سه شنبه ۲۷ شهریور ۰۳ | ۱۸:۱۲ ۸ بازديد
3.1.3
Accelerating progress
towards safely managed
sanitation services
A range of technologies can be used
to achieve safely managed sanitation,
including sewerage systems, which
transport waterborne waste through
pipes to off-site treatment, and on-
site systems. On-site, also called
non-sewered, systems either provide
treatment in-situ (such as simple pit
latrines) or contain waste that can be
transported to off-site treatment (such as
septic tanks or emptiable latrines).
On-site facilities are effective and low-
cost, and can provide safe sanitation for
users when designed, built and used
well, and when part of a functional
sanitation service chain. However, on-
site storage and treatment systems,
such as pit latrines and septic tanks,
may be compromised due to a number
of factors, including poor design,
inadequate operation and maintenance,
damage or flooding, high population
density in urban areas and lack of
appropriate regulation.
On-site systems are widely used
and their use is growing in some
regions. In 2017, 41 per cent of the
world’s population reported using
improved sanitation facilities with on-
site storage, such as flush or pour-flush
toilets connected to a septic tank, and
dry or wet pit latrines (including facilities
shared with other households). Use of
on-site sanitation was more common in
rural areas (51 per cent) than in urban
settings (32 per cent). Use of sewers and
on-site systems varies widely between
regions, but on-site systems are clearly
driving progress in least-developed
countries (see Figure 8).
© UNICEF/UN0352551/Ose
Data on the performance of on-site
sanitation is hard to obtain, but is
available from some household surveys
and reports compiled by governments
from periodic inspections. For example,
the Environmental Protection Agency of
Ireland is a rare example of an agency
that publishes the results from periodic
inspections of decentralized wastewater
treatment systems, including septic
tanks and small-scale secondary or
tertiary treatment plants. Of the 6,000
systems inspected between 2013 and
2018 in Ireland, nearly half were issued
with an advisory notice, and one in four
were found to present a risk to human
health or the environment. 25
Relatively few countries have
sufficient data to report on safely
managed sanitation. In 2017, there
were 94 countries with national data,
mostly countries with relatively small
populations using on-site sanitation
(see Figure 9). Despite the lack of data,
it is clear that in many countries a low
proportion of the population is using
safely managed sanitation.
Sewer connections are driving progress in some
regions, while on-site systems are predominant in
others
FIGURE 8
PERCENTAGE OF POPULATION USING SEWER CONNECTIONS, SEPTIC TANKS, LATRINES
AND OTHER IMPROVED ON-SITE SYSTEMS IN 2017, AND PERCENTAGE POINT CHANGE,
2000-2017
0
10
20
30
Sewer Septic Latrine and other
0
20
40
-10
8 10
31
8
14 12 13
28
33
48
23 19 23
10
17
9 9 6
12
1 4
12
34
41
20 21
60
80
100
Sub-Saharan
Africa World
Least
Developed
Countries
Australia and
New Zealand
Northern
Africa and
Western Asia
Eastern and
South-Eastern
Asia
Europe and
Northern
America
Latin America
and the
Caribbean
Central and
Southern
Asia
Oceania
CHANGE IN USE OF IMPROVED SANITATION FACILITIES, BY TYPE, % PT
USE OF IMPROVED SANITATION FACILITIES BY TYPE, %
1 7 3
-1 0 -7
3
17
22 22
5
-1
14
-2 -3
17
-1 -3
5
-2 -1
1
0 -1
1 7
10 9 6 5
59
66
84 88
3.1.4
Current rates of
progress
Achieving universal access to
sanitation by 2030 will require
dramatic acceleration in current
rates of progress. To achieve universal
access to at least basic sanitation
by 2030, global rates of progress
would need to double (see Figure 10).
Achieving universal access to safely
managed sanitation by 2030 would
require quadrupling the current global
rate of progress. But these are global
averages; the required rate of change
in least-developed countries is even
higher. To achieve basic sanitation in
these countries, the rate of change
would have to increase from an
estimated 0.7 percentage points per
year to 5 percentage points per year, a
seven-fold increase.
In many low-income countries, less than 50 per
cent of the population uses safely managed
sanitation
Achieving universal access by 2030 will
require dramatic acceleration in current rates
of progressFIGURE 9 FIGURE 10
PERCENTAGE OF POPULATION USING SAFELY MANAGED SANITATION SERVICES, 2017
PERCENTAGE OF POPULATION WITH SANITATION SERVICES IN 2000 AND 2017, AND RATE
OF CHANGE REQUIRED TO MEET SDG TARGETS BY 2030
2000 2005 2010 2015 2020 2025 2030
Proportion of the population (%)
0
20
40
60
80
100
56
79
91
1x
2x
4x74
45
28
No open defecation
Basic sanitation
Safely managed
sanitation
Acceleration
required
100
© UNICEF/UN0352570/Ose
© UNICEF/UN0139454/Prinsloo
Nineteen per cent of schools worldwide
were estimated to have no service in
2019. 26 Children and teachers at these
schools either rely on unimproved
facilities, such as pit latrines without a slab
or platform, hanging latrines or bucket
latrines, or had no sanitation facility at all.
An estimated 367 million children attend
a school in which there is no sanitation
facility at all. Over half of these children
live in two SDG regions: sub-Saharan
Africa (213 million children) and Central
and Southern Asia (200 million children).
Some countries have made progress
in school sanitation. Between 2015 and
2019, Bhutan and Nigeria increased
the proportion of schools with basic
sanitation by 3 percentage points
per year. South Sudan reduced the
proportion of schools with no sanitation
service by 4 percentage points per year
over the same period.
However, achieving universal access to
basic sanitation services in schools by
2030 will require a five-fold increase in the
current rate of progress. Figure 12 shows
the trends in reaching sanitation coverage
in schools globally, in the eight SDG
regions and in least-developed countries.
Sanitation in schools
3.2
SDG 4 calls for the global community to
“Ensure inclusive and quality education
for all and promote lifelong learning”.
The goal includes a range of targets
related to educational outcomes from
early years through to adulthood, and
additional targets addressing the means
of achieving them. Target 4.a focusses
on school infrastructure and the need
to “Build and upgrade education
facilities that are child, disability and
gender sensitive and provide safe,
non-violent, inclusive and effective
learning environments for all”. One of
the indicators used to track progress
towards this target is the “Proportion of
schools with access to single-******* basic
sanitation facilities”.
Sanitation services ladder for schoolsFIGURE 11
SERVICE LEVEL DEFINITION
Basic service Improved sanitation facilities at the school that are single-*******
and usable (available, functional and private) at the time of the
survey.
Limited service Improved sanitation facilities at the school that are either not
single-******* or not usable at the time of the survey.
No service Unimproved sanitation facilities or no sanitation facilities at the
school.
Analysis of data from rural schools in 12
sub-Saharan African countries revealed
that many school toilets did not meet
criteria for accessibility, quality
or acceptability (see Figure 13). In
particular, almost half did not have doors
that locked from inside, and hardly any
had a bin with a lid inside the cubicle for
garbage disposal. Both of these features
are important to female students and
staff who need a safe place to practise
menstrual hygiene management.
Two thirds of school toilets were not
accessible to children with disabilities.
Globally, less than two thirds of schools have
basic sanitationFIGURE 12
REGIONAL AND GLOBAL SANITATION COVERAGE IN SCHOOLS, 2015 AND 2019
2015 2019
World
0
20
40
60
80
100
Least
Developed
Countries
Australia and
New Zealand
Northern
Africa and
Western Asia
Eastern and
South-Eastern
Asia
Oceania
Europe and
Northern
America
Latin America
and the
Caribbean
Central and
Southern Asia
Sub-Saharan
Africa
43
27
30
47
27
27
47
13
40
47
13
40
56
20
24
64
20
16
78
11
10
75
19
6
79
10
11
87
3
10
98
1
0
99
1
0
100 100
33 32
48
27
25
51
28
22
2015 2019 2015 2019 2015 2019 2015 2019 2015 2019 2015 2019 2015 2019 2015 20192015 2019
60 63
17
23
18
19
No service Limited Basic Insufficient data
© UNICEF/UN033691/Arcos
In rural sub-Saharan Africa, many school
toilets do not meet criteria for accessibility,
quality or acceptability
FIGURE 13
PERCENTAGE OF SCHOOLS IN RURAL SUB-SAHARAN AFRICA WHERE ALL SANITATION
FACILITIES MEET ADDITIONAL CRITERIA, 2017
Source: Survey of sanitation facilities in rural schools in Ethiopia, Ghana, Kenya, Malawi, Mali, Mozambique, Niger, Rwanda,
Uganda, United Republic of Tanzania, Zambia and Zimbabwe, World Vision, 2017.
* At least one facility accessible to the smallest children and children with limited mobility.
3
28
55
56
78
1
4
5
12
13
81
91
97
31
71
86
91
99
0 20 40 60 80 100
Proportion of schools where all sanitation facilities meet criteria
Private space for washing
No flies present
27No bad smell
No faeces present on floor, slab or walls
Doors that can be locked from inside
No major holes in superstructure
Acceptability
Bin with lid within cubicle
Soap available
Lid covering hole/slab
Water available
Functional lighting
Slab stable and not cracked or broken
No pit that is caving or flooded
No pit that is full
Quality
Accessible by children with limited mobility*
Always unlocked or key available
No barriers blocking entry or use
Accessible by smallest children*
Located on premises
Accessibility
BOX 7
In Togo, the proportion of the country’s nearly
9,000 schools with basic sanitation facilities
increased from 44 per cent in 2016 to 65 per
cent in 2019. Strong government leadership in
policy and planning for WASH in schools laid
the foundation for this considerable increase.
The Education Sector Plan (2014-2025) and the
National Action Plan for the Water and Sanitation
(2016-2030) both identify WASH in schools as a
priority area and provide dedicated support and
capacity building. The Ministry of Education has
led the development of norms and standards
to improve the quality of WASH infrastructure
and hygiene promotion programmes and has
incorporated WASH indicators into its Integrated
Education Information System. The 2017 Roadmap
for an Open Defecation Free Togo by 2025 also
contributed to strengthening sanitation in schools
by including school-led total sanitation as a key
strategy. School-led total sanitation has resulted
in significant progress in sanitation and hygiene
practices in over 2,000 schools.
Supported by the World Bank, between 2010
and 2019 the government implemented a school
infrastructure construction programme that
included the construction of at least 1,000 toilets
in schools. WASH programmes funded by others,
such as UNICEF, the French Development
Agency and the Islamic Development Bank, also
supported the construction of gender-separated
toilets that enable adolescent girls to manage
their menstruation. The Government of Togo plans
to consolidate its achievements by focussing
on sustainability, strengthening national-level
coordination of WASH in schools under the
leadership of the education sector, and mobilizing
resources for capital and recurrent costs.
Improving sanitation in schools in Togo
© UNICEF/UNI284675/Prinsloo
In the global baseline report published in
2019, only 18 countries had sufficient data
to estimate coverage of basic sanitation
services in health care facilities in 2017. 27
When WHO and UNICEF updated the
global database in 2020, the number
increased by 50 per cent. However, the 27
countries with sufficient data still represent
only 12 per cent of the global population. 28
To fully assess progress towards basic
sanitation coverage, data are required
on the adequacy of facilities, including
whether or not there are private toilets
for men and women, accessible facilities
for people with limited mobility and
menstrual hygiene facilities. Lack of
data mean that the actual situation is
likely much worse than the available
figures suggest. Figure 15 shows three
contrasting countries, in which the
proportion of health care facilities with
elements of basic sanitation varies
considerably.
While many countries lacked some of the
data needed to report on basic sanitation
services, they did have some information
about how many health care facilities
lacked any kind of improved sanitation
facilities, and are classified as having no
sanitation service (see Figure 16).
In 28 countries, more than 10 per
cent of health care facilities had no
sanitation service, and in the sub-
Saharan African countries with data,
29 per cent of health care facilities
had no sanitation service.
Sanitation services ladder for health care
facilities
Sanitation in health care facilities varies
considerably between countries
FIGURE 14
FIGURE 15
SERVICE LEVEL DEFINITION
Basic service Improved sanitation facilities are usable, with at least one
toilet dedicated for staff, at least one *******-separated toilet with
menstrual hygiene facilities, and at least one toilet accessible for
people with limited mobility.
Limited service At least one improved sanitation facility is available, but not all
requirements for basic service are met.
No service Toilet facilities are unimproved (e.g. pit latrines without a slab or
platform, hanging latrines, bucket latrines) or there are no toilets.
PERCENTAGE OF HEALTH CARE FACILITIES WITH ELEMENTS OF BASIC SANITATION ACROSS
THREE COUNTRIES, 2019
KUWAIT BRAZIL NIGER
Facility 100 100 -
Improved 100 100 74
& usable 100 84 29
& dedicated for staff 100 82 30
& dedicated for women 100 - 31
& menstrual hygiene management 100 - 0
& limited mobility 100 45 27
Basic 100 45 0
Sanitation in health
care facilities
3.3
The availability of sanitation in health
care facilities, especially in maternity
and primary-care settings, supports
health care quality and equity, helping
ensure dignity for all people. Basic
sanitation services in health care
facilities are fundamental to providing
quality care.
Evidence shows that lack of access
to WASH in health care facilities may
significantly compromise safe childbirth
and access to primary health care. More
than one million deaths each year are
associated with unclean births, while
infections account for 26 per cent of
neonatal deaths and 11 per cent of
maternal mortality. An estimated 15 per
cent of patients in low- and middle-
income countries develop one or more
infections during a hospital stay. Many
of these patients are women who come
to health facilities to deliver. Inadequate
WASH in health care facilities has been
linked to the spread of antimicrobial-
resistant infections, placing patients
and staff at risk of serious infections that
are hard to treat.
© UNICEF/UN0306431/Abdul
Sanitation for forcibly
displaced persons
3.4
Achievement of SDG target 6.2 ‘for all’
implies the inclusion of refugees, asylum
seekers, stateless people and IDPs. The
world is currently witnessing the highest
levels of human displacement on record.
At the end of 2019, there were 79.5
million people globally who were forcibly
displaced as a result of persecution,
conflict, violence, human rights violations
or other events. 29 Approximately 26
million of these are refugees and another
45 million are internally displaced
persons (IDPs). The vast majority, 85
per cent, of displaced people live in
developing countries where access to
safely managed water, sanitation and
hygiene services may be limited. In these
situations, sanitation implementation
approaches must take into consideration
the weak institutional context and unique
deprivations and vulnerabilities of the
population to fulfil every individual’s right
to sanitation.
The United Nations High Commissioner
for Refugees (UNHCR) and its
partners manage over 220 camps and
settlements globally and collect data on
WASH services in them. According to
data from 175 of these sites in September
2020, only 32 per cent of households at
the sites used basic sanitation services.30
© UNICEF/UN013597/Georgiev
In 28 countries, more than ten per cent of
health care facilities had no sanitation serviceFIGURE 16
PERCENTAGE OF HEALTH CARE FACILITIES WITH NO SANITATION SERVICE, 2019
Note: Not showing 21 countries reporting less than 1 per cent of health care facilities with no sanitation service.
1
6
7
8
4
10
10
11
12
12
3
3
13
2
3
18
14
20
32
36
4
5
18
19
37
1
1
5
5
7
7
7
9
9
11
11
12
14
16
16
19
24
24
25
26
36
49
51
52
0 20 40 60 80 100
Bhutan
Bangladesh
Sri Lanka
Nepal
Honduras
Guatemala
Peru
Haiti
Paraguay
Nicaragua
China
Timor-Leste
Indonesia
Serbia
Romania
Russian Federation
Tonga
Cook Islands
Papua New Guinea
Vanuatu
Iraq
Libya
Lebanon
Armenia
Sudan
Zimbabwe
Rwanda
Mali
Djibouti
Burkina Faso
Zambia
Malawi
Benin
Namibia
Sierra Leone
Mauritania
Guinea
Chad
Kenya
Somalia
Senegal
Ethiopia
Liberia
Uganda
Niger
Democratic Republicof the Congo
Comoros
Nigeria
United Republic of Tanzania
Sub-Saharan
Africa
Northern Africa
and Western Asia
Oceania
Europe and
Northern America
Eastern and
South-Eastern Asia
Latin America
and the
Carribean
Central and
Southern Asia
BOX 8
At the end of 2018, there were over 2.7 million
forcibly displaced persons in Afghanistan. 33
There is only one managed camp in
Afghanistan, which hosts less than 1 per cent
of the forcibly displaced living in the country.
In 2018, a survey was carried out to look at the
needs of the 99 per cent of forcibly displaced
who are dispersed throughout the country.
The results show a dramatic disparity between
refugees and the rest of the population,
as shown in Figure 17. Only 28 per cent of
refugees had access to basic sanitation, and
as many as 55 per cent of refugee households
practiced open defecation. 34 These figures are
in stark contrast to JMP figures for Afghanistan,
which estimate that 43 per cent of the overall
population had access to basic sanitation in
2017. 35 Even in rural areas, only 17 per cent of
households practiced open defecation.
The survey found a significant disparity in service
between female- and male-headed households.
Among the forcibly displaced, a significantly
higher proportion of female-headed households
(30 per cent) reported not having access to an
improved latrine compared to male-headed
households (21 per cent).
These disparities demonstrate the importance
of ensuring that monitoring programmes
systematically include vulnerable groups to
generate the evidence needed to design and
deliver programmes to reach them. In the
absence systematic monitoring, there is a
considerable risk that the most vulnerable will be
left behind.
Estimating access to sanitation service amongst forcibly
displaced persons in Afghanistan
Source: UNHCR
Sanitation services available in
refugee and non-refugee populations
in Afghanistan
FIGURE 17
0
20
40
60
80
100
Population (%)
National* Urban*Rural* Refugees
43
10
34
13
37
40
6
17
27
1
1
16
55
62
21
16
0
Open defecationUnimprovedLimitedBasicSafely managed
There are considerable practical
challenges to reaching the SDG targets
for sanitation in camps and settlements.
One challenge is the lack of sufficient
space for installing household facilities.
A recent review found that globally 43
per cent of sites exceeded UNHCR
population density standards. 31 For
example, in the Kutapalong camp in
Bangladesh, the average population
density is almost 44,000 people per
square kilometre, making it one of
the highest population densities on
earth. 32 In these situations, designing
and installing improved sanitation
systems, which are not shared between
households, may not be feasible.
Instead, the focus should be on
minimizing the number of individuals
sharing a facility, and safe excreta
management (transport and treatment
off-site), while ensuring that the
planning, design, location and
management of facilities is done with full
participation of the affected population.
An estimated 60 to 70 per cent
of forcibly displaced persons live
outside of camps and settlements.
Unfortunately very few countries have
disaggregated san
dfs3434