41. Water Supply, Sanitation, and Hygiene Promotion

Abstract

The main health benefit of water supply, sanitation, and hygiene is a reduction in diarrheal disease, but the effect on other diseases, such as dracunculiasis, schistosomiasis, and trachoma, is substantial. Water, sanitation, and hygiene improvements could eliminate 3 to 4 percent of the global burden of disease.

Many people assume that the most important health characteristic of a water supply is quality; however, it is convenient access to water in quantity that encourages better hygiene and limits the spread of diarrheal disease. Placing a water tap close to a home nearly doubles the odds of a mother cleaning her hands after contact with fecal material from a child. Yet poor women who spend hours per day collecting water usually view the time–saving aspect of an improved water supply as its greatest benefit. This is what motivates politicians to invest in water infrastructure.

Similarly, access to even basic forms of improved sanitation, such as pit latrines, helps prevent diseases such as diarrhea, intestinal worm parasites, and trachoma. This may be because of the improved hygiene practices that accompany better sanitation. But it is the social advantages of having a private latrine?higher status in the community, safety, convenience, and privacy?that appeal to poor people, rather than the health benefits. Interventions aimed at encouraging private investment in improved sanitation products may be more cost–effective than subsidies aimed at consumers, which tend to distort the market and discourage production of low–cost latrines.