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The
EDUCATION Millennium Development Goal
What
water, sanitation and hygiene can do
This
Briefing Note presents evidence for the impact of
water supply, sanitation and improved hygiene on
education.
Compiled
by Julie Fisher of WEDC, 2004
Content
contributions by Annemarieke Mooijman and
Marielle Snel, IRC
Headline
Facts
The
MDGs are strongly inter-dependent and
programme interventions must reflect
this. Water, sanitation and
hygiene deliver outcomes across the MDGs.
Why
is water, sanitation and hygiene so
important for children's education?
Children
and Health - Appropriate environmental
health interventions relating to water, sanitation
and hygiene education can significantly reduce the
mortality rate and incidence of sickness and disease
in children under five.
School
Attendance - Improved water and sanitation
increases the opportunity for children to attend
school
Performance
at School - Reducing the incidence of
water-related illness and disease increases
children's performance in school.
Girls'
Education - More girls attend school when
community water supplies are improved and when there
are separate and private sanitation facilities for
girls and boys.
Teachers
- Safe water supply and appropriate sanitation
facilities increases the recruitment, attendance and
retention rate of teachers.
Children
and Health
The
facts
-
Diarrhoea
is the largest preventable
killer of
children under five.
-
Some
1.7 million young children die each year from
diarrhoea associated with inadequate water
supplies, sanitation and hygiene.
-
Worms
infect more than one third of the world’s
population. Worm infection (helminths) is ranked
as the main cause of disease in children aged
5-14 years old. These are spread through
unhygienic environments (such as contaminated
soil or water) and unhygienic behaviour.
-
The
global estimated figures are:
-
Roundworm:
320 million
-
Whipworm:
233 million
-
Hookworm:
239 million
-
Other
diseases related to inadequate water and
sanitation services include skin and eye
infections, (trachoma, preventable by hand and
face washing), schistosomiasis (transmitted
through infected water), and dengue (carried by
mosquitoes in unhygienic domestic water
vessels).
Why
water, sanitation and hygiene?
Water
supply and sanitation
-
Improving
sanitary conditions in schools, in the
community and the home, together with
improvements in hygiene behaviour drastically
reduces the incidence of diarrhoea and
helminth infections among school children.
-
More
than 1,100 people in central Honduras have
benefited from an initiative to provide clean
water and sanitation systems. Children who
once suffered from diarrhoea and skin sores no
longer do so.
-
Small
rural settlements in Malawi developing safe
water sources and upgrading sanitation
facilities, saw a reduction in cholera and
diarrhoea. Prior to the project, 70% of
inhabitants had no access to safe water or
sanitation and one in four babies did not
reach their fifth birthday.
-
About
6 million people are blind from trachoma.
Adequate water supply can reduce the infection
rate by 25%.
-
The
Water and Sanitation Extension Programme (WASEP)
in Pakistan 1997-2001 found that
children
not living in WASEP villages had a 33% higher
chance of diarrhoea than those who did.
-
About
200 million people are infected with
schistosomiasis. Studies found that adequate
Water
supply and sanitation could reduce the
infection rate by 77%.
Hygiene
behaviour
-
Several
studies in the last decade have failed to find
any health benefits when water quality alone
is improved without hygiene education.
-
Most
diarrhoeal disease is transmitted from person
to person on hands and food due to poor
hygiene behaviour. Handwashing with soap
reduces diarrhoea by more than 40%, and cases
of hospitalised diarrhoea, cholera and
dysentery by more than 50%.
-
Poor
access to clean water and good sanitation is
associated with poor growth in children. In
Lima, Peru, those without access to clean
water and sanitation were 1cm shorter and had
54% more episodes of diarrhoea than children
who grew up in the cleanest conditions.
School
Attendance
The Facts
-
More
than 104 million children do not receive any
education.
-
15%
of boys and 24% of girls do not complete primary
school.
-
Non-fatal
incidence of common illnesses such as diarrhoea
and intestinal worm infection are related to
poor water, sanitation and hygiene and are the
cause of absence from school. In Madagascar, 3.5
million schooldays are lost each year due to
ill-health related to poor sanitation.
-
Children
frequently miss school due to domestic and water
carrying duties.
-
Children
caring for relatives suffering water-related
illness or replacing the role of a deceased
parent also miss school.
-
Children
are often excluded from school if they are dirty
or might spread infections.
