UNICEF: Without toilets, childhood is even riskier due to malnutrition

19 November 2015
Student at Temeke primary school in Tanzania
UNICEF Tanzania/2013/Bisin
Student at Temeke primary school in Tanzania, where only four percent of schools have made any sanitation or handwashing provision for children with disabilities.

DAR ES SALAAM, United Republic of Tanzania, 19 November 2015 – Lack of access to toilets is endangering millions of the world’s poorest children, UNICEF said today, pointing to emerging evidence of links between inadequate sanitation and malnutrition.

Some 2.4 billion people globally do not have toilets and 946 million – roughly 1 in 8 of the world’s population – defecate in the open. Meanwhile, an estimated 159 million children under 5 years old are stunted (short for their age) and another 50 million are wasted (low weight for age).

In Tanzania, access to improved toilets is still very low and, as a result, the country did not achieve the Millennium Development Goal (MDG) for water and sanitation. It is estimated that only one in three families (34 per cent) in Tanzania has access to improved toilets, with wide disparities between regions, across urban and rural areas. Access to improved sanitation in schools and health care facilities is also a concern. In addition, one in three children under five (35 per cent) is stunted.

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, contributes to the incidence of diarrhoea, cholera and to the spread of intestinal parasites, which in turn cause malnutrition.

“We need innovative solutions to an old problem that has huge, negative consequences for children. Without innovation, children will continue to suffer from preventable diseases including cholera”, said Dr. Jama Gulaid, UNICEF Tanzania’s Representative.

Globally, diarrhoea accounts for 9 per cent of the deaths of children under 5 years old each year and is essentially a faecal-oral disease, where germs are ingested due to contact with infected faeces. Where rates of toilet use are low, rates of diarrhoea tend to be high.

Children under 5 years old suffer 1.7 billion cases of diarrhoea per year. Those in low income countries are hit hardest, with an average of three episodes per year. The highest frequency is in children under 2 years old, who are weakest and most vulnerable. Multiple episodes of diarrhoea permanently alter their gut, and prevent the absorption of essential nutrients, putting them at risk of stunting and even death.

Some 300,000 children under 5 years old die per year – over 800 every day – from diarrhoeal diseases linked to inadequate water, sanitation and hygiene. The poorest children in sub-Saharan Africa and South Asia are particularly at risk.

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


Note to Editors:
For more information about global levels of sanitation please see Progress on Sanitation and Drinking Water: 2015 Update and MDG Assessment

B-roll, videos and photos available at: http://uni.cf/1QkH2Qr

Media contacts

Usia Ledama
Communication Specialist
UNICEF Tanzania
Tel: +255 762 871830


UNICEF promotes the rights and wellbeing of every child, in everything we do. Together with our partners, we work in 190 countries and territories to translate that commitment into practical action, focusing special effort on reaching the most vulnerable and excluded children, to the benefit of all children, everywhere.

For more information about UNICEF Tanzania and its work for children, visit www.unicef.org/tanzania.

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