In 2015, 663 million people lacked improved drinking water sources and 2.4 billion lacked access to appropriate sanitation facilities.1 A recent UNICEF study showed that global access to water in schools is at 71 percent and sanitation access at 69 percent. For least-developed countries, this drops to appallingly lower coverage rates of 52 percent and 51 percent, respectively.2 The daily and long-term consequences of the burdens experienced by girls across the globe caused by a lack of safe water and underdeveloped sanitation and hygiene facilities are considerable. This situation is particularly pronounced for young girls and female adolescents who often miss school because of a lack of access to safe and improved water, sanitation, and hygiene (WaSH) facilities. While gender disaggregated data for availability of WaSH facilities in schools is limited, reports point to average sanitation coverage being five percent lower for girls than for boys, a critical factor in school attendance.1 Indeed, there is mounting evidence that access to safe water and improved sanitation and hygiene at schools reduces student absenteeism and improves achievement.3 Access to education is a catalyst for greater change, leading to decreased poverty rates, improved economic well-being, and better health.

Box 1

Women are often the primary caregivers in the household, and often ‘women’ are no more than young girls starting their journey into adolescence. Too often it is the girl-child who is kept at home to assist with the household chores, including collecting water for her family, while her brother or male family members attend school. Even for girls who continue to attend school, when they have their menses, they often stay at home for its duration due to a lack of adequate sanitation and hygiene facilities in schools. Because of this, girls miss out on up to one week of school per month.4 Knowledge and transmission of reproductive health information and the importance of supporting a safe space and environment for girls to adequately respond to their changing needs are often limited or unavailable. This can be exacerbated by weak policies, or more often, poor implementation of well-intentioned policies as a result of inadequate governance, monitoring systems, and limited budgets to equip schools with equitable and inclusive WaSH facilities. When girls miss school, their education suffers, which in turn increases their risk of poverty, poor health, and general well-being.  An educated girl is more likely to delay having sex, marries later, has fewer children, adds more to a country’s GDP, and consequently helps raise herself, her family, and her community out of poverty.5

The newly launched Sustainable Development Goals (SDGs) for the first time include a target to achieve access to adequate and equitable sanitation and hygiene for all, with specific attention on the needs of women and girls. With this newly found international attention, the time has arrived to address WaSH challenges in schools. Evidence shows that investing in safe and improved WaSH facilities improves girls’ health and enhances knowledge, which in turn empowers girls to reach their full potential and become agents of change within their communities. The following solutions suggest concrete ways in which governments, donors, nongovernment organizations (NGOs), civil society organizations, and community members and leaders can come together to ensure that by 2030, girls around the globe have access to adequate and equitable water, sanitation, and hygiene.

WaSH in Schools: Proposed Solutions

Since Build Africa began working with The Kalampete Primary School in Kibuku District, Uganda, the improved access to sanitation facilities, hygiene education, and the ability to harvest water during rainy seasons has greatly increased attendance and performance.

1. Access to safe water in schools. Extreme poverty often prevents families from sending all of their children to school, and when a choice needs to be made to send only a few, it is the boys who attend most often. This ensures that girls are able to help with household chores and bear the burden of collecting water for household-related needs.6 When girls do attend school, these same cultural norms mean that girls are the ones to miss class to fetch water for school-related needs, often miles away from the school, and from sources located in unsafe areas. When water is available at schools, this burden is reduced and the school becomes a safe place for parents to send all of their children. Specifically, these issues of inequality can be addressed by the following:

  • Installing a safe, gender-friendly water supply facility inside the school compound, such as a borehole with a hand pump, rain water catchment system, or a piped water system (appropriate for urban or peri-urban schools) in line with national guidelines;
  • Setting aside government funds for operation and maintenance of facilities, including establishing water quality monitoring as part of the operation and maintenance of facilities;
  • Training staff on upkeep of facilities and linking schools to local service providers for repairs; and,
  • Ensuring water is placed in key areas for use by girls and boys, including in classrooms, at hand washing stations, and in latrine or toilet blocks.

2. Access to improved sanitation and hygiene in schools. A lack of improved sanitation and hygiene facilities in schools impacts girls disproportionately to boys and is a significant factor in keeping girls from attending school. Unsafe sanitation facilities, including shared toilets and a lack of doors, impede girls from using the toilets (potentially leading to increased health issues) and, when used, feeling dignified and safe. In addition, latrines and toilets that lack facilities to manage menstrual hygiene-related needs prevent girls from attending school when they have their menses. This reduces their quantity and quality of learning and in turn affects their long-term health and economic development. A lack of hand-washing facilities also negatively impacts girls’ (and boys’) health, contributing to increased morbidity and mortality. It is possible for these challenges to be tackled by the following actions:

  • Installing improved sanitation (latrine or toilet) facilities within the school compound, including gender-friendly stalls with water and space to wash, hooks for hanging clothing, and safe waste disposal options;
  • Provision of sanitary pads, available in case of an emergency through the head female teachers; and,
  • Adequate hand-washing facilities located near the latrine or toilet blocks with sufficient water and soap.
Figure 1. WaSH in schools: a cycle of opportunity.

