Gender and health

Gender and nutrition

Gender and water, sanitation and hygiene(WASH)

Gender and education

Gender and child protection

Gender and emergencies

Gender and HIV/AIDS: Prevention of Mother-to-Child-Transmission (PMTCT) and paediatric treatment

Gender and HIV/AIDS: Prevention among young people


Gender and water, sanitation and hygiene(WASH)

© UNICEF/NYHQ2010-1476/Noorani
Girls walk to the latrines at Kisojo Model Primary School in Uganda.

Throughout Africa women and girls are the main providers of household water supply and sanitation, and also have the primary responsibility for maintaining a clean home environment. The lack of access to safe water and sanitation facilities therefore affects women and girls most acutely.

About 157 million people in the Eastern and Southern Africa region (ESAR) are not connected to a clean and safe water distribution system, and thus need to use external water sources. Around 247 million people have no access to improved sanitation. In countries such as Eritrea, Ethiopia and Somalia, well over half of the population has to practise open defecation. Poor water and sanitation, as well as unsafe hygiene practices are the main causes of diarrhoea, one of the main child killers in the region. Each year more than 250,000 children under the age of five die from diarrhoeal diseases.

Key issues

The burden of fetching drinking water from outdoor sources falls disproportionately on girls and women. Surveys from 45 developing countries show that in almost two-thirds of households without a drinking water source on the premises, it is women and girls who collect water. In the 12 percent of households where children collect water, girls are twice as likely as boys to be responsible.

In several countries in the region (Lesotho, Zambia, Malawi, Mozambique, Kenya and Ethiopia) collecting water takes longer than 30 minutes for more than a quarter of the population. This considerably reduces the time women and girls have available for other activities such as childcare, income generation and school attendance.

Education: Girls often have to walk long distances to fetch water and firewood in the early morning. After such an arduous chore, they may arrive late and tired at school. Being ‘needed at home’ is a major reason why children, especially girls from poor families, drop out of school. Providing water closer to homes increases girls’ free time and boosts their school attendance.

A study in Tanzania showed a 12 percent increase in school attendance when water was available within 15 minutes compared to more than half an hour away. When girls enter puberty they are often forced to skip classes or drop out of school, because there are no separate toilets for them which guarantee a minimum of privacy. Lack of separate and decent sanitation and washing facilities discourages girls who are menstruating from attending full time, often adding up to a significant proportion of school days missed.

HIV and AIDS: The absence of clean water and sanitation also increases the risk of opportunistic infections and diarrhoeal diseases among people living with HIV and AIDS. In sub-Saharan Africa, women and girls account for 60 percent of all HIV infections. In many cases, they are also the caregivers of chronically sick family members. With better access to water and sanitation facilities, the burden on households caring for AIDS-affected members is reduced.

Protection: Without access to latrines, many women and girls become ‘prisoners of daylight’,daring to relieve themselves only under the cover of darkness. Night-time trips to fields or roadsides, however, can put them at risk of physical attack and sexual violence. According to a 2010 Amnesty International report, a high number of women in slum areas in Kenya are raped when they resort to open defecation because they have no private sanitation facilities at home.

© UNICEF/NYHQ2008-1306/Tanner
A girl carries containers filled with safe water provided by UNICEF in the suburb of Budiriro in Zimbabwe.

Emergencies: Conflicts and natural disasters that exacerbate water scarcity can lead to a double hardship for women. When water is scarce, women and girls may have to travel longer distances to obtain water, which can expose them to danger. Their mobility in disasters may be restricted or affected due to cultural and social constraints, and as a result they may have limited to no access to water or adequate sanitation facilities. 

Women’s empowerment: While women often have the primary responsibility for the management of household water supply, they are rarely consulted or involved in the planning and management of this vital resource. In sub-Saharan Africa, women produce up to 80 percent of basic foodstuffs, yet they have the least access to the means of production. There is evidence to show that water and sanitation services are generally more effective if women take an active role in the various stages involved in setting them up, from design to planning, through to the ongoing operations and maintenance procedures required to make any initiative sustainable. A World Bank evaluation of 122 water projects found that the effectiveness of a project was six to seven times higher where women were involved than where they were not.

UNICEF interventions

UNICEF is working to ensure that women are directly involved in the planning and management of water supply and sanitation programmes, and that hygiene promotion interventions are specifically designed to reach them. UNICEF-supported programmes also strive to address the inequities suffered by women and girls in relation to water and sanitation services.

Gender is a guiding principle of the UNICEF Water, Sanitation and Hygiene Strategy (2006–2015). The School Sanitation and Health Education programme which is implemented in Eastern and Southern Africa(ESA) in the context of the “Child Friendly Schooling” strategy is an example of its practical application.

The programme focuses on building separate toilets for girls and boys and providing hygiene education in several countries in the region. This is proving to significantly increase girls’ school attendance. In Uganda improved attendance and lowered drop-out rates for girls have been noted since introducing female-only washrooms. In Kenya and Zambia murals or ‘talking walls’ in schools are demonstrating the effectiveness of delivering hygiene messages to students. UNICEF also supports research in Somalia and Tanzania on the effects of menstruation on school performance.

Community Approaches to Total Sanitation (CATS), a set of principles that reflect and guide UNICEF’s programme strategy, were defined at global level in 2008. CATS is a distillation of best practices collected from community-based sanitation programming worldwide. It focuses on community leadership, behaviour change and eliminating open defecation. In ESA, CATS is implemented by UNICEF and partners in 13 countries. The involvement of women in local sanitation committees has been important, not only because it raises their status in the community, but also because it improves programming.

During emergencies, UNICEF responds with a package of water and sanitation interventions, including the distribution of hygiene kits for women and girls.



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