Water, sanitation and hygiene (UNICEF)

© UNICEF/NYHQ2009-1244/Pirozzi

Children use soap attached to a string to wash their hands before lunch at a public school in Madagascar.

Poor access to water and sanitation facilities, and unsafe hygiene practices are the main causes of diarrhoea, one of the biggest child killers in the world. Without addressing the problems in water, sanitation and hygiene (WASH), children's rights to an adequate standard of living and the highest attainable standard of health, as enshrined in the Convention on the Rights of the Child (CRC), can never be entirely fulfilled. Because of this, WASH is regarded as a central component of the millennium development agenda. Progress in this area is closely related to that of child mortality, primary education, and poverty eradication. 

“Safe drinking water and adequate sanitation are crucial for poverty reduction, crucial for sustainable development, and crucial for achieving any and every one of the Millennium Development Goals.” –Ban Ki-moon, UN Secretary-General

Not only WASH impacts on children’s health and wellbeing, it impacts on their ability to learn and thrive. In Eastern and Southern Africa, on average, less than half of schools have adequate water supply and sanitation facilities. In many communities, women and girls are burdened with the responsibility of collecting water, a household chore that can take up large parts of their day. Poor water and sanitation can make girls especially vulnerable, especially for those who start menstruating. Many are forced to skip classes and even drop out when their schools do not have separate toilets for boys and girls. 

School children with disabilities are also disadvantaged. Although there are no sufficient data, many education professionals attest to the lack of access to WASH services for students with physical disabilities.

Progress towards the MDGs

As a region ESA still has a long way to go to achieve the Millennium Development Goals (MDGs) of improving access to safe water and sanitation. Only five of the 21 countries in the region - Botswana, Malawi, Namibia, South Africa and Uganda - are on track to meet the MDG target of reducing the proportion of the population without access to safe water by half by 2015. Geographical disparities are vast, with 87 per cent of people in urban areas having access to improved drinking water sources, compared to 52 per cent in rural areas.

Access to sanitation is lagging even further behind. Only three countries - Angola, Botswana and South Africa - are on track to meet the MDG target of reducing the proportion of people without sanitation by half. Open defecation – the unhealthiest sanitation practice of all – is still common in some countries. In Ethiopia, Namibia and Mozambique, for example, the proportion of people who practice open defecation stands at 46, 52 and 41 per cent, respectively. Disparities are enormous. In Namibia, for example, only 10 per cent of the poorest families have access to improved sanitation, compared to 89 per cent coverage among the wealthiest households. 

UNICEF in action

© UNICEF/NYHQ2007-1350/Pirozzi

Two girls with pails walk towards latrines at a primary school, which is supported by UNICEF with child-friendly teaching and learning, and has separate latrinte for boys and girs, Rwanda.

Working directly with communities and families, UNICEF helps increase access to clean and secure supply of water, and safe and convenient sanitary facilities. While maximizing health benefits that WASH programmes bring, particularly to the survival, growth and development of young children, UNICEF also supports efforts to make schools  a more conducive learning environment to children. Separate and decent sanitation facilities in schools can reduce dropout rates, especially among girls, and hygiene promotion not only benefits children but empowers them to be agents of change in their families and communities.

Behaviour and social change is critical to sustainable access to water and sanitation. UNICEF, therefore, works on changing unhealthy behavior such as open defecation, and promoting healthy behaviours such as handwashing with soap, and safe water handling, water treatment and storage. Communities are also supported to be drivers of change through programmes such as community-led total sanitation. 

At the global level, UNICEF is the lead agency in water, sanitation and hygiene in emergencies. In line with its own mandate in emergencies – the Core Commitments for Children (CCCs) in Humanitarian Action - UNICEF supports countries in emergency preparedness and response, with WASH as a critical component.

Results for children

• In 2010 alone, about 4.5 million people in 14 countries in ESA got access to water, and 2 million to sanitation facilities through UNICEF-supported programmes. In 2012, the number of new users of sanitation, attributable to UNICEF programming, is well over 7.6 million.


• In 2012, 11 countries in ESA had sanitation-specific policies compared to only three countries at the start of the International Year of Sanitation in 2008. Eleven countries now have a national plan towards achieving the MDG target for sanitation, and a number of countries made progress in allocating discrete budget lines for sanitation and hygiene. 


• The number of countries with national behaviour change communication programmes that promote handwashing with soap is gradually increasing. In 2012, a total of 15 UNICEF country offices in the region supported the commemoration of the Global Handwashing Day, reaching more than 20 million children.


• UNICEF promotes and supports the implementation of the Community Approach to Total Sanitation (CATS) – an approach that triggers a change of mindset and social norms to encourage entire communities to abandon open defecation. Countries such as Zambia, Zimbabwe, Eritrea, Ethiopia, Madagascar, Malawi, Angola, Kenya and Mozambique have adopted CATS as a key national strategy to scale up sanitation.


• UNICEF has made significant progress in scaling up household water treatment and safe storage, particularly in emergency settings. During the Horn of Africa crisis in 2011, UNICEF was instrumental in supporting hygiene promotion, and providing safe drinking water to the affected population, including schools and feeding centres.