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Gender and sex inequalities in water, sanitation, and hygiene

Libbet Loughnan's picture

This blogpost is part of a series of thematic blogs for the World Bank's Water Supply, Sanitation, and Hygiene (WASH) Poverty Diagnostic.

Woman carries water containers near polluted stream and water pipe in Maputo, Mozambique

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. 

How can we make water and sanitation more inclusive and accessible?

Kamila Anna Galeza's picture

“What’s wrong with this picture?” Louisa Gosling of WaterAid asked the participants at her training on Disability-inclusive Water Operations at the World Bank Water Week in March 2017. She pointed to a photo of a woman standing on the wall of a well. It was round and high, the ground around it muddy, and there was no lifting mechanism in sight.

More pictures followed… latrines and water sources with steep steps, narrow doorways, unstable construction without handles or rails. The more pictures we saw, the clearer it became what was wrong - all the facilities shown were inaccessible and dangerous, quite likely impossible to use for many people. 

Photo Credit: WaterAid

The biggest bang for our limited water and sanitation buck: can investing in small towns lead the way?

Aroha Bahuguna's picture



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.

Starting life strong in slums: the role of engaging vulnerable groups on sanitation and nutrition

Claire Chase's picture
This blog is co-authored with Lawrence Haddad, Executive Director, The Global Alliance for Improved Nutrition (GAIN)

Other co-authors: 
Beatrice Montesi, GAIN  
Martin P. Gambrill, The World Bank 
Rebecca Jean Gilsdorf, The World Bank

 
Children in a slum in Dhaka, Bangladesh.
Credit: UN Photo/Kibae Park

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 - children who are stunted early in life go on to learn and earn less, 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.

Starting a marathon with a broken ankle: how poor water and sanitation sets children behind

Maximilian Leo Hirn's picture
Children in Koutoukalé, Niger

Have you ever wondered how your life chances are affected by where you were born? Odds of being born at all are already miraculously small, but only one in ten of us is born into the relative security of a high-income country. What if you are born in Niger or in the Democratic Republic of the Congo (DRC)? Before you could even walk or talk, your challenges would be daunting. That's because, despite progress, deaths of children under five years old are more than twenty times higher than in the EU and nearly ten times higher than in China.

Even if you survived, you would confront another major risk to your development: malnutrition. In Niger and DRC, almost one out of every two children is stunted. Stunting has significant and long-lasting negative effects on early childhood development, impeding physiological and mental development, and making small children more vulnerable to disease. Starting off in life stunted is akin to starting a marathon with a broken ankle.

Water works: how a simple technology in Dhaka is changing the way people get clean water

Daphna Berman's picture

Amy Pickering laughs when she thinks of all the things that went wrong with the impact evaluation she recently completed of a water chlorination project in the slums of Bangladesh’s capital city Dhaka: delays, monsoons, and more delays.

“It was the hardest project I’ve ever done,” says the seasoned research engineer, now a professor at Tufts University, who was working on a project funded through the World Bank’s Strategic Impact Evaluation Fund.  

Clean water is an issue in Dhaka and other overcrowded cities in the region, where contamination by bacteria can lead to high rates of diarrhea, harming children’s growth and health. For Pickering, who specializes in water quality and diarrheal disease, the challenge was finding a water treatment technology that could work without electricity and operate in Dhaka’s extreme weather. 

Amy Pickering, a professor at Tufts University, working on a water chlorination project in the slums of Bangladesh’s capital city Dhaka

Shared toilets as the path to health and dignity

Guangzhe CHEN's picture

This post is co-authored with Tim Wainwright, Chief Executive, WaterAid and Neil Jeffery, Chief Executive Officer, Water & Sanitation for the Urban Poor and was originally published on the Financial Times’ BeyondBrics Blog.  

An alley in Mollar Bosti, Dhaka, Bangladesh.
Where space and funding do not permit household toilets, safe, well-managed community latrines can provide a healthier alternative to makeshift, unhygienic toilets.
© Rasel Chowdhury/WaterAid

Mollar Bosti is a crowded slum in Dhaka, Bangladesh, home to 10,000 people: garment workers, rickshaw drivers, and small traders, all living side-by-side in tiny rooms sandwiched along narrow passageways.

With the land subject to monsoon flooding, and no municipal services to speak of, the people of Mollar Basti have been struggling with a very real problem: what to do with an enormous and growing amount of human faeces.

Traditionally, their ‘hanging latrines’ consisted of bamboo and corrugated metal structures suspended on poles above the ground, allowing waste to fall straight down into a soup of mud and trash below. Residents tell stories of rooms flooded with smelly muck during monsoons; outbreaks of diarrhoea and fever would quickly follow.

But conditions have improved for much of the slum. With help of a local NGO, the residents negotiated permission for improvement from a private landowner, and mapped out areas of need. Today, they proudly show visitors their pristine, well-lit community latrines and water points. They report fewer problems with flooding and disease.

World Population Day 2017: What can we learn from Bangladesh?

Maitreyi Bordia Das's picture
Mom and daughter at a community health center outside Dhaka,
Bangladesh. Photo: Rama George-Alleyne / World Bank

Today marks World Population Day and this year’s theme is “Family Planning: Empowering People, Developing Nations”. It is an opportune moment to reflect and continue the conversation on demographic trends that I started through my blog on fertility decline last month.

Changing the village, changing the country

Robin van Kippersluis's picture
How do you persuade people to use a toilet? This is an urgent question across rural India: somewhere near half a billion people are still defecating in the open, and the Swachh Bharat Mission is urging them to stop by 2019.

India has about 650,000 villages. Many have tried different techniques - some successfully, some not. What if there were a “Google of sanitation”, where you could search for success stories of others who have faced the same situation, and a “LinkedIn of Sanitation” where you could reach out to peers with questions?
Pictures: Left: Ms Lunga Devi from Pawa, Pali is interviewed by Government officials in Rajasthan on how she became a natural leader on ODF in her village and helped it transform, as part of the ‘World Bank - Capturing Local Sanitation Solutions’ training.  Right: Villagers from Muzzafarpur district in the State of Bihar talking about local sanitation solutions.

Four political errors to avoid in achieving water and sanitation for all

Nathaniel Mason's picture

Eliminating inequality is integral to the Sustainable Development Goals , from ‘universal access’ to water, to ending poverty ‘everywhere’. Yet in a world where the politics of who gets what is increasingly polarised, leaving no-one behind is fundamentally a political project.

In a recent study with WaterAid in Nepal, for example, we found that in rural areas a combination of poverty, caste, and geography have shut the poorest fifth out of politics. While access to water has increased significantly for others, they are lagging behind.

Every city, country or district has its own political rules, most of which aren’t written down. Yet despite all this complexity, experts working on essential services like water, sanitation, health or education can avoid some common political missteps, wherever they work. Here are four most typical ones:

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