Promoting universal access

to water, sanitation and

hygiene

Clarissa Brocklehurst

Chief, Water, Sanitation

and Hygiene Section

UNICEF New York

• Health, HIV/AIDS, Nutrition

� 88% of diarrhoeal deaths from poor WASH

� fewer diarrhoea episodes & worm infestation can impact nutritional status

� new evidence linking hand-washing and ARI

� WASH linked to helminths, guinea worm, fluorosis, arsenicosis

� home-based WASH helps to reduce opportunistic infections

• Education� improving WASH in schools has an impact on

enrolment levels, particularly for girls

• Poverty

� 5.5 billion productive days per year lost due to diarrhoea and burden of fetching water

� household water required for small-scale productive activities

• Gender� Women & girls bear the brunt of fetching water

& benefit most when distances are reduced.

LINKAGES

Health:

WASH Disease Burden is high

Soil Transmitted Helminthes:

Hookworm, Roundworm Whipworm

Prevalence: 2 billion

Mortality: 12,000

Trachoma (blindness)

Prevalence: 5 million

Mortality: 0

Schistosomiasis (Bilharzia);

Prevalence: 200 million

Mortality: 15000

Respiratory Infections

(23% reduction in morbidity through

handwashing with soap)

Guinea worm disease (Dracunciliasis)

Incidence: <2,000

Diarrhea

1.5 million child deaths annually

88% attributable to poor WASH

Sanitation and handwashing are effective interventions

to reduce diarrhea morbidity in children under 5

Nutrition: WASH conditions are a determinant

of nutritional status

…a key cause of child undernutrition is a subclinical disorder of the small intestine known as tropical enteropathy, …caused by faecal bacteria

ingested in large quantities by young children living in conditions of poor sanitation and hygiene

(Lancet 2009, Humphrey).

Lancet 2008, Checkley, data pooled from 9

studies

25% of all stunting in 24-

month-old children

attributable to having five or

more episodes of diarrhoea.

Esrey 1996, multi-country analysis, sample size almost

17.000

Improvements in sanitation were associated with

increases in height ranging from 0.8cm to 1.9cm. (decrease in stunting 4–37%

(rural) and 20–46% (urban)

Lancet 2004, Peru, Checkley.

Children lacking adequate sewage

connections and using small water-storage

containers had a 1·8 cm growth deficit

compared with those in households with

sewage connections and which used large

containers.

Yet sanitation coverage is low!

2.6 billion lack improved sanitation,and 1.1 billion practise open

defecation

>25%

Proportion of the population that

spends >30 minutes per water

collection trip

Water collection is a time consuming burden

Source: WHO/UNICEF JMP,

2008

Source: WHO/UNICEF JMP, 2008

� Less than half of schools in LDCs have safe water, and only one third have toilets

� Lack of facilities have a stronger negative impact on girls , who need to have access to safe, clean, separate and private sanitation facilities

WASH in Schools

FACT: A girl can miss up to 10-20% of her school days (Cooke, 2005)

The poorest in sub-Saharan Africa

are 15 more likely to practise open

defecation than the richest

The poorest in sub-Saharan Africa are

more than four times as likely as the

richest to use an unimproved drinking

water source

Equity: Large disparities in access remain

Source: WHO/UNICEF Joint Monitoring Programme on

Water and Sanitation (JMP)

Inequity also exists in aid targeting:

basic systems are not targeted by

water sector aid

Only 42% of sector aid goes to low-

income countries

What is needed?

�Greater political commitment�Better targeting of resources�Strengthened national systems�Stronger partnerships�Simple, sustainable solutions

Water supply: focus on sustainability

�Robust, simple technical solutions�leveraged household investment�governance and good policy

�local government strengthening

�Support to community management �Capacity building

Sanitation: building demand� community-led models for

building demand� change social norms around

open defecation� harness household

investments� Clear institutional

responsibility

A new partnershipAlliance of like-minded organizations:

Sanitation and Water for All

Currently 66 Partners:

• 32 Developing Countries

• including 19 LDCs

• 6 Donors

• 3 Civil Society networks

• 1 Development Bank

• 8 Multi-laterals

• 16 Sector partners

Support Country Planning ProcessesStronger Focus on off-track countries/sectors

Improve technical assistanceCatalytic support for actionable frameworks

Establish Global Framework for Sector Dialogue

Forum for global dialogue on waterGlobal and Regional High Level Meetings

Improve Information for Decision-makingJMP, GLAAS, CSOs, etc.

Activities

Thank you!