Water Supply, Sanitation, and Hygiene

Excerpt

Safe drinking water, sanitation, and hygiene (WASH) are fundamental to improving standards of living for people. The improved standards made possible by WASH include, among others, better physical health, protection of the environment, better educational outcomes, convenience time savings, assurance of lives lived with dignity, and equal treatment for both men and women. Poor and vulnerable populations have lower access to improved WASH services and have poorer associated behaviors. Improved WASH is therefore central to reducing poverty, promoting equality, and supporting socioeconomic development. Drinking water and sanitation were targets in the Millennium Development Goals (MDGs) for 2015; under the Sustainable Development Goals (SDGs) for the post-2015 period, Member States of the United Nations (UN) aspire to achieve universal access to WASH by 2030. The Human Right to Safe Drinking Water and Sanitation (HRTWS) was adopted in 2010 under a UN resolution calling for safe, affordable, acceptable, available, and accessible drinking water and sanitation services for all.

The scope of WASH services included in this chapter is shown in table 9.1. The focus is on services at the household and institutional level and on services for personal rather than productive uses.

This chapter summarizes global evidence on current WASH coverage and effects of intervention options, and it recommends areas for research and policy. Evidence comes from published synthesized evidence, such as systematic reviews and meta-analyses, evidence papers, and literature reviews. When those sources were not available, evidence was compiled from the next best sources of published research, thus using accepted criteria of the hierarchy of evidence for studies on health effectiveness. Unpublished and grey literature was used where no peer-reviewed published evidence exists.

This chapter is structured as follows:

1. Progress in improving drinking water, sanitation, and hygiene coverage

2. Impacts of poor WASH, thereby summarizing the evidence on the continued decline in mortality from diarrheal disease and the emerging evidence on the long-term developmental and cognitive effects of inadequate WASH on children

3. Effectiveness of interventions, thereby examining the health effects of specific WASH interventions, the approaches to service delivery, and the key role of broader institutional policy in accelerating and sustaining progress

4. Intervention costs, efficiency, and sustainability, thereby assessing the socioeconomic returns of improved WASH and considering the requirements for populations to have continued access to WASH services

5. Challenges, opportunities, and recommendations.

This chapter uses the World Health Organization (WHO) classification of superregions as follows: Africa, the Americas, South-East Asia, Europe, Eastern Mediterranean, and Western Pacific.