Monitor and regularly review progress in improving WASH services, practices and the enabling environment.

HCFs become unable to provide safe services (such as hygienic births and clean surgeries), especially to mothers, newborns and children. The report includesfourrecommendations to all countries and partners, particularly health and community leadersto accelerate investments and improvements in WASH services in health care facilities. These are: Aerial view of completed Dadin-Kowa treatment plant in Gombe State. Photo: Nigeria National Urban Water Sector Reform Program (NUWSRP)Chemical contamination of water continues to pose a health burden, whether natural in origin such as arsenic and fluoride, or anthropogenic such as nitrate. Expanding WASH coverage and monitoring in non-household settings such as schools, healthcare facilities, and work places, is included in Sustainable Development Goal 6. [153]

Most National Adaptation Plans published by the UN Framework Convention for Climate Change include measures to improve sanitation and hygiene. [132] WASH is critical to the Sustainable Development Goals (SDGs). Safely managed water and sanitation services and adequate and equitable hygiene for all will drive progress across the 2030 Agenda, particularly in health, gender equality and livelihoods. Water and sanitation services contribute to greenhouse gas emissions. These emissions are grouped into three scopes in the international greenhouse gas protocol: direct emissions, as well as two types of indirect emissions (see below). [108] [109] :9 Direct emissions (Scope 1) [ edit ] Under-fives living in countries experiencing protracted conflict are 20 times more likely to die from causes linked to unsafe water and sanitation than from direct violence. ( UNICEF, 2019) Ritchie H, Roser M (2018), "Water Access, Resources & Sanitation", OurWorldInData.org , retrieved 22 March 2018Building resilience against future diseases:Safely managed WASH services are needed tosupport affected, at-risk, and low-capacity countries to build resilience against futurepandemics,as well asagainst diseases that afflict the poor in the developing world on a more routine basis, such as diarrhea.In 2016, the WHO estimated that poor WASH practices were responsible for 829,000 deaths from diarrheal disease – equivalent to 1.9% of the global burden of disease. Cholera, an acute diarrheal disease linked to contaminated water that can kill within hours if left untreated, infects up to 4 million people each year, and kills an estimated 21,000-143,000 people. The spread of other diseases, like typhoid and measles, increase precipitously in the developing world when domestic water supply outages occur. In some individuals these diseases are fatal, and in many others their burden leads to reduced labor productivity and wages. Where the burden is high, repeated illnesses for family members can trap households in a vicious poverty cycle.

a b "Goal 6 .:. Sustainable Development Knowledge Platform". sustainabledevelopment.un.org . Retrieved 2017-11-17. Nature-based solutions (NbS) can play an important role for climate change adaptation approaches of water and sanitation services. [109] :45 This includes ecological restoration (which can improve infiltration and thus reduce flooding), ecological engineering for wastewater treatment, green infrastructure for stormwater management, and measures for natural water retention. [109] :45 Safe and sufficient WASH plays a key role in preventing numerous NTDs such as trachoma, soil-transmitted helminths and schistosomiasis. Diarrhoeal deaths as a result of inadequate WASH were reduced by half during the Millennium Development Goal (MDG) period (1990–2015), with the significant progress on water and sanitation provision playing a key role. There are three main barriers to improvement of urban services in slum areas: Firstly, insufficient supply, especially of networked services. Secondly, there are usually demand constraints that limit people's access to these services (for example due to low willingness to pay). [90] Thirdly, there are institutional constraints that prevent the poor from accessing adequate urban services. [91] Water pollution [ edit ] Women at a Village Pond in Matlab, Bangladesh: The woman on the right is putting a sari filter onto a water-collecting pot (or kalash) to filter water for drinking. The human rights to water and sanitation prohibit discrimination on the grounds of "race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth, disability or other status". These are all dimensions of inequality in WASH services. [12] :13 Urban low income areas [ edit ]WASH in HCF improvement programs have registered promising initial successes, but several sustainability challenges remain: