Improved water, sanitation and hygiene (WASH) are significant in preventing diarrhea morbidity and mortality caused by protozoa in low- and middle-income countries. Due to the intimate and complex relationships between the different WASH components, it is often necessary to improve not just one but all of these components to have sustainable results. The objective of this paper was to review the current state of WASH-related health problems caused by parasitic protozoa by: giving an overview and classification of protozoa and their effect on people’s health, discussing different ways to improve accessibility to safe drinking water, sanitation services and personal hygiene behavior; and suggesting an institutional approach to ensure improved WASH. The findings indicate that Giardia and Cryptosporidium are more often identified during waterborne or water-washed outbreaks and they are less sensitive than most of the bacteria and viruses to conventional drinking water and wastewater treatment methods. There are various institutions of control and prevention of water-related diseases caused by protozoa in developed countries. Unfortunately, the developing regions do not have comparable systems. Consequently, the institutional and systems approach to WASH is necessary in these countries.

Climate change is likely to have severe effects on water availability in Ethiopia. The aim of the present study was to assess the impact of climate change on the Gilgel Abay River, Upper Blue Nile Basin. The Statistical Downscaling Tool (SDSM) was used to downscale the HadCM3 (Hadley centre Climate Model 3) Global Circulation Model (GCM) scenario data into finer scale resolution. The Soil and Water Assessment Tool (SWAT) was set up, calibrated, and validated. SDSM downscaled climate outputs were used as an input to the SWAT model. The climate projection analysis was done by dividing the period 2010-2100 into three time windows with each 30 years of data. The period 1990-2001 was taken as the baseline period against which comparison was made. Results showed that annual mean precipitation may decrease in the first 30-year period but increase in the following two 30-year periods. The decrease in mean monthly precipitation may be as much as about -30% during 2010-2040 but the increase may be more than +30% in 2070-2100. The impact of climate change may cause a decrease in mean monthly flow volume between -40% to -50% during 2010-2040 but may increase by more than the double during 2070-2100. Climate change appears to have negligible effect on low flow conditions of the river. Seasonal mean flow volume, however, may increase by more than the double and +30% to +40% for the Belg (small rainy season) and Kiremit (main rainy season) periods, respectively. Overall, it appears that climate change will result in an annual increase in flow volume for the Gilgel Abay River. The increase in flow is likely to have considerable importance for local small scale irrigation activities. Moreover, it will help harnessing a significant amount of water for ongoing dam projects in the Gilgel Abay River Basin.