The world is unlikely to reach the Millennium Development Goal sanitation target of 75%
Trends in the percentage of the global population using piped water on premises or other improved drinking water sources, unimproved sources or surface water, 1990─2012
Source: WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation (JMP), 2014.
Universal access to adequate sanitation is a fundamental need and human right. Securing access for all would go a long way in reducing illness and death, especially among children. Since 1990, 1.9 billion people have gained access to an ‘improved’ form of sanitation, such as flush toilets or latrine with a slab. This means that, in 2012, 64 per cent of the global population was using such facilities – an impressive accomplishment but still far from the 2015 Millennium Development Goal target of 75 per cent. At current rates of progress, the target will be missed by over half a billion people. In 2012 a shocking one billion people still practised open defecation and a further 1.5 billion people did not have an improved sanitation facility.
Gains in access to improved sanitation since 1990 have varied substantially between regions. Progress has been particularly remarkable in Eastern Asia, where coverage of improved sanitation has increased by 40 per cent since 1990. In contrast, gains have been more moderate in sub-Saharan Africa and Oceania – the two regions where coverage remains below 50 per cent. Progress in increasing access to improved facilities has been mirrored by a decline in open defecation, a practice that can negatively affect the health of entire communities. Open defecation remains most common in Southern Asia where 38 per cent of the population defecate in fields, forests, bushes, bodies of water or other open spaces.
Of the estimated 2.5 billion people without improved sanitation in 2012, most of these people – 1.8 billion, or 70 per cent – live in rural areas. Rural–urban disparities have diminished over the years, but are still substantial: in 2012 one in seven people without an improved sanitation facilities lived in rural areas. There are also striking disparities between regions and within both urban and rural areas. As illustrated in Figure 3, open defecation is twice as common in the South of Lao PDR as in the Central region. People living in rural areas without road access are even less likely to use improved sanitation than those living in areas with road access.
DISPARITIES BY WEALTH
There is a strong relationship between wealth, as measured by household assets, and use of improved sanitation facilities. In many countries increases in rural coverage have not been equitably distributed with the wealthy gaining most of the benefits of improved sanitation. Despite increases overall, in 35 countries the gap between the richest and poorest rural dwellers has grown between 1995 and 2012. In contrast, in 28 countries the poorest are catching up with the richest, often a result of “levelling up” when there is near complete coverage in the richest quintiles.
Defecating in the open is an affront to dignity and risk to community health. Yet in 2012 one billion people still practised open defecation. The majority of these live in ten countries with over half a billion in India alone. Nine out of ten people practising open defecation live in rural areas. Although there has been substantial progress in reducing open defecation in several countries, globally the number of people has dropped by only 1.2 to 1 billion - at current rates it would take several decades to eliminate the practice altogether. Greater efforts in these countries will be needed in order to ensure the availability and use of adequate sanitation facilities.
The world has made great strides in increasing access to drinking water and sanitation for billions of people but progress has been uneven.
This joint WHO/UNICEF report documents the gains that have been made since 1990 and highlights substantive disparities such as those between regions, rural and urban areas and for marginalized groups.
WHO/UNICEF JOINT MONITORING PROGRAMME FOR WATER SUPPLY AND SANITATION
Since 1990, WHO and UNICEF have tracked progress on global water and sanitation goals through the Joint Monitoring Programme for Water Supply and Sanitation (JMP). The JMP monitors trends in coverage; helps build national monitoring capacity in developing countries; develops and harmonises questionnaires, indicators and definitions to ensure comparability of data over time and among countries; and informs policymakers of the status of the water supply and sanitation sector through annual publications. The JMP draws guidance from a technical advisory group of leading experts in water supply, sanitation and hygiene, and from institutions involved in data collection and sector monitoring. Further information about the JMP and its methodology can be found at the JMP website.
The JMP estimates are primarily based on information collected in household surveys such as Multiple Indicator Cluster Surveys (MICS) and Demographic and Health Surveys (DHS). For the 2014 update well over 1400 datasets were included, a median of 8 surveys or censuses per country. Household surveys are usually conducted by national institutes of statistics, carried out by trained national staff who collect information on a wide range of health and living conditions through face-to-face interviews. Nationally owned and independently verifiable, these data sources provide national governments with a periodic update of the status and progress with respect to the use of different drinking water sources and sanitation facilities – complementing line-ministry monitoring and information systems. Increasingly household survey data allow for assessing disparities in access by marginalized populations and geographic areas.
DEFINITION OF ACCESS TO SANITARY MEANS OF EXCRETA DISPOSAL
An ‘improved sanitation facility’ is defined as one that hygienically separates human excreta from human contact. To allow for international comparability of estimates, the JMP uses the following classification to differentiate between improved and unimproved types of sanitation facilities.
Key to sanitation data
Improved sanitation facilities
Unimproved sanitation facilities
Flush or pour-flush to:
Flush or pour-flush to elsewhere