How Water and Sanitation Drive Development: Impacts on Poverty, Health, and Education

Water and sanitation are often treated as basic infrastructure, but they sit at the heart of how nations grow and how people escape poverty. When a household gains a clean water source and a safe toilet, the effects ripple outward into health, schooling, work, and dignity. This connection is so strong that global development frameworks have placed water and sanitation at their core for over two decades. Understanding this relationship explains why a single tap or toilet can shape outcomes far beyond hygiene alone.

Water, sanitation, and the Millennium Development Goals
How water and sanitation reduce poverty
Reducing child mortality
Gender equality and education
Water collection and the time burden on women
Why toilets keep girls in school
Environmental sustainability
Safe waste disposal and reduced pollution
The unfinished task of treatment
A single chain of development

Water, sanitation, and the Millennium Development Goals

The Millennium Development Goals (MDGs) were eight targets adopted by 189 United Nations member states in September 2000, to be achieved by 2015. They covered poverty, education, gender equality, child mortality, maternal health, disease, environmental sustainability, and global partnership. Water and sanitation were placed under MDG 7, which dealt with environmental sustainability. Specifically, Target 7C aimed to halve the proportion of people without sustainable access to safe drinking water and basic sanitation by 2015.

What makes water and sanitation special is that they do not stay confined to one goal. Access to safe water and a working toilet feeds directly into almost every other MDG. The combination of safe drinking water and hygienic sanitation is treated as a precondition for success in the fight against poverty, hunger, child deaths, and gender inequality, and it is central to the basic dignity of every person. In other words, you cannot reduce poverty or save children’s lives at scale while ignoring how people drink water and dispose of waste.

How water and sanitation reduce poverty

The link between poor sanitation and poverty is statistical, not just moral. Extreme poverty and lack of sanitation are closely connected, which is why ending open defecation is treated as an important part of poverty elimination. When people fall sick from waterborne diseases, the costs compound. Poor sanitation has a ripple effect on national development because workers suffer illnesses, live shorter lives, produce and earn less, and struggle to afford care.

There is also a strong economic return on the other side. A World Health Organisation study calculated that for every one dollar invested in sanitation, there was a return of about 5.5 dollars in lower health costs, higher productivity, and fewer premature deaths. Sanitation is therefore not just welfare spending. It is an investment that pays back through a healthier and more productive population.

Reducing child mortality

Few links are as direct as the one between sanitation and child survival. Poor access to toilets and the resulting open defecation raise the risk of diarrhoeal disease, which adversely affects child health and increases mortality. In India, unsafe water and sanitation historically contributed to nearly 100,000 diarrhoeal deaths of children under five each year.

Recent evidence shows how reversible these deaths are. Research published in a Nature journal found a clear association between toilet construction under the Swachh Bharat Mission and falling child mortality. Researchers estimated that every 10 percent increase in toilets built was linked to a reduction of roughly 0.9 infant deaths per 1,000 live births, scaling to about 67,000 fewer infant deaths a year. The lesson is that sanitation infrastructure is, in effect, a child survival programme.

Gender equality and education

Water and sanitation carry a gender dimension that is easy to overlook. Women and girls are disproportionately affected by a lack of water, sanitation, and hygiene facilities, partly because of their needs during menstruation and reproduction, and partly because they carry a larger share of domestic and water-related labour. Improving these services therefore does more than raise hygiene standards. It shifts the daily lives of half the population.

Water collection and the time burden on women

In most households without piped supply, women and girls are the primary carriers of water and often travel long distances to collect it. This produces what researchers call “time-poverty”, which reinforces inequality by stealing hours that could go to schooling, childcare, rest, paid work, or community participation. Where a water source is far away, that burden falls hardest on women and girls. Bringing a safe water source closer to home returns time to them, and time is the resource that allows education and income to grow.

