More than half of all primary schools in developing countries have inadequate water facilities and nearly two-thirds lack single-gender bathrooms1. Lack of WASH puts everyone’s health and chances of survival at risk – particularly children, who are the most vulnerable.
Each year, children lose 443 million school days because of water related illnesses,2of which 272 million are lost due to diarrhea alone.3 More than 40 percent of diarrhea cases in schoolchildren result from transmission in schools rather than homes.4
Improving WASH conditions in schools can also help to prevent worm infestations, of which 100 percent of annual cases globally can be attributed to poor sanitation and hygiene.5 Studies have shown that the average IQ loss per worm infestation is 3.75 points, representing nearly 633 million IQ points lost among students living in the world’s lowest-income countries.6 A recent impact evaluation of a deworming program in Kenya demonstrated that the worm burden in children contributed to 25 percent of overall school absenteeism.7 Malnutrition and repeated episodes of diarrhea during childhood caused by WASH-related diseases can impair physical growth and cognitive function throughout later life.8As a result, children that live long enough to attend school often start school at a disadvantage.
Women and children bear the economic and educational costs associated with unsafe drinking water and poor sanitation. Girls who have reached puberty and female school staff who are menstruating need gender-specific sanitation facilities. Without the privacy afforded by these facilities, students will often not use school bathrooms, resulting in absenteeism 10-20 percent of the time.9 Worse yet, a survey of South African girls revealed that over 30 percent had been raped in school.10 Many times, these rapes occurred in toilets isolated from school or lacking basic provisions for privacy. Women and young girls spend much of their time collecting and transporting water for their families—often walking over 6 kilometers daily11—and finding adequate sanitation.
Investments in WASH in schools have immediate benefits for children’s health and education. Prioritizing the funding and implementation of integrated packages to include WASH interventions in schools and communities is an important part of creating long-term change in infrastructure, health and education systems. Handwashing practiced in facilities such as day-care centers and primary schools reduces cases of diarrhea by 30 percent.12 Children in primary schools in Bogotá who reported proper handwashing behaviors at school were 20 percent less likely to miss school than similar students in schools without good hygiene practices.13 Similarly, project evaluations and research have found that students in Tanzania were 12 percent more likely to attend school when water was available within a 15-minute walk.14
An example from Alwar District, India, showed that the implementation of a sanitation program at school increased girls’ enrollment by one third and increased academic improvement by 25 percent in both girls and boys.15 Furthermore, research shows that for every 10 percent increase in female literacy, a country’s economy can also grow by 0.3 percent.16 This is because girls who can stay in school can become better educated and this, in turn, improves their economic output.
By integrating cost-effective and sustainable WASH solutions with education programs, we can dramatically decrease child morbidity while improving access to and effectiveness of education. Cost-effective, scalable and context-relevant interventions, which may include hand-dug wells, harvesting rainwater for drinking purposes, protecting springs, purifying water, building safe latrines, handwashing with soap and integrating hygiene education into curricula are key elements to improve WASH in Schools. Each stakeholder (implementing organization, donor, academic, community, and government) plays an essential role in WASH in Schools. Specifically, national, regional, and local governments can help ensure that WASH in Schools is a component of their basic education strategies.
1. UNICEF. (2010). Raising Clean Hands: Advancing Learning, Health and Participation through WASH in Schools. Retrieved from http://www.unicef.org/wash/schools/files/raisingcleanhands_2010.pdf
2. UNDP. (2006). Human Development Report; Beyond Scarcity: Power, poverty and the global water crisis. Retrieved from http://www.undp.org/content/dam/undp/library/corporate/HDR/2006%20Global%20HDR/HDR-2006-Beyond%20scarcity-Power-poverty-and-the-global-water-crisis.pdf
3. Hutton, G. & Haller, L. (2004). Evaluation of the Costs and Benefits of Water and Sanitation Improvements at the Global Level. Retrieved from http://www.who.int/water_sanitation_health/wsh0404.pdf.
4. WHO/UNICEF (2010). Water, Sanitation and Hygiene. Retrieved from http://www.unicef.org/media/media_45481.html
5. Prüss-Üstün, A, et al. (2008). Safer Water, Better Health: Costs, benefits and sustainability of interventions to protect and promote health. World Health Organization, Geneva.
6. WHO. (2005). Report of the Third Global Meeting of the Partners for Parasite Control: Deworming for health and development.
7. Poverty Action Lab. (2007). Mass Deworming: A best-buy for education and health. Policy Briefcase, no. 4. Massachusetts Institute of Technology Department of Economics, Cambridge, MA.
8. Lorntz, B., et al. (2006). Early Childhood Diarrhea Predicts Impaired School Performance. The Pediatric Infectious Disease Journal. 5(6), 513-520.
9. IRC International Water and Sanitation Centre. (2005).
School Sanitation and Hygiene Notes & News May 2005.
10. Prinsloo, S. (2006). Sexual harassment and violence in South African schools. South African journal of education. 26(2), 305-318. Retrieved from http://www.ajol.info/index.php/saje/article/viewFile/25072/20742?origin=publication_detail
11. United Nations OHCHR/UN-HABITAT/WHO. (2010). The Right to Water Fact Sheet No. 35. Retrieved from http://www.ohchr.org/Documents/Publications/FactSheet35en.pdf
12. Ejemot-Nwadiaro, R., et al. (2009). Hand washing for preventing diarrhoea (Review). Cochrane Database of Systematic Reviews. 1, CD004265. Retrieved from http://www.thecochranelibrary.com/userfiles/ccoch/file/Water%20safety/CD004265.pdf.
13. Lopez-Quintero, C., Freeman, P., & Neumark, Y. (2009). Hand Washing Among School Children in Bogotá, Colombia. American Journal of Public Health. 99(1), 94–101.
15. UN-Water. (2008). Sanitation Contributes to Dignity and Social Development. International Year of Sanitation Factsheet no. 3.
16. Brocklehurst, C. (2004). The Case for Water and Sanitation: Better water and sanitation make good fiscal and economic sense, and should be prominent in PRSPs and budget allocations. Sector Finance Working Paper, no. 11. World Bank Water and Sanitation Program. Retrieved from: http://www.wsp.org/sites/wsp.org/files/publications/af_makingcase.pdf.