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 Table of Contents  
Year : 2015  |  Volume : 2  |  Issue : 2  |  Page : 149-150

Why we have failed to improve the sanitation facilities and what are the possible consequences? Public health perspective

Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Kancheepuram, Tamil Nadu, India

Date of Web Publication31-Dec-2015

Correspondence Address:
Saurabh R Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur - Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2349-4220.172921

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How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Why we have failed to improve the sanitation facilities and what are the possible consequences? Public health perspective . Int J Adv Med Health Res 2015;2:149-50

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Why we have failed to improve the sanitation facilities and what are the possible consequences? Public health perspective . Int J Adv Med Health Res [serial online] 2015 [cited 2021 Sep 19];2:149-50. Available from: https://www.ijamhrjournal.org/text.asp?2015/2/2/149/172921


The year 2015 marks the end of the period set for accomplishing the eight Millennium Development Goals (MDGs) globally. [1] The findings of a recently released report with regard to MDG-7 (targets to halve the proportion of people living without sustainable access to safe drinking water and basic sanitation services), has revealed that close to 2.4 billion people (almost one in every three persons) worldwide have no access to improved sanitation facilities. [2] Although, the global target pertaining to access to safe water was met worldwide in the year 2012 itself, nevertheless, even now close to 950 million people still practice open air defecation. [1],[2] In addition, despite extending improved sanitation services to more than 2 billion people worldwide, only 68% (as opposed to the target of 77%) of the global population use an improved sanitation facility. [2],[3]

From the developing nations' perspective, ensuring access to adequate water and sanitation is a critical intervention for the prevention and containment of almost all the neglected tropical diseases, which is affecting the lives of more than 1.5 billion poor and marginalized individuals annually across 149 nations. [2],[4],[5] In addition, a direct association has been established between the practice of open air defecation and the risk of stunting/chronic malnutrition, which interferes with the development of almost 160 million children on a global platform. [3] Furthermore, it is very important to realize that due to the lack of progress on sanitation front, whatever improvement was achieved as a result of access to safe drinking water (viz. current global diarrhea specific death rate is <1000 under-five deaths per day, in contrast to more than 2000 under-five deaths about 15 years back), is under enormous threat. [3],[6],[7]

Furthermore, it has been observed that massive gap pertaining to basic sanitation services is prevalent in rural settings, with 70% of people without access to improved sanitation facilities, and 90% of people who practice open defecation are from rural areas. [3] These are alarming facts and clearly suggest that the policy makers have failed to bridge the inequality among the rich and poor sections of the society which is a crucial step to ensure sustainable progress. [1],[2] The slow progress in the field of sanitation has been attributed to multiple factors such as minimal commitment from the policy makers, absence of sanitation from the priority list, limited monetary allocation, limited coordination between different departments, lack of sound understanding about the existing sanitation beliefs and practices, insufficient investments in behavior change campaigns to help people change their existing behavior, and inability of the stakeholders to ensure availability of affordable products for the poor. [3],[6],[8],[9]

In the recently drafted Sustainable Development Goals of the United Nations, it has been aimed to accomplish universal access to sanitation by 2030 by eliminating the practice of open air defecation. [2] On the global scale, the World Bank has initiated a water and sanitation program with an aim to assist the poor people in gaining access to improved water supply and safe sanitation services. [10] In addition, other nation-wide initiatives (viz. in India - central rural sanitation program, urban sanitation program, constitution of district and village level water and sanitation committees, etc.,) have also been implemented to address the problem of poor sanitation. [11]

In order to improve the sanitation services, the need of the hour is to double-up the efforts, especially in South-East Asia and sub-Saharan African regions, with a primary objective to ensure that poor people from low resource settings start their progress with immediate effect. [3],[7],[8] In addition, interventions like devising mechanisms and approaches to enable the reach of services to remote areas; implementing measures to improve the sanitation facilities in homes/schools/healthcare establishments; strengthening of the surveillance mechanism so that communities with higher prevalence of diarrheal diseases can be identified and targeted accordingly; and adopting innovative technologies to provide low cost, yet sustainable solutions to the sanitation needs of poor people. [2],[8],[9],[10] Further, conducting large-scale community based epidemiological studies to obtain a clear insight among populations who are reluctant to use improved sanitation facilities, can also provide important evidence to the policy makers. [12]

To conclude, in order to improve the universal health standards of the general population and to achieve the sustainable development goals, there is a great need to accelerate the progress on sanitation, especially in rural and underserved settings.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

World Health Organization. Millennium Development Goals (MDGs) - Fact Sheet No. 290; 2015. Available from: http://www.who.int/mediacentre/factsheets/fs290/en/. [Last accessed on 2015 Jun 22].  Back to cited text no. 1
World Health Organization. Lack of Sanitation for 2.4 Billion People is Undermining Health Improvements; 2015. Available from: http://www.who.int/mediacentre/news/releases/2015/jmp-report/en/. [Last accessed on 2015 Jul 01].  Back to cited text no. 2
UNICEF, World Health Organization. Progress on Sanitation and Drinking Water: 2015 Update and MDG Assessment. Geneva: WHO Press; 2015. p. 2-12.  Back to cited text no. 3
World Health Organization. Neglected Tropical Diseases - Fact Sheets Relating to NTD; 2015. Available from: http://www.who.int/neglected_diseases/mediacentre/factsheet/en/. [Last accessed on 2015 Jun 22].  Back to cited text no. 4
Grimes JE, Croll D, Harrison WE, Utzinger J, Freeman MC, Templeton MR. The relationship between water, sanitation and schistosomiasis: A systematic review and meta-analysis. PLoS Negl Trop Dis 2014;8:e3296.  Back to cited text no. 5
Nguyen-Viet H, Zinsstag J, Schertenleib R, Zurbrügg C, Obrist B, Montangero A, et al. Improving environmental sanitation, health, and well-being: A conceptual framework for integral interventions. Ecohealth 2009;6:180-91.  Back to cited text no. 6
Clasen T, Pruss-Ustun A, Mathers CD, Cumming O, Cairncross S, Colford JM Jr. Estimating the impact of unsafe water, sanitation and hygiene on the global burden of disease: Evolving and alternative methods. Trop Med Int Health 2014;19:884-93.  Back to cited text no. 7
Akter T, Ali AM. Factors influencing knowledge and practice of hygiene in water, Sanitation and Hygiene (WASH) programme areas of Bangladesh Rural Advancement Committee. Rural Remote Health 2014;14:2628.  Back to cited text no. 8
Teague J, Johnston EA, Graham JP. Water, sanitation, hygiene, and nutrition: Successes, challenges, and implications for integration. Int J Public Health 2014;59:913-21.  Back to cited text no. 9
World Bank Group. Water and Sanitation Program; 2015. Available from: http://www.water.worldbank.org/related-topics/water-and-sanitation-program. [Last accessed on 2015 Aug 20].  Back to cited text no. 10
Kishore J, editor. Programs for water and sanitation. In: National Health Programs in India. 9 th ed. New Delhi: Century Publications; 2011. p. 554-8.   Back to cited text no. 11
Tilley E, Strande L, Lüthi C, Mosler HJ, Udert KM, Gebauer H, et al. Looking beyond technology: An integrated approach to water, sanitation and hygiene in low income countries. Environ Sci Technol 2014;48:9965-70.  Back to cited text no. 12


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