November 11, 2014
World Toilet Day is a fitting moment for the World Health Organization (WHO) and UN-Water to release their biannual 2014 Global Analysis and Assessment of Sanitation and Drinking Water (GLAAS) Report. The GLAAS report is always eagerly anticipated by the WASH sector because it sheds valuable light on the status of water, sanitation, and hygiene in 94 countries around the world. For those of us working in handwashing, the stand-out finding from the report was that, despite it being a very cost effective investment, countries are spending less than 1% of their total budget for WASH on hygiene promotion.
As with water and sanitation, hygiene behavior change requires investment—not only in hygiene promotion but also in the “hardware” components, such as water sources and soap. The lack of attention to funding hygiene is not, however, surprising given the finding that only 19 of the 93 countries surveyed had an approved, funded, implemented, and reviewed national hygiene policy. Likewise, only 18 countries had national hygiene policies in schools and healthcare centers that fulfilled the same requirements.
The GLAAS report doesn’t delve into inequities in access to hygiene, but it does explore the issue of access to water and sanitation. We know from analysis conducted on the Multiple Indicator Cluster Surveys (MICS) and the Demographic Health Surveys (DHS) that poorer households, those located in rural areas, and those with less education have lower access to functional handwashing stations than wealthier households, those in urban areas, and those with higher education.
The GLASS report echoes what many of us already know: lack of investment in hygiene is a serious barrier to progress in international development, and there are inequities in access to proper handwashing facilities. Knowing these shortcomings exist, however, is very different than taking action to address them, but with the United Nations’ work on developing global Sustainable Development Goals, there is a valuable opportunity to prioritize water, sanitation, and hygiene.
Universal WASH coverage is key for healthy children, families, and communities. For this vision to become a reality we must collaborate – both horizontally and vertically. The systems and enabling environments that support WASH must be better aligned so that funding isn’t only flowing towards service delivery, but to behavior change programming as well. Likewise, we must work better with our colleagues both within and outside of the WASH sector. If we hope to make a dent on childhood mortality, collaboration will be essential.
The 2014 GLAAS report clearly outlines steps that we must take. Hygiene investment is the right choice. Now we call upon the member states of the United Nations to do their part by including comprehensive WASH targets and indicators in the Post-2015 Sustainable Development Goals. Doing so will motivate governments around the world to recognize the huge impact of hygiene investment, start closing the massive hygiene funding gap, and ultimately save lives.
 Swapna Kumar, Handwashing behavior in 20 countries: analysis of proxy measures of handwashing in Multiple Indicator Cluster surveys (MICS) and Demographic Health Surveys (DHS), 2009-11, UNC Water and Health Conference, 2013, Chapel Hill, NC.
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