Water, hygiene and sanitation
Clean water, basic toilets and good hygiene practices are essential for the survival and development of every child
The challenge
According to a 2016 World Bank report, only 38 per cent of people in Tajikistan have access to safely managed drinking water services. 78 per cent use basic drinking water services and only 53 per cent have access to basic sanitation. The figures are even worse in rural areas.
Inadequate water, sanitation and hygiene (WASH) in maternity and newborn departments of health facilities is one of the leading factors behind high neonatal and infant mortality.
The shortfall in WASH facilities not only discourages care seeking and service utilization by pregnant women, but also hinders effective infection control and hygiene practices by mothers of newborns and their caregivers. Out of the 73 maternities in Tajikistan, where more than 80 per cent of deliveries take place, 65 (89 per cent) do not meet the required WASH standards and thus pose hygiene and sanitation-related threats to mothers and their new-born babies.
There is growing evidence that unhygienic conditions during labour and childbirth, at home or in health facilities, and poor hygiene practices after delivery lead to 8 per cent of global maternal deaths, and approximately 10-15 per cent of maternal deaths in developing countries.
A recent study showed that 80 per cent of infant deaths in hospitals in Tajikistan were registered during the first month after a child’s birth. Around 70 per cent of these deaths were in the first week of life and nearly 70 per cent occurred during the first six days of life.
A 2008 study confirms that hand washing with soap by both birth attendants and mothers results in a 41 per cent reduction in neonatal mortality.
The WASH situation in schools in Tajikistan is far from ideal. Only 55 per cent of schools have access to safe water; lack of safe drinking water is a crucial factor for 25 per cent of students who failed to attend or dropped out of school; 48 per cent of schools have access to functioning water supply systems; only 86 per cent of schools have separate toilets for boys and girls; and 83.8 per cent of school toilets are simple pit latrines. A 2015 UNICEF study found that 18 per cent of girls who had dropped out of school or were at risk of dropping out, mentioned poor sanitation facilities as a reason for missing school.
The solution
UNICEF focuses on rehabilitating or constructing WASH infrastructure in schools and in health facilities and promoting safe sanitation and hygiene behaviour by health caregivers and school children. UNICEF is working closely with the Ministry of Health and Social Protection of the Population, the Ministry of Education and Science and other development partners with Ministry of Water Resources and Energy coordination to map the status of WASH facilities in health and learning institutions, improve WASH infrastructure, and develop standards for WASH in schools and health facilities and guidelines and messages to enable hygiene and sanitation behavioural change by school children and health workers. International best practices on WASH in institutions, including on menstrual hygiene promotion, informs UNICEF’s work in Tajikistan.
To save neonatal lives, UNICEF is working to improve WASH at maternity and newborn departments and to promote hygiene.
UNICEF is supporting the Government to analyse capacity gaps and needs, build institutional capacity, and facilitate school community involvement in WASH in institutions. Development of national WASH standards for health and education institutions is also supported as well as the development of guidelines, and a framework for monitoring WASH in institutions.
UNICEF is collaborating with the Government and development partners to facilitate increased resourcing of WASH in institutions. It is supporting the generation of evidence to inform national WASH programming. and costing to guide resource allocation and mobilization for WASH in health and educational facilities.
UNICEF is working with adolescents and young people to develop innovative solutions to WASH problems in their communities and helping mobilize resources to pilot innovations. It advocates with both the public and private sectors to apply the results of innovative work at scale.
UNICEF focuses on influencing behavioural change concerning handwashing, menstrual hygiene management, safe water handling, and safe disposal of excreta. To help ensure that hygiene, and especially handwashing with soap, becomes a lifelong practice, UNICEF supports the forming of habits among children at an early age.
UNICEF is developing its knowledge base on WASH programming and making it available to partners, to ensure that skills, knowledge, and strategies are widely shared in the sector to reduce the learning period for adjustments to at-scale sanitation programmes.
