Improving health through water, sanitation and hygiene

HealthcareSanitationWater and sanitation

Promoting sanitation and hygiene. Photo: Richard Hanson/Tearfund
Promoting sanitation and hygiene. Photo: Richard Hanson/Tearfund

Goal 4 Reduce child mortality

by Sue Yardley

Reducing child and maternal mortality are targets within Millennium Development Goals 4 and 5. In 2010 many donor governments and international agencies are focusing on these issues. There has been some encouraging progress in meeting these goals, but greater effort is still needed to achieve them. Improving access to water, sanitation and hygiene education (WASH) can help significantly to improve the life chances of children and women. There are simple practices we can adopt and promote to achieve this.

The links between WASH and maternal and child mortality

Each year millions of children and women die from preventable diseases. Women are particularly vulnerable in pregnancy and when giving birth. One of the safest options for women is giving birth in a health centre. However, many centres lack adequate clean water, safe sanitation and effective management of medical waste. In order for medical care to be effective, access to clean water and good hygiene and sanitary practices are needed.

Young children are very vulnerable to the effects of poor WASH, especially within the first 28 days of a child's life, which is the period when about half the deaths in children under five years occur. It is estimated that the effects of poor WASH are responsible for about 28 per cent of all under-five deaths. Diarrhoea alone is responsible for killing about 1.5 million children each year, which is more than AIDS, malaria and measles combined. In fact, 88% of all cases of diarrhoea globally are caused by a lack of clean water, sanitation and hygiene.

Simple ways to improve sanitation and hygiene

  • Birth attendants must ensure that they maintain hygienic childbirth techniques. This can prevent half of all infections contracted just after birth (see article on page 10).
  • The positive impact of hand washing with soap cannot be underestimated. Using soap can reduce the number of deaths caused by diarrhoea by nearly 40 per cent. It is a cheap and easy solution.
  • Ensure adequate clean water supplies at home, in schools and at health centres.
  • Provide education on good hygiene and sanitary practices. Children are especially good at sharing what they have learned (see article on page 4).

Linking health with hygiene education in South Sudan

In Motot, South Sudan, Tearfund's Disaster Management Team runs one of the few health centres in the area.

Here, many mothers take their children to the centre to receive tetanus injections and immunisation against diphtheria, whooping cough, tuberculosis, polio and measles. While the women wait, Community Health Workers provide vital hygiene education on how to prevent diarrhoea, such as washing hands with soap after defecating, before preparing food and eating, and after dealing with a baby's faeces.

Local tradition dictates that villagers defecate in the bush, but this is beginning to be recognised as a problem, as explained by a local Chief: 'Sanitation is poor here, so people are being taught about sanitation in churches and community meetings.' It is difficult to challenge tradition, but linking health with sanitation and hygiene work is making a difference.


It is important to ensure decision-makers understand the crucial links between WASH and the health of women, babies and children. Some ideas:

  • Tell your local government officials about the recorded health benefits a community has experienced through sanitation and hygiene promotion work.
  • Ask your local government health officials to identify how access to sanitation and hygiene can be improved through health programmes. 
  • Celebrate WASH messages on International Women's Day (8 March), on World Health Day (7 April), Global Handwashing Day (15 October), or World Water Day (22 March). (Mothers' Day and Children's Day can also be used – these days are different depending on the country).

With just five years left before the year the MDGs are meant to be achieved, it is important we show governments that improving access to clean water, sanitation and hygiene will help to achieve not just Goals 4 and 5 but most of the other goals as well.

Sue Yardley is Tearfund's Public Policy Officer for Water and Sanitation.