WASH Poverty Diagnostic
Water and sanitation data figures in Guatemala show a challenging reality. Nationally, 91 percent of the population has access to improved drinking water, an increase of 14 percent points since the establishment of the MDGs.
Despite the improvement in coverage in relative terms, in absolute terms there are still a significant number of Guatemalan households using water from precarious or unimproved sources such as unprotected wells, rivers, or lakes. In addition, water quality is a concern -- from the monitoring of 20% of the water systems in the country, 54% reported to be at high and imminent risk for human health.
In Kinshasa, the capital and largest city of the Democratic Republic of the Congo (DRC), the vast majority of the population has access to “improved” water. This means sources such as piped networks, covered wells, boreholes, or protected springs, which are constructed to protect water from outside contamination, are widely available. Yet it is increasingly clear that “improved” water is not enough; when the 2017 DRC WASH Poverty Diagnostic tested water quality in over 1,600 households in Kinshasa, water samples from nearly 40% of improved sources were still contaminated with fecal E. Coli Bacteria at point of use.
Childhood stunting is one of the most significant impediments to human development and economic growth, affecting approximately 155 million children under the age of five globally, with long-term consequences later in life such as impaired cognitive development, chronic disease, and lower earnings as adults. Evidence shows that there is an urgent need for collaboration between actions in water, sanitation, health, nutrition, and other sectors to effectively combat childhood stunting.
This was discussed during the recent World Bank-IMF Annual Meetings, where leaders from the World Bank and client countries met to talk about ‘Changing Behaviors to Incentivize Collaboration to Address Childhood Stunting’. Aimed to provide guidance on how to collaborate better across sectors and institutions, this event provided an opportunity to share the latest results from the global Water Supply, Sanitation, and Hygiene (WASH) Poverty Diagnostic Initiative, led by the World Bank’s Water and Poverty Global Practices in collaboration with the Health, Nutrition, and Population and Governance Global Practices.
Co-author: Sophie Durrans, Research Uptake Officer at London School of Hygiene & Tropical Medicine
A child who is stunted early in life – who fails to grow as tall as expected for their age – often has reduced physical and mental development. Water supply, sanitation, and hygiene (WASH) influences a child's growth in multiple ways. Evidence across low and middle-income countries demonstrates that higher open defecation rates are associated with stunting and higher overall incidence of poverty.
Two years ago, I visited a village in Rudaki, a hilly district located to the south of Dushanbe, Tajikistan. It lies about forty kilometres from the capital, but it feels like a thousand kilometres away. On our drive up a hill, we saw women carrying buckets of water from a nearby spring. Moving further up, we saw children bathing and animals drinking from the same river. Once in the village, it was clear that life is largely shaped by water scarcity—the backyards were filled with pots and buckets, fuel and stoves for boiling water, and pit latrines that were no longer used because of lack of water. Although we could spot remnants of a once-functional water supply network, people living there had not had access to piped water for at least two decades. Without it, they were only able to practice the most basic forms of sanitation and hygiene.
The conditions we witnessed in Rudaki were harsh, but not rare. Located on the western tip of the Himalayas, Tajikistan is a country blessed with large fresh water resources in its lakes, rivers, and glaciers. Yet, access to safe drinking water and sanitation connected to a functioning sewer system is lacking, particularly for rural residents and the poor. Much of the existing infrastructure was built during the Soviet era and has not been upgraded for decades. Tajikistan is one of the few countries outside Africa that did not meet the Millennium Development Goal on drinking water and basic sanitation. Because poor water and sanitation conditions, together with poor nutrition and care, are key determinants of childhood stunting, Tajikistan’s childhood stunting rates remain high. and will not reach their full potential as adults.
In a new report, Glass Half Full: Poverty Diagnostic of Water Supply, Sanitation and Hygiene (WASH) Conditions in Tajikistan, we document the realities of Tajikistan’s WASH-deprived population. Our analysis builds on one of the largest data collection efforts of its kind – including national surveys of households and schools, water quality tests, ethnographic work, and case studies of existing WASH projects. It also includes poverty mapping and analysis of other secondary data, including a UNICEF nutrition survey that shared a subsample with our WASH survey.
This blogpost is part of a series of thematic blogs for the World Bank's Water Supply, Sanitation, and Hygiene (WASH) Poverty Diagnostic.
Addressing gender and sex inequalities in WASH is not only recognized in Sustainable Development Goals (SDGs) 4 and 6, it is central to the entire ambition of the SDGs themselves. Some water, sanitation, and hygiene issues are faced only by women because of their biological sex, whereas others are more influenced by gendered societal norms. To truly leave no one behind, we need to be mindful of and work against gender and sex inequalities in all development work.
