Improving hygiene in Africa is essential to breaking the cycle of disease, promoting human dignity, and achieving sustainable development goals.
Hygiene remains a critical public health challenge across Africa, with significant disparities in access to sanitation and hygiene facilities. According to recent reports by UNICEF, over 178,000 cholera cases were recorded in Eastern and Southern Africa between January 2024 and March 2025, highlighting the urgent need for improved water, sanitation, and hygiene (WASH) infrastructure. Limited access to clean water and proper sanitation facilities exacerbates the spread of waterborne diseases, posing a severe threat to public health, as highlighted by the report.
Poor sanitation and high-risk hygiene behaviors confine the poor in a vicious cycle of poor health, environmental degradation, malnutrition, reduced productivity and loss of incomes. For women and adolescent girls, the lack of privacy and dignity has deleterious impacts on health and safety, self-esteem, education and well-being.
More than 70% of the population in Eastern and Southern Africa (340 million people) have no access to basic sanitation services. Among these, 98 million people (19%) practice open defecation, 179 million use unimproved facilities and 63 million shared sanitation facilities.
Ethiopia, Uganda, Kenya and Tanzania, have by far the largest number of people in the region with no access to basic sanitation services, while countries like Eritrea, South Sudan and Ethiopia have the largest proportions and numbers of people practicing open defecation.
The greatest concern in the region is the pace of increase in access on basic sanitation services. As highlighted by the UNICEF report, access to basic sanitation services in communities has only increased by 6% since 2000 and projections showing that only 36% of the population will be having access to basic sanitation services by 2030.
Efforts to improve hygiene practices have been made, but challenges persist. In one report, UNICEF has emphasized that 418 million people still lack even a basic level of drinking water service, 779 million lack basic sanitation services, and 839 million still lack basic hygiene services on the continent. In many rural areas, communities still rely on unsafe water sources, and open defecation remains prevalent, all contributing to the contamination of water supplies and the spread of diseases such as diarrhea, cholera, and typhoid.
Significant inequalities persist within countries including between urban and rural, between sub-national regions and between the richest and the poorest. In urban areas, 2 out of 5 people lack safely managed drinking water, 2 out of 3 people lack safely managed sanitation, and half the population lacks basic hygiene services. In rural areas, 4 out of 5 people lack safely managed drinking water, 3 out of 4 people lack safely managed sanitation, and 7 out of 10 lack basic hygiene services.
Another challenge is the financial constraints faced by governments and communities. As highlighted in research conducted by Bose et al. (2024), the finance gap is the discrepancy between available and needed financial resources to offer water, sanitation, and hygiene services. Many African nations struggle to allocate sufficient budgets for water, sanitation, and hygiene (WASH) programs, relying heavily on donor funding. This reliance often leads to inconsistencies in service delivery and hampers long-term sustainability. Meanwhile, if local governments have the ability to manage budgets, they can build resilient, community-driven WASH systems tailored to local needs.
Urbanization also poses a unique set of challenges. The implications of rapid urbanization extend beyond mere population increases, as water demand and infrastructure are seriously affected. Rapid population growth in cities has outpaced the development of sanitation infrastructure, resulting in overcrowded and unsanitary living conditions. This growing urban population demands immediate attention to ensure that sustainable water management practices are established to meet present and future needs.
Additionally, cultural and behavioral factors play a role in hindering hygiene improvements. According to research conducted by Okesanya et al. (2024), cultural beliefs and limited understanding of improved sanitation and hygiene hinder the adoption of healthy WASH practices, as some individuals and cultures are resistant to changing their ways. In some regions, traditional practices and a lack of awareness about the importance of hygiene contribute to the persistence of preventable diseases. Resistance to efficient WASH practices is especially common in areas where open defecation is robustly practiced.
Addressing hygiene challenges in Africa requires a multifaceted approach that combines infrastructure development, education, and policy reforms. Worldwide, many organizations, including UNICEF, work in over 100 countries to help provide access to safe water and reliable sanitation, and to promote basic hygiene practices in rural and urban areas. Better water, sanitation and hygiene results can be achieved for children by working directly with schools and healthcare facilities to improve access to these services, providing life-saving support in humanitarian settings.
Promoting hygiene education is crucial for behavioral change. Campaigns that emphasize the importance of hand washing, safe water storage, and proper sanitation practices can significantly reduce the spread of diseases. In addition, governments and international organizations must prioritize funding for water, sanitation, and hygiene (WASH) infrastructure. This includes building safe water supply systems, proper sewage facilities, and public toilets, particularly in rural and underserved urban areas.
As another solution, leveraging smart technologies, such as AI-powered water management systems, can optimize resource distribution and improve sanitation services. These technologies should be adapted to local contexts to ensure accessibility, affordability, and responsiveness to the realities of African communities.
Strengthening governance and policies, along with regional and international collaboration, can be effective strategies to enhance service delivery. On the one hand, governments need to implement and enforce policies that promote equitable access to WASH services. Transparency in resource allocation and collaboration with private sectors. On the other hand, Partnerships between African nations and global organizations can provide technical expertise, funding, and innovative solutions to address hygiene challenges.
By implementing these solutions, and some others such as implementation of open defecation game plan (UNICEF’s ‘game plan’ to end open defecation), strategic public-private partnerships to move populations up the sanitation ladder, ending high-risk hygiene practices, and improving urban sanitation systems and services, Africa can make significant strides toward improving hygiene, reducing disease burdens, and enhancing the quality of life for its people.
Improving hygiene in Africa is not only a matter of public health but also a step toward achieving broader development goals. By investing in WASH infrastructure and promoting behavioral change, African nations can reduce disease burdens, enhance productivity, and improve the quality of life for millions of people.
References
www.unicef.org
washmatters.wateraid.org/blog/accelerating-progress-afwasa-water-sanitation-hygiene-africa
www.unicef.org/wca/press-releases/africa-drastically-accelerate-progress-water-sanitation-and-hygiene-report
pumps-africa.com/challenges-in-water-infrastructure-the-impact-of-rapid-urbanization-in-africa/
www.unicef.org/esa/sanitation-and-hygiene#:~:text=More%20than%2070%20per%20cent,63%20million%20shared%20sanitation%20facilities.
Bose, Debajyoti, Riya Bhattacharya, Tanveen Kaur, Ritesh Banerjee, Tanya Bhatia, Aritra Ray, Bhavika Batra, Arnab Mondal, Paulami Ghosh, and Surajit Mondal. “Overcoming water, sanitation, and hygiene challenges in critical regions of the global community.” Water-Energy Nexus (2024). https://www.sciencedirect.com/science/article/pii/S2588912524000171
Okesanya, Olalekan John, Gilbert Eshun, Bonaventure Michael Ukoaka, Emery Manirambona, Olaleke Noah Olabode, Ridwan Olamilekan Adesola, Inibehe Ime Okon et al. “Water, sanitation, and hygiene (WASH) practices in Africa: exploring the effects on public health and sustainable development plans.” Tropical medicine and health 52, no. 1 (2024): 68. https://link.springer.com/article/10.1186/s41182-024-00614-3