Gender equality: WASH and menstrual health and hygiene 

Inadequate drinking water, sanitation and hygiene (WASH) pose critical health risks to all children, but have additional implications for the health, psychosocial well-being and mobility of women and girls. Indeed, progress on universal and equitable access to safe and affordable drinking water, and adequate and equitable sanitation and hygiene for all, is now widely recognized as crucial for achieving the SDG goal on gender equality and the empowerment of women and girls.

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Despite progress since 2000, millions of adolescent girls around the world lack access to basic drinking water, sanitation and hygiene, compromising their health and well-being.

Between 2000 and 2022, 54 million adolescent girls aged 10–19 gained access to basic drinking water, but nearly 1 in 10 adolescent girls (55 million) still lacked access in 2022, the majority of whom reside in sub-Saharan Africa. Between 2015 and 2022, more than 40 million adolescent girls and their families gained access to basic hygiene services, but one in four adolescent girls globally (an estimated 156 million) still lacked access in 2022. Progress has also been observed in access to basic sanitation services, with around 138 million adolescent girls gaining access between 2000 and 2022. Yet nearly one in five adolescent girls worldwide (121 million) still lacked access in 2022. In the absence of sanitation, adolescent girls may rely on open defecation, exposing them to physical health complications as well as the risk of physical attack and sexual violence as they look for a secluded place to excrete. While globally, the proportion of adolescent girls aged 10–19 practicing open defecation decreased by 16 percentage points since 2000, nearly 33 million adolescent girls practiced open defecation in 2022.

Girls bear the burden of water collection from an early age, reinforcing gender inequalities that persist into adulthood

Time spent collecting drinking water, by sex, age and country, 2017–2021

In households lacking drinking water on premises, the burden of collection often falls to women and girls. In 7 out of 10 households with water off premises, women and adolescent girls aged 15 and above are responsible for water collection.[1] Further disaggregation of age groups in an analysis of time spent collecting water in 31 countries shows that while few girls and boys under 10 years of age spend time collecting water, the activity becomes highly gendered in adolescence. In 20 countries, adolescent girls are more likely than boys to be responsible for water collection and to spend more time collecting water than adolescent boys – and in some countries, to even spend more time on carrying water than adult men.

Moreover, even small differences disadvantaging girls can socialize them into thinking domestic duties are primarily women’s and girls’ responsibilities, jeopardizing the continuity of their education and movement into the labour market as they transition into adulthood. Water collection can also result in injuries, especially to young girls and pregnant women, and expose women and girls to risks of sexual violence while travelling back and forth to the water source.

The ability of adolescent girls to manage their monthly menstrual cycle in privacy and with dignity is fundamental to their health, psychosocial well-being and mobility.

In many places, the onset of puberty is a signal for constraining girls’ movement, schooling, friendships, and sexuality. Adolescent girls require access to adequate menstrual hygiene facilities, supplies, information and a supportive social environment without stigma and taboo. If their menstrual needs are unmet, they may not be able to take advantage of important educational, social and economic opportunities.

Between 2016 and 2022, more than 10 million adolescent girls aged 15–19 across 41 countries missed out on school, work or social activities during their last menstrual period. In 32 of these 41 countries, 10 per cent or more of adolescent girls aged 15–19 did not participate in school, work or social activities during their last period. In the Gambia, Algeria, Central African Republic and Chad, as many as one in three girls did not participate during their last period.

For more information on WASH, and to access the data, click here.

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