toilets) Sphere Standard : One toilet for every 25 people. Accepted : Shelters with more than 25 people per toilet (such as those with 31 people per toilet) fail to meet this standard and can lead to sanitation problems, spread of diseases, and health risks. 4. Water Supply Sphere Standard : A minimum of 15 liters of water per person per day. Accepted : A water supply of 1–2 liters per person per day (such as the 60% of households receiving this quantity) is insufficient and violates the minimum Sphere standard. This could lead to dehydration, poor hygiene, and the spread of waterborne diseases. 5. Hygiene and Health Conditions Sphere Standard : Access to soap (200g per person per month) and sanitary facilities, including safe waste disposal. Accepted : A majority of households lacking soap (96%) and those engaging in open defecation (44%) fail to meet basic hygiene standards, leading to increased risks of infections and diseases. Lack of formal solid waste management systems (90% relying on open dumps) is a significant health concern. 6. Food Security Sphere Standard : 2,100 kcal per person per day. Accepted : A majority of households reporting sufficient food availability (66%) but lacking balanced nutrition (e.g., high reliance on legumes) indicates potential nutritional deficiencies and violation of minimum standards for protein, fat, and micronutrient intake. 7. Vector Control (Mosquito Nets) Sphere Standard : All people exposed to mosquitoes should have access to mosquito nets. Accepted : A significant proportion (70%) of households without access to mosquito nets and inadequate vector control practices present risks for vector-borne diseases such as malaria. 8. Waste Management Sphere Standard : Solid waste should be managed in a way that prevents health risks and environmental pollution. Accepted : Open dumping of solid waste in 90% of the camps indicates non-compliance with Sphere standards, leading to environmental pollution and health risks for the displaced population Results Table (1): standard of temporary camps management for displaced population in Shendilocality, River Nile State- Sudan Temporary shelters No of individuals m 2 / Person Persons/Room Persons/ toilet Acceptability and risk Analysis 1. 623 2 10 10 Not Acceptable : The space per person is too small, leading to significant overcrowding. 2. 27 11 2 7 Acceptable : Adequate space per person, but the number of people per room is slightly high. 3. 93 6 3 8 Acceptable : Space is moderate, but the number of people per toilet is still high. 4. 417 2 24 26 Not Acceptable : Overcrowding in rooms is severe, indicating inadequate living conditions. 5. 251 3 22 31 Not Acceptable : Overcrowding in both rooms and toilets, leading to unhealthy living conditions. 6. 171 3.5 15 21 Acceptable : Reasonable balance between space and room occupancy, though the number of people per toilet is high. 7. 307 6.5 14 31 Not Acceptable : The number of people per toilet is excessively high. 8. 202 10 9 20 Acceptable : Excellent space per person, but the number of people per toilet needs improvement. 9. 186 9.5 14 23 Acceptable : Good space, but the toilet-to-person ratio needs improvement. 10. 167 7 13 21 Acceptable : Adequate space, but improvements are needed for the toilet-to-person ratio. 11. 86 9 8 14 Acceptable : Sufficient space, but room occupancy is still high. 12. 96 6 10 16 Acceptable : Space is adequate, but improvements are needed for the toilet-to-person ratio. 13. 211 10.5 12 21 Acceptable : Excellent space, but the number of people per toilet needs improvement. 14. 135 14 9 17 Acceptable : Excellent space, but toilet-to-person ratio could be improved. 15. 86 6 12 22 Acceptable : Space is moderate, but the toilet ratio needs improvement. 16. 286 7 (3 36 Not Acceptable : The number of people per toilet is unreasonably high, indicating poor sanitation. 17. 257 10 15 26 Acceptable : Good space, but improvements are needed for the number of people per toilet. 18. 59 10 12 15 Acceptable : Adequate space with a reasonable toilet ratio. 19. 87 7 12 22 Acceptable : Adequate space, but the toilet-to-person ratio needs improvement. 20. 141 12.5 8 14 Acceptable : Good space per person, though the toilet ratio needs some improvement. 21. 91 13 8 15 Acceptable : Excellent space, but improvements are needed for the toilet-to-person ratio. 22. 78 6.5 15 20 Acceptable : Reasonable space, but the number of people per toilet needs improvement. 23. 88 8 10 15 Acceptable : Space is acceptable, but the toilet-to-person ratio requires improvement. 24. 251 7 15 25 Acceptable : Space per person is fine, but improvements are needed for the toilet ratio. 25. 109 17 8 14 Acceptable : Excellent space per person, though the room occupancy is still high. 26. 46 11 9 12 Acceptable : Space is good, but improvements are needed for the number of people per toilet. 27. 37 16 5 10 Acceptable : Excellent space, but toilet conditions need improvement. 28. 185 12 14 23 Acceptable : Reasonable space, though the toilet-to-person ratio needs improvement. 29. 93 19 8 12 Acceptable : Excellent space per person, but the toilet ratio needs improvement. 30. 113 10.5 8 14 Acceptable : Adequate space, though improvements are required for the number of people per toilet. 31. 229 8.5 13 23 Acceptable : Space is fine, but the toilet-to-person ratio could be improved. 32. 153 11.5 10 19 Acceptable : Reasonable space, but improvements are needed for the toilet-to-person ratio. 33. 215 8 16 22 Acceptable : Adequate space, though improvements in the toilet-to-person ratio are necessary. 34. 127 4.5 11 21 Not Acceptable : The space per person is too small, leading to severe overcrowding. 35. 247 10 14 25 Acceptable : Adequate space, but improvements are needed for the toilet-to-person ratio. The table indicates the evaluation of temporary shelters used by individuals, focusing on the space available per person, the number of people per room, and the number of people per toilet. The conditions are classified as "Acceptable" or "Not Acceptable" based on criteria such as personal space (in square meters) and the ratio of people in rooms and sanitary facilities. In many cases, shelters suffer from severe overcrowding (such as 24 people in one room), leading to a lack of privacy and space. The ratio of people to toilets is also high in some cases, affecting cleanliness and overall health. While some shelters provide good space (such as 11 m² per person), improvements are needed in balancing the number of people per toilet and room. Table (2): distribution demographic information of household heads in temporary displaced camps, Shendi locality- River Nile State Demographic variables of household heads No % Age 15–20 years 8 8% 21–25 years 14 14% 26-30years 18 18% More than 30years 60 60% Gender Male 12 12% Female 88 88% Eduacation level Un educate 24 12% Primary 30 30% Secondary 36 36% University and above 22 22% Occupation Homemaker 66 66% Employee 8 8% Free job 26 26% Number of family members Less than 4members 20 20% 4-6members 46 46% 7–9 members 26 26% More than 10 member 8 8% Family income Less than 100 thousand 50 50% 100–150 thousand 30 30% 160–200 thousand 2 2% More than 200 thousand 18 18% The table presents demographic data of household heads, highlighting their age, gender, education level, occupation, family size, and income. Most heads of households are over 30 years old (60%), with a significant majority being female (88%). In terms of education, 36% have completed secondary education, and 66% of heads are homemakers. Family sizes vary, with 46% having 4–6 members, and 50% earn less than 100 thousand, indicating economic constraints. Table (3): health and nutrition standards among displaced households in temporary camps management for displaced population in Shendy locality, River Nile State- Sudan. Information about Health and nutrition standards No (%) Minimum standers and Acceptability analysis Woman Vaccination status Unvaccinated 42(42%) There is a clear difference in the vaccination rates for Tetanus. A significant portion of the population has received this vaccine, which is essential for maternal and child health. Regarding meningitis and yellow fever: show a much lower rate of vaccination compared to Tetanus, indicating potential gaps in the health coverage of displaced populations. Tetanus 52(52) Meningitis 4(4%) Yellow fever 2(2%) Woman's delivered in last pregnant after displacement In hospital 72(72%) Maternity services must be available to pregnant women in ideal health conditions In camp 28(28%) Under one year children vaccination status Un applicable 82(82%) Acceptable standard: All children should receive vaccines. Vaccinated 10 (10%) Unvaccinated 8(8%) Availability of Mosquito net Available 30(30%) 30% reported having access to mosquito nets, which is well below the required standard for preventing vector-borne diseases. The risk of diseases like malaria would likely be higher in the absence of mosquito nets and a comparison of health outcomes between those with and without nets could provide meaningful conclusions. Unavailable 70(70%) food available in sufficient quantities Yes 66(66%) 66% of households reported sufficient food availability, which aligns with the minimum standard of 2,100 kcals per person per day. A significant 34% of households reported insufficient food, which may correlate with increased risks of malnutrition. No 34(34%) Food consumed among displaced household Legumes 92(92%) 10 per cent of total energy provided by protein, 17 per cent of total energy provided by fat, Adequate micronutrient intake. Meat 6(6%) Milk 2(2%) food be stored in closed container Yes 90(90%) Food is kept in suitable containers and covered to prevent insect access and to protect it from the surrounding environmental conditions No 10(10%) The table provides information on health and nutrition standards among displaced populations. It shows that 52% of women are vaccinated against tetanus, but vaccination rates for meningitis (4%) and yellow fever (2%) are low, indicating gaps in health coverage. While 72% of women gave birth in hospitals, 28% gave birth in camps, suggesting limited access to proper maternity services. Food availability meets minimum standards for 66% of households, though 34% face food shortages, and 90% store food in closed containers. However, only 30% have access to mosquito nets, leaving many at risk of vector-borne diseases. Table (4); status of water supply standard, source, storage, quantity and quality in temporary displaced camps, Shendi locality- River Nile State Investigated Water standards No (%) Minimum standards and Acceptability Analysis Water source Tap 95 (95%) Given that 95% have access to tap water; the access to safe drinking water is high. However, only 5% rely on well water, which may indicate a minimal risk to public health if well water is not properly treated. Well 5(5%) Distance of water point Less than 50 m 78(78%) A significant number (78%) have water sources within 50 meters, which is an acceptable distance for quick access. However, 20% being farther than 50 meters may pose a barrier, especially for women and children who need to carry water More than 50m 20(20% Outside the temporary camp 4(4%) Container capacity Less than 20 liters 78(78%) 78% of the population uses containers less than 20 liters, which could be insufficient for daily needs. Ideally, larger containers (20–40 liters) should be used for larger families. 20 to 40 liters 22 (22%) Water quantity 1–2 L/P/D 60(60%) 60% of individuals consume only 1–2 liters of water per day, which is below the minimum daily requirement. This indicates that water scarcity is an issue for a majority of individuals in the camp. 3-4L/P/D 34(34%) 5-6L/P/D 6(6%) water containers clean Yes 74(74%) 74% of individuals use clean containers, which is a good practice for preventing contamination. However, 26% using unclean containers poses a significant risk for waterborne diseases. No 26(26%) defecation near a water source Yes 20(20% 20% of individuals defecate near water sources, posing a significant risk for contamination. Proper sanitation practices and further distancing of latrines from water sources are recommended. No 80(80%) water source protected from contamination Yes 70(70%) 70% of water sources are protected from contamination, which is acceptable. However, 30% of sources are unprotected, which increases the risk of waterborne illnesses. No 30(30%) Table (5); situation of hygiene and sanitation standards in temporary displaced camps, Shendi locality- River Nile State surveyed hygiene and Sanitation standards No (%) Minimum standards and Acceptability Analysis Availability of soap for household/month Not available 96(96%) A large percentage (96%) of households do not have soap available, which is well below the minimum standard. This lack of soap creates a significant health risk. Only 2% have access to sufficient soap, indicating that most households are not meeting hygiene standards. Less than 4 soups/household/month 2(2%) 4–6 soups/household/month 2(%) open defecation Exist 44(44%) With 44% of households practicing open defecation, the risk of water contamination and the spread of diseases is high. Proper sanitation facilities are essential to meet hygiene standards. Not exist 66(66%) Solid waste disposal Open dump 90(90%) A vast majority (90%) of households use open dumping, which presents serious health risks and environmental pollution. Only 10% have access to formal waste disposal, which is in line with minimum standards for sanitation. Formal disposal 10(10%) The table outlines water quality standards in a temporary camp. 95% of individuals have access to tap water, while 5% rely on wells, indicating low health risks. 