3. Enhance access to knowledge, information, and decision making. Due to cultural norms or social taboos, girls and women often lack access to information about reproductive health and the changes they go through during puberty. These subjects are difficult to discuss in social settings, particularly in schools where there is male leadership. Thus, girls’ WaSH needs are frequently neglected within the broader education context and information is not easily accessible or shared within institutions or at the household level, perpetuating generational knowledge gaps.7 In addition, girls (and women) are regularly excluded from decision-making processes that directly impact their personal care and daily lives. Girls seldom have control of WaSH-related decisions because they lack the financial resources to spend on items such as sanitary materials. The following solutions offer a starting point to address these challenges:

  • Advocate for the inclusion of menstrual hygiene management and reproductive health information in school curriculum (for both boys and girls);
  • Encourage active participation of girls and women in decision making and in assuming leadership roles;
  • Partner with community members, local leaders, school health clubs, and students (males and females) to address cultural taboos and social norms around gender equality and specific WaSH-related needs; and,
  • Ensure that girls and women are able to manage menstruation hygienically and with privacy and dignity (linked to Solution 2).
Box 2

4. Improve the enabling environment. A significant factor for improving the health status and economic opportunity for girls is enhanced access to education. This enabling initiative is hindered by indifferent governance systems whose policies create an absence of national guidelines for WaSH in schools and are out of alignment with national gender policies. Developing countries face a shortage of funds to meet the needs of and sustain gains made for WaSH in schools for every child and have a limited capacity or ability for local government line ministries to support WaSH in schools. Weak coordination between key stakeholders, combined with the complexity of school-based interventions (requiring input from multiple ministries, local councils/government, service providers, and school management committees and students) also hinders the impact of WaSH initiatives to improve the prospects for girls to enhance their education and facilitate improvement in their health options.8 The following solutions are ways to improve the environment to enable girls to have greater access to education:

  • Utilize/create a participatory WaSH-related steering committee or working group under a key Ministry to inform evidence-based policies and decision making processes for the development of guidelines for WaSH in schools and the national implementation of these guidelines;
  • Support and use global initiatives, such as the global partnership Sanitation and Water for All,9 to achieve universal access to clean water and adequate sanitation—and global commitments such as the SDGs—to garner momentum and political and financial support for WaSH in schools at a national level; and,
  • Provide coordinated, quality training for line ministry officials and their counterparts in the communities and schools, by government and/or NGOs, to improve understanding and knowledge about the importance of WaSH in schools and the capacity to be able to adequately plan, implement, monitor, and sustain improved WaSH facilities.

Final Thoughts

Students in class at Sor Elementary and Junior School in Ethiopia. WaterAid Ethiopia and its partner Ethiopia Wetlands and Natural Resources Association have partnered with the school to build gender-segregated toilet rooms with access to clean water. In the interim, the school collaborates with NGOs to make sanitation kits available for girls who are in their menstrual periods.

Education is the cornerstone of a healthy and productive society. Yet around the globe, girls miss out on attending school more so than their male counterparts. According to UNESCO’s most recent Global Education Monitoring Report,10 there are still many countries with less than 90 girls enrolled for every 100 boys in primary and secondary schools, with an even greater gap between rich and poor female students. Many factors can be attributed to low attendance rates for girls, and, as has been demonstrated in this article, a lack of access to safe water, improved sanitation, and hygiene are three of them. Without access to these basic WaSH services, girls, and boys, miss out on critical development opportunities. Girls are particularly affected as they have additional needs to be met, especially as they hit puberty and need effective and dignified ways to manage menstruation. Provision of these facilities is one step toward ensuring more equitable access to education and, in turn, economic opportunity. It is critical that the provision of these facilities be supported by increased knowledge and capacity to effectively plan, manage, and monitor WaSH-related educational gains. In addition, a supportive enabling environment to sustain these gains must be in place. By developing and operationalizing national-level guidelines, mobilizing and sustaining funds to support the provision of services to meet these guidelines, enhancing knowledge and buy-in of key stakeholders at the local and community levels, and building capacity to manage WaSH facilities in schools, paying particular attention to the specific needs of girls, equitable hygiene facilities can be achieved. In implementing some or all of these solutions, girls are more likely to attend school, increase their confidence, and feel empowered to actively engage in decision making (with simultaneous support by male leaders, teachers, caregivers, and students), stay in school longer, have fewer children, marry at a more mature age and stage of life, and lead healthier and more productive lives.


The author would like to thank WaterAid Canada for providing the material for the personal case studies included in this article.


  1. UNICEF and WHO Joint Monitoring Program. Progress on sanitation and drinking water—2015 update and MDG assessment [online] (2015).
  2. Advancing WASH in Schools Monitoring [online] (2015).
  3. Raising even more clean hands: Advancing health, learning and equity through WASH in schools [online] (2012).
  4. House, S, Mahon, T & Cavill, S. Menstrual hygiene matters: A resource for improving menstrual hygiene around the world. WaterAid [online] (2012).
  5. PLAN International. Because I am a Girl – The State of the World’s Girls 2012: Learning for Life [online] (2012).
  6. Millennium Development Goals. Goal: promote gender equality and empower women. UNICEF [online] (2016).
  7. Gakidou, E, Cowling, K, Lozano, R & Murray, CJL. Increased educational attainment and its effect on child mortality in 175 countries between 1970 and 2009: A systematic analysis. Lancet 376: 959–74 (2010).
  8. Raising even more clean hands: Advancing health, learning and equity through wash in schools [online] (2012).
  9. Sanitation and Water for All [online] (2016).
  10. Education for all, 2000–2015: Achievements and challenges [online] (2015).

Leslie Moreland

Leslie currently works as an independent global health and WASH consultant, with a specific interest in supporting research, monitoring, and evaluation efforts to improve the evidence base for reducing...

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