WASH

WASH consists of water, sanitation, and hygiene, with photos from top left: A woman pumps water from a handpump in her village in Sindh, Pakistan; a girl collects clean water from a communal water supply in Kawempe, Uganda; school toilets at an elementary school in Boquete, Panama; a simple handwashing setup for when there is no running water, shown in Omaruru, Namibia.

WASH (or WatSan, WaSH; stemming from the first letters of "water, sanitation and hygiene") is a sector in development cooperation, or within local governments, that provides water, sanitation, and hygiene services to communities. The main purposes of providing access to WASH services are to achieve public health gains, implement the human right to water and sanitation, reduce the burden of collecting drinking water for women, and improve education and health outcomes at schools and healthcare facilities. Access to WASH services is an important component of water security.^[1] Universal, affordable, and sustainable access to WASH is a key issue within international development, and is the focus of the first two targets of Sustainable Development Goal 6 (SDG 6).^[2] Targets 6.1 and 6.2 aim for equitable and accessible water and sanitation for all. In 2017, it was estimated that 2.3 billion people live without basic sanitation facilities, and 844 million people live without access to safe and clean drinking water.^[3] The acronym WASH is used widely by non-governmental organizations and aid agencies in developing countries.

The WASH-attributable burden of disease and injuries has been studied in depth. Typical diseases and conditions associated with a lack of WASH include diarrhea, malnutrition, and stunting, in addition to neglected tropical diseases.^[4] There are additional health risks for women, for example, during pregnancy and birth, or in connection with menstrual hygiene management.^[5] Chronic diarrhea can have long-term negative effects on children in terms of both physical and cognitive development.^[6] Still, collecting precise scientific evidence regarding health outcomes that result from improved access to WASH is difficult due to a range of complicating factors. Scholars suggest a need for longer-term studies of technological efficiency, greater analysis of sanitation interventions, and studies of the combined effects of multiple interventions to better analyze WASH health outcomes.^[7]

Access to WASH is required not only at the household level but also in non-household settings like schools, healthcare facilities, workplaces, prisons, temporary use settings and for dislocated populations.^[8] In schools, group handwashing facilities can improve hygiene. Lack of WASH facilities at schools often causes female students to not attend school, thus reducing their educational achievements.^[9]

It is difficult to provide safely managed WASH services in urban slums. WASH systems can also fail quite soon after installation (e.g., leaking water distribution systems). Further challenges include polluted water sources and the impacts of climate change on water security. Planning approaches for more reliable and equitable access to WASH include, for example, national WASH plans and monitoring, women's empowerment,^[10] and improving the climate resilience of WASH services. Adaptive capacity in water management systems can help to absorb some of the impacts of climate-related events and increase climate resilience.^[1]: 25 Stakeholders at various scales, for example, from small urban utilities to national governments, need to have access to reliable information about the regional climate and any expected changes due to climate change.