Tag Archives: Clarissa Brocklehurst

Swimming upstream: why sanitation, hygiene and water are so important to mothers and their daughters

Water, sanitation and hygiene and the most under-recognized interventions when it comes to improving the health and well-being of women, say Clarissa Brocklehurst and Jamie Bartram in an editorial in the Bulletin of the World Health Organization [1].

Let us start with a pregnant woman. She is likely to have to collect and carry water for her baby’s delivery from a hand pump outside her home; globally more than 40% of households do not have a water supply on their premises. If she is very unfortunate she will be among the 13% who do not even have a hand pump and rely on an unimproved water source, made even more risky by the fact that most people in her community lack even a basic toilet. These unhygienic conditions take on new significance when she weans her child. Diarrhoea kills 1.5 million children every year1 and there is a strong link between diarrhoea and malnutrition.

By around the age of six, the child should be going to school. However, if this child is a girl, much of her time will be needed for tasks at home, including water collection. In half of all households worldwide, water is carried to the home and in 72% of households, women and girls are the primary water collectors. Girls are twice as likely as boys to be the carriers. Our girl child is exposed to an increasing range and burden of infections as she encounters the world beyond her home. Intestinal helminths affect 400 million – one in three – schoolchildren. Infestations such as hookworm reduce physical growth and impair intellectual development. Girls weakened by energy loss, intestinal worms and repeated infections are predisposed to anaemia that takes on new significance as they enter menarche, which may also mark the end of their limited schooling. The lack of school toilets with privacy and facilities for menstrual hygiene contribute to sporadic attendance and drop out. If our girl child does not overcome these constraints and she drops out of school, she will likely face early marriage and early childbearing.

But the vicious cycle of inadequate water, sanitation and hygiene that keeps women in poor health, out of education, in poverty and doomed to bearing sickly children can be reversed.

The first hurdle our mother and child encountered was the unsanitary conditions and lack of hygiene at the time of birth. A study in Nepal showed that hand-washing by birth attendants and mothers increased newborn survival rates by up to 44%. Hygiene promotion has been shown to be one of the most cost-effective health interventions, particularly with the use of marketing techniques based on those used by private companies.

In sanitation, though global progress has been poor, some developing countries achieved up to 60% reduction in the proportion of their population lacking improved sanitation. It is likely that political will, modest financing cleverly applied and a focus on changing behaviour and social norms, not just installing infrastructure, contributed to this rapid progress. Building demand for toilets, especially among those people who have practiced open defecation all their lives, helps trigger household investments. Evidence that these approaches are effective suggests that accelerated progress is possible.

Barriers in providing drinking-water can also be overcome. Innovations include low-cost drilling techniques and cheaper hand pumps, the use of locally-managed, small-scale systems, entrepreneurial water kiosks and civil society intermediation between poor communities and service providers. Providing water, sanitation and hygiene in schools is increasingly a priority for ministries of education in developing countries. Emerging designs for toilets that incorporate privacy and facilities for menstrual hygiene provide a multitude of benefits. For instance, women who have been to school are less likely to die during childbirth – each additional year of education prevents two maternal deaths for every 1000 women.

The authors add that “water, sanitation and hygiene also enable women to play roles in their community’s development” including “decision-making and management of water and sanitation systems”.

Clarissa Brocklehurst is Chief of Water, Sanitation and Hygiene at UNICEF headquarters in New York. Jamie Bartram is Professor of Environmental Sciences and Engineering at the Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USA.

[1] Read the full editorial, including references:
Brocklehurst, C. and Bartram, J. (2010). Swimming upstream: why sanitation, hygiene and water are so important to mothers and their daughters. Bulletin of the World Health Organization ; vol. 88, no. 7 ; p. 482.
doi: 10.2471/BLT.10.080077

IYS one year later: interview with Clarissa Brocklehurst

Updated IYS logo. UN-Water

Updated IYS logo. UN-Water

As a follow-up to the 2008 International Year of Sanitation (IYS) there are plans for a virtual scrapbook of IYS activities and a review of sanitation advocacy campaigns commissioned by the Bill and Melinda Gates Foundation. The IYS logo has been updated with a bar of soap and the “timeless”slogan, “Sanitation for All”. These are some of the activities that Clarissa Brocklehurst, Chief of Water and Environmental Sanitation at UNICEF and coordinator of UN-Water’s Task Force on Sanitation, mentioned in an interview with UN-Water. During the IYS,  the Task Force assumed a leadership role in global advocacy and capacity building.

Several countries have  developed specific sanitation policies, as a result of the IYS campaign events, Ms. Brockelhurst said. The United Nations Department of Economic and Social Affairs (UNDESA) is preparing the Secretary-General’s Report on the IYS.

“In some countries the campaign succeeded in leveraging more funds for sanitation. For example, in Nepal, the Department of Local Infrastructure Development and Agricultural Roads decided to allocate 20 percent budget of its water supply project for sanitation and the national government has allocated US $660,000 for a stand-alone sanitation programme. In Nigeria, budget allocations in some states and at national level have increased for sanitation and hygiene and the fact that the National Council on Water Resources has made 2009 the National Year of Sanitation, clearly show a commitment to improving sanitation nationwide. Reports we have received from China also indicated that the IYS campaign contributed to an increased budget allocation for rural sanitation.”

Clarissa Brocklehurst. UN-Water

Clarissa Brocklehurst. UN-Water

“Some country’s reported that the IYS campaigns had helped bring out about institutional changes in how sanitation is addressed at the national level. In Angola, the government has taken steps to establish a new national technical unit for environmental sanitation within the ministry of environment. In Pakistan, a Water and Sanitation Sector Donor Coordination Group and National Working Group on School Sanitation and Hygiene Education have been established.”

“With funding from the United Kingdom’s Department for International Development (DFID), we have commissioned a new project to be carried out by the German Toilet Organization: The My School Loo Contest, which will use comic strips to educate school children about the importance of sanitation.”

UN-Water’s Task Force on Sanitation is supporting implementation of the recommendations of Ministerial Declaration on Water Supply and Sanitation in Small Rural Settlements in the Black Sea Region. The declaration was one of the ouputs of the recent roundtable organised by the UN Secretary-General’s Advisory Board on Water and Sanitation (UNSGAB).

“The Task Force is also supporting follow up to the other sanitation conferences that took place during IYS, particularly AfricaSan and the eThekwini Declaration.”

Read the full UN-Water interview with Clarissa Brocklehurst or listen below to the audio version.

Interview with Clarissa Brocklehurst (audio)