Access to clean water is a human right, essential for public health - but around 2.1 billion people worldwide have no safe and convenient water source at home.
Women and children are disproportionately affected, since safe delivery requires clean water and according to a 2015 World Health Organisation (WHO) report on water, sanitation and hygiene (WASH) in low- and middle-income country health facilities, 38 percent lack safe water, 19 percent lack sanitation and 35 percent lack water and soap for hand-washing.
Eight percent of maternal deaths
The consequences of poor WASH for maternal and newborn health can be devastating. Exposure to dirty, stagnant water during pregnancy may lead to malaria, typhoid, dysentery and amoebiasis, which can result in miscarriage, foetal death and maternal mortality.
An estimated eight percent of maternal deaths (and up to 15 percent in LMICs) can be directly linked to unhygienic conditions during labour and birth and poor post-natal hygiene.
Improving WASH for a safer start in life
The benefits of improving WASH provision for women and children are life-saving.
The WHO Partnership for Maternal, Newborn and Child Health (PMNCH) found that improving birth attendant hand-washing and clean surfaces can reduce the risk of infections, sepsis and death for infants and mothers by up to 25 percent.
Clean birthing kits for cutting the umbilical cord can reduce the odds of cord site infection two-fold, while improved drinking water sanitation also leads to improved child growth and development.
Adequate WASH facilities are just as important for mothers and babies after leaving health facilities. 6 in 10 people worldwide lack safely managed sanitation at home. Decreasing distances from safe water supplies improves maternal health post-delivery and may reduce the likelihood of infant infections.
As noted in the 2019 United Nations World Water Development Report: Leaving No One Behind, access to safely managed water systems also varies considerably between regions - from 24 percent in sub-Saharan Africa to 94 percent in Europe and Northern America – meaning women and children in these areas are particularly at risk.
Breaking down barriers to safer access
WASH is often viewed as an infrastructure problem, outside the remit of health systems. Lack of alignment between policies acts as a barrier to the integration of WASH into health strategies and programmes.
Recognising the fundamental link between water, sanitation and health is not an immediate guarantee of improvement. The WHO-led Global Analysis and Assessment of Sanitation and Water survey of 78 countries found that of 80 percent have a policy for WASH or infection prevention and control, but only 25 percent reported that these policies are fully funded and being implemented.
Reality often overtakes policy. Many countries fundamentally lack effective water and sanitation services. National budgets are often focused heavily on direct management of disease and onslaught epidemics, leaving them little time to deliver core health systems functions.
Women and children must not be left behind
There is a clear association between WASH and reproductive, maternal, neonatal and child health (RMNCH), meaning Goals 3 and 6 of the 2030 Agenda for Sustainable Development are inextricably linked. Without access to water and basic hygiene, the progress being made towards cutting maternal mortality can only go so far.
In March 2018, UN Secretary-General António Guterres launched a Call to Action that envisions universal and sustainable access to WASH in all healthcare facilities. He called for multi-sector collaborations and investment in evidence-based interventions to improve WASH outcomes, as well as better coordination between those promoting WASH programmes and the maternal health sector.
As the global voice for women’s health, FIGO is committed to advocating for the specific needs of women and girls to be considered of primary importance when improving WASH facilities. By integrating WASH into new and existing frameworks for health, this generation has the potential to create lasting change for women and children – and only then, truly ensure that no one is left behind.