Some Hard Facts

Diarrhoea causes over 2 million deaths a year, mostly among children under five years old. To put that into perspective, that is the equivalent of one child dying every ten seconds, or a jumbo jet full of children crashing every hour. Deaths from diarrhoeal diseases represent about a third of all child deaths under the age of five in developing countries. Many more contract eye and skin infections and other conditions that are exacerbated by poor hygiene and malnutrition. In India a child succumbs to diarrhoea every 30 seconds. Yet a World Bank study estimates that handwashing with soap and water can reduce diarrhoeal diseases by up to 48%, preventing over one and a half million children from dying each year.

In fact, soap is more effective than vaccines, medications, or clean water initiatives alone. Hundreds of thousands of lives could be saved each year if people had ongoing access to soap and understood how to properly wash their hands.

Undernutrition accounts for more than one third of child deaths around the world. When children are undernourished, they have lowered resistance to infection and are more likely to die from diarrheal diseases and respiratory infections. Frequent illness also saps the nutritional status of those who survive, locking them into a vicious cycle of recurring sickness and faltering growth. A reduced growth rate, known as stunting, is a primary manifestation of malnutrition in early childhood. Proper sanitation, and hygiene can prevent undernutrition and stunting in children by preventing the development of environmental enteropathy and diarrheal disease. Children living in households with proper sanitation and hygiene are taller for their age, or less stunted, compared to children living in contaminated environments.

According to the Public Health Association, only 53 per cent of the population wash hands with soap after defecation, 38 per cent wash hands with soap before eating and only 30 per cent wash hands with soap before preparing food. According to the UNICEF, hand washing with soap, particularly after contact with excreta, can reduce diarrhoeal diseases by over 40 per cent and respiratory infections by 30 per cent. Hand washing by birth attendants before delivery has been shown to reduce mortality rates by 19 percent while a 4 per cent reduction in risk of death was found if mothers washed their hands prior to handling their newborns.

This is no easy challenge. About 70% of India's 1.2 billion population live in rural areas not reached by television, radio or newspapers. If that were not challenge enough, illiteracy is widespread and there are deep-rooted beliefs about cleanliness that have to be addressed, such as the widely held belief that if hands look clean, they are clean. According to UNICEF, Over 750,000 deaths during the neonatal period (babies under 28 days old) are estimated to occur annually because of infectious syndromes such as sepsis, acute respiratory infection, neonatal tetanus, and diarrhea.

UNICEF's long standing support for improving water supply, sanitation and hygiene stems from a firm conviction and based on sound evidence that these are central to ensuring the rights of children.

In fact, it is essential for children to survive, grow and develop into healthy and fulfilled citizens of the world.


  • Hand washing with soap, particularly after contact with excreta, can reduce diarrhoeal diseases by over 40 per cent and respiratory infections by 30 per cent. Diarrhoea and respiratory infections are the number one cause for child deaths in India.
  • Hand washing with soap is among the most effective and inexpensive ways to prevent diarrhoeal diseases and pneumonia.
  • With 594 million people defecating in the open and 44 per cent mothers disposing their children's faeces in the open, there is a very high risk of microbial contamination (bacteria, viruses, amoeba) of water which causes diarrhoea in children. This worsens with lack of knowledge and resources to clean hands with soap.
  • Children weakened by frequent diarrhoea episodes are more vulnerable to malnutrition and opportunistic infections such as pneumonia. About 48 per cent of children in India are suffering from some degree of malnutrition. Diarrhoea and worm infection are two major health conditions that affect school age children impacting their learning abilities.
  • Adequate, well-maintained water supply, hygiene and sanitation facilities in schools encourage children to attend school regularly and help them achieve their educational goals. Inadequate water supply and sanitation in schools are health hazards and affect school attendance, retention and educational performance.

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