Written by Anupma Jain, Senior Social Sector Specialist
It’s time to turn off the snooze button on the alarm clock and wake up!
Incremental achievements in reaching the Millennium Development Goals (MDGs) are possible before they “expire” in 2015 if linkages among strategies to achieve various goals are made. MDG 5 demands an improvement in maternal health. MDG 4 calls for an improvement in child health. MDG 7c demands for improved water and sanitation. The links between WASH (water, sanitation and hygiene) and maternal and child health are evident. Accelerated efforts to improve WASH will not only move us toward achieving MDG 7c, but they will also contribute to the achievement of health MDGs 4 and 5.
According to the 2012 Joint Monitoring Programme Report, more than 780 million people, or 11% of the global population, remain without access to an improved source of drinking water. About 2.5 billion people in 2010 lacked improved sanitation. An estimated 1.1 billion people, or 15% of the global population, still practice open defecation. The adoption of better sanitation and hygienic practices require easy access to water sources. In fact, five out of six users of improved sanitation also use improved water sources.
The Post-2015 Development Agenda in Asia and the Pacific is looking to the future. The region is faced with emerging challenges such as aging populations, non-communicable or “lifestyle related” diseases, and impacts of climate change on health. We don’t have to wait for new goals to know that the job is not done. Instead, we need to continue our existing efforts to strengthen the links between different goals and make progress over the coming years. Are we doing enough or are post-2015 discussions diverting current efforts?
Water and sanitation continue to be women’s issues. Women are disproportionately affected by inadequate water supply, lack of sanitation and poor hygiene practices. About 4% of all maternal deaths can be linked to poor WASH conditions. Women that live in households with poor sanitation are more than 3.0 times more likely to die, and with inadequate water are more than 1.5 times more likely to die. Easy access to clean water reduces women’s time spent in collecting water and the physical hardship brought about by travelling far distances to the source. The risk of uterine prolapse (or “fallen womb”) is real—it’s a debilitating condition brought about in part by carrying heavy loads. Access to sanitation facilities, especially in the home, increases women’s dignity and reduces her risk of sexual harassment. Women no longer have to travel in the dark to relieve themselves. Behavioral change requires information on how improved water use and sanitation practices can lead to better health outcomes. However, such behavior changes are not possible without easy access to water and sanitation.
Improved water and sanitation would also contribute to better child health and nutrition. Access to clean water reduces a child’s risk of acquiring water-borne diseases. Dirty and contaminated drinking water sources will only yield higher incidence of disease, such as diarrhea and worms. Recent studies attribute a lack of sanitation facilities and poor hygiene practices to child stunting. The links between WASH and the 17 neglected tropical diseases (NTDs) are also evident; yet, WASH is still referred to as “the silent weapon against NTDS”. NTDs affect one in six people globally. Where open-defecation is prominent, there is a risk of disease caused by feces and infected water sources. Proper water resource management, sanitation and hygiene practices can help reduce the risk of NTDs.
A number of encouraging partnerships are taking form—the Alliance for the Global Elimination of Blinding Trachoma by the year 2020 (GET 2020) and the Maternal Health Task Force and WASH Advocates. Health and WASH sector specialists are coming together to find innovate ways to work with one another. They are recognizing the importance of establishing links between WASH and health, and addressing the challenges faced in operationalizing them in projects.
WASH projects with health outcomes must include robust health indicators and ensure appropriate technological choices. Data needs to be readily available; water safety needs to be a priority; and latrines must be durable, hygienic and environmentally friendly. Expanding access and increasing coverage is important; however, realizing health outcomes in WASH projects contributes to sustainability.
We cannot afford to be passive about developing some of these linkages. The movement is gaining momentum, and snoozing is not an option. Innovative opportunities and partnerships for improving maternal and child health through focused WASH interventions have sounded the alarm clock today. We cannot wait until tomorrow to wake up.