78% of people have water sources within 50 meters, but 20% are farther, creating accessibility challenges. 60% consume less than the daily required amount of water, highlighting a scarcity issue. Table (6): Direct observation for environment around sheltersin temporary displaced camps, Shendi locality- River Nile State Observed items around households shelters Yes No Minimum standers and Acceptability analysis Toilet close to where food is prepared 52(52%) 48(48%) The p-value of 0.89 indicates that there is no significant difference between households with toilets close to where food is prepared and those without. Therefore, the proximity of toilets to food preparation areas does not significantly impact sanitation. Defecation in toilet 78(78%) 22(22%) The p-value of 0.002 is significant (p < 0.05), indicating a strong relationship between having a toilet used for defecation and maintaining proper sanitation. The high percentage of households with toilets used for defecation is a positive sign in terms of meeting sanitation standards. Proper disposal of children’s feces 82(82%) 18(18%) The p-value of 0.06 is marginally significant (p close to 0.05), suggesting that there may be an association between proper disposal of children's feces and sanitation practices. However, further data or analysis may be needed to draw stronger conclusions. Wash hand after cleaning child’s a stool 93(93%) 7(7%) The p-value of 0.04 is significant (p < 0.05), showing that a majority of households wash their hands after cleaning a child’s stool. This practice is critical for preventing the spread of infections and maintaining hygiene. Covers for garbage cans 60(60%) 40(40%) Garbage disposal 84(84%) 16(16%) 84% of households manage waste properly, indicating positive practices in this area, which help minimize health risks related to waste mismanagement. Dispose of stagnant water 42(42%) 58(58%) 58% of households do not dispose of stagnant water properly, which poses a health risk, especially in environments where vector-borne diseases like malaria could spread. Children play in stagnant water 29(29%) 71(71%) 29% of households report that children play in stagnant water. This is a significant health hazard as stagnant water is often a breeding ground for harmful bacteria and mosquitoes. Household waste removed regular 96(96%) 4(4%) Only 32% of households use mosquito nets, which reflects a lack of protection against mosquito-borne diseases. This needs improvement as mosquitoes can spread diseases like malaria and dengue. Breeding of files and rodents 96(96%) 4(4%) 22% of households still practice open defecation, posing a significant public health risk, particularly in areas with inadequate sanitation facilities. Used mosquito nets 32(32%) 68(68%) Only 32% of households use mosquito nets, which reflects a lack of protection against mosquito-borne diseases. This needs improvement as mosquitoes can spread diseases like malaria and dengue. Use enough water for washing and bathing 58(58%) 62(62%) 58% of households use enough water for washing and bathing, but the remaining 62% face limitations in water access, which affects hygiene practices and personal cleanliness. Washing facilities available 60(60%) 40(40%) Open defecation 22(22%) 78(78%) 22% of households still practice open defecation, posing a significant public health risk, particularly in areas with inadequate sanitation facilities. House fly 42(42%) 58(58% The presence of flies, mosquitoes, and rodents in 96% of households is a significant concern. This indicates a high risk of environmental contamination and possible disease transmission. Mosquito 48(48%) 52(52%) Cockroach 10(10%) 90(90%) method used for mosquitoes Spraying 3 3% 73% of households use repellents to control mosquitoes, while others use traps and spraying methods. This shows a variety of approaches, but the overall usage of mosquito nets is still low, highlighting a gap in preventive measures. Using repellents 73 73% Traps 24 24% mosquito nets available Yes 30 30% Mosquito activity peaks in the evening ( 67% ), suggesting that interventions during this time may be more effective in controlling mosquito-related health risks. No 70 70% time during connected Morning 2 2% Evening 67 67% Night 31 31% The table provides an analysis of environmental health factors in households, showing the percentage of households adhering to sanitation standards, such as using toilets for defecation, proper disposal of waste, and handwashing after cleaning children's stool. It highlights the importance of health practices like disposing of stagnant water and using mosquito nets, while also showing challenges in certain areas like toilet usage and insect prevention. Discussion This study aimed to assess the living conditions of displaced populations in Shendi camps according to Sphere Project standards. The findings reveal significant gaps in space allocation, sanitation, food security, and healthcare, highlighting the urgent need for improved living conditions and humanitarian support. Managing temporary camps during emergencies is critical, and schools are frequently used as temporary shelters due to their existing facilities for cooking and sanitation. Table 1 indicates that schools were the most commonly used shelters for displaced individuals, despite concerns about privacy, room sizes, and overcrowding. Nevertheless, schools were the most accessible option due to their spaciousness, adequate health facilities, and access to safe drinking water. Additionally, schools are close to public facilities such as hospitals, markets, and transportation, which is an added benefit. These findings align with previous studies such as Al-Tuwaijri et al. (2013), who highlighted that educational facilities are an effective temporary shelter solution in cases of displacement due to conflicts or natural disasters. The availability of large spaces and immediate access to facilities are essential in these situations. Furthermore, Hassan et al. ( 2020 ) demonstrated that adequate health facilities in shelters improve displaced populations' health, and Gonzalez et al. ( 2022 ) noted the importance of proximity to community resources for improving well-being in temporary shelters. Access to healthcare in the area significantly eases the challenges faced by displaced populations. The proximity to hospitals and the freedom of movement are critical, particularly for pregnant women, children, and other vulnerable groups. The study found that many women were able to access vaccination and maternal health services at hospitals, as reflected in Table 3, which shows a high rate of vaccination for Tetanus. However, some children missed vaccinations due to a lack of awareness and guidance from mothers, as indicated by the 8% of missed vaccinations. This finding is consistent with a study by Brooks et al. ( 2023 ), which found that limited maternal health education in refugee camps contributed to missed immunizations and other healthcare services, leading to preventable diseases among children. Regarding food security, the study found that many displaced families rely on grains as their primary food source (92%), with limited consumption of meat (6%) and nearly no milk intake (2%). This lack of dietary diversity is a significant cause of malnutrition, particularly among children. According to UNICEF ( 2016 ), poor economic conditions and the lack of resources to purchase diverse foods are major factors contributing to malnutrition in displaced families. Smith et al. ( 2022 ) also highlighted dietary diversity as a challenge in refugee populations, urging efforts to diversify food aid to improve nutritional outcomes. Similarly, a study by Ahmed et al. ( 2018 ) showed that reliance on grains in Sudanese camps led to deficiencies in essential nutrients such as proteins and fats, contributing to higher rates of malnutrition. Ghosh et al. ( 2015 ) also found that displaced families often suffer from protein and fat deficiencies. Additionally, Thompson et al. (2023) pointed out that long-term reliance on grains exacerbates the risk of vitamin and mineral deficiencies, especially among children and pregnant women. Water availability is crucial for health and hygiene. According to Table 4, 98% of households rely on tap water, while 2% depend on well water. However, water supply was sometimes intermittent, which violates Sphere Project ( 2018 ) standards, which recommend 7.5 liters of water per person per day. The study also found that the water quality was compromised by the presence of stagnant water near the camps, increasing the risk of waterborne diseases. Previous studies, such as IOM ( 2019 ) in South Sudan, have shown that camps lacking clean water are more prone to outbreaks of diseases like cholera and dysentery. These findings are consistent with the JMP (2018) report, which emphasized the importance of providing clean and accessible water to reduce health risks. WHO ( 2023 ) also confirmed that inadequate access to clean water in displacement settings leads to higher morbidity and mortality rates from waterborne diseases, urging a reevaluation of water distribution strategies in camps. Sanitation and hygiene were also major concerns in the camps. Table 5 indicates that 44% of households practice open defecation, and 90% of the camps use open waste disposal, both of which significantly increase the risk of disease outbreaks. Moreover, 96% of households reported lacking soap for personal hygiene, which does not meet the international standards requiring 200 grams of laundry soap and 250 grams of bathing soap per person per month. This hygiene gap contributes to the spread of skin diseases, respiratory infections, and other hygiene-related illnesses. Studies by Parker et al. ( 2017 ) and Stern et al. ( 2018 ) have also emphasized the link between inadequate sanitation and the spread of infectious diseases. Adnan et al. ( 2022 ) also reinforced the importance of improving sanitation infrastructure and hygiene practices to reduce the incidence of infectious diseases in refugee camps. Conclusion This study underscores the critical challenges faced by displaced populations in Shendi's temporary camps, such as overcrowded shelters, limited healthcare access, poor food security, and inadequate water, sanitation, and hygiene standards. These factors significantly increase health risks and vulnerability among displaced individuals. Based on the study's findings, there is an urgent need to improve the living conditions in these camps by enhancing food security, improving waste management, and promoting better hygiene practices. Clean and safe water sources must be provided, along with awareness campaigns on hygiene and public health. Collaboration between humanitarian organizations and governments is essential to provide financial support and improve the living standards of displaced families. Abbreviations No Abbreviations Full meaning 1 AIDS Acquired Immune Deficiency Syndrome 2 ECO-SAN Ecological Sanitation 3 HIV Human Immunodeficiency Virus 4 IDP Internally Displaced Person 5 JMP Joint Monitoring Programme 6 PH-RAM Public Health Risk Assessment Model 7 SPSS Statistical Package For Social Sciences 8 UDT Urine Division Toilet 9 VIP Ventilated Improved 10 WASH Water Supplies and Sanitation and Hygiene Promotion Declarations Ethical approval and consent to participate: The study was initially approved by the ethical committee of the Faculty of Public Health (Institutional Research Board) at Shendi University. In addition, permission was obtained from the Health and Population Department – Shendi locality, directors of temporary camps, and household heads in shelters to be studied. We have also ensured that all names and personal data were completely secured to protect the privacy and confidentiality of the participants. This revision now provides full transparency regarding the ethical considerations involved in the study. Consent for publication: Not applicable Competing interests The authors declared no conflict of interest. Funding The researchers did not receive any fund from any source. Author Contribution ASMA designed the study and wrote the manuscript. RAAK collect and analyzed the data and designed tables. All authors reviewed manuscript. All authors read and approved the final manuscript. All authors contributed significantly to this work, conceiving the idea of the research, collection and analysis of data, writing and editing of the manuscript. All authors read and approved the manuscript. Acknowledgement The cooperation and devotion of the health teams in all health institutions and camps selected for the study is very much appreciated. Their support and detection should be acknowledgment. Data Availability The datasets used and analyzed during this study are available from the corresponding author or reasonable request. References Adnan S, Chandra P, Williams A. Improving Sanitation in Displacement Camps: A Path to Reducing Infectious Diseases. Int J Hyg Environ Health. 2022;243:83–92. Ahmed S, et al. Nutritional assessment of displaced populations in Sudan. J Humanitarian Assistance. 2018;15(2):34–48. Alhaj R, et al. Challenges in Humanitarian Aid Delivery in South Kordofan: A Focus on Water and Sanitation. Journal of Humanitarian Response; 2020. Borton J. Humanitarian Assistance: A Review of the Humanitarian System’s Effectiveness. Oxford University Press; 2019. Brooks S, Smith J, Jackson L. Health Access in Refugee Camps: Barriers and Solutions. Global Public Health J. 2023;15(2):112–24. El-Din M, et al. Living Conditions and Public Health Risks in Displacement Camps in Darfur: A Case Study. Sudanese Journal of Public Health; 2018. Ghosh S, et al. Food security and malnutrition in refugee camps: A comparative study. Int J Disaster Manage. 2015;25(3):103–15. Gonzalez M, Lopez R, Perez V. Temporary Shelters in Crisis: The Role of Educational Facilities. Disaster Manage Rev. 2022;31(4):245–58. Hassan R, et al. Provision of adequate health facilities and safety measures in shelters: Impact on health outcomes in refugee camps. Health Humanitarian Affairs J. 2020;11(1):56–63. International Federation of Red Cross and Red Crescent Societies. The Sphere Handbook: Humanitarian Charter and Minimum Standards in Humanitarian Response. Geneva: Sphere Project; 2017. IOM. Water, sanitation, and hygiene in displaced populations in South Sudan. IOM Rep. 2019;22(5):45–56. Parker A, et al. Sanitation challenges in refugee camps: Lessons learned. Public Health J. 2017;37(1):92–104. Smith K, Brown A, Miller E. Nutritional Challenges in Refugee Populations: A Call for Diversified Aid. J Humanitarian Assistance. 2022;18(1):60–72. Sphere Project. Sphere Handbook: Humanitarian Charter and Minimum Standards in Humanitarian Response. Geneva: Sphere Association; 2016. Sphere Project. Sphere Handbook: Humanitarian Charter and Minimum Standards in Humanitarian Response. 4th ed. Geneva: The Sphere Project; 2018. Stern R, et al. Hygiene practices and health outcomes in refugee camps: A longitudinal study. Global Health Rev. 2018;48(4):78–91. UNICEF. Nutrition in Emergencies: Challenges and Solutions. New York: UNICEF; 2016. United Nations High Commissioner for Refugees. Global Trends: Forced Displacement in 2018. UNHCR; 2019. United Nations Office for the Coordination of Humanitarian Affairs. Sudan Humanitarian Response Plan 2021. OCHA; 2021. WHO. The Impact of Clean Water Access on Health in Refugee Settings. World Health Organization Report; 2023. World Health Organization. Health and Humanitarian Crises: A Guide for Health Practitioners. WHO; 2020. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6117389","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":437054457,"identity":"471503e4-48f5-43a1-b611-83a9accb4adf","order_by":0,"name":"Alhaj Saad Mohamed Ahmed","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA7ElEQVRIie2RsQrCMBCGI4V0Oa3jFYq+QqRQCgq+iiA4pW8gIghO1Wdx6qwE61L3QEbBwakgiIOIqTq3HQXzLXeB+7j7CSEGwy9iAyFICDj2Yquf6FUr1kfx3DgdFQrUUzQDJjkrmmrFWTR3efhIgGXZ9SKnIRBb7DdlCorWGN2lAvewSvo81YfBZCJL1whg6M4VtLJj4nOqFYSgVOkK8O/4UEAkP/v8WUNhAgJEqqAtuXWKljWUnlbCd5Y4DaxojUCrsnQOsa/0YUP9lacrv806ji3S8vgaCz+VviutGi9o5F81rzNtMBgM/8cLvfhGGE5zC1AAAAAASUVORK5CYII=","orcid":"","institution":"Shendi University","correspondingAuthor":true,"prefix":"","firstName":"Alhaj","middleName":"Saad Mohamed","lastName":"Ahmed","suffix":""},{"id":437054458,"identity":"6c0ec1b1-ecc5-418f-9112-0b6fe65f01bc","order_by":1,"name":"Rowyda Alnile Ahmed Khamees","email":"","orcid":"","institution":"Shendi University","correspondingAuthor":false,"prefix":"","firstName":"Rowyda","middleName":"Alnile Ahmed","lastName":"Khamees","suffix":""}],"badges":[],"createdAt":"2025-02-27 04:38:12","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6117389/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6117389/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":79763446,"identity":"f324f9f5-bc0b-4b4c-92b3-7fb37d138784","added_by":"auto","created_at":"2025-04-02 11:50:17","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2271025,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6117389/v1/90a51dc4-6975-49f6-9d9b-ccab87ae2626.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Living Conditions and Public Health Challenges in Temporary Camps for Displaced Populations in Shendi Locality, Sudan","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe ongoing armed conflict in Sudan, characterized by civil wars, internal strife, and political instability, has led to widespread displacement across the country. As a result, millions of individuals have been forced into temporary camps, primarily in regions such as Shendi locality in River Nile State. These camps, housing an estimated 5,950 displaced persons across 35 centers (schools), serve as emergency shelters for displaced populations, where the living conditions are often overcrowded, unsanitary, and severely lacking in essential services. These displaced persons face heightened vulnerabilities due to inadequate access to clean water, sanitation, food, healthcare, and shelter, which intensify the public health challenges they experience. The lack of basic needs in temporary camps significantly raises the risk of infectious diseases, malnutrition, and mental health problems, thus exacerbating the humanitarian crisis in the region (United Nations High Commissioner for Refugees, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; World Health Organization, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eArmed conflict often results in the destruction of infrastructure and disruption of local health services, leaving displaced populations without adequate healthcare access. The collapse of essential services such as transportation, communication, and medical facilities makes it increasingly difficult for humanitarian organizations to reach and provide relief to those in need. The exposure to harsh environmental conditions in camps, coupled with inadequate shelter and sanitation facilities, accelerates the spread of diseases, contributing to higher mortality rates and further health deterioration (Sphere Handbook, 2018). This situation highlights the urgent need for effective, coordinated humanitarian interventions that adhere to internationally recognized standards in order to improve the living conditions and health outcomes of displaced populations (United Nations, 2016).\u003c/p\u003e \u003cp\u003eHumanitarian organizations such as the United Nations (UN), World Health Organization (WHO), and various non-governmental organizations (NGOs) emphasize the importance of adhering to minimum humanitarian standards during crises. These standards, outlined by organizations like the Sphere Project, cover essential areas such as water, sanitation, shelter, nutrition, and healthcare. Their purpose is to ensure that displaced individuals receive life-saving assistance while maintaining human dignity and upholding fundamental rights. However, the implementation of these standards in emergency settings is often hindered by logistical challenges, resource constraints, and coordination issues among agencies (International Federation of Red Cross and Red Crescent Societies, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Despite these challenges, it remains critical to assess how effectively these standards are being applied, especially in the context of displacement camps in Sudan.\u003c/p\u003e \u003cp\u003ePrevious studies, such as those by El-Din and colleagues (2018) and Alhaj et al. (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2020\u003c/span\u003e), have examined displacement camps in Sudan and the broader region. These studies highlighted the critical gaps in meeting humanitarian standards, particularly in water and sanitation, healthcare access, and food security. El-Din's study focused on the displacement camps in Darfur, finding similar challenges with overcrowded shelters and inadequate healthcare services, while Alhaj's research in South Kordofan underscored the impact of poor hygiene practices and insufficient nutrition on the displaced populations, (El-Din et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Alhaj et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). These studies provide valuable context for understanding the broader challenges faced by displaced populations across Sudan and emphasize the need for improved humanitarian responses in these settings.\u003c/p\u003e \u003cp\u003eThis study aims to examine the living conditions and public health challenges faced by displaced populations in temporary camps, specifically focusing on the application of humanitarian standards in Shendi locality, River Nile State. It will evaluate the extent to which these standards are met in the areas of water, sanitation, healthcare, and shelter, and assess their impact on the health and well-being of displaced persons. The study will also explore the barriers and challenges that hinder the effective implementation of these standards and provide recommendations for improving humanitarian responses.\u003c/p\u003e \u003cp\u003eThe choice of Shendi locality in River Nile State is particularly significant due to its vulnerability to the effects of ongoing conflict and the large number of internally displaced persons (IDPs) in the region. The region is one of the many parts of Sudan affected by displacement due to armed conflict, and the situation in Shendi represents the broader crisis faced by many displaced populations across Sudan. The camp populations in Shendi are often forced to live in overcrowded conditions with limited access to clean water, adequate sanitation, and healthcare services, making it a critical area for studying the public health implications of displacement and the challenges of meeting humanitarian standards.\u003c/p\u003e \u003cp\u003eBy focusing on Shendi, this study not only addresses the specific challenges faced by the displaced populations in this region but also provides insights that can be applied to similar contexts of displacement in other conflict-affected areas of Sudan and beyond. The region\u0026rsquo;s context allows for a deeper understanding of the real-world implications of humanitarian standards in emergency settings, particularly when resources are scarce, and coordination among various agencies is weak. This makes Shendi an important case study for identifying gaps in the implementation of humanitarian aid and exploring ways to improve future responses to displacement crises.\u003c/p\u003e \u003cp\u003eThis study aims to evaluate the living conditions and public health challenges faced by displaced populations in temporary camps in Shendi locality, River Nile State, Sudan, with a specific focus on the implementation of humanitarian standards. The research will assess the effectiveness of these standards in improving health and well-being within the camps and identify the gaps and barriers that hinder their full implementation. By addressing these objectives, the study will contribute to a better understanding of the real-world challenges in applying humanitarian standards in emergency displacement contexts. The findings will offer insights into how improving the adherence to these standards can mitigate public health risks and enhance the overall quality of life for displaced individuals in Shendi and similar regions.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy design\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCross-sectional descriptive and household based study was conducted on the displaced shelters in the temporary camps in Shendilocality; between August to October \u003cstrong\u003e2024\u003c/strong\u003e for the purpose of observe theLiving Conditions and Public Health Challenges in Temporary Camps for Displaced Populations.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy area\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted in Shendi locality, located in the River Nile State of Sudan, which has become a major destination for displaced populations fleeing conflict zones in other parts of Sudan. Due to ongoing crises, many individuals and families have sought refuge in temporary camps within this area, which currently house a significant population of 5,950 displaced individuals. A significant reason for selecting Shendi as the study location is its high concentration of displaced populations, providing an ideal setting to assess the living conditions and public health challenges faced by these individuals. The community residing in the area obtains their water through a public network with a distribution point within the camps. However, the flow rates are low, and water is typically collected using common plastic containers and stored accordingly. Regarding sanitation, most of the temporary camps are former schools, equipped with a sewage system such as siphons. However, they face challenges such as improper disposal of solid waste and unhealthy behaviors among the residents.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSample and Sampling Techniques\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study sample comprised 100 households, systematically and randomly selected from a total of 750 households across 35 temporary shelter camps in Shendi locality, River Nile State. The sample size was determined by selecting 10% of the households, which equated to 75 households. This was subsequently increased to 100 households to address potential sampling biases and ensure robustness in the findings. It is important to note that the majority of households shared similar housing characteristics, particularly in terms of quality and overcrowding, as most shelters exhibited comparable living conditions. The selection process followed a systematic random sampling technique, with a sampling interval of every 7th household. This approach ensured a representative sample from the overall population in the camps. The camps included all the temporary shelter schools in the area.\u003c/p\u003e\n\u003cp\u003eThe methodology for gathering data involved several techniques aimed at obtaining a comprehensive understanding of the living conditions and public health standards within the camps:\u003c/p\u003e\n\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n\u003ch2\u003e\u003cstrong\u003e❖ Interviews with Camp Administrators\u003c/strong\u003e:\u003c/h2\u003e\n\u003cp\u003eAn unstructured interview was conducted with the camp administrator to gather detailed information on the size of the displaced population, the area of the camp, and the availability of facilities. The interview also explored the suitability of the camp as a shelter and the implementation of sanitation and public health programs within the camp. This provided essential contextual information necessary for understanding the challenges faced by displaced populations and the resources available to address these challenges.