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Without toilets, children’s lives and dignity at stake in Ghana

ACCRA, Ghana 19 November 2015 – Lack of access to toilets is endangering the lives of thousands of the Ghana’s most vulnerable children, UNICEF said today, pointing to emerging evidence of links between inadequate sanitation and malnutrition.

Twenty-one percent of Ghanaians have no access to a toilet and still use the bush or open field for defecation. This is worse in rural areas where 34 percent of the population still practise open defecation. Meanwhile, according to the Ghana Demographic and Health Survey 2014, among Ghanaian children under the age five, 19 percent were stunted (short for their age), five percent were wasted (thin for their height), and 11 percent were underweight (thin for their age).Stunting is a sign of chronic malnutrition, potentially causing reduced intelligence and associated opportunities for life.

A report issued today, Improving Nutrition Outcomes with Better Water, Sanitation and Hygiene, from UNICEF, USAID and the World Health Organization, for the first time brings together years of research and case studies which demonstrate the link between sanitation and malnutrition. More importantly, it provides guidance for action. 

Lack of sanitation, and particularly open defecation, which is high in Ghana, contributes to the incidence of diarrhoea and to the spread of intestinal parasites, which in turn contributes to malnutrition.

“Improvements in sanitation mean children in Ghana will avoid becoming stunted due to diarrhoea,” said Susan Namondo Ngongi, the UNICEF Representative in Ghana.

 Diarrhoea is one of the main causes of deaths of children under five years of age each year and is essentially a faecal-oral disease, where humans come in contact with germs-carrying faeces and ingest them. In Ghana where rates of toilet use are low, rates of diarrhoea tend to be high.

Similarly, 12 percent of children under five years of age were suffering from diarrhoea when the Demographic and Health Survey was conducted countrywide in 2014. The highest frequency was in children under two years of age, who are weakest and most vulnerable. Multiple episodes of diarrhoea permanently affect young children by preventing the absorption of essential nutrients, putting them at risk of stunting and even death. 

Intestinal parasites such as roundworm, whipworm and hookworm are transmitted through soil contaminated with infested faeces in areas where open defecation is practiced. Hookworm is a major cause of anaemia in pregnant women, leading to malnourished, and underweight babies.

Some districts in Ghana such as Mion have made significant progress in addressing both access to sanitation and the nutritional status of their children. Most of these districts have successfully used the Community-Led Total Sanitation approach supported by UNICEF, in which the affected populations themselves devise local solutions to the problem of open defecation.

Today, the world is celebrating World Toilet Day with the theme better sanitation for better nutrition. With this in mind whilst some progress has been made in Ghana, more needs to be done in providing equitable access to basic toilets, as well as behaviour change programmes to ensure these toilets are used. This is crucial in ensuring the nutritional health and development of all children, and giving every child a fair chance at life in Ghana.



UNICEF works in more than 190 countries and territories to help children survive and thrive, from early childhood through adolescence. The world’s largest provider of vaccines for developing countries, UNICEF supports child health and nutrition, good water and sanitation, quality basic education for all boys and girls, and the protection of children from violence, exploitation, and AIDS. UNICEF is funded entirely by the voluntary contributions of individuals, businesses, foundations and governments. For more information about UNICEF and its work visit:

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Monica Arach, External Relations and Fundraising Specialist


Evelyn Offeibea Baddoo, Communication Officer (Accra)


 Innocent Kafembe, Communication Officer (Tamale)




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