Water and Sanitation

Millions of people in the Region of the Americas still lack adequate sources of drinking water and safe facilities for the disposal and elimination of feces. It is estimated that in 2017, 28 million people in the Region lacked access to an improved water source, 83 million people lacked access to improved sanitation facilities, and 15.6 million still practiced open defecation (Ref: Joint Monitoring Program, JMP)

The Regional Technical Team on Water and Sanitation (ETRAS) gears its technical cooperation for countries in the Region of the Americas toward actions that facilitate sustainable management of water and sanitation for all by strengthening strategic partnerships to achieve Sustainable Development Goal 6 (SDG6) in all contexts, including health care facilities; by strengthening local, national, and regional capacity to provide safely managed water, sanitation, and hygiene (WASH) services; by strengthening policies and regulations for a comprehensive approach to the elements of a safely managed water and sanitation framework; by supporting the creation of national systems to monitor the quality of WASH services and their financing as a management tool; through interprogrammatic actions to address the environmental determinants of health in surveillance strategies to control vectors and neglected infectious diseases; and by improving national and regional preparedness and response capacity for public health and natural disaster emergencies.

Key facts
  • Inadequate access to water, sanitation, and hygiene services have significant consequences for the health of a population. 
  • Diseases related to the use of water include malnutrition, neglected diseases, diarrhea, and poisonings, among others. These are caused by micro-organisms and chemicals in drinking water.
  • Approximately 7,600 children under 5 die annually from diarrheal diseases in the Region. The countries with the highest rates of mortality from diarrhea in children under 5 are Haiti (23%), Guatemala (10%), Bolivia (7%), and Venezuela (5%).
Fact sheet
  • Deficits in service coverage and quality tend to be concentrated in low-income groups, vulnerable groups, and rural populations. This is compounded by the lack of access to adequate water, sanitation, and hygiene services in health care facilities.
  • Changes in vectors, climate, and the environment are some of the main factors that have led to the appearance or reappearance of vector-borne diseases (VBDs). These factors can expand the geographical distribution of such diseases and extend the transmission season, increasing the morbidity and mortality associated with these diseases.
  • Considering how environmental determinants impact the incidence of vector-borne diseases, it will be necessary to incorporate multisectoral and integrated approaches into surveillance and vector control strategies. This same approach should be used to address neglected infectious diseases. 
  • In the countries of the Americas region, water quality is a limiting factor to access to a secure managed service. Water quality monitoring systems do not yet register as they should, the indicator associated with SDG 6.1: “water quality free of microbiological and chemical contaminants (primarily arsenic and fluorine)”.
  • Sanitation is an important determinant of the Childhood Chronic Malnutrition, however, it is the service that has had the least progress during the past 10 years in the region, registering a difference of 43 percentage points between the population with access to water managed safely and population with sanitation managed safely.
water and sanitation
PAHO Response

PAHO is helping to improve the performance of environmental public health programs by emphasizing water, sanitation, and hygiene. In this matter:

  • Provides technical support for countries to align public policies with Sustainable Development Goal 6.
  • Promotes the generation of evidence for a better manage of water and sanitation services and review the financial accounts of the sector using tools such as GLAAS (Global Analysis and Assessment of Sanitation and Drinking Water) and TrackFin.
  • Strengthens the technical capacity of countries. In addition, creates and disseminates technical guidelines on water, sanitation, and hygiene.
  • Supports countries in the dissemination and inclusion of the principles of equity of affordability for the assessment of SDG 6 indicators and in the tool planning tools of countries, emphasizing in the open defecation elimination.

PAHO strengthens public health environmental surveillance systems for water, sanitation, and hygiene, and monitors progress toward achievement of the SDGs.

  • Developing a system to monitor SDGs 6.1, 6.2, and 6.3a in the Region in accordance with the Joint Monitoring Program (JMP) and incorporating water and sanitation plans.
  • Technical Cooperation in the monitoring and vigilance of the water quality in countries around Latin America and The Caribbean.

PAHO is helping to build a health sector infrastructure that includes safe water, sanitation, and hygiene services.

  • Creating opportunities for discussion and analysis in order to build consensus around water, sanitation, and hygiene in health care facilities.
  • Adapting and disseminating a toolkit for water, sanitation, and hygiene in health care facilities that takes an inter programmatic approach to neglected infectious diseases, quality in health facilities, patient safety, maternal and child health and antimicrobial resistance, among others.

PAHO is helping to build communities that are more environmentally healthy and resilient in terms of managing environmental risks to health associated with water, sanitation, and hygiene.

  • Developing tools to strengthen collaborative work at the local level, with an intersectoral approach to addressing the environmental determinants of health.
  • Developing technical content for the training and education of workers in health and other sectors (environment, housing, water and sanitation, etc.) in order to develop the capacity to respond to outbreaks and emergencies related to water, sanitation, and hygiene. 
  • Strengthening coordination mechanisms in the health sector and in the water, sanitation, and hygiene sector for emergency and disaster preparedness and response.
  • Provides technical support to develop national and local capacity to address communicable diseases and their presence in the community.