Background
Access to Water, Sanitation and Hygiene (WASH) services
Water supply services in Afghanistan are limited and access to improved water infrastructures
is among the lowest in the world. According to the Joint Monitoring Programme (JMP) of
WHO-UNICEF 2015, the proportion of the population using an improved water source is 55%,
with important differences between rural (47%) and urban areas (78%). With only 32% of the
population having access to improved sanitation (rural: 27% and urban 45%), the situation with
regard to sanitation continues to be very poor. Safe hygiene behaviors like hand washing with
soap at critical times is practiced by less than 30% of people in 24 out of 34 provinces (ALCS
2014-2015).
As a result, water-borne diseases like diarrhea that has strong association with chronic
malnutrition among children are a matter of concern (HNO, 2017). Globally, Afghanistan has
the fourth highest diarrheal mortality rate and approximately nine percent of all deaths among
children under-five (U5) are due to diarrheal diseases (Aluisio, 2015). Diarrheal diseases, if
not treated, also traps young children in a vicious circle of malnutrition and diarrhea leading to
chronic malnutrition and potential death. In Afghanistan, more than a quarter of all provinces
have acute malnutrition rates above 15%, with 1.3 million children U5 who will require
treatment for acute malnutrition in 2017 (HNO, 2017).
In a country like Afghanistan, a lack of access to water and sanitation affects women
disproportionately. Women are often vulnerable to harassment or violence when they have to
travel long distances to fetch water, use shared toilets, or practice open defecation in absence
of toilet at home. Recent researches in Afghanistan also suggested that poor water environment
was associated with higher maternal mortality.
Nearly 25% of all health facilities lack basic services. Recent assessments suggested that
access to safe water is lacking in about 23% of health facilities in Eastern Region and in 33%
in Southern Region. In the same regions, only one third of health facilities have access to a
sufficient number of toilets (WHO, 2016).
The humanitarian situation
Afghanistan remains one of the most dangerous and violent, crisis ridden countries in the world
(Global Peace Index, 2016). As a consequence, the country is facing increasing numbers of
people on the move and near to one third of the country is hardly accessible to most of the
humanitarian actors. In 2016, the conflict has led to unprecedented levels of displacement,
reaching a record high of 630,000 by end of December – the highest number recorded to date
(HRP 2017). Fifty six percent of the displaced are children and face particular risk. Multiple
form of gender based violence are reported, affecting individuals in hosting and displaced
communities alike (HRP 2017).
Afghanistan is also a natural disaster prone country which is frequently affected by floods,
earthquakes, landslides, avalanches, extreme temperatures, cyclic droughts and epidemics
(table 1). There is an average of eight significant natural disasters per year. Humanitarian needs of Afghan people are exacerbated by underdevelopment coupled with conflicts and frequent
natural disasters.
In its response plan 2017, the WASH Cluster estimated that 2.3 million people were in needs
of assistance for WASH and targeted 1.1 million people. The priority objective of the WASH
cluster was to ensure timely access to a sufficient quantity of safe drinking water, the use of
adequate and gender sensitive sanitation, and appropriate means of hygiene practices by the
affected population (HRP 2017).
