[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-148247-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-148247-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","household-sanitation-access-before-and-after-an-extreme-weather-event-tropical-cyclone-freddy-in-rural-malawi-research-article","Household sanitation access before and after an extreme weather event: Tropical Cyclone Freddy in rural Malawi - Research article","","Study activities were carried out within Malawi’s Water, Sanitation, and Hygiene for Everyone programme in Chiradzulu District, where a programme area obtained Open Defecation Free (ODF) status in December 2022 after a Community-Led Total Sanitation (CLTS) intervention. In March 2023, Tropical Cyclone Freddy struck Chiradzulu District and damaged critical infrastructure. Using the WHO/UNICEF JMP sanitation ladder, household surveys in the same 311 households compared sanitation access before Cyclone Freddy (April 2022) and at 10-month follow-up (June 2023).",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/research-report/","Research & Report",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/household-sanitation-access-before-and-after-an-extreme-weather-event-tropical-cyclone-freddy-in-rural-malawi-research-article/148247/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/household-sanitation-access-before-and-after-an-extreme-weather-event-tropical-cyclone-freddy-in-rural-malawi-research-article/148247.png","ImageObject",300,407,{"name":42,"@type":43},"Fahsai","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-08-26",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",14,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Where and under what programme was the study conducted?","Question",{"text":63,"@type":64},"The study was embedded in the Water, Sanitation, and Hygiene for Everyone programme in Chiradzulu District, Malawi.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How did the study compare sanitation access before and after the cyclone?",{"text":68,"@type":64},"Household surveys were administered in the same 311 households at baseline before CLTS (April 2022) and at follow-up three months after Cyclone Freddy (June 2023), using the WHO/UNICEF JMP sanitation ladder.",{"name":70,"@type":61,"acceptedAnswer":71},"What was the reported impact of Cyclone Freddy on household sanitation facilities?",{"text":72,"@type":64},"After the cyclone, 68% of households reported their sanitation facility—mainly unimproved—had collapsed.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},148247,1787777773,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,111,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":108,"show_sort_weight":109,"slug":110},7,"Healthcare",40,"healthcare",{"id":112,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":113,"slug":114},8,30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":112,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":140,"language":141,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":12,"update_tm":80,"read_time":113,"preview_page_count":4},549768702563,"https://ap-avatar.wpscdn.com/avatar/8000c4aa63b76e948b?x-image-process=image/resize,m_fixed,w_180,h_180&k=1786536092046926083","OPEN ACCESS  \nCitation: MacLeod C, Sidira G, Kapazga T, Njolomole P, Panulo M, Vigneri M, et al. (2025) Household sanitation access before and after an extreme weather event: Tropical Cyclone Freddy in rural Malawi. PLOS Clim 4(10):  \ne0000721. [https://doi.org/10.1371/journal](https://doi.org/10.1371/journal). pclm.0000721  \nEditor: Erin Coughlan de Perez, Tufts University / Red Cross Red Crescent Climate Centre, UNITED STATES OF AMERICA  \nReceived: February 4, 2025  \nAccepted: September 15, 2025  \nPublished: October 17, 2025  \nCopyright: © 2025 MacLeod et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.  \nData availability statement: The dataset and code to reproduce results are available via the LSHTM data repository at [https://doi](https://doi). org/10 . 17037/DATA.00004722.  \nRESEARCH ARTICLE  \nHousehold sanitation access before and after an extreme weather event: Tropical Cyclone Freddy in rural Malawi  \nClara MacLeod1, Gray Sidira2, Timeyo Kapazga2, Panganani Njolomole2, Mindy Panulo3, Marcella Vigneri4, Tracy Morse5, Robert Dreibelbis1*, Kondwani Chidziwisano3,6*  \n1 Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom, 2 World Vision Malawi, Blantyre, Malawi, 3 Centre for Water, Sanitation, Health and Appropriate Technology Development (WASHTED), Malawi University of Business and Applied Sciences, Blantyre, Malawi, 4 Department of Global Health and Development, Faculty of Public Health Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom, 5 Department of Civil and Environmental Engineering, University of Strathclyde, Glasgow, Scotland, 6 Department of Public and Environmental Health, Malawi University of Business and Applied Sciences, Blantyre, Malawi  \n* [robert.dreibelbis@lshtm.ac.uk](robert.dreibelbis@lshtm.ac.uk) (RD); [kchidziwisano@mubas.ac.mw](kchidziwisano@mubas.ac.mw) (KC)  \nAbstract  \nThis study is embedded within the Water, Sanitation, and Hygiene for Everyone programme in Chiradzulu District, Malawi, where one programme area achieved Open Defecation Free (ODF) status in December 2022 following a Community-Led Total Sanitation (CLTS) intervention. In March 2023, Tropical Cyclone Freddy made landfall in Chiradzulu District, causing widespread damage to essential infrastructure. This study compares household sanitation access, classified according to the WHO/ UNICEF Joint Monitoring Programme (JMP) sanitation ladder, before and after the cyclone in a rural area of southern Malawi. Household surveys were administered in the same 311 households at programme baseline in April 2022, prior to CLTS implementation, and at 10-month follow-up in June 2023, three months after Cyclone Freddy. ODF status verification data were also used to estimate pre-cyclone sanitation access. These data were used to estimate the proportion of household sanitation facilities that collapsed and became unusable due to the cyclone. The types of JMP sanitation facilities most prone to collapse and those most likely to be reconstructed three months after the cyclone are also reported. Of the 311 households surveyed, 5% had access to basic sanitation, 3% to limited sanitation, and 92% relied on unimproved sanitation prior to Cyclone Freddy. Following the cyclone, 68% of households reported that their sanitation facility, primarily unimproved, had collapsed. Three months later, 36% of surveyed households had no sanitation facility at all, while 50% relied on unimproved sanitation. Among the 211 households whose facility collapsed, 43% rebuilt an unimproved facility. These findings underscore the vulnerability of  \nPLOS Climate | [https://doi.org/10.1371/journal.pclm.0000721](https://doi.org/10.1371/journal.pclm.0000721) October 17, 2025","cbCaih4yFvY3WxYZ","https://ap.wps.com/l/cbCaih4yFvY3WxYZ","pdf",640315,12,"English","# Abstract\n## Background and setting\n## Methods and measurement framework\n## Findings: sanitation access changes\n## Implications for resilience","[{\"question\":\"Where and under what programme was the study conducted?\",\"answer\":\"The study was embedded in the Water, Sanitation, and Hygiene for Everyone programme in Chiradzulu District, Malawi.\"},{\"question\":\"How did the study compare sanitation access before and after the cyclone?\",\"answer\":\"Household surveys were administered in the same 311 households at baseline before CLTS (April 2022) and at follow-up three months after Cyclone Freddy (June 2023), using the WHO/UNICEF JMP sanitation ladder.\"},{\"question\":\"What was the reported impact of Cyclone Freddy on household sanitation facilities?\",\"answer\":\"After the cyclone, 68% of households reported their sanitation facility—mainly unimproved—had collapsed.\"}]","Household sanitation access before and after an extreme weather event: Tropical Cyclone Freddy in rural Malawi - Research article | PDF"]