\u003c/p\u003e\n\u003c/div\u003e\n\u003ch2\u003e\u003cstrong\u003e❖\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eHousehold Survey Using a Questionnaire\u003c/strong\u003e:\u003c/h2\u003e\n\u003cp\u003eA structured questionnaire was developed and administered to the head of each selected household (100 households in total). The questionnaire aimed to assess the living conditions of the displaced families and gather information related to basic humanitarian needs. The questions focused on various aspects of the household's situation, including:\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eDemographic information\u003c/strong\u003e (age, gender, education level, occupation).\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eWater source and storage capacity\u003c/strong\u003e (availability of clean water, methods of water storage, etc.).\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eHuman and solid waste management\u003c/strong\u003e (methods of disposal, availability of facilities for waste management).\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003ePersonal hygiene practices\u003c/strong\u003e (availability of soap, handwashing habits, sanitation practices).\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eVector control\u003c/strong\u003e (use of mosquito nets, control measures for vectors such as flies and mosquitoes).\u003c/p\u003e\n\u003c/li\u003e\n\u003c/ul\u003e\n\u003ch2\u003e\u003cstrong\u003e❖\u003c/strong\u003e \u003cstrong\u003eChecklist for Direct Observation\u003c/strong\u003e:\u003c/h2\u003e\n\u003cp\u003eA checklist was designed to allow direct observation of environmental factors around the camp that could impact the health of displaced populations. The checklist focused on key items related to the camp's sanitation and hygiene standards, including:\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eCleanliness of water storage containers\u003c/strong\u003e: Observing whether water containers were covered, clean, and properly stored to prevent contamination.\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eDistance of water storage from potential sources of contamination\u003c/strong\u003e: Notes were taken on the distance between water sources and sanitation facilities or waste disposal areas.\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eSolid waste management\u003c/strong\u003e: Observations were made regarding the availability of solid waste containers, their proper maintenance, and methods of disposal.\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eLiquid waste management\u003c/strong\u003e: Special attention was given to how liquid waste, especially children's feces, was disposed of and whether it met the necessary standards.\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003ePersonal hygiene practices\u003c/strong\u003e: The checklist noted any evidence of personal hygiene practices within households and whether proper sanitation protocols were followed.\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eFood preservation\u003c/strong\u003e: The checklist included observations regarding how food was stored and protected to prevent contamination.\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eMosquito net usage\u003c/strong\u003e: The checklist also recorded the availability and use of mosquito nets, as part of the efforts to control vector-borne diseases.\u003c/p\u003e\n\u003c/li\u003e\n\u003c/ul\u003e\n\u003ch2\u003e\u003cstrong\u003e❖\u003c/strong\u003e Interview Description\u003c/h2\u003e\n\u003cp\u003eAn unstructured interview was conducted with the camp official to gain a deeper understanding of the camp's management dynamics, the effectiveness of the sanitation and public health programs being implemented, and the overall support systems in place for displaced populations. The interview provided valuable insights into the distribution of food and non-food supplies, the organizations supporting the camp, and how households respond to sanitation programs. It also highlighted the challenges faced by the camp authorities in ensuring the health and safety of the displaced population.\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003e❖\u003c/strong\u003e Data Entry and Preparation\u003c/h2\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eData Coding\u003c/strong\u003e: All responses from the questionnaires and checklists were coded numerically to ensure that the data could be efficiently analyzed. For categorical variables (e.g., yes/no responses, education level, type of waste disposal), numerical values were assigned (e.g., \"1\" for Yes, \"2\" for No). For continuous variables (e.g., number of family members, quantity of water used), raw data were entered directly.\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eData Cleaning\u003c/strong\u003e: The data were reviewed for any inconsistencies, missing values, or outliers. Missing data were handled by using imputation techniques or excluding certain cases based on the pattern of missingness. Outliers were identified using descriptive statistics and visual inspection of histograms.\u003c/p\u003e\n\u003c/li\u003e\n\u003c/ul\u003e\n\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\n\u003ch2\u003e\u003cstrong\u003e❖\u003c/strong\u003e\u0026nbsp;Data Analysis\u003c/h2\u003e\n\u003cp\u003eTo analyze the data collected from the questionnaires, checklist observations, and interviews, the Statistical Package for Social Sciences (SPSS) version 22 was used. SPSS is a widely utilized software for statistical analysis, particularly in the field of social sciences, as it provides a robust platform for managing, analyzing, and interpreting data.\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003e\u0026bull; Descriptive Analysis of Survey Data\u003c/h3\u003e\n\u003cp\u003eDescriptive statistics were applied to analyze the demographic and health data gathered from the households in the camps. This involved calculating frequencies and percentages for categorical variables like age, gender, education level, and occupation, as well as continuous variables like family size and income. The analysis provided insights into the socio-economic profile of the displaced population, with key findings such as:\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cp\u003eA predominance of female-headed households.\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003eA significant portion of the population falls within lower income brackets.\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003eEducation levels\u003c/p\u003e\n\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eFor health and nutrition standards, descriptive statistics were used to highlight discrepancies in vaccination status and nutritional intake, emphasizing critical gaps such as:\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cp\u003ePercentage of women and children remaining unvaccinated, posing a public health risk.\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003eInsufficient availability of nutritious food, with most households relying on legumes, while meat and milk consumption was minimal.\u003c/p\u003e\n\u003c/li\u003e\n\u003c/ul\u003e\n\u003ch3\u003eWater Supply Analysis\u003c/h3\u003e\n\u003cp\u003eFor the analysis of water supply, both descriptive and comparative analysis was conducted:\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cp\u003eWater Source\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003eWater Quantity\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003eWater Storage and Hygiene\u003c/p\u003e\n\u003c/li\u003e\n\u003c/ul\u003e\n\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\n\u003ch2\u003eHygiene and Sanitation Analysis\u003c/h2\u003e\n\u003cp\u003eThe analysis of hygiene and sanitation was based on the frequency and practices related to waste disposal, handwashing, and access to soap:\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cp\u003eA significant gap in soap availability\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003esanitation,\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003eSolid waste disposal\u003c/p\u003e\n\u003c/li\u003e\n\u003c/ul\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\n\u003ch2\u003e\u0026bull; Observational Data Analysis\u003c/h2\u003e\n\u003cp\u003eDirect observation data focused on assessing sanitation and hygiene practices in the households:\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cp\u003eThe presence of toilets close to food preparation areas\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003eA large percentage households regularly remove waste\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003emosquito control\u003c/p\u003e\n\u003c/li\u003e\n\u003c/ul\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\n\u003ch2\u003e\u0026bull; Integration of Qualitative Data (Interviews)\u003c/h2\u003e\n\u003cp\u003eThe qualitative data from unstructured interviews with camp officials were analyzed thematically to supplement the quantitative findings. Key themes from the interviews included:\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eCamp Management\u003c/strong\u003e: Officials highlighted the challenges in managing overcrowded shelters and providing adequate sanitation facilities.\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003ePublic Health Programs\u003c/strong\u003e: Limited access to vaccinations and health services was a recurrent issue, which corresponds with the low vaccination rates found in the survey data.\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eWater and Hygiene Programs\u003c/strong\u003e: The absence of basic hygiene materials, such as soap, and the inadequate provision of water, were identified as major barriers to maintaining public health.\u003c/p\u003e\n\u003c/li\u003e\n\u003c/ul\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\n\u003ch2\u003e\u003cstrong\u003e❖\u003c/strong\u003e\u0026nbsp; Results Interpretation\u003c/h2\u003e\n\u003cp\u003eAfter analyzing the data using SPSS, the results were interpreted to assess the compliance with humanitarian standards in the displacement camps and identify areas of improvement in the living conditions and health outcomes of displaced populations.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAccepted Standards Based on Sphere Guidelines\u003c/strong\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\n\u003cp\u003e1. Space Allocation per Person (Shelter)\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eSphere Standard\u003c/strong\u003e: At least 3.5 m\u0026sup2; per person in emergency shelters.\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eAccepted\u003c/strong\u003e: Shelters with less than 3.5 m\u0026sup2; per person are considered overcrowded and may result in insufficient ventilation, safety concerns, and increased health risks.\u003c/p\u003e\n\u003c/li\u003e\n\u003c/ul\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\n\u003cp\u003e2. Room Occupancy\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eSphere Standard\u003c/strong\u003e: A maximum of 8 persons per room.\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eAccepted\u003c/strong\u003e: Rooms with more than 8 persons per room (such as those accommodating up to 24 persons) violate this standard and can cause overcrowding, reduced privacy, and health issues.\u003c/p\u003e\n\u003c/li\u003e\n\u003c/ul\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e\n\u003cp\u003e3. Sanitation Facilities (Toilets)\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eSphere Standard\u003c/strong\u003e: One toilet for every 25 people.\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eAccepted\u003c/strong\u003e: Shelters with more than 25 people per toilet (such as those with 31 people per toilet) fail to meet this standard and can lead to sanitation problems, spread of diseases, and health risks.\u003c/p\u003e\n\u003c/li\u003e\n\u003c/ul\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec18\" class=\"Section2\"\u003e\n\u003cp\u003e4. Water Supply\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eSphere Standard\u003c/strong\u003e: A minimum of 15 liters of water per person per day.\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eAccepted\u003c/strong\u003e: A water supply of 1\u0026ndash;2 liters per person per day (such as the 60% of households receiving this quantity) is insufficient and violates the minimum Sphere standard. This could lead to dehydration, poor hygiene, and the spread of waterborne diseases.\u003c/p\u003e\n\u003c/li\u003e\n\u003c/ul\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec19\" class=\"Section2\"\u003e\n\u003cp\u003e5. Hygiene and Health Conditions\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eSphere Standard\u003c/strong\u003e: Access to soap (200g per person per month) and sanitary facilities, including safe waste disposal.\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eAccepted\u003c/strong\u003e: A majority of households lacking soap (96%) and those engaging in open defecation (44%) fail to meet basic hygiene standards, leading to increased risks of infections and diseases. Lack of formal solid waste management systems (90% relying on open dumps) is a significant health concern.