Closing Gender Gaps in Water, Sanitation and Hygiene (WASH): Challenges, Progress and Equitable Access

1 August, 2023

by Sam Biden, Research Assistant

Global Overview

Between 2000 and 2022, the global population increased from 6.1 billion to a predicted 8 billion people. During this period, significant advancements were made in providing safe drinking water to communities worldwide. The number of people lacking at least basic drinking water services decreased from 1.2 billion to 703 million.

In urban areas, 1.4 billion people gained access to safely managed drinking water services, marking a notable improvement. However, it is important to note that the number of people lacking at least basic services in urban areas increased slightly from 136 million to 152 million during the same period. This indicates the challenges faced in meeting the growing water demand in rapidly urbanizing regions. The rural population experienced minimal changes between 2000 and 2022, rising from 3.3 billion to 3.4 billion. However, significant progress was made in providing safe drinking water to rural communities. Over this period, 704 million people in rural areas gained access to safely managed drinking water services and the number of people lacking at least basic services reduced from 1 billion to 549 million.

Regional Progress

1. Central and Southern Asia (CSA)

In CSA, access to safe drinking water, sanitation and hygiene services has seen notable improvements. Between 2000 and 2022, the number of people lacking at least basic drinking water services decreased from 140 million to 135 million. The coverage of safely managed drinking water in rural areas increased at a faster rate of 1.39% per year while the increase for urban areas stood at 0.21%. The progress in sanitation services was also hopeful with a significant increase in the number of individuals without at least basic sanitation decreasing from 482 million to 135 million. Rural coverage in safely managed sanitation improved significantly at a rate of 2.22% per year, narrowing the gap between rural and urban areas to just 34% in total.

Basic hygiene services in CSA demonstrated significant progress, with rural coverage increasing from 52% to 70% between 2015 and 2022. However, there was a slight decline in urban coverage, falling from 36% to 32%, putting denser populations at greater risk. Sanitation services in CSA made more noteworthy progress in expanding access to basic sanitation, resulting in a stark decrease in the number of people lacking basic water services, falling from 482 million to 377 million. However, challenges still exist in rural areas, with twice as many people lacking basic sanitation compared to urban areas (506 million vs. 255 million). Additionally, open defecation practices were prevalent among 187 million people, making it the second-highest region in terms of open defecation.

Drinking water services in CSA saw an overall decrease in the number of people lacking at least basic drinking water services from 140 million to 104 million. However, urban areas still remain under great pressure to provide clean water, with 32 million individuals lacking access to basic drinking water services, while the rural areas face a much more significant challenge, totalling 549 million individuals lacking both clean and basic drinking water.

2. Sub Saharan Africa (SSA)

SSA confronted significant challenges regarding drinking water and sanitation services. In this region, over half of the global population without basic drinking water services resided, posing a major concern. Urban areas alone accounted for 73 million individuals lacking access to basic drinking water, which was more than double the number in CSA. Meanwhile, in rural areas, SSA was responsible for two-thirds of the global population without basic drinking water, with 73 million individuals relying on surface water sources. Despite witnessing progress in expanding access to drinking water services, the region still struggled, as it had the largest number of people lacking basic drinking water services in both urban and rural areas, standing at 73 and 506 million respectively. However, the number of people without at least basic drinking water services decreased from 408 million to 275 million, indicating some improvement in the area. Despite this, sanitation services accounted for the highest number of individuals lacking basic sanitation, with a staggering 762 million people facing this challenge as of 2022.

Rural areas were similarly affected, with twice as many people lacking basic sanitation compared to urban areas, showing a strong similarity between SSA and CSA. Open defecation practices were also prevalent, with 193 million people engaging in it in both urban and rural regions as people struggled to find adequate facilities. These numbers show a growing disconnect in support when comparing urban and rural areas across both SSA and CSA. The nature of the location, support available and barriers to access puts those in rural areas at a greater risk regarding a lack of essential services,

Other issues such as the contraction of pneumonia and diarrhea have a direct link to hygiene and sanitation and are the leading causes of under-five year old deaths in the region, accounting for 17% and 9%, respectively. During school years, access to proper sanitation plays a pivotal role in children’s education. Basic sanitation and hygiene measures significantly reduce the incidence of infections, ensuring children miss fewer classes due to illness.

3. Oceania

Oceania faced similar challenges in improving hygiene, drinking water and sanitation services, with substantial gaps between urban and rural areas, as seen in the prior two regions. The coverage for hygiene services showed a disparity, with 71% in urban areas and only 30% in rural areas. Similarly, for drinking water services, there was a significant 42% difference between urban and rural areas, standing at 93% and 51% respectively. Although there was progress in urban regions regarding sanitation services, rural areas experienced a minimal decline in basic sanitation coverage, falling from 35% to 33%.