New World Bank research is a valuable contribution to doing just that. ‘Reducing Inequalities in Water Supply, Sanitation, and Hygiene in the Era of the Sustainable Development Goals’ reveals that a drastic change is required in the way countries manage resources and provide key services, starting with better targeting to ensure they reach those most in need. In many cases, this means women and girls.
Community-Led Total Sanitation might be the greatest Bangladeshi export you’ve never heard of. In countries across Asia, Africa and Latin America, a consensus has emerged that the best approach is Community-Led Total Sanitation, which is widely credited with changing people’s behavior around the world to no longer defecate in the open, which has greatly improved global health.
Bangladeshis can take plenty of pride in these far-away accomplishments. That’s because it is Northern Bangladesh - more specifically the Mosmoil village in Rajshahi district - that pioneered this approach seventeen years ago. Its success at home led to its widespread adoption abroad.
Safe drinking water is a right and proper sanitation is dignity of the citizens. Proper management of freshwater ecosystems and access to safe water and sanitation are essential to human health, environmental sustainability and economic prosperity. Water and sanitation are at the core of sustainable development critical to the survival of people and the planet. Goal 6 of Agenda 2030 not only addresses the issues relating to drinking water, sanitation and hygiene, but also the quality and sustainability of water resources worldwide.
The ‘Global Water Supply and Sanitation Assessment’ by World Health Organization (WHO), United Nations Children Fund (UNICEF), Water Supply and Sanitation Collaborative Council (WSSCC) reported that in 2012 about 40% (2.6 billion) of the world’s population was without access to safe water. Approximately 4 billion cases of diarrhea each year causes 2.2 million deaths, and majority of them are children under the age of five. This situation in Bangladesh is also challenging. A study by Water and Sanitation Program (WSP) wing of the World Bank reveals that Bangladesh incurred a loss of Tk295.48 billion in 2010 due to inadequate sanitation, which is 6.3% of the GDP.
Indeed, there is much to emulate in Bangladesh’s remarkable progress in recent years in the field known as WASH -water, sanitation access, and hygiene. Today, 98 percent of the population gets drinking water from a technologically improved source – water which comes from a manmade structure– up from 79 percent in 1990. Bangladesh also largely succeeded in providing access to basic sanitation. It is estimated that only three percent of the population practice open defecation, down from 34 percent in 1990, thanks to behavior change campaigns and the building of many new toilets.
But, much has yet to be done. Bangladesh has still a long way to go to meet the Sustainable Development Goal (SDG) of providing universal access to clean water and sustainable sanitation by 2030. The World Bank recently completed a study, the WASH Poverty Diagnostic, which examines the remaining challenges in ensuring access to safe water, sanitation, and hygiene. The findings are startling.
While the share of poor people in Sub-Saharan Africa decreased from 56 percent in 1990 to 43 percent in 2012, the region’s rapid population growth outpaced the decrease in poverty, resulting in higher number of poor people than before. More specifically, Africa’s urban population is expected to triple in size in the next half century, which is putting pressure on scarce resources in cities, exacerbated by capacity, budget and governance bottlenecks. The densely-populated areas with low levels of water and sanitation services pose a serious threat to public health – cholera epidemics have broken out in urban areas in several African countries in recent years.
Beatrice Montesi, GAIN
Martin P. Gambrill, The World Bank
Rebecca Jean Gilsdorf, The World Bank
Crowded slums, poor sanitation and unhealthy diets. It’s a potent cocktail and for too many families across the world, a daily reality. Right now, an estimated one billion people live in slums and that number is expected to double by 2030. Slums are where the many deprivations facing the urban poor collide, including lack of access to clean drinking water, sanitation, safe and nutritious foods, sufficient living space, durable housing and secure tenure (UN Habitat). They’re where human waste is routinely emptied into streets, canals, and garbage dumps. And where overcrowding and low rates of immunization and breastfeeding combine to exacerbate the already perilous problems children face.
Children growing up in these surroundings are at a higher risk of death and disease and are more likely to be chronically malnourished (Ezeh et al. 2017). For example, forthcoming World Bank research from Bangladesh shows that children living in slums are 50 percent more likely to be stunted than children living in other urban areas. This doesn’t just have implications for today - , and face a higher risk of chronic disease as they grow older. Tragically, these effects are often passed on to offspring, trapping families in poverty and malnutrition for generations, as per findings in a forthcoming World Bank report called Uncharted Waters.