Table of contents

Water for Health - Taking Charge
Epilogue: Opportunities for actors and stakeholders

Health Ministries And Administrations - Local Communities And Civil Society - The Research Community - The Private Sector - Government - Local And National - International And Bilateral Organizations

While clear linkages between poverty and ill-health are evident, rarely do governments and aid agencies consider the improvement of health as a potential strategy for reducing poverty. Economic development remains the favoured option for poverty reduction. While the health sector is expected to deliver good care and provide an acceptable level of community health, resources to effectively fulfil these two essential tasks are often lacking. Water may provide an entry point to support health and development.

Health Ministries And Administrations

A major structural adjustment of the health sector with regard to water is needed in many countries to ensure that:

• it can function as an equal partner with other agencies in the planning, development, and management of water resources and basic services;
• it can provide other sectors with reliable data on water-associated diseases and effectiveness of interventions to facilitate decision-making on water projects;
• it can provide leadership for action in health and water-related issues;
• it can assimilate the concept of human rights and equity in health into development with the support of political leaders;
• it can promote health-efficient water interventions not supported by other sectors.

Local Communities And Civil Society

• Communities can manage water supply for households or irrigation effectively if backed-up by government and private aid agencies.
• International NGOs are well-positioned to support their local counterparts and to engage in international advocacy.
• NGOs working on water projects (e.g. irrigation and water supply schemes) can assist local communities in overcoming health problems.
• Epidemiological networks can bring water-health problems to the attention of other professionals.

Basic Development Needs Community and intersectoral participation are recognized as important for socioeconomic development. Approaches such as basic development needs (BDN), which address all determinants of health, give a wider perspective than can be achieved by health services alone. BDN was successful in Somalia in 1987 and is being implemented in other areas.

The Research Community

Priority research areas depend greatly on specific circumstances. Nevertheless, there are a number of general trends that are of special importance:

• recognizing the importance of water for health and encouraging interdisciplinary research;
• ensuring that research targets the poor as they bear the burden of water-related disease and stand to gain from improved water management;
• bringing expertise and data together to provide new insights to existing information;
• fostering innovation and technical development in priority areas;
• collecting high quality data on the impact of water interventions on disease prevention to support or assist informed decisions.

The Private Sector

• Deregulation of the water sector offers opportunity for improved delivery of safe water to needy customers.
• Private-sector initiatives of smallholder farmers can potentially decrease water use for crop production and improve irrigation techniques for better health and economy.
• Goods and services supportive of health targeted at poor households can boost private-sector enterprise in areas such as soap manufacture, emptying of latrines, septic tanks and water vending.
• Public/private partnerships should be established with due consideration to the health needs of the poor.

Government - Local And National

• Water development policy-makers should be responsible for the health impact of their actions.
• Decentralization creates new opportunities for productive alliances among diverse groups involved in local water projects for health.
• Health must be included in environment impact assessment studies.
• The special water and health problems of the urban and rural poor which restrