This World Water Day, almost half of healthcare facilities in least developed countries do not have water on site, making handwashing difficult and compromising the delivery of safe, clean care

5 min read
A midwife washing her hands
Image: A midwife washing her hands at FEO CHPS health centre in Bongo district, Ghana. Not all healthcare facilities can do this. WaterAid/ Apag Annankra

Stopping COVID-19 requires strong and urgent action from all individuals, communities, organisations and governments. We must lookout for the most vulnerable.

WaterAid is challenging the public to remember that despite handwashing with soap helping to slow the spread of disease, including COVID-19, clean water, soap and good information on why, when and how to wash hands are not available for millions across the globe.

Frequent handwashing with soap and water is one of the key components of controlling the spread of infectious diseases, including COVID-19. However, two in five healthcare facilities globally do not have both soap and water available for doctors and nurses to wash their hands at points where care is provided. This can make disease prevention and delivering safe, quality care much more challenging.

Close to 800 million people do not have access to clean water and a staggering two billion people lack access to a water service that is free from contamination.

Two in five households globally lack handwashing facilities with soap and water. With access to soap, water and good hygiene information, people are better placed to wash their hands and protect themselves and their families against disease, including the current pandemic.

Handwashing is one of the simplest and most effective disease prevention methods available. It has been shown to reduce the incidence of acute respiratory infection by 16-23% [12], reduce pneumonia by up to 50% [13] and result in up to a 48% reduction in the risk of endemic diarrhoea. [14].

In Cambodia and Timor-Leste, where WaterAid Australia operates water, sanitation and hygiene (WASH) programmes, the data shows that only 61% of people in Cambodia have access to handwashing facilities with both soap and water, and 29% of the population has no access to any type of handwashing facilities. In Timor-Leste, only 28% of the population has access to handwashing facilities with both soap and water.

With the need for handwashing as urgent as ever, we need to amplify the action that WaterAid has long been advocating for; safe water and good hygiene for all. The action needed is not just infrastructure alone, it is ensuring good quality water, sanitation and hygiene service delivery and behaviour change to create strong health systems and strong communities.

As WASH experts, WaterAid is focusing on the importance of promoting clean water, sanitation and hygiene which is as critical now, as it always has been.

Rosie Wheen, Chief Executive of WaterAid Australia said:

"In the current COVID-19 world, we must focus on handwashing and hygiene practice to keep safe and with World Water Day on Sunday, it is a crucial time for us to be calling for action on the water and hygiene struggles faced by billions of people globally.

WASH is at the core of the work we do here at WaterAid, and we have been calling for urgent action for many years on bringing clean water and hygiene to everyone, everywhere.

Handwashing is one of the simplest and most effective disease prevention methods available, as we have seen from the advice in stopping the spread of COVID-19. It’s been shown to reduce the incidence of pneumonia by up to 50% [12] and acute respiratory infection by up to 23% [12] and can help healthcare centres be better placed to support a response to an outbreak. If everyone, everywhere had a place to wash their hands with soap and water as often as needed it would go a long way towards helping to contain and prevent the spread of many diseases.

We need governments to take urgent action on sustainable hygiene behaviour change programmes in the long term through permanent government channels such as schools and community health programmes, not just now."

Fast facts on handwashing:

  • Only 1 in 5 (19%) people globally wash their hands with soap after using the toilet. [6]

  • 1 in 3 primary schools worldwide does not have handwashing facilities. [7]Around 310,000 children die each year from diarrheal diseases caused by dirty water and poor sanitation. That’s over 800 children each day, or one child every two minutes. [8]

  •  443 million school days are lost every year because of water-related illnesses. [9]

  • Handwashing with soap reduces the risk of diarrheal diseases by up to 47%. [10]

  • Lack of access to sanitation and poor hygiene contribute to approximately 88% of childhood deaths caused by diarrheal diseases. [11]





[1] WHO/UNICEF Joint Monitoring Programme (JMP) Progress on drinking water, sanitation and hygiene: 2017 update and SDG Baselines
[2] Prüss-Ustün et al. (2014) and The Institute for Health Metrics and Evaluation (2018)
[3] World Health organization (2012) Global costs and benefits of drinking-water supply and sanitation interventions to reach the MDG target and universal coverage
6 Freeman MC, Stocks ME, Cumming O, Jeandron A, Higgins JPT, Wolf J et al. Hygiene and health: Systematic review of handwashing practices worldwide and update of health effects. Trop Med Int Heal 2014; 19: 906–916.
8. Prüss-Ustün et al. (2014) and The Institute for Health Metrics and Evaluation (2018)
9. Human Development Report, 2006
10. Curtis V, Cairncross S (2003) Effect of washing hands with soap on diarrhoea risk in the community: A systematic review. Lancet Infectious Diseases, vol 3, no 5, pp275-81.
11. Prüss-Üstün A., Bos, R., Gore, F. & Bartram, J. 2008. Safer water, better health: costs, benefits and sustainability of interventions to protect and promote health. World Health Organization.
12. Rabie T, Curtis V. Handwashing and Risk of Respiratory Infections: A Quantitative Systematic Review. Tropical Medicine and International Health. 2006; 11(3): 269-78
13. Luby S, Agboatwalla M, Feikin D, Painter J, Billhimer W, Altaf A, et al. Effect of handwashing on child health: a randomized controlled trial. Lancet. 2005; (366): 225-33
14. Curtis V, Cairncross S. Effect of washing hands with soap on diarrhoea risk in community: a systematic review. Lancet Infect Dis 2003: 3:275-81