Water sanitation hygiene

Key facts from JMP 2015 report

The report marks the 25th anniversary of the WHO/UNICEF Joint Monitoring Programme. It is the final report on access to drinking water and sanitation ahead of the MDG’s. There has been significant progress.

A: Drinking water

  • 91% of the global population uses an improved drinking water source, up from 76% in 1990.
    • 6.6 billion of the people of the world have access to improved sources of drinking water.
    • The total without access to improved drinking water globally is now 663 million – the first time the number has fallen below 700 million.
    • 2.6 billion people have gained access to an improved drinking water source since 1990
    • The least developed countries (LDCs) did not meet the target, but 42% of the current population has gained access since 1990.
    • In sub-Saharan Africa, 427 million people gained access during the MDG period – an average of 47000 people per day for 25 years
    • In 2015 only 3 countries – Angola, Equatorial Guinea and Papua New Guinea – have coverage of less than 50%, compared to 23 countries in 1990.
  • There are regional variations
    • Five developing regions met the target, but the Caucasus and Central Asia, Northern Africa, Oceania, and sub-Saharan Africa did not
    • The lowest levels of coverage are found in the 48 UN-designated LDCs.
    • Coverage in Eastern Asia increased by 27 percentage points and exceeded the MDG target, with over half a billion people gaining access in China alone.
    • Access in Southern Asia and South-eastern Asia rose by 20% and 19% respectively, and these regions met the target.
    • Sub-Saharan Africa did not meet the MDG target but still achieved a 20 percentage point increase in the use of improved sources of drinking water.
  • There are rural and urban disparities
    • 96% of the global urban population uses improved drinking water sources, compared with 84% of the rural population
    • 8 out of 10 people still without improved drinking water sources live in rural areas
  • The populations without access are mainly in sub-Saharan Africa and Asia.
    • Sub Saharan Africa – 319 million
    • Southern Asia – 134 million
    • Eastern Asia – 65 million
    • South Eastern Asia – 61 million
    • All other regions – 84 million

B: Sanitation

The MDG target called for halving the proportion of the population without basic sanitation, and so extend access from 54% to 77% of the global population.

  • The MDG target was not met, although there was progress.
    • 68% of the global population now uses an improved sanitation facility, 9 percentage points below the MDG target
    • The global MDG target for sanitation has been missed by almost 700 million people
    • 2.1 billion people have gained access to an improved sanitation facility since 1990
    • In 2015 it is estimated that 2.4 billion people globally have no access to improved sanitation facilities. Of them, 946 million defecate in the open.
  • Some regions did better than others.
    • Only four developing regions met the sanitation target: the Caucasus and Central Asia; Eastern Asia; Northern Africa; and Western Asia
    • 50% of the population in Western Asia and 41% in Northern Africa gained access since 1990. By contrast, less than 17% gained access in sub-Saharan Africa.
    • Eastern Asia increased coverage by 27 percentage points and met the target.
    • LDCs did not meet the sanitation target, and only 27% of their current population has gained access since 1990
    • In Southern Asia, 576 million people gained access during the MDG period – an average of 63000 people per day for 25 years.
    • Due to a combination of population growth and slow progress, the number of people in sub-Saharan Africa without access to sanitation has increased since 1990.
  • As with water, there were rural and urban disparities.
    • 82% of the global urban population vs. 51% of the rural population uses improved sanitation facilities
    • 7 out of 10 people without improved sanitation facilities, and 9 out of 10 people still practising open defecation, live in rural areas
  • The population without sanitation access live primarily in Asia, sub-Saharan Africa and Latin America and the Caribbean.
    • Southern Asia – 953 million
    • Sub-Saharan Africa – 695 million
    • Eastern Asia – 337 million
    • South Eastern Asia – 176 million
    • Latin America & the Caribbean – 106 million
    • Other areas – 98 million
  • Open defecation is still a major problem globally, though some countries and regions have made remarkable progress.
    • Ethiopia achieved the largest decrease in the proportion of the population practising open defecation. It has reduced from 92% (44 million people) in 1990 to 29% (28 million people) in 2015 – an average reduction of over 4% per year over 25 years.
    • In Southern Asia, where the number of open defecators is highest:
      • Bangladesh, Nepal and Pakistan have all achieved reductions of more than 30 percentage points since 1990.
      • In India there has been a reduction of 31 percentage points, representing 394 million people
    • The number of people practising open defecation has actually increased in sub-Saharan Africa, and the region now accounts for a greater share of the global total than in 1990.
    • At current rates of reduction, open defecation will not be eliminated among the poorest in rural areas by 2030

C: Hygiene

There was no specific target on hygiene in the MDGS, however its health benefits are significant and linked to adequate water and sanitation. The JMP covers hygiene practices in its data gathering.

  • Data from over 50 countries show low levels of handwashing in many countries. In sub-Saharan Africa, in the 38 countries for which data are available, it is at best 50%.
  • In many parts of the developing world, up to 4 out of 10 schools and healthcare facilities lack basic water, sanitation and hygiene facilities

D: Key facts related to children

  • Latest estimates are that 5.9 million children under five die annually from all causes.
  • Diarrhoeal disease is the third leading cause of death among children under five. We estimate that more than 340000 children under five die annually from diarrhoeal diseases due to poor sanitation, poor hygiene, or unsafe drinking water – that is almost 1000 per day.
  • Some 161 million children suffer from stunting, or chronic malnutrition, which has been linked to WASH and particularly open defecation.

E: Key facts on implications for heath

  • 842000 deaths from diarrhoeal diseases each year could be prevented by improved water, sanitation and hygiene
  • Poor water, sanitation and hygiene are major contributors to neglected tropical diseases like schistosomiasis, trachoma and intestinal worms, which affect more than 1.5 billion people every year.
  • Basic hygienic practices by birth attendants can reduce the risk of infections, sepsis and death for infants and mothers by up to 25%, yet many health facilities lack even basic water and sanitation facilities. In Africa, 42% of health facilities do not have access to an improved water source within 500 metres.

F: Moving from MDGs to SDGs

The report highlights the great strides that have been made in improving monitoring of drinking water, sanitation and hygiene, pointing to prospects of more accurate data gathering to measure the progress of the SDGs and to pinpoint gaps.

  • The SDG targets will call for universal access to drinking water, sanitation and hygiene, which cannot be achieved without a much sharper focus on inequalities in access between groups – such as rich and poor, rural and urban, or disadvantaged groups versus the general population. Disaggregated and better WASH data would identify inequalities where they occur to allow targeted intervention.
  • WASH monitoring must move from access to quality, and in addition to families, also encompass schools, health care facilities and work places.
  • An innovative and cost effective approach to testing water quality has been developed and already piloted in five countries opening up the possibilities of also monitoring quality as well as access
  • Work is now underway to develop new methods for assessing safe collection, transport, disposal and reuse of faecal waste along the sanitation chain.

G: 1990 and 2015 compared