How Clean Water and Toilets Affect Women, Girls and Maternal Health

Society’s most vulnerable are hit the hardest by poor water access. Photo: ADB
Society’s most vulnerable are hit the hardest by poor water access. Photo: ADB

By Anupma Jain

Women are disproportionately affected by water and sanitation issues, including inadequate water supply, lack of sanitation and poor hygiene practices.

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?  

More than 780 million people, or 11% of the global population, remain without access to an improved source of drinking water.

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.