\u003c/p\u003e\n\u003c/li\u003e\n\u003c/ul\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec20\" class=\"Section2\"\u003e\n\u003cp\u003e6. Food Security\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eSphere Standard\u003c/strong\u003e: 2,100 kcal per person per day.\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eAccepted\u003c/strong\u003e: A majority of households reporting sufficient food availability (66%) but lacking balanced nutrition (e.g., high reliance on legumes) indicates potential nutritional deficiencies and violation of minimum standards for protein, fat, and micronutrient intake.\u003c/p\u003e\n\u003c/li\u003e\n\u003c/ul\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec21\" class=\"Section2\"\u003e\n\u003cp\u003e7. Vector Control (Mosquito Nets)\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eSphere Standard\u003c/strong\u003e: All people exposed to mosquitoes should have access to mosquito nets.\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eAccepted\u003c/strong\u003e: A significant proportion (70%) of households without access to mosquito nets and inadequate vector control practices present risks for vector-borne diseases such as malaria.\u003c/p\u003e\n\u003c/li\u003e\n\u003c/ul\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec22\" class=\"Section2\"\u003e\n\u003cp\u003e8. Waste Management\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eSphere Standard\u003c/strong\u003e: Solid waste should be managed in a way that prevents health risks and environmental pollution.\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003e\u003cstrong\u003eAccepted\u003c/strong\u003e: Open dumping of solid waste in 90% of the camps indicates non-compliance with Sphere standards, leading to environmental pollution and health risks for the displaced population\u003c/p\u003e\n\u003c/li\u003e\n\u003c/ul\u003e\n\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003e \u003cb\u003eTable\u0026nbsp;(1): standard of temporary camps management for displaced population in Shendilocality, River Nile State- Sudan\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTemporary shelters\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo of individuals\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003em\u003csup\u003e2\u003c/sup\u003e/ Person\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePersons/Room\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePersons/ toilet\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAcceptability and risk Analysis\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e623\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eNot Acceptable\u003c/b\u003e: The space per person is too small, leading to significant overcrowding.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Adequate space per person, but the number of people per room is slightly high.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Space is moderate, but the number of people per toilet is still high.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e417\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eNot Acceptable\u003c/b\u003e: Overcrowding in rooms is severe, indicating inadequate living conditions.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e251\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eNot Acceptable\u003c/b\u003e: Overcrowding in both rooms and toilets, leading to unhealthy living conditions.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e171\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Reasonable balance between space and room occupancy, though the number of people per toilet is high.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e7.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e307\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eNot Acceptable\u003c/b\u003e: The number of people per toilet is excessively high.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e202\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Excellent space per person, but the number of people per toilet needs improvement.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e9.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e186\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Good space, but the toilet-to-person ratio needs improvement.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e167\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Adequate space, but improvements are needed for the toilet-to-person ratio.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e11.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Sufficient space, but room occupancy is still high.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e12.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Space is adequate, but improvements are needed for the toilet-to-person ratio.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e13.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e211\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Excellent space, but the number of people per toilet needs improvement.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e14.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e135\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Excellent space, but toilet-to-person ratio could be improved.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e15.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Space is moderate, but the toilet ratio needs improvement.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e16.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e286\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eNot Acceptable\u003c/b\u003e: The number of people per toilet is unreasonably high, indicating poor sanitation.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e17.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e257\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Good space, but improvements are needed for the number of people per toilet.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Adequate space with a reasonable toilet ratio.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e19.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Adequate space, but the toilet-to-person ratio needs improvement.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e141\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Good space per person, though the toilet ratio needs some improvement.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e21.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Excellent space, but improvements are needed for the toilet-to-person ratio.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e22.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Reasonable space, but the number of people per toilet needs improvement.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e23.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Space is acceptable, but the toilet-to-person ratio requires improvement.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e24.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e251\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Space per person is fine, but improvements are needed for the toilet ratio.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e25.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e109\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Excellent space per person, though the room occupancy is still high.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e26.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Space is good, but improvements are needed for the number of people per toilet.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e27.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Excellent space, but toilet conditions need improvement.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e28.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e185\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Reasonable space, though the toilet-to-person ratio needs improvement.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e29.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Excellent space per person, but the toilet ratio needs improvement.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Adequate space, though improvements are required for the number of people per toilet.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e31.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e229\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Space is fine, but the toilet-to-person ratio could be improved.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e32.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e153\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Reasonable space, but improvements are needed for the toilet-to-person ratio.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e33.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e215\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Adequate space, though improvements in the toilet-to-person ratio are necessary.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e34.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e127\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eNot Acceptable\u003c/b\u003e: The space per person is too small, leading to severe overcrowding.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e35.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e247\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAcceptable\u003c/b\u003e: Adequate space, but improvements are needed for the toilet-to-person ratio.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe table indicates the evaluation of temporary shelters used by individuals, focusing on the space available per person, the number of people per room, and the number of people per toilet. The conditions are classified as \"Acceptable\" or \"Not Acceptable\" based on criteria such as personal space (in square meters) and the ratio of people in rooms and sanitary facilities. In many cases, shelters suffer from severe overcrowding (such as 24 people in one room), leading to a lack of privacy and space. The ratio of people to toilets is also high in some cases, affecting cleanliness and overall health. While some shelters provide good space (such as 11 m\u0026sup2; per person), improvements are needed in balancing the number of people per toilet and room.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable\u0026nbsp;(2): distribution demographic information of household heads in temporary displaced camps, Shendi locality- River Nile State\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabb\" border=\"1\"\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eDemographic variables of household heads\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15\u0026ndash;20 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21\u0026ndash;25 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26-30years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMore than 30years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e88%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eEduacation level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUn educate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUniversity and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eOccupation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHomemaker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e66%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmployee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFree job\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eNumber of family members\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLess than 4members\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4-6members\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e46%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u0026ndash;9 members\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMore than 10 member\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eFamily income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLess than 100 thousand\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e100\u0026ndash;150 thousand\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e160\u0026ndash;200 thousand\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMore than 200 thousand\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe table presents demographic data of household heads, highlighting their age, gender, education level, occupation, family size, and income. Most heads of households are over 30 years old (60%), with a significant majority being female (88%). In terms of education, 36% have completed secondary education, and 66% of heads are homemakers. Family sizes vary, with 46% having 4\u0026ndash;6 members, and 50% earn less than 100 thousand, indicating economic constraints.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable\u0026nbsp;(3): health and nutrition standards among displaced households in temporary camps management for displaced population in Shendy locality, River Nile State- Sudan.\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabc\" border=\"1\"\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eInformation about Health and nutrition standards\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMinimum standers and Acceptability analysis\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eWoman Vaccination status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnvaccinated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42(42%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eThere is a clear difference in the vaccination rates for Tetanus. A significant portion of the population has received this vaccine, which is essential for maternal and child health.