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We won’t end malnutrition without toilets

Posted 19 Nov 2015 by Dan Jones

The new Global Goals commit countries to ending malnutrition and achieving universal access to water and sanitation by 2030. On World Toilet Day, WaterAid’s Advocacy Coordinator Dan Jones reflects on the need for joint action on these inter-connected issues.

Today is World Toilet Day, and WaterAid is marking the occasion in many ways. From shit-themed comedy nights to a new report ‘It’s No Joke: The State of the World’s Toilets’, our staff from New York to Nepal and London to Mali are busy grabbing attention with toilet humour. But behind this light-heartedness we are carrying a serious message to global health decision makers. With the ink barely dry on the new Global Goals to end poverty and address inequality by 2030, it’s time for world leaders to swiftly turn their words into a new kind of action to spur progress.

The global theme the UN has chosen for World Toilet Day 2015 is the links between sanitation and nutrition; from our perspective, this timing couldn’t be more appropriate. The new era Global Goals require joint action on inter-connected issues, and WaterAid is determined to make those links. So, while our ‘State of the World’s Toilets’ report highlights the plight of more than 2.3 billion people in the world who do not have access to a safe, private toilet, it also emphasises the knock-on effect that this crisis has on maternal health, newborn deaths and child nutrition.

Child nutrition and water, sanitation and hygiene are interconnected

WASH-related infections contribute to undernutrition
From the infographic 'Healthy Start: Child nutrition and water, sanitation and hygiene (WASH).
See the full infographic >

An estimated 314,000 children under five die each year of diarrhoeal illnesses which could be prevented with safe water, good sanitation and good hygiene. Perhaps more surprising and less obvious is that many hundreds of thousands more are left stunted, their physical, cognitive and social development impaired by undernutrition because repeated infections and diarrhoea prevent children’s bodies from absorbing the nutrients they need to grow.

The links between nutrition and sanitation are often overlooked, and yet WHO estimates that 50% of undernutrition is associated with repeated diarrhoea or intestinal worm infections directly resulting from inadequate water, sanitation and hygiene. Approximately 25% of all cases of stunting (where a child is of short height for their age – a sign of malnutrition) can be attributed to five or more episodes of diarrhoea before the age of two. And 88% of cases of diarrhoea are directly associated with inadequate water and sanitation.

Conversely, interventions to ensure the use of water free from faecal contamination, effective separation of faeces from human contact through improved disposal of excreta, and the simple act of regular handwashing all contribute to better nutrition for mothers, their newborn babies and children in the first vital years of life.

A child being weighed at a clinic in Niassa District, Mozambique.
A doctor weighs a young child at a clinic in Niassa District, Mozambique.

The new era Global Goals require joint action

Much has been made of the need for a more integrated approach to sustainable development that recognises the inter-connectedness of the challenges that cause poverty and preventable deaths. The close links between nutrition, water, sanitation and hygiene are a tangible example.

Global Goal 2 seeks to “End hunger” and includes the commitment to “end all forms of malnutrition” by 2030 (Target 2.2). Integrating water, sanitation and hygiene into national nutrition action plans, strategies and budgets will be critical to achieving this target. Similarly, Goal 6 calls for universal access to water and sanitation by 2030. Achieving this will be fundamental to reaching goals on health and nutrition.

Opportunities for an integrated approach

Now that the celebrations from the signing of the new goals have quietened down, we must all turn our attention to the need for tangible joint action to implement the goals and achieve the world we all want by 2030. At WaterAid we are aiming to turn our own words into action by engaging with the health and nutrition sectors at global and national levels.

Last week, our Research Manager Erin Flynn presented at the Bonn WASH Nutrition Forum in Germany, which brought together experts from both sectors in ‘mirror’ sessions to reflect on the need for a more integrated approach (research presented at the conference can be found on the SuSanA website). Meanwhile, WaterAid Country Programmes are building their relationships with initiatives like the ‘Scaling Up Nutrition’ movement, and we sit alongside civil society allies focused on nutrition within the Generation Nutrition campaign. Next year will see the second ‘Nutrition for Growth’ summit hosted by the Brazilian Government at the Rio Olympics, and we will be calling for commitments to water, sanitation and hygiene to be at the heart of national and international plans to tackle malnutrition.

So World Toilet Day represents much more than a moment to focus on toilets. For us, it symbolises a new era for development thinking that challenges us all to think and act in more integrated ways if we are to achieve a world free from poverty by 2030.

Dan Jones is WaterAid’s Advocacy Coordinator, focused on our ‘Healthy Start’ global advocacy, which aims to improve the health and nutrition of newborn babies and children. He tweets as @danrodmanjones.

You can download and use our Nutrition and WASH infographics, or read our more detailed advocacy brief on this topic.

To mark World Toilet Day 2015, WaterAid staff across the world have been talking about the importance of toilets and sanitation, from launching our ‘State of the World’s Toilets’ report, to hosting toilet-themed comedy nights.

Read more about World Toilet Day 2015 >

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