July 1, 2015
The omission of hygiene from the Millennium Development Goals (MDGs) has inhibited the international community in delivering fully on aspirations for sanitation, health, nutrition, education, and gender equity. With the MDG deadline rapidly approaching, this is an apt moment for the WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation (JMP) to release their latest report on progress. While the report focuses on the MDG priorities of access to improved sanitation and drinking water, it also highlights hygiene, and particularly handwashing with soap, as clear priority areas for the Post-2015 development agenda.
In the report, the JMP recommends that the forthcoming Sustainable Development Goals (SDGs) should aspire to “achieve universal access to basic drinking water, sanitation and hygiene for households, schools and health facilities”, and underlines that the full benefits of improvements in access to sanitation and drinking water cannot be realized without good hygiene.
Significantly, the report recognizes that we are not close to achieving hygiene for all, and this is a grave problem. Since 2009, over 50 Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) have included questions about handwashing at the household level. These surveys reveal that current levels of handwashing with soap are low in many countries, especially in sub-Saharan Africa, where in the 38 countries that provided data, coverage is, at most, 50 percent. There are clear disparities in access between different groups and settings, including between urban and rural areas.
In addition to presenting the findings from the DHS and MICS surveys, the report also highlights the fact that monitoring handwashing with soap remains inadequately prioritized in the school setting. Only 17 of 54 information monitoring systems in education now address hygiene, and the indicators used vary, making it difficult to compare progress over time and across countries. In healthcare, the report found that 36 percent of healthcare facilities in Sub-Saharan Africa, 35 percent of healthcare facilities in Latin America and the Caribbean, and 20 percent of healthcare facilities in South East Asia lacked soap for handwashing.
The JMP report concludes that hygiene is fundamental to the Post-2015 development agenda, and that handwashing with soap in all settings should be considered a top priority. Unfortunately, recent discussions amongst those developing the indicators that will be used to measure progress on the SDGs have suggested that monitoring hygiene at this level should be optional rather than being recognized as a mandatory global indicator. This report is another reminder that hygiene has been considered optional for too long. A global-level hygiene indicator will be a step towards the achieving the ambition of the SDGs, and the lofty but achievable aspiration stated in the JMP report: water, sanitation and hygiene for all by 2025.
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