Improved sanitation strengthens the impact of safe water


Why sanitation?

A number of rigorous studies over the past two decades have confirmed that a large proportion of child deaths are preventable through basic WASH interventions. However, these studies also make it clear that such interventions must be implemented in an integrated way, not as stand-alone projects, or the impact will be muted. For example, the net impact on diarrheal deaths among children younger than 5 of providing access to safe water is only 3% to 5% if unaccompanied by other interventions, whereas providing access to effective sanitation reduces such deaths by 5 percent to 10 percent (latrines) up to 20 percent (flush toilets). However, the impact of safe water is multiplied many times over by combining it with improved sanitation in the same location—the median reduction in all-cause child deaths when the two are joined is 55%. This is because access to clean water is a prerequisite to maximise the health impacts of sanitation, and effective sanitation is a prerequisite to maximise the health impacts of safe water.

As World Vision engages in WASH in a community, a variety of approaches are utilised to address sanitation needs. This includes behaviour change programming to promote the construction, maintenance and use of latrines or toilets at households, schools and healthcare facilities, and the installation of latrines or toilets and hand-washing stations in schools and healthcare facilities to prevent the spread of sickness and disease. One example is community-led total sanitation – an approach that engages the community in recognising areas where open defecation occurs and taking their own actions to become totally free of open defecation, including the faeces of children under 2. World Vision also focuses on areas of environmental sanitation, including household waste management.

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  • 2 billion people lack access to basic sanitation services, such as toilets or latrines. Of these, 673 million defecate in the open.

  • Currently, 74% of the global population (5.5 billion people) use an improved sanitation facility that is not shared with other households.

  • More than 80% of wastewater resulting from human activities is discharged into rivers or sea without any pollution removal.
  • Diarrhoea is the second leading cause of death in children under age 5 years ago. A significant proportion of these deaths can be prevented by safe water, sanitation and hygiene.
  • Inadequate sanitation is estimated to cause 280 000 diarrhoeal deaths annually and is a major factor in several neglected tropical diseases, including intestinal worms, schistosomiasis, and trachoma. Poor sanitation also contributes to malnutrition.
  • Sustainable Development Goal 6 includes an ambitious but achievable target for sanitation: "By 2030, achieve access to adequate and equitable sanitation and hygiene for all and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations."


WHO/UNICEF, 2019. Progress on household drinking water, sanitation and hygiene: 2000-2017.

WHO, 2014. Preventing diarrhoea through better water, sanitation and hygiene:exposures and impacts in low- and middle-income countries.