Why
water, sanitation and hygiene?
-
There
was a 12% increase in Tanzanian school
attendance when water was 15 minutes away
rather than one hour.
-
A
school Environmental Health Club was
established in the Nigerian village of Bashibo,
promoting hygienic behaviour in the home. By
2001, handwashing had increased by 95%, with
90% bathing and brushing teeth regularly.
School attendance, especially amongst girls,
has increased, as has the
general health and nutritional status of the
community.
Performance
at School
The Facts
-
Chronic
early childhood diarrhoea can result in
decreased blood flow to the brain or failure to
absorb sufficient dietary nutrients. Repeated
episodes may have permanent effects on brain
development. This may have an impact on a
child’s learning achievement and on their
health at school age.
-
Children
who suffer from severe early childhood diarrhoea
enter school later than their classmates, and
perform worse in non-verbal intelligence tests.
-
Children
from a Brazilian shantytown community, who
suffered serious and ongoing episodes of
diarrhoea during the first two years of life,
performed less well than other children in
intelligence tests some 5-10 years later.
Why
water, sanitation and hygiene?
-
The
impact of helminth reduction programs in
schools is remarkable. A study in Jamaica
found that children treated against a helminth
infection perform much better in school than
children who do not receive
treatment.
-
A
clean and hygienic environment is vital,
because de-worming will only be effective in
the longer-term if no new infections can take
place.
-
Time
taken by children in Andhra Pradesh to collect
water means they often have no time to eat
before school, which adversely affects
concentration levels.
Girls'
Education
The Facts
-
Of
the 120 million school-age children not in
school, the majority are girls.
-
41%
of primary aged girls worldwide, not enrolled at
school, are in South Asia, and 35% are in Sub-Saharan
Africa.
-
In
low and middle income countries the general
trend towards equity in education is upwards.
Female illiteracy has fallen from 32.6% in 1998
to 29.9% in 2002. Nevertheless, two thirds of
illiterates are women.
Why
water, sanitation and hygiene?
In
the community
-
When
women and girls have access to water and
sanitation, less school time is lost fetching
water.
-
School
attendance by girls has risen since the
introduction of water points in four
communities in
Arappalipatti and Panjapatti India, with a
recorded increase in women’s literacy
levels.
In
schools
-
Where
there are working and well-maintained separate
sanitation facilities for girls, school
enrolment increases.
-
In
rural Pakistan more than 50% of girls drop out
of school in grade 2-3 because the schools do
not have latrines.
-
In
the Noakhali district of Bangladesh in 1998,
the provision of water and sanitation
facilities increased girls’ attendance at
school by 15%.
-
An
assessment in 20 schools in rural Tajikistan
revealed that all girls choose not to attend
when they have their periods, as there are no
facilities
Teachers
The Facts
-
Retention
and recruitment of teachers is problematic where
schools lack adequate water and sanitation
facilities.
-
Teachers
want to work in good schools. This is often
defined by whether they have access to toilets
or not.
-
Teacher
shortages result in large class sizes, which
affects the standard of education children
receive.
-
Water
and sanitation-related illnesses mean that
teachers are themselves absent from school which
causes children to be sent home.
-
Children
infected by water-related skin conditions can
spread the disease to teachers.
-
Teachers
also miss school due to domestic chores such as
water carrying.
Why
water, sanitation and hygiene?
-
Since
the implementation of Water Aid clean water
programmes in India, Tanzania and Ghana,
teachers are more likely to accept posts in
areas where recruitment was difficult due to
the lack of clean drinking water.
Key
references
Burrows,
G. et al (2004) Water and Sanitation: the Education
Drain. London. WaterAid
UNICEF
(2004) Monitoring the Situation of Children and
Women. http://www.childinfo.org/index2.htm
Nokes,
C; Bundy, C. and Donald A. P. (1993), “Compliance
and absenteeism in school children: Implications for
helminth control” ,Trans R Soc Trop Med Hyg;
87(2):148-52, Mar.-Apr.
Full
list of references for Briefing Note 2 (Word file)
For
further information contact:
WELL
Water,
Engineering and Development Centre (WEDC)
Loughborough
University
Leicestershire
LE11 3TU UK
Email:
well@lboro.ac.uk
Phone:
+44 (0)1509 228304
Fax:
+44 (0)1509 223970
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