A healthy and dignified life experience requires adequate water, sanitation, and hygiene (WaSH) coverage. However, inadequate WaSH resources remain a global health challenge, affecting about one-third of the world’s population. The numbers are staggering: globally, 2 billion people lack safe drinking water and 3.6 billion people—almost half the world’s population—use sanitation services that leave human waste untreated. Over 263 million people walk long distances to collect water from rivers, streams, and lakes. Furthermore, each year at least 1.4 million people, many of them children, die from preventable causes linked to unsafe water and poor sanitation. Right now, for example, there is an acute upsurge of cholera cases, which has put one billion people in 43 countries at risk, according to the World Health Organization.
The challenge of inadequate WaSH facilities is particularly dire in Africa, where about 70 percent of rural water schemes are non-functional or intermittently functional at any given time, resulting in compromised health and wellbeing. Rural areas are the most affected by poor access and availability of WaSH facilities compared to urban settings. However, even where the best WaSH coverage exists in Africa, 1 in 4 people still lack adequate sanitation. Healthcare facilities, where proper hygiene practices are especially critical, are also affected and often lack water and soap or alcohol-based hand sanitizing solutions.
Consequences of poor WaSH on public health in Africa
Poor access to WaSH has tremendous negative consequences for public health and the development of the African populace. Water shortages, contaminated water, and poor sanitation are interrelated and linked to the spread of diseases such as cholera, diarrhoea, dysentery, and typhoid, which are prevalent in most sub-Saharan African countries.
73 percent of the diarrhoeal and enteric disease burden in Africa is linked to poor access to WASH facilities, with the greater proportion occurring in poorer children. Reports show that 115 people in Africa die every hour from diseases linked to poor water and sanitation conditions.
Also, in places where water supply is not readily available, people often ignore the practice of regular hand washing, which can further increase the risk of infectious diseases.
Facing probably the highest preventable health risk are patients and healthcare workers who are at risk of infection and disease in health facilities where there are inadequate WASH services. Globally, 15% of patients develop an infection during a hospital stay, with the proportion being much greater in low-income countries.
Poor access to WaSH also has an economic impact on society, resulting in a decrease in schooling and working. Communities that suffer ill health due to poor WaSH-related issues are more likely to spend less time working because of health-related issues and be required to spend more money on healthcare related to this. Hence, investing in proper WaSH facilities offers both public health and economic returns and contributes to the overall wellbeing of the community.
Challenges and strategies to improve WaSH in Africa
Addressing the water and sanitation crisis in Africa is crucial to achieving SDG 6, “clean water and sanitation for all,” and building healthy societies. To achieve this, there is a need for regional and national collaboration between governments, private sector organizations, non-governmental organizations, and other stakeholders in the public health sector.
Key barriers that must be tackled to improve WaSH practices include low investments in WaSH infrastructure, inadequate knowledge on water-borne illnesses, a lack of community engagement, and climate change, among others.
Inadequate funding, especially in rural areas, leads to inadequate WaSH infrastructure with poor or no maintenance of existing facilities. Increased investment to finance WaSH interventions is therefore essential.
However, efforts to achieve sustainable transformation are expensive, require a pooled investment from various stakeholders, and should focus on rural communities with the most pressing needs.
Another major challenge is poor perception, knowledge, and behaviour regarding WaSH facilities. Inadequate knowledge on the transmission of diseases associated with poor WaSH practices was reported as one of the challenges to healthy lifestyle change. Hence, the establishment of community-based and publicly supported programmes that promote behavioural change and education is crucial to improving the public’s adoption of safe and hygienic practices.
Effective local community engagement in interventions for WaSH practices is also critical. Engaging local community members from the design of interventions to their implementation can have a direct impact on the success of public health interventions.
Climate change, resulting in floods and drought, is also a significant factor that exacerbates public health issues associated with poor sanitation and hygiene practices. Drought leads to inadequate water supply, especially during the dry seasons, and is a constraint to improved hygiene, including handwashing. This can be addressed by the adoption of smart water management systems.
In conclusion
Given the significance of universal, affordable, and sustainable access to water, sanitation, and hygiene in safeguarding public health, African governments need to intensify efforts with support from UN agencies, multilateral partners, the private sector, and civil society organizations to address barriers to WaSH in Africa as a non-negotiable pathway to achieving universal health coverage on the continent.