\u003c/p\u003e \u003cp\u003eRegarding meningitis and yellow fever: show a much lower rate of vaccination compared to Tetanus, indicating potential gaps in the health coverage of displaced populations.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTetanus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52(52)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMeningitis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4(4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYellow fever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2(2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eWoman's delivered in last pregnant after displacement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIn hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72(72%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMaternity services must be available to pregnant women in ideal health conditions\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIn camp\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28(28%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eUnder one year children vaccination status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUn applicable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e82(82%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eAcceptable standard: All children should receive vaccines.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVaccinated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (10%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnvaccinated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8(8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAvailability of Mosquito net\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAvailable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30(30%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e30% reported having access to mosquito nets, which is well below the required standard for preventing vector-borne diseases.\u003c/p\u003e \u003cp\u003eThe risk of diseases like malaria would likely be higher in the absence of mosquito nets and a comparison of health outcomes between those with and without nets could provide meaningful conclusions.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnavailable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70(70%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003efood available in sufficient quantities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e66(66%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e66% of households reported sufficient food availability, which aligns with the minimum standard of 2,100 kcals per person per day.\u003c/p\u003e \u003cp\u003eA significant 34% of households reported insufficient food, which may correlate with increased risks of malnutrition.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34(34%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eFood consumed among displaced household\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLegumes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e92(92%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e10 per cent of total energy provided by protein,\u003c/p\u003e \u003cp\u003e17 per cent of total energy provided by fat,\u003c/p\u003e \u003cp\u003eAdequate micronutrient intake.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMeat\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6(6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMilk\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2(2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003efood be stored in closed container\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e90(90%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFood is kept in suitable containers and covered to prevent insect access and to protect it from the surrounding environmental conditions\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10(10%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe table provides information on health and nutrition standards among displaced populations. It shows that 52% of women are vaccinated against tetanus, but vaccination rates for meningitis (4%) and yellow fever (2%) are low, indicating gaps in health coverage. While 72% of women gave birth in hospitals, 28% gave birth in camps, suggesting limited access to proper maternity services. Food availability meets minimum standards for 66% of households, though 34% face food shortages, and 90% store food in closed containers. However, only 30% have access to mosquito nets, leaving many at risk of vector-borne diseases.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable\u0026nbsp;(4); status of water supply standard, source, storage, quantity and quality in temporary displaced camps, Shendi locality- River Nile State\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabd\" border=\"1\"\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eInvestigated Water standards\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMinimum standards and Acceptability Analysis\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eWater source\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTap\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95 (95%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGiven that 95% have access to tap water; the access to safe drinking water is high. However, only 5% rely on well water, which may indicate a minimal risk to public health if well water is not properly treated.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWell\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5(5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eDistance of water point\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLess than 50 m\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e78(78%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eA significant number (78%) have water sources within 50 meters, which is an acceptable distance for quick access. However, 20% being farther than 50 meters may pose a barrier, especially for women and children who need to carry water\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMore than 50m\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20(20%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOutside the temporary camp\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4(4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eContainer capacity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLess than 20 liters\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e78(78%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e78% of the population uses containers less than 20 liters, which could be insufficient for daily needs. Ideally, larger containers (20\u0026ndash;40 liters) should be used for larger families.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20 to 40 liters\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22 (22%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eWater quantity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026ndash;2 L/P/D\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60(60%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e60% of individuals consume only 1\u0026ndash;2 liters of water per day, which is below the minimum daily requirement. This indicates that water scarcity is an issue for a majority of individuals in the camp.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3-4L/P/D\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34(34%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5-6L/P/D\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6(6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ewater containers clean\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e74(74%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e74% of individuals use clean containers, which is a good practice for preventing contamination. However, 26% using unclean containers poses a significant risk for waterborne diseases.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26(26%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003edefecation near a water source\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20(20%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e20% of individuals defecate near water sources, posing a significant risk for contamination. Proper sanitation practices and further distancing of latrines from water sources are recommended.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e80(80%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ewater source protected from contamination\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70(70%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e70% of water sources are protected from contamination, which is acceptable. However, 30% of sources are unprotected, which increases the risk of waterborne illnesses.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30(30%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eTable\u0026nbsp;(5); situation of hygiene and sanitation standards in temporary displaced camps, Shendi locality- River Nile State\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabe\" border=\"1\"\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003esurveyed hygiene and Sanitation standards\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMinimum standards and Acceptability Analysis\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eAvailability of soap for household/month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot available\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e96(96%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eA large percentage (96%) of households do not have soap available, which is well below the minimum standard. This lack of soap creates a significant health risk. Only 2% have access to sufficient soap, indicating that most households are not meeting hygiene standards.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLess than 4 soups/household/month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2(2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u0026ndash;6 soups/household/month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2(%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eopen defecation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44(44%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eWith 44% of households practicing open defecation, the risk of water contamination and the spread of diseases is high. Proper sanitation facilities are essential to meet hygiene standards.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot exist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e66(66%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSolid waste disposal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOpen dump\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e90(90%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eA vast majority (90%) of households use open dumping, which presents serious health risks and environmental pollution. Only 10% have access to formal waste disposal, which is in line with minimum standards for sanitation.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFormal disposal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10(10%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe table outlines water quality standards in a temporary camp. 95% of individuals have access to tap water, while 5% rely on wells, indicating low health risks. 78% of people have water sources within 50 meters, but 20% are farther, creating accessibility challenges. 60% consume less than the daily required amount of water, highlighting a scarcity issue.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable\u0026nbsp;(6): Direct observation for environment around sheltersin temporary displaced camps, Shendi locality- River Nile State\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabf\" border=\"1\"\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eObserved items around households shelters\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMinimum standers and Acceptability analysis\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eToilet close to where food is prepared\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52(52%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48(48%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eThe \u003cb\u003ep-value of 0.89\u003c/b\u003e indicates that there is \u003cb\u003eno significant difference\u003c/b\u003e between households with toilets close to where food is prepared and those without. Therefore, the proximity of toilets to food preparation areas does not significantly impact sanitation.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eDefecation in toilet\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e78(78%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22(22%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eThe \u003cb\u003ep-value of 0.002\u003c/b\u003e is \u003cb\u003esignificant\u003c/b\u003e (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), indicating a strong relationship between having a toilet used for defecation and maintaining proper sanitation. The high percentage of households with toilets used for defecation is a positive sign in terms of meeting sanitation standards.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eProper disposal of children\u0026rsquo;s feces\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e82(82%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18(18%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eThe \u003cb\u003ep-value of 0.06\u003c/b\u003e is marginally significant (p close to 0.05), suggesting that there may be an association between proper disposal of children's feces and sanitation practices. However, further data or analysis may be needed to draw stronger conclusions.