Proportion of population using safely managed sanitation services, by service level (%) (WHO and UNICEF 2023)

• Open defecation
• Unimproved
• Basic
• Limited
• Safely managed

Applies to:

• SH_SAN_SAFE

This disaggregation tracks the quality of sanitation services provided to the population by order of increasing quality. This is critical information for monitoring whether a country is on track with the objective of access to adequate and equitable sanitation services for all, which is both fundamental for human development and a distinct human right recognized by the UN General Assembly in 2015 (UNGA 2016a). It can point to the efforts engaged to fill the identified gaps. Especially in responding to the needs of women, youth and vulnerable groups. This will require strong investments from governments as well as setting up adequate regulatory, institutional and funding frameworks.

Inadequate access to sanitation results in increasing inequalities and disproportionately affects women and girls, the poor and the most vulnerable populations (i.e. slums, people living with disabilities or in remote areas, indigenous peoples, and minorities). Improved sanitation services halt adverse health effects (e.g. dissemination of water-borne diseases such as diarrhea, cholera, typhoid and several parasitic infections, acute respiratory infections, or stunting), promote social inclusion (e.g. poverty, dignity or safety), and reduce the impact on the economy (e.g. the high costs of poor sanitation due to loss of life and healthcare expenditures) (UNICEF and WHO 2020).

Proportion of population using safely managed sanitation services, by sex (%)

• Male
• Female

Applies to:

• SH_SAN_SAFE

This disaggregation aims to highlight the gender divide regarding access to adequate sanitation systems and to identify adequate interventions to reduce the gender disparities and impediments that women are facing, with a view to secure equitable and safe access to sanitation. Inadequate sanitation services pose specific challenges to women and girls due to physical differences and gender norms in terms of hygiene, health risks, dignity, safety, or well-being (UN-Water 2006; UNICEF and WHO 2023). A focus on gender differences in sanitation policies is therefore necessary, which entails improved involvement of women in decisions concerning sanitation programmes and interventions to ensure that their specific needs and concerns are considered.

This disaggregation is in line with the UN General Assembly resolution of 2015 recognizing access to sanitation as a distinct human right(UNGA 2016a)

Access to safe sanitation by women and girls is essential for their personal hygiene, good physical health and general well-being.

Accelerating progress on the provision of safe sanitation services to women and girls is a priority for achieving gender equality, with the aim of securing safe access to using toilets with privacy and dignity and to end their exposure to infection, violence or harassment. Equipping schools with water and latrines and promoting hygiene education to schoolchildren is an action that can generate short-term, high-leverage effects by reaching a young population that will benefit from better health and awareness on the issue (UN-Water 2006; UNICEF and WHO 2023).

Proportion of population with basic handwashing facilities on premises, by wealth quintile (%) (WHO and UNICEF 2023)

Ratio of basic hygiene coverage in richest quintile to coverage in poorest quintile

Applies to:

• SH_SAN_HNDWSH

Hand hygiene is a key measure for preventing the spread of infectious diseases. Yet the poor and most vulnerable populations too often lack access to basic hygiene services at their premises (WHO and UNICEF 2021a). This disaggregation provides a measure of inequality in access to hygiene services through the basic hygiene access ratio between the richest and poorest wealth quintiles. It can be used to develop a pro-poor hygiene policy to restore greater equity in access to hygiene services.

The beneficial impacts of such policies on health (i.e. halting the spread of infectious diseases), the economy (i.e. a reduction in the economic impacts of death and diseases), social inclusiveness (e.g. increasing security and the feeling of dignity and privacy), and its cost-effectiveness are the incentives needed for governments to close the remaining gaps in access. The necessary strategic policy and financial measures are needed to promote hand hygiene to everyone at home and also in public spaces – like schools, healthcare facilities or workplaces – and take the requisite accompanying steps to support hand hygiene behavioural changes among the population (WHO and UNICEF 2021a; WHO and UNICEF 2021b)

Proportion of population with basic handwashing facilities on premises, by geographical location (%) (WHO and UNICEF 2023)

Applies to:

• SH_SAN_HNDWSH

This disaggregation provides a breakdown of the population with basic handwashing facilities on premises by geographical location, to be determined by each country according to their national context. It shows the variation of the coverage of handwashing facilities on premises across sub-national territories of a country and can be used by policymakers to identify where corrective measures need to be implemented to ensure a more equitable and widespread distribution of handwashing facilities. These include the regulatory framework, the financial and human means, the institutional and individual capacities, the technical options, and the required investment programmes. This applies in particular to local authorities that have most often a direct responsibility in terms of handwashing facilities development and are the main player on the ground.