The issue explained

Poverty and social exclusion are closely linked, so the poorest people are often socially excluded, have fewer opportunities for development and their voices go unheard when decisions are made on their behalf.

This means that often water, hygiene and sanitation services don't serve the needs of the least powerful. Disabled and older people are excluded from water points and toilets if they can't easily access them, and women’s needs for safety and privacy are often ignored in the design of services.

Many people are also excluded through discrimination due to their gender, caste, age, disability, social status, or sexual orientation. Some groups, such as prisoners, refugees and sex workers are particularly stigmatised. People can also be left out from services because of where they live, their occupation or lifestyle.

For example people living in remote areas, migrant workers, pavement dwellers and pastoralists do not fit easily into mainstream service provision. The extent to which different groups of people are marginalized depends on the local context, and many people face multiple disadvantages. Women are often amongst the most powerless and invisible members of marginalised groups.

WaterAid has adopted equity and inclusion as a core principle, intrinsic to a rights-based approach, to ensure we address issues of marginalisation and exclusion in order to realise our vision of a world where everyone has access to safe water and sanitation.

We seek to tackle exclusion and marginalisation wherever it occurs, and we try to ensure that the principle of 'equity and inclusion' is at the heart of everything we do, from having accessible office buildings to tackling discrimination, and bad design at the water pump.

  • Equity is the principle of fairness. It involves recognising that different people have different needs and no-one should be discriminated against or put at a disadvantage.
  • Inclusion is ensuring that everyone is able to participate fully. It can involve improving the design of toilets and water points so they are usable by everyone, and also supporting people in demanding their rights and getting their voices heard, regardless of their social status.

Our approach

Tackling discrimination, marginalisation and exclusion is not always straight-forward.

The first step is to raise awareness and understanding – among staff and local partners – by training and influencing people through workshops.

Once we are aware of and better able to appreciate the issues, we are much better placed to tackle them:

  • In our programme work, we deliberately focus on the most marginalised and excluded groups in society – women, children, people with disabilities, older people, people living with chronic illness, and people from minority groups, whose needs are most likely to be ignored by service providers
  • We use guidelines to make sure toilet blocks or water points are accessible by all.
  • We support marginalised groups to take part in decision making about WASH.
  • Across our organisation as a whole, we try and ensure that the principles of equity and inclusion are incorporated across all areas of policy, strategy and action.

Through our partnership with Loughborough University’s Water, Engineering and Development Centre (WEDC), we have produced a range of resources to help water and sanitation practitioners ensure their programmes are accessible to all.

The resources include presentations, background information and activity sheets to identify barriers and solutions to water and sanitation. The resources are available to all on the WEDC website.

This short film shows what it's like to be socially excluded, and what we're doing to tackle the problem:

A woman in a wheelchair approaches a toilet.


This week in recognition of World AIDS Day, 1 December, and International Day of Persons with Disabilities, 3 December, we're taking a closer look at what making water and sanitation accessible for all really means. People who live with disabilities or chronic illness are often excluded from using available facilities. At WaterAid we are working to make sure the everyone is considered in every step of providing clean water and sanitation.

A woman washing the hands of her grandchildren

World AIDS Day

This World AIDS Day, we will be standing in solidarity with people around the world with HIV or AIDS on 1 December. Read our factsheet on how water and sanitation make a difference.

Read more about World AIDS Day
Leave no one out report

Leave no one out

Find out about WaterAid Ethiopia's experience of reaching people with disabilities and leprosy with water, sanitation and hygiene.

Read the report
Sagar Pressin at the UN High Level Meeting on disability

International Day of Persons with Disabilities

15% of the world's population lives with some form of disability. Sagar Prasai, a Disability Rights Activist in Nepal, blogged at the Huffington Post about how reaching disabled people is key to achieving the Millennium Development Goals.

Read it here
Loingnois Hachalambwela

Beyond taps and toilets

Empowering people doesn’t stop at a safe tap and toilet. In Nepal and Zambia, we’ve been working to empower disabled people to feel their voices are heard.

Find out more
Esther (who is blind) using the guide rope to get from her house to her accessible toilet

Esther's story

Esther is blind and has mobility issues. Before access to clean water came to her village Esther was unable to live a dignified life.

Read Esther's story