Sanitation as a Gender and Human Rights Issue


Shawna Lewkowitz
Ph.D. Student,  Geography and Environment, Western University


It is easy to ignore the issue of sanitation inequities from the comfort of our homes and public washrooms bathrooms here in Canada. But, lack of access to adequate sanitation is a major global health gender and human rights issue.

While 2.4 billion people lack access to clean drinking water, nearly half of the global population or 4.2 billion people lack access to safe sanitation (WHO and Unicef, 2021). It is estimated that 673 million people worldwide are without access to toilets and are forced to defecate publicly. At the same time, 4.2 billion have sanitation services that do not adequately treat human waste. Without proper sanitation to treat waste, the surrounding land and water become contaminated. Over 80% of human waste end up in rivers or seas without being treated. This leads to devastating health implications, but it also degrades agricultural land and urban and rural environments.

While all in a community can suffer the health, economic, and social impacts of inadequate sanitation, impacts of poor sanitation services are gendered, posing the most disadvantage to women and girls (Heller, 2018). From a biological perspective girls and women take longer and go more frequently to the toilet. Those who menstruate or are pregnant have additional toileting needs. Around the world, women also carry disproportionate responsibility for childcare responsibilities. Every time an individual is exposed to human waste that is not their own, this places them at heightened risk for contracting cholera, intestinal health worms, typhoid and more. Women will face these risks more often where sanitation is lacking, through a combination of their biological needs and social roles.

The lack of private sanitation in the home which leads to public defecation and urination also puts women at risk of increased violence as they travel away from home and find private places to go in often remote and darker spaces (Jadhav et al., 2016). Where there is a lack of or unsafe public toilets and because of women and girls’ toileting needs, this can also further limit their participation in public life and moving freely through cities and beyond (Heller, 2018). There are economic impacts if women are unable to work due to commuting or a lack of facilities at work (Abu et al, 2019). It is not only adults who are impacted: children’s education is put at risk when they are unable to attend school because of a lack of sanitation, or they need to stay home because they have become ill. Girls are further impacted as menstruation begins, when they must choose to stay home rather than deal with the complications of menstruating at school without sanitation facilities (Morgan et al., 2017).

There has been some global movement on acknowledging and acting on the need for sanitation for all. The United Nations declared sanitation as a universal human right in 2010 (UN, 2010)and included it in the Sustainable Development goals, and at the same time recognized that sanitation is critical to achieving gender equality for women and girls. While there is an acknowledgement by countries globally that access to sanitation is an equity issue in need of solving, unfortunately, progress remains slow. According to the UN, at the rate we are going, sanitation for everyone won’t be realized until the next century.

United Nations Water is one organization that is pressing for quicker change to the sanitation landscape. This organization has developed a Global Acceleration Framework to speed up and address global sanitation issues (Unicef & WHO, 2020). These accelerators provide guidance for countries to move quickly on sanitation. The accelerators include good governance with cross-sector collaborations; a focus on public financing; data and information that leads to accountability; capacity development at all levels; and innovation that creates new solutions, particularly for hard-to-reach communities. It will take genuine commitment and a sense of urgency to use all five accelerators for countries to get to sanitation goals by 2030.

We have less than 10 years left to achieve the sustainable development goals connected to sanitation and gender equality. Across the globe, countries are lagging, and access to safe, clean, and available toilets, a basic human need, is still too far out of reach for many. This exacerbates gender inequalities and leads to poorer outcomes for those already marginalized. Without attention, the situation will not only remain unacceptable but could get worse. The impacts of climate change on human health are enormous, with an estimated additional 250,000 deaths yearly by 2030 (UN, 2020). It is expected that climate change will lead to more people living in urban environments, putting additional stress on limited or nonexistent sanitation services.

Countries need to put the same emphasis on clean drinking water, sanitation, and waste. Human dignity, well-being and fundamental gender and human rights continue to be put at risk if they don’t.





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Jadhav, A., Weitzman, A., & Smith-Greenaway, E. (2016). Household sanitation facilities and women’s risk of non-partner sexual violence in India. BMC Public Health, 16(1), 1139.

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World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF), 2021

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United Nations Children’s Fund (UNICEF) and the World Health Organization, 2020.

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Photo credit: World Vision