The first ever global guidelines on sanitation and health were recently published by the World Health Organization (WHO), aiming to help countries reduce the 829,000 annual deaths resulting from unsafe water, sanitation, and hygiene-related diseases such as diarrhea. WHO asserts that every US dollar invested in sanitation generates about six times return in terms of lower health costs, elevated productivity, and fewer premature deaths.
The Implication of WHO’s Guidelines
The newly devised WHO Guidelines on Sanitation and Health summarize evidence on various sanitation interventions’ effectiveness, thus providing an exhaustive framework for preserving health through sanitation. These guidelines cover measures for policy and governance, the launch of sanitation technologies, behavioral interventions, risk-based management, and monitoring strategies. They are primarily directed at national and local authorities responsible for maintaining the safety standards of sanitation systems.
Understanding Sanitation
According to WHO, sanitation refers to the access and use of facilities and services for the safe disposal of human waste. A safe sanitation system is one designed to insulate human contact with human excreta at every stage of sanitation; which includes toilet capture, containment, transport, treatment, and disposal.
The Importance of Sanitation for Health
Sanitation is crucial for health as it not only prevents infections, but also contributes to improved mental and social wellbeing. Lack of proper sanitation facilities can lead to diseases like diarrhea, which is a leading cause of death among under-five children in low-income countries. Poor sanitation also contributes to tropical diseases and adverse effects such as malnutrition.
WHO Recommendations on Sanitation
1. Ensure universal access and use of toilets that safely contain excreta
2. Ensure universal access to safe systems along the entire sanitation service chain
3. Address sanitation as part of locally delivered services and broader development programmes and policies
4. The health sector should fulfill core functions to ensure safe sanitation to protect public health
Principles for Implementation of Sanitation Interventions
The successful implementation of sanitation interventions rests on various factors ranging from the toilet design, which should ensure that users are safely separated from excreta, to the conveyance, where motorized emptying and transport should be prioritized over manual processes. The treatment process requires that both liquid and solid waste be treated before their final disposal.
The Need for Change in Sanitation Behavior
The reasons for practicing open defecation range from lack of facilities to the inconvenience of poorly-maintained or foul-smelling toilets and limited awareness of its health implications. Changes in behavior can be achieved through various approaches such as Information, Education, and Communication (IEC) messaging strategies, community-based strategies like Community-Led Total Sanitation (CLTS) initiatives aimed at ending open defecation, social marketing initiatives, and approaches based on psychological and social theories. These varied approaches are necessary to change attitudes and behaviors, making sanitation practices more effective and widespread.