Safer sanitation and hygiene

Quality, equitable access and sustainability

A student demonstrates proper handwashing techniques for his classmates and teachers at a school in Mirpur, Dhaka.
UNICEF/UNI157180/Khan

The challenge

Safe disposal of faecal matter from rural and urban areas is a major challenge

Bangladesh has made remarkable progress to in eliminating the practice of open defecation. But climbing the ‘sanitation ladder’ still represents a challenge.

Access to sanitation remains moderate at 55.9 per cent. In Bangladesh, there is a high proportion of shared toilets particularly in urban slums, said the 2013 MICS survey.

The knowledge of key hygiene messages is high in Bangladesh, but the practice of effective handwashing, the most effective hygiene behaviour, is very low.

Just about 59.1 per cent of people practice handwashing with water and soap at critical times, found the 2013 UNICEF survey.

Conventional sewerage systems are absent in all urban areas except Dhaka. But even in the capital city, only 1 in 5 people are served by a sewer network. 

The safe disposal of faecal matter generated in rural and urban areas is recognised as a major challenge by the Bangladesh government.
 
Only about two out of five households practice safe disposal of child faeces, despite implications that lead to illness and death of children. One in four pit latrines is unhygienic and without lids to seal away faeces from the environment.

There are solid links among diarrhoeal diseases, stunting and sanitation. Unimproved sanitation can lead to faecally transmitted infections like diarrhoea, intestinal inflammation and worms.
 

Even though in Bangladesh 84 per cent of schools have toilets, only 24 per cent are improved and functional and clean, while only 45 per cent are unlocked

Sanitation facilities sensitive to the needs of disabled children are lacking.

Disparities in access to sanitation facilities vary between the rich and poor. Such gaps are also geographical and based on gender. 

People living in poor households are ten times more likely to use unimproved sanitation than those living in the richest households, said the 2013 MICS survey.

Only 33 per cent of rural households dispose of child faeces safely, as opposed to 60.2 per cent households in urban locations.
 
Knowledge and practice of menstrual hygiene is poor among girls in Bangladesh. Only 36 per cent of adolescent school girls know about menstruation during its first occurrence, according to the National Hygiene Baseline Survey.

Only 10 per cent of adolescent schools girls use sanitary pads during menstruation, the survey found. 

Bangladesh is vulnerable to environmental disasters due to combined effects of climate change, population growth and urban migration. There are frequent extreme events like flooding and cyclones that destroy sanitation facilities, cause toilets to overflow, and contaminate drinking water sources.

There are barriers to scaling up sustainable services in areas like urban slums, islands, hilly terrain, coastal regions and wetlands. Among them, is the absence of low-cost, appropriate climate-resilient sanitation technologies.

The economic cost to Bangladesh of poor sanitation and hygiene is US$ 4.2 billion per year, or the equivalent of 6.3 per cent of annual GDP. But the benefits of investments in sanitation are conservatively estimated as 2.3 times the investment costs, according to the World Bank. 

Students stand in front of a latrine facility
UNICEF/UNI138969/Haque
Students stand in front of a latrine facility built with support from UNICEF at Krishnopur High School, Rokonpur, Chapai Nawabganj.

Only 22 per cent of schools have separate toilet facilities for girls, as most facilities continue to deny girls their right to privacy and dignity

The solution

UNICEF is working to help the Bangladesh goverment provide improved sanitation services to 72 million people by 2030

UNICEF works with government and partners to protect the rights of children, especially those who are most vulnerable. It aims to provide safe sanitation and hygiene services in emergencies, when children and adolescents are most vulnerable and at risk.

The cross-sectoral interventions are aligned with the Sustainable Development Goals. UNICEF supports scaling up safe sanitation and hygiene for communities and health, education and nutrition institutions in urban and rural areas.

UNICEF works across the sanitation management chain to help reduce the unsafe discharge of faecal wastes into the environment and to ensure inclusive, sustainable and equitable access.

In terms of hygiene, UNICEF focuses on influencing hygiene behaviour change in the four key areas of handwashing with soap, safe water handling, menstrual hygiene management and safe disposal of faeces and urine.

For schools, adequate WASH facilities improve learner enrolment, attendance, completion and achievements. In health facilities, good hygiene practices like handwashing with soap by mothers reduces neonatal deaths by 44 per cent and Acute Respiratory Infections by 25 per cent.

Sanitation and hygiene are crucial for people living with AIDS, and their care givers. These, along with safe water supply, protects patients from infections and improves the quality of life.

UNICEF works focus on women and girls to ensure safe management of menstrual hygiene. Adequate sanitation facilities and gender-segregated toilets at secondary schools improve school completion rates, particularly of adolescent girls and even delays the age of marriage.

Evaluating the impact in schools, a study by BRAC found that attendance of girls increased by more than 10 percentage points when schools provided separate toilets, and by more than 20 percentage points when such facilities were available during their menstrual periods.

UNICEF supports safe sanitation and hygiene practices for containing diarrhoeal diseases and intestinal inflammatory diseases contributing to still-high rates of undernutrition

UNICEF uses the community approach to prevent open defecation as the practice, mostly in rural communities, has the potential to expose children and women to violence and indignity.

UNICEF’s advocacy is key for the adoption, implementation and funding of the implementation on a national plan for managing faecal sludge.

UNICEF supports and scales up climate-resilient technologies through advocacy and building the capacity of climate-resilient institutions. 

UNICEF demonstrates integrated models for improved sanitation. The Community-Led Total Sanitation approach to eliminate open defecation is an example. UNICEF advocates for the promotion of Sanitation Marketing Systems to increase access to facilities that are climate-resilient, sensitive to the needs of women and people with disabilities.

UNICEF also enables communities with information, support and resources for utilisation of sustainable and resilient services.

UNICEF believes engaging and empowering communities and increasing their participation, especially that of children and adolescents, can increase sustainability of services for safe water, sanitation and hygiene.

UNICEF works to strengthen civil society organisations, both to facilitate engagement with communities and engender a sense of ownership, as well as to influence societal change, and will work as an advocacy partner to inform policy change.