Nepal WASH Blog Water, Sanitation and Hygiene (WASH) & Development in Nepal

November 13, 2013

Linking WASH into health in the South Asia region

Filed under: Advocacy,Diarrhoea,Health,Hygiene,SACOSAN,SACOSAN V,Sanitation — nepalwash @ 6:27 pm

Water, sanitation and hygiene (WASH) are the basic foundations of public health. Therefore Fourth South Asian Conference on Sanitation (SACOSAN IV) held in Colombo in April 2011 recognised that ‘Sanitation in South Asia is at crisis point’. Over a billion people do not use improved sanitation and out of those nearly 700 million people practice open defecation – a sanitation facility that ensures hygienic separation of human excreta from immediate human contact is very essential. This situation represents a constant barrier to human and economic development, through direct impact on health, as well as broader impacts on poverty.

The Lancet infectious disease review 2011 clearly highlights that while the correlation between U5 diarrhoea related mortality and sanitation coverage is abundantly clear, the cause and effect chain of WASH related disease in public health are varied and has many fold implications and deserves urgent attention. Adding to its Child Health Epidemiology Reference Group 2012 shows that in South Asia main diseases for under five are Pneumonia 22%; Diarrhoea 11%. Diarrhoea is the second leading cause of death between age 1 and 5 in South Asia region, according to global disease burden 2012.

WASH-related infections such as diarrhoeal diseases are among the most common causes of illness and death in South Asia. India and Pakistan are the hotspots of child deaths which is located in South Asia. So far health systems are more focused on medical interventions for prevention (vaccines) and cure (oral rehydration sachets (ORS), zinc, antibiotics) of such diseases. This has led to little engagement of the health sector in WASH, frequently viewed as a largely infrastructure-related issue. WASH agencies, while able to respond to supply-side constraints of WASH provision, are less able to generate demand for sanitation and the accompanying hygiene behaviour change necessary for WASH infrastructure to translate into better health outcomes. Such expertise often lies within the sphere of the health sector.

This fall between the WASH and health sectors has resulted in lack of progress on disease reduction, and also in reduced political will to address WASH coverage gaps. In contrast to the experience of developed countries, in which public health considerations have contributed to the legislative and investment drive resulting in universal water and sanitation coverage. The lack of positioning of WASH as a social determinant of health and public health issue rather than one of infrastructure acts as a barrier to political and financial prioritisation of WASH.

The post is written by Ms Upama Adhikari Tamang, Health and Advocacy Officer, WaterAid Nepal in context of her presentation at SACOSAN V held in Nepal.

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