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eWash hand after cleaning child\u0026rsquo;s a stool\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e93(93%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7(7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eThe \u003cb\u003ep-value of 0.04\u003c/b\u003e is \u003cb\u003esignificant\u003c/b\u003e (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), showing that a majority of households wash their hands after cleaning a child\u0026rsquo;s stool. This practice is critical for preventing the spread of infections and maintaining hygiene.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eCovers for garbage cans\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60(60%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40(40%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eGarbage disposal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e84(84%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16(16%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e84% of households manage waste properly, indicating positive practices in this area, which help minimize health risks related to waste mismanagement.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eDispose of stagnant water\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42(42%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e58(58%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e58%\u003c/b\u003e of households do not dispose of stagnant water properly, which poses a health risk, especially in environments where vector-borne diseases like malaria could spread.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eChildren play in stagnant water\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29(29%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e71(71%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e29%\u003c/b\u003e of households report that children play in stagnant water. This is a significant health hazard as stagnant water is often a breeding ground for harmful bacteria and mosquitoes.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eHousehold waste removed regular\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e96(96%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4(4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOnly 32% of households use mosquito nets, which reflects a lack of protection against mosquito-borne diseases. This needs improvement as mosquitoes can spread diseases like malaria and dengue.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eBreeding of files and rodents\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e96(96%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4(4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e22%\u003c/b\u003e of households still practice open defecation, posing a significant public health risk, particularly in areas with inadequate sanitation facilities.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eUsed mosquito nets\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32(32%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e68(68%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOnly \u003cb\u003e32%\u003c/b\u003e of households use mosquito nets, which reflects a lack of protection against mosquito-borne diseases. This needs improvement as mosquitoes can spread diseases like malaria and dengue.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eUse enough water for washing and bathing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e58(58%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e62(62%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e58%\u003c/b\u003e of households use enough water for washing and bathing, but the remaining \u003cb\u003e62%\u003c/b\u003e face limitations in water access, which affects hygiene practices and personal cleanliness.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eWashing facilities available\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60(60%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40(40%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eOpen defecation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22(22%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e78(78%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22% of households still practice open defecation, posing a significant public health risk, particularly in areas with inadequate sanitation facilities.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eHouse fly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42(42%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e58(58%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eThe presence of flies, mosquitoes, and rodents in 96% of households is a significant concern. This indicates a high risk of environmental contamination and possible disease transmission.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eMosquito\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48(48%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e52(52%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eCockroach\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10(10%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e90(90%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003emethod used for mosquitoes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSpraying\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e73% of households use repellents to control mosquitoes, while others use traps and spraying methods. This shows a variety of approaches, but the overall usage of mosquito nets is still low, highlighting a gap in preventive measures.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUsing repellents\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e73%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTraps\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003emosquito nets available\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eMosquito activity peaks in the \u003cb\u003eevening\u003c/b\u003e (\u003cb\u003e67%\u003c/b\u003e), suggesting that interventions during this time may be more effective in controlling mosquito-related health risks.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e70%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003etime during connected\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMorning\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEvening\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe table provides an analysis of environmental health factors in households, showing the percentage of households adhering to sanitation standards, such as using toilets for defecation, proper disposal of waste, and handwashing after cleaning children's stool. It highlights the importance of health practices like disposing of stagnant water and using mosquito nets, while also showing challenges in certain areas like toilet usage and insect prevention.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study aimed to assess the living conditions of displaced populations in Shendi camps according to Sphere Project standards. The findings reveal significant gaps in space allocation, sanitation, food security, and healthcare, highlighting the urgent need for improved living conditions and humanitarian support.\u003c/p\u003e \u003cp\u003eManaging temporary camps during emergencies is critical, and schools are frequently used as temporary shelters due to their existing facilities for cooking and sanitation. Table\u0026nbsp;1 indicates that schools were the most commonly used shelters for displaced individuals, despite concerns about privacy, room sizes, and overcrowding. Nevertheless, schools were the most accessible option due to their spaciousness, adequate health facilities, and access to safe drinking water. Additionally, schools are close to public facilities such as hospitals, markets, and transportation, which is an added benefit. These findings align with previous studies such as Al-Tuwaijri et al. (2013), who highlighted that educational facilities are an effective temporary shelter solution in cases of displacement due to conflicts or natural disasters. The availability of large spaces and immediate access to facilities are essential in these situations. Furthermore, Hassan et al. (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) demonstrated that adequate health facilities in shelters improve displaced populations' health, and Gonzalez et al. (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) noted the importance of proximity to community resources for improving well-being in temporary shelters.\u003c/p\u003e \u003cp\u003eAccess to healthcare in the area significantly eases the challenges faced by displaced populations. The proximity to hospitals and the freedom of movement are critical, particularly for pregnant women, children, and other vulnerable groups. The study found that many women were able to access vaccination and maternal health services at hospitals, as reflected in Table\u0026nbsp;3, which shows a high rate of vaccination for Tetanus. However, some children missed vaccinations due to a lack of awareness and guidance from mothers, as indicated by the 8% of missed vaccinations. This finding is consistent with a study by Brooks et al. (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2023\u003c/span\u003e), which found that limited maternal health education in refugee camps contributed to missed immunizations and other healthcare services, leading to preventable diseases among children.\u003c/p\u003e \u003cp\u003eRegarding food security, the study found that many displaced families rely on grains as their primary food source (92%), with limited consumption of meat (6%) and nearly no milk intake (2%). This lack of dietary diversity is a significant cause of malnutrition, particularly among children. According to UNICEF (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2016\u003c/span\u003e), poor economic conditions and the lack of resources to purchase diverse foods are major factors contributing to malnutrition in displaced families. Smith et al. (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) also highlighted dietary diversity as a challenge in refugee populations, urging efforts to diversify food aid to improve nutritional outcomes. Similarly, a study by Ahmed et al. (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) showed that reliance on grains in Sudanese camps led to deficiencies in essential nutrients such as proteins and fats, contributing to higher rates of malnutrition. Ghosh et al. (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2015\u003c/span\u003e) also found that displaced families often suffer from protein and fat deficiencies. Additionally, Thompson et al. (2023) pointed out that long-term reliance on grains exacerbates the risk of vitamin and mineral deficiencies, especially among children and pregnant women.\u003c/p\u003e \u003cp\u003eWater availability is crucial for health and hygiene. According to Table\u0026nbsp;4, 98% of households rely on tap water, while 2% depend on well water. However, water supply was sometimes intermittent, which violates Sphere Project (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) standards, which recommend 7.5 liters of water per person per day. The study also found that the water quality was compromised by the presence of stagnant water near the camps, increasing the risk of waterborne diseases. Previous studies, such as IOM (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) in South Sudan, have shown that camps lacking clean water are more prone to outbreaks of diseases like cholera and dysentery. These findings are consistent with the JMP (2018) report, which emphasized the importance of providing clean and accessible water to reduce health risks. WHO (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) also confirmed that inadequate access to clean water in displacement settings leads to higher morbidity and mortality rates from waterborne diseases, urging a reevaluation of water distribution strategies in camps.\u003c/p\u003e \u003cp\u003eSanitation and hygiene were also major concerns in the camps. Table\u0026nbsp;5 indicates that 44% of households practice open defecation, and 90% of the camps use open waste disposal, both of which significantly increase the risk of disease outbreaks. Moreover, 96% of households reported lacking soap for personal hygiene, which does not meet the international standards requiring 200 grams of laundry soap and 250 grams of bathing soap per person per month. This hygiene gap contributes to the spread of skin diseases, respiratory infections, and other hygiene-related illnesses. Studies by Parker et al. (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) and Stern et al. (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) have also emphasized the link between inadequate sanitation and the spread of infectious diseases. Adnan et al. (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) also reinforced the importance of improving sanitation infrastructure and hygiene practices to reduce the incidence of infectious diseases in refugee camps.