Water, Sanitation, and Hygiene Programs as a Strategy to Advance Maternal Health

May 2014: Of all the Millennium Development Goals, the maternal health and sanitation targets are among the farthest off track, said Rebecca Fishman, operations and special projects director of WASH Advocates. 

An estimated 800 women die from pregnancy- or childbirth-related causes every day, and 20 times that number suffer non-lethal, but no less life-altering, complications. At the same time, 780 million people are without access to safe drinking water and 2.5 billion lack access to safe sanitation.

What is the interaction between these two trends – poor maternal health and water, sanitation, and hygiene (WASH)? And could there be ways to address both in developing countries? To commemorate International Women’s Day and World Water Day, a panel of experts gathered to discuss at the Wilson Center on March 10.

The Risk of Delivering

“The links between WASH and maternal health are quite strong,” said Fishman.

Of 54,507 health care facilities recently surveyed by the World Health Organization in 40 countries, only 46 percent had access to safe drinking water, said Merri Weinger, environmental health team leader of the Maternal Child Health Division of USAID’s Bureau for Global Health. A study conducted in Tanzania found only 44 percent of health facilities that delivered women were water and sanitation safe and the number was even lower when considering the actual delivery room – 24 percent – said Lenka Benova, research fellow at the London School of Hygiene and Tropical Medicine.

This, unsurprisingly, affects mother and child health in major ways. According to a meta-analysis of three studies conducted by Benova and two other authors, women living in poor sanitation environments are three times as likely to die from maternal health-related issues compared to women who do not, while women living under poor water conditions have a maternal mortality ratio 50 percent higher than those that do not. Half the malnutrition cases worldwide can be attributed to poor water, sanitation, and hygiene, said Annie Toro, senior adviser to International Medical Corps.

Poor WASH also undermines efforts by governments and NGOs to get more women to deliver with skilled attendants. When conditions are so bad, “we have to be careful…when we push women to deliver in health care facilities,” said Benova. “What is the actual environment that they are delivering in?”

This feedback loop tends to affect the poor and marginalized the most, contributing to stubborn levels of inequality. “Women that are least likely to have a safe water and sanitation environment at home are also the most likely to deliver [in places without safe water and sanitation],” said Benova. “Women who have a better water and sanitation environment can actually afford to give birth in a [better] facility.” Read More

29-05-2014 | Posted by Admin