WATER &

SANITATION
IN SINDH

Dr. Zoya Fatima

Dr. Fizza Islam
Dr. Faiza Waseem
Dr. Hammad Jawaid
 OBJECTIVES

We conducted a health situation

analysis on the SINDH MICS (2018-
19):
• To acknowledge lack of safe
water, sanitation, & hygiene
(WASH)
• To assess the burden and to study
the risk factors associated with
poor water quality, accessibility, &
availability.
• To identify the potential
interventions to improve quality
& access to WASH.

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WHY WASH?
It was adopted by all UN states in 2015 as a universal call to end poverty, protect
the planet and ensure that all people enjoy peace and prosperity by 2030

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Goal 6: Ensure availability and sustainable
management of water and sanitation for all

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 Problem
Statement

Understanding the water problem &

acknowledging it as a major public
health concern

Source: https://www.dawn.com/news/1381595 5
 PROBLEM STATEMENT
• Nobody wants a child to die or get sick because of drinking contaminated
water,
• Nobody wants to get exposed to other people’s excreta or to have no place
to wash their hands.
• Nobody wants a child should have to stay away from school for lack of a
clean toilet and privacy.
• Nobody wants a mother or newborn should contract an infection from an
unsanitary delivery room when they are most vulnerable.
• And no one should suffer the indignity of having to defecate in the open.

Progress on Drinking Water, Sanitation and Hygiene 2017 6

 UNFORTUNA
TELY
Too many children, women and men around the world experience some
or all these risks to their health and wellbeing -- and, thus to their futures.

Progress on Drinking Water, Sanitation and Hygiene 2017

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 WASH CRISIS
Approx 70 percent of
Diarrhoeal diseases Diarrhea remain a
households still drink
exacerbate leading global cause of
bacterially
malnutrition. child deaths.
contaminated water.

90,000 cases of Poor performance and

diarrhea were reported Impairs physical & high dropout rates
in a single day on 1 cognitive growth and among girls due to
September 2022 after development. Lack of Menstrual
flood. Hygiene.

53,000 Pakistani children under five die annually from

diarrhoea due to poor water and sanitation

https://www.abc.net.au/news/2022-09-16/waterborne-diseases-spread-among-flood-victims-in-pakistan/101450376? 8
utm_campaign=abc_news_web&utm_content=link&utm_medium=content_shared&utm_source=abc_news_web
Global, National, and
local burden

Burden of
WASH
Problem:

Source: https://www.akdn.org/gallery/world-water-day-2019
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WATER & SANITATION IN OUR WORLD
TODAY

2.2 2.3 billion

billion
people globally use
a source of drinking
water that is fecally
contaminated.
people lack access to basic
sanitation such as a toilet
or latrine.
673 million
people continue to practice
open defecation.

80% of wastewater resulting from

human activities is discharged into rivers or
seas without any pollution removal. 10
 Access to
drinking water
supply by source
in Sindh

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Access and Availability of Drinking Water in Sindh

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Quality of Drinking Water in Sindh

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DRINKING WATER LADDER

Saf
ely
Ma
nag
ed
Basic 90%

Limited  6%
Unimproved 2%
Surface Water
2%

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SANITATION LADDER

Saf
ely
Ma
nag
ed
Basic 50.9%

Limited  7%
Unimproved
10%
Open defecation

24%

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HYGIENE LADDER

B
a
si 76%
c
Limited 
17%

No facility
6%

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WATER, SANITATION, &
HYGIENE
RISK FACTORS

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 Factors associated with Unsanitary/unhygienic
Conditions
Public or
Latrines with Hanging Open
shared
open pits toilets defecation
latrines

Poor solid
Open Unsafe High density
waste
defecation drinking water living
management

Lack of
education
Source: https://doi.org/10.1177/00219096221076112​

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Factors Girls with education < grade 10th 
associated with
Poor Menstrual Limited access to menstrual products
Hygiene  Lack of knowledge and awareness

Cultural and social taboos

Lack of access to sanitation facilities at home

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Interventions to
improve quality
& access to
WASH.

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 Water related interventions (quality/quantity)

Create public awareness

Using water treatment
Booster chlorination be Increase the share of through education and
methods to ensure
ensured at different WaSH expenditure in campaigns to promote
provision of safe
pumping stations. the National GDP water safety and
drinking water 
conservation

Drilling boreholes and

Train farmers to avoid Supply clean water with supporting communities
overuse of supply lines far away to install water pumps
agrochemicals from sewage sites.  so they have access to
clean water

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 SANITATION SPECIFIC
INTERVENTIONS
Safe disposal of
Encourage use of Increase number of
wastewater before
private sanitation public toilets especially
discharging it to the
facilities  in RURAL areas
mainstreams .

Creating an Open Provision of incentives

defecation free and rewards to Providing education on
environment by tehsils/towns for the improved hygiene
increasing numbers and implementation of the practices
access to public toilets. sanitation policy

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854459/

https://tribune.com.pk/story/2276750/100000-toilets-to-be-built-in-s-punjab
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Hygiene specific interventions

Handwashing with water and soap is the most

cost-effective health intervention

Provide WASH facilities in schools as well as

hospitals 

Exposure to advertisements promoting

handwashing, masks, sanitizers, use of sanitary
towels/napkins, etc

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854459/
https://www.unicef.org/pakistan/wash-water-sanitation-and-hygiene-0 23
 Schools should
focus on:
Menstrual • Provision of
Hygiene knowledge on
menstruation.
Management • Access to MHM
intervention friendly toilets and
washing areas.
• Provision of
materials and
disposal.
• Access to menstrual
products.

Usman, G., Abbas, K., Arshad, R., Muneer, A., Syed, H.S., Iqbal, A., Dar, F.N., Anum, U., Ahmed, M., Tehreem, K. and Zulfi, M.H., 2020. Knowledge and practice of menstrual hygiene management among
women living in a low-income neighbourhood, Karachi, Pakistan. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 9(10), pp.3953-3959.
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 Even though Open
Pakistan has made The
defecation
Access to significant progress authorities
& urination
WaSH is a in improving access must come
is a major
basic to WaSH, millions of together to
Conclusion human
right 
people still lack
basic access to safe
problem in
both rural
and urban
tackle the
rising WaSH
water and adequate crisis
sanitation facilities.  Sindh.

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Reference
• Progress on Drinking Water, Sanitation and Hygiene 2017.
• https://www.abc.net.au/news/2022-09-16/waterborne-diseases-spread-among-flood-victims-in-pakistan/101450376?utm
_campaign=abc_news_web&utm_content=link&utm_medium=content_shared&utm_source=abc_news_web
• https://www.akdn.org/gallery/world-water-day-2019.
• Sindh 2018-19 MICS
• https://doi.org/10.1177/00219096221076112​
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854459/

• https://tribune.com.pk/story/2276750/100000-toilets-to-be-built-in-s-punjab

• https://www.unicef.org/pakistan/wash-water-sanitation-and-hygiene-0

• Usman, G., Abbas, K., Arshad, R., Muneer, A., Syed, H.S., Iqbal, A., Dar, F.N., Anum, U., Ahmed, M., Tehreem, K. and Zulfi,
M.H., 2020. Knowledge and practice of menstrual hygiene management among women living in a low-income
neighbourhood, Karachi, Pakistan. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 9(10),
pp.3953-3959.

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THANKYOU
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