Why toilets keep girls in school

The connection between sanitation and girls’ education is one of the clearest in development. When schools provide clean, separate toilets, running water, and facilities to manage menstruation, more children attend and learn. The presence of separate toilets and menstrual hygiene management facilities helps girls stay in school and reduces drop-out. Without them, girls miss days every month or leave education altogether.

The scale of the problem is significant. National guidelines require every school to have separate toilets for boys and girls, a toilet for roughly every 40 students, water storage, soap, and safe disposal for menstrual waste. Yet many schools still fall short. A 2020 survey of nearly 2,000 co-educational government schools found that 40 percent of toilets were non-existent or unused and around 72 percent had no running water. When facilities are missing, girls limit food and water to avoid using unsafe toilets, and absenteeism rises.

The courts have started treating this as a rights issue rather than optional welfare. The Supreme Court recently observed that many girls drop out because of poor sanitation, particularly the absence of separate hygienic toilets and access to sanitary napkins, and directed authorities to treat menstrual hygiene as part of the right to education. This reframing matters because it ties a sanitation gap directly to a constitutional guarantee.

Environmental sustainability

Because water and sanitation sat under MDG 7 on environmental sustainability, the environmental angle is built into how the world thinks about them. Safe disposal of human and household waste protects water bodies, soil, and air, while unsafe disposal degrades all three. This is why ending open defecation and managing waste are treated as environmental goals, not only health goals.

Safe waste disposal and reduced pollution

Open defecation introduces large quantities of faeces into the environment daily, contaminating water sources and exposing communities, especially children, to disease. India has made rapid progress here, reducing the number of people defecating in the open by an estimated 450 million people. National open defecation rates fell from around 60 percent to 19 percent in the first five years of the Swachh Bharat Mission, and toilet availability doubled.

Measurable environmental gains followed. A long-term study using over 1.7 million measurements found that groundwater faecal coliform concentration and acute diarrhoeal cases both declined over the years, with stronger improvement after accelerated toilet construction began in 2014. Cleaner waste disposal translated into cleaner groundwater, which is the most common drinking source across the country.

The unfinished task of treatment

Building toilets is only the first step. The waste they collect still has to be treated, and this is where sustainability efforts remain incomplete. Even in major cities, only a small share of wastewater is collected by sewage systems and an even smaller fraction is treated before disposal, so large amounts of unsafe sludge are discharged into water bodies. Only about 27 percent of household wastewater is safely treated.

Ignoring treatment can undo health gains. One study found that rapidly scaling up latrines without adequate sludge treatment increased faecal contamination of rivers by 72 percent, and the positive health effect of building toilets disappeared where upstream areas lacked wastewater infrastructure. The overall effect of the sanitation push was still positive because reduced open defecation outweighed the pollution, but the finding is a clear warning. Sanitation is sustainable only when collection, toilets, and treatment are built together. Treated wastewater and sludge can even become resources for agriculture rather than threats to it.

A single chain of development

The pattern across all three areas is the same. A clean water source frees time and prevents disease, which lifts incomes and keeps children alive. A safe toilet keeps girls in school and protects water bodies from contamination. Proper waste treatment turns sanitation from a local fix into a lasting environmental gain. The MDG framework recognised this by tying water and sanitation to poverty, gender, child survival, and the environment at once. Progress in one feeds the others, and neglect in one undermines them all.

What do you think? If a single sanitation investment can affect poverty, education, gender equality, and the environment together, should it be funded as health spending, education spending, or environmental spending? And in your own town or city, which part of the chain, water access, school toilets, or waste treatment, do you think needs attention first?

References

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How Water and Sanitation Drive Development: Impacts on Poverty, Health, and Education

Table of Contents

Water, sanitation, and the Millennium Development Goals 🔗

How water and sanitation reduce poverty 🔗

Reducing child mortality 🔗

Gender equality and education 🔗

Water collection and the time burden on women 🔗

Why toilets keep girls in school 🔗

Environmental sustainability 🔗

Safe waste disposal and reduced pollution 🔗

The unfinished task of treatment 🔗

A single chain of development 🔗