Direct Effects on Women

Issues regarding access to water services, sanitation facilities and the overall disparities between urban and rural areas have had a particularly damaging effect on women.

Access to drinking water service is shown to have regressive implications for gender equality. In many parts of the world, women and girls bear the disproportionate burden of ensuring access to sufficient and safe water for drinking, cooking, cleaning and caregiving. They often face the physical burden and psychosocial stress associated with water collection, especially in rural areas where the local source of clean water is 6km away on average. Data indicates that in the regions discussed, responsibility for fetching drinking water falls primarily on women, particularly in countries where household water sources are located off premises, such as many countries in SSA. In an analysis of 34 countries, on average, women were identified as the primary collectors of water. This was most prevalent in SSA where women bear the responsibility in a majority of households, with eight countries heavily relying on women for water collection. Furthermore, gender disparities persist in terms of feeling safe during water collection, both physically and mentally. Women and girls, especially when they have to venture outside the household for water collection or defecation/urination may face harassment or risks of sexual violence in higher risk areas, particularly at night. These issues are exacerbated when toilets or clean water are not in close proximity to the household.

WASH issues for women expand further into motherhood and childbearing especially regarding the high child mortality rates, particularly in SSA where 6.6 million children failed to reach their fifth birthday in 2012. There are heightened risks for new mothers and infants, particularly when it comes to poor sanitation that can have a direct influence on the health of the mother and child. From the moment of birth, both infants and mothers face the risk of infections due to unsanitary conditions, increasing the risk of serious illness and even death. Research indicates that practicing handwashing, especially by birth attendants and mothers, can increase newborn survival rates by up to 44 percent, significantly contributing to reducing child mortality rates. Yet despite this research, access to clean water to carry out the process is heavily limited, particularly in rural areas where the source is not in close proximity.

For girls reaching puberty, access to safe and private toilets becomes essential. Hygienic facilities with clean water for personal hygiene and menstrual care play a decisive role in whether girls can attend school regularly during their monthly periods. Irregular attendance due to the lack of proper facilities often results in lower grades and may lead to girls dropping out of school altogether. The inadequate access to toilets forces women to resort to outdoor defecation, especially at night, jeopardizing their privacy and dignity and putting themselves at a greater risk of sexual crimes and harassment. While the taboo nature of such incidents hinders data collection, existing studies and programs confirm the alarming reality of this issue that must be urgently addressed. The impact of poor sanitation extends to the workplace, affecting health, productivity and ultimately the economy. Women are known to withhold going to the bathroom, eating and drinking less as well as stopping work altogether due to the lack of adequate facilities to handle menstruation. Providing hygienic facilities can improve women’s livelihoods and ensure their active participation in the workforce.

Conclusion

The global overview of the period between 2000 and 2022 reflects significant progress in providing safe drinking water and sanitation services to communities worldwide. Despite the increase in global population to a predicted 8 billion people, the number of individuals lacking at least basic drinking water services decreased from 1.2 billion to 703 million. The improvements in both rural and urban areas are commendable, but challenges persist, particularly in rapidly urbanizing and distant, rural regions. There are key areas that need to be improved:

1. Prioritize urban water infrastructure – To tackle the challenges of water demand, it is crucial for governments and organizations to prioritize investments in water infrastructure. Improved water management and innovative technologies will help to ensure equitable distribution among rural and urban communities.

2. Rural initiatives – Rural areas remain the most in need communities and still struggle with water and sanitation challenges. Implementing targeted and sustainable solutions, such as community-led water projects and purification systems will allow governments and local provinces to begin to bridge the gap between urban and rural areas.

3. Promote equality in water management – Recognizing gender disparities in water collection and management is essential, especially since large bodies of research exist and accurately portray the discrepancies between male and female experiences regarding WASH. By empowering women and involving them in decision-making processes, we can alleviate their burden and improve water-related activities.

4. Prioritize menstrual hygiene – Adequate and private sanitation facilities should be provided in schools, workplaces and public spaces, especially for menstruating girls and women. The lack of these facilities have forced women out of work and education, a devastating consequence for those who have access to these rare opportunities in struggling 3rd world nations.

5. Enhance awareness – Public health campaigns must prioritize hygiene education, with a particular focus on standard practices to ensure hygiene among those who have access to the facilities, taking into account the need for initiatives for those who do not have this luxury.

Image: Children play by a newly installed hand pump in the village of Jedane, Ethipoia (Source: U.S. Navy photo by Mass Communication Specialist 2nd Class Michael Lindsey/Public Domain)