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The Global Handwashing Partnership

Leave No One Behind: Advocacy & Action for Universal WASH

March 22, 2019

By: Aarin Palomares, Global Handwashing Partnership Secretariat

On World Water Day, the Global Handwashing Partnership is thrilled to announce that the 2019 Global Handwashing Day theme will focus on “Clean Hands for All.” We will continue advocacy efforts focused on leaving no one behind by emphasizing more equitable approaches, sharing success stories, and advocating for better hygiene for all. This is part of a year-long effort in partnership with advocacy days like World Water Day and World Toilet Day to highlight universal access to water, sanitation, and hygiene (WASH).

The goals set forth in the SDG agenda are abundantly clear. For SDG 6, that means water, sanitation, and hygiene for all by 2030. This World Water Day, we emphasize water as a human right, with special focus on marginalized groups, such as women, children, refugees, indigenous people, people with disabilities, and so many others who are often overlooked when addressing water issues. As we celebrate World Water Day, we must also think about how we use water and the key behaviors that can impact our health and well-being. Handwashing with soap is a simple, yet often neglected act. In order to achieve handwashing equity, access and behavior change messaging must reach those who are often overlooked or left behind.

What does leave no one behind mean?

When the Sustainable Development Goals launched, there was a commitment to universal access and to leaving no one behind. In committing to the realization of the Sustainable Development Goals, it is important to put these commitments into practice, recognizing that these targets must be met by all – all nations, all people, and all sectors. This is a testament to a more collective and shared process for development moving forward. This commitment means more than just a pledge; it means taking explicit actions to curb inequalities and confront discrimination to ensure progress for those furthest behind.

A discussion paper by the United Nations Development Program defines the key factors in addressing who is left behind. These include: discrimination, governance, socioeconomic status, geography, and shock and fragility. Accordingly, an individual’s gender, disability status, ability to access services, geographic setting, and other individual factors could make them more vulnerable to certain outcomes. For example, a project in Bangladesh found that 73% of women who worked at a factory missed an average of 6 days of work during their menstrual cycle. Failing to recognize gender dimensions often leads to policies and interventions that do not serve women’s needs, causing loss of productivity and economic challenges for these women. Likewise, only 23% of refugee adolescents attend secondary school compared to the world average of 84%. Transitional settings, such as refugee camps, make it increasingly difficult for these individuals to receive the education they deserve.

Access to WASH can vary by location (rural/urban), socioeconomic status, gender, and other factors. For example, while Angola has relatively high coverage for drinking water, there is a 65% gap between the richest and poorest individuals in the country. Likewise, in the slums of Jakarta, Manila, and Nairobi, individuals pay 5-10 times more for water than those living in high-income areas. Basic WASH coverage is also higher in urban schools compared to rural schools. In Tanzania, there is a 37% coverage gap in hygiene facilities between urban and rural schools. Groups who have lower access to adequate WASH facilities and behavior change programs have a higher risk for diseases that can adversely impact their health, education, and economic outcomes. We must prioritize and track the progress of the furthest behind if we want to address the drivers that create these disparities.

From pledge to practice

In 2010, the United Nations General Assembly explicitly recognized the human right to water and sanitation. While this pledge establishes an important step toward WASH equity, we must take action to address key barriers that perpetuate these inequities among certain groups.

Here are some practical examples of successful actions others have taken to address WASH equity:

1. Mum’s Magic Hands is a program developed by Oxfam and Lifebuoy (Unilever) to encourage handwashing with soap at key times in emergency affected communities. The program is customized to support community health workers in reaching mothers in camp settings, and utilizes storytelling, games, and nudges to increase handwashing behavior. In Nepal, the program saw a 45% increase in handwashing with soap after using the toilet, an 18% increase in handwashing with soap before eating, and a 17% increase in handwashing with soap before cooking. By focusing on motivating factors, such as nurture and affiliation, the program is able to change handwashing behavior among mothers in emergency settings.

2. In 2004, the Ethiopia WASH movement was launched under the Water Supply and Sanitation Collaborative Council (WSSCC). Ethiopia was ranked 105 out of 108 on the human poverty index with high rates of sanitation and hygiene-related diseases. The WASH Ethiopia Movement sought to promote improved WASH and gain political and social commitment within the country. It offers a good example of successful coalition building. Through the movement, WASH sectors were able to better coordinate with one another to gain attention from the government and other agencies. Through mobilization and strategic advocacy initiatives, the movement contributed to the development of a National Hygiene and Sanitation Strategy Protocol.

3. A program by Mougnousi, an association led by people with disabilities, along with its partners, World Vision and Messiah College, used innovative ways to overcome accessibility barriers for persons with disabilities in Mandiakuy, Mali. This included modifying water pumps, providing guides for those who are blind or visually impaired, and capacity building trainings around inclusive hygiene promotion messaging. The impacts of the project include accessible facilities in the community, allowing members of the association to become independent from their neighbors for many WASH matters. It was also successful in delivering WASH training that was inclusive to those with disabilities. Because people with disabilities were involved throughout every stage of the project, they were able to make decisions throughout the process, ensuring the community was more accessible to their needs.

Beyond a tagline

We are well into the Sustainable Development era, and thus far, several trends have stood out in this fight for equitable WASH. Focusing on marginalized groups, institutions, countries, and settings, and finding innovative ways to address unique needs is crucial in ensuring WASH for all. Now, we are at a turning point between stagnation and truly transformative progress. This year-long campaign focused on “leave no one behind” only reiterates the promise made when developing the Sustainable Development Agenda.

Global events, like World Water Day and Global Handwashing Day, present important opportunities for us to capitalize on this message throughout the year. However, this has to be more than a tagline. If we want to ensure we meet SDG 6, we must continue to make more ambitious goals, use more integrative approaches, and actively include those who are furthest behind in our work.

Join us in advocating to leave no one behind beyond World Water Day, and pledge to work toward inclusive WASH year-round. As Global Handwashing Day approaches, our Partnership will be releasing new materials to help support your advocacy efforts. Learn more at www.globalhandwashing.org.

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