According to the latest published data, 122 million people were practicing open defecation (OD) in WCAR in 2015. This number has increased by 34 million since 2000 as the rate of progress in ending OD was insufficient to account for population growth. WCAR accounts for 14% of global OD with eight countries having more than 5 million open defecators, including Nigeria which ranks second in the world with 47 million. In addition, in 12 of the region’s 24 countries, more than 20% of the population practices OD.
Inequities persist in terms of location and wealth, with almost 85% of the open defecators living in rural areas, while people in the poorest quintile are nine times more likely to defecate in the open than those from the richest quintile.
Why is Ending Open defecation a Key Result for Children in WCAR?
OD contaminates the environment and spreads disease (diarrhoea, cholera, typhoid, dysentery). These preventable killers of children result from poor sanitary and hygiene condition and contribute to stunting, which affects the physical and mental development of 28 million children in WCAR. OD also causes losses in productivity and valuable time that can be spent on productive tasks. When there is no toilet at school, children are going home to use the toilet or defecating on the school grounds. Girls are often absent from school during menstrual periods and lack access to quality products, infrastructure and information for managing their menstrual cycle in safety and dignity. The World Bank estimates that inadequate sanitation costs African countries billions of dollars each year in lost GDP.
 WHO/UNICEF JMP report 2017