It is widely accepted that water, sanitation and hygiene are necessary foundations for public health. For this reason, the WASH sector, which includes the German development actors (GIZ, 2011), have traditionally based their justification for WASH interventions on the hypothesis that the health status of the target groups will improve. Despite the fact that these impacts are in general not questioned, it is costly and difficult to provide proof. There are methodological and practical difficulties with generating evidence and isolating the direct intervention effects. These challenges include confounding factors such as seasonal interferences, local economic developments and parallel interventions that affect the health status of the local population at the same time.

In accordance with Schmidt (2014), this paper makes the case that even if the health impacts of WASH are limited or non-existent, the numerous additional social, psychological, gender-related, educational, economic and environmental impacts and benefits of effective water and sanitation are alone considerable enough to merit investment. Additional non-health-related impacts of WASH include: keeping children in school, which leads to better educational status; higher productivity due to time savings and less absence from work; improving dignity; and positive environmental effects like keeping eco-systems and water sources clean.

This paper also outlines the available knowledge, monitoring methods and evidence on health impacts of WASH interventions which was gathered from the desk study conducted by Mosler et al. (2014) and consultations with international WASH and health experts which accompanied the desk study. This paper draws from those discussions to develop recommendations on how WASH interventions could be improved in the German development sector and beyond, particularly in the context of improving health impacts, thereby improving the effectiveness of WASH interventions.

Bibliographic information

Rieck, C., Graham, R. (2015). WASH interventions – going beyond direct health impacts Recommendations for improving and monitoring the health impacts of water, sanitation and hygiene (WASH) interventions Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ)

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