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study underscores the critical challenges faced by displaced populations in Shendi's temporary camps, such as overcrowded shelters, limited healthcare access, poor food security, and inadequate water, sanitation, and hygiene standards. These factors significantly increase health risks and vulnerability among displaced individuals. Based on the study's findings, there is an urgent need to improve the living conditions in these camps by enhancing food security, improving waste management, and promoting better hygiene practices. Clean and safe water sources must be provided, along with awareness campaigns on hygiene and public health. Collaboration between humanitarian organizations and governments is essential to provide financial support and improve the living standards of displaced families.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"652\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 8.74233%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.3313%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAbbreviations\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73.9264%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;Full meaning\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 8.74233%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.3313%;\"\u003e\n \u003cp\u003eAIDS\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73.9264%;\"\u003e\n \u003cp\u003eAcquired Immune Deficiency Syndrome\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 8.74233%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.3313%;\"\u003e\n \u003cp\u003eECO-SAN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73.9264%;\"\u003e\n \u003cp\u003eEcological \u0026nbsp;Sanitation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 8.74233%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.3313%;\"\u003e\n \u003cp\u003eHIV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73.9264%;\"\u003e\n \u003cp\u003eHuman Immunodeficiency Virus\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 8.74233%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.3313%;\"\u003e\n \u003cp\u003eIDP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73.9264%;\"\u003e\n \u003cp\u003eInternally Displaced Person\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 8.74233%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.3313%;\"\u003e\n \u003cp\u003eJMP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73.9264%;\"\u003e\n \u003cp\u003eJoint Monitoring Programme\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 8.74233%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.3313%;\"\u003e\n \u003cp\u003ePH-RAM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73.9264%;\"\u003e\n \u003cp\u003ePublic Health Risk Assessment Model\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 8.74233%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.3313%;\"\u003e\n \u003cp\u003eSPSS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73.9264%;\"\u003e\n \u003cp\u003eStatistical Package For Social Sciences\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 8.74233%;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.3313%;\"\u003e\n \u003cp\u003eUDT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73.9264%;\"\u003e\n \u003cp\u003eUrine Division Toilet\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 8.74233%;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.3313%;\"\u003e\n \u003cp\u003eVIP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73.9264%;\"\u003e\n \u003cp\u003eVentilated Improved\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 8.74233%;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.3313%;\"\u003e\n \u003cp\u003eWASH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73.9264%;\"\u003e\n \u003cp\u003eWater Supplies and Sanitation and Hygiene Promotion\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Declarations","content":" \u003cp\u003e \u003cstrong\u003eEthical approval and consent to participate:\u003c/strong\u003e \u003cp\u003eThe study was initially approved by the ethical committee of the Faculty of Public Health (Institutional Research Board) at Shendi University. In addition, permission was obtained from the Health and Population Department \u0026ndash; Shendi locality, directors of temporary camps, and household heads in shelters to be studied. We have also ensured that all names and personal data were completely secured to protect the privacy and confidentiality of the participants. This revision now provides full transparency regarding the ethical considerations involved in the study.\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eConsent for publication:\u003c/h2\u003e \u003cp\u003eNot applicable\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eCompeting interests\u003c/strong\u003e \u003cp\u003eThe authors declared no conflict of interest.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eThe researchers did not receive any fund from any source.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eASMA designed the study and wrote the manuscript. RAAK collect and analyzed the data and designed tables. All authors reviewed manuscript. All authors read and approved the final manuscript. All authors contributed significantly to this work, conceiving the idea of the research, collection and analysis of data, writing and editing of the manuscript. All authors read and approved the manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eThe cooperation and devotion of the health teams in all health institutions and camps selected for the study is very much appreciated. Their support and detection should be acknowledgment.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe datasets used and analyzed during this study are available from the corresponding author or reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAdnan S, Chandra P, Williams A. Improving Sanitation in Displacement Camps: A Path to Reducing Infectious Diseases. Int J Hyg Environ Health. 2022;243:83\u0026ndash;92.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAhmed S, et al. Nutritional assessment of displaced populations in Sudan. J Humanitarian Assistance. 2018;15(2):34\u0026ndash;48.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlhaj R, et al. Challenges in Humanitarian Aid Delivery in South Kordofan: A Focus on Water and Sanitation. Journal of Humanitarian Response; 2020.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBorton J. Humanitarian Assistance: A Review of the Humanitarian System\u0026rsquo;s Effectiveness. Oxford University Press; 2019.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBrooks S, Smith J, Jackson L. Health Access in Refugee Camps: Barriers and Solutions. Global Public Health J. 2023;15(2):112\u0026ndash;24.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEl-Din M, et al. Living Conditions and Public Health Risks in Displacement Camps in Darfur: A Case Study. Sudanese Journal of Public Health; 2018.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGhosh S, et al. Food security and malnutrition in refugee camps: A comparative study. Int J Disaster Manage. 2015;25(3):103\u0026ndash;15.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGonzalez M, Lopez R, Perez V. Temporary Shelters in Crisis: The Role of Educational Facilities. Disaster Manage Rev. 2022;31(4):245\u0026ndash;58.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHassan R, et al. Provision of adequate health facilities and safety measures in shelters: Impact on health outcomes in refugee camps. Health Humanitarian Affairs J. 2020;11(1):56\u0026ndash;63.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eInternational Federation of Red Cross and Red Crescent Societies. The Sphere Handbook: Humanitarian Charter and Minimum Standards in Humanitarian Response. Geneva: Sphere Project; 2017.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIOM. Water, sanitation, and hygiene in displaced populations in South Sudan. IOM Rep. 2019;22(5):45\u0026ndash;56.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eParker A, et al. Sanitation challenges in refugee camps: Lessons learned. Public Health J. 2017;37(1):92\u0026ndash;104.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSmith K, Brown A, Miller E. Nutritional Challenges in Refugee Populations: A Call for Diversified Aid. J Humanitarian Assistance. 2022;18(1):60\u0026ndash;72.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSphere Project. Sphere Handbook: Humanitarian Charter and Minimum Standards in Humanitarian Response. Geneva: Sphere Association; 2016.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSphere Project. Sphere Handbook: Humanitarian Charter and Minimum Standards in Humanitarian Response. 4th ed. Geneva: The Sphere Project; 2018.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStern R, et al. Hygiene practices and health outcomes in refugee camps: A longitudinal study. Global Health Rev. 2018;48(4):78\u0026ndash;91.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUNICEF. Nutrition in Emergencies: Challenges and Solutions. New York: UNICEF; 2016.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUnited Nations High Commissioner for Refugees. Global Trends: Forced Displacement in 2018. UNHCR; 2019.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUnited Nations Office for the Coordination of Humanitarian Affairs. Sudan Humanitarian Response Plan 2021. OCHA; 2021.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWHO. The Impact of Clean Water Access on Health in Refugee Settings. World Health Organization Report; 2023.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization. Health and Humanitarian Crises: A Guide for Health Practitioners. WHO; 2020.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"journal-of-epidemiology-and-global-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Journal of Epidemiology and Global Health](https://www.springer.com/journal/44197)","snPcode":"44197","submissionUrl":"https://submission.nature.com/new-submission/44197/3","title":"Journal of Epidemiology and Global Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Open","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Living Conditions, Public Health Challenges, Temporary Camps, Displaced Populations, Sudan","lastPublishedDoi":"10.21203/rs.3.rs-6117389/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6117389/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: Humanitarian aid aims to address the essential needs of displaced populations, especially regarding shelter, water supply, sanitation, and hygiene. This study evaluates the living conditions of displaced populations in Shendi, River Nile State, Sudan, based on the Sphere Guidelines.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: A cross-sectional descriptive study was conducted between August and October 2024. Structured face-to-face interviews, a standardized questionnaire (administered to 100 household heads), a checklist-based assessment, and non-structured interviews were employed. Data were analyzed using SPSS software.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: Most displaced families (52%) live in overcrowded rooms, and 48% are near cooking areas. Food security is critical, with 92% of families relying on grains, while only 6% consume meat and 2% consume dairy. Health coverage is low, with only 52% of women vaccinated against tetanus, and 4% and 2% are vaccinated for meningitis and yellow fever, respectively. While 72% of women gave birth in hospitals, 28% gave birth in camps. Water is accessible to 95% of families, but only 60% consume the recommended daily amount, and 20% face difficulties accessing it. In terms of sanitation, 44% practice open defecation, and 90% dispose of waste openly. Additionally, 96% lack sufficient soap, and 96% face health threats from flies and mosquitoes, with only 32% using mosquito nets.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e The displaced families face significant challenges, including overcrowding in shelters, poor nutrition, limited access to healthcare and clean water, and inadequate sanitation. These conditions pose serious health risks, especially for children and vulnerable populations. Immediate intervention is necessary to address food security, healthcare, sanitation, and overall living conditions.\u003c/p\u003e","manuscriptTitle":"Living Conditions and Public Health Challenges in Temporary Camps for Displaced Populations in Shendi Locality, Sudan","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-02 11:42:12","doi":"10.21203/rs.3.rs-6117389/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-04-01T19:30:17+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"274330796250331822430226131335347321612","date":"2025-04-01T19:25:45+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-04-01T19:20:06+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-03-31T08:31:50+00:00","index":"","fulltext":""},{"type":"submitted","content":"Journal of Epidemiology and Global Health","date":"2025-03-28T23:52:02+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"journal-of-epidemiology-and-global-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Journal of Epidemiology and Global Health](https://www.springer.com/journal/44197)","snPcode":"44197","submissionUrl":"https://submission.nature.com/new-submission/44197/3","title":"Journal of Epidemiology and Global Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Open","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"fe7a4008-98d2-4119-97a1-157e1264a119","owner":[],"postedDate":"April 2nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-04-02T14:23:21+00:00","versionOfRecord":[],"versionCreatedAt":"2025-04-02 11:42:12","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6117389","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6117389","identity":"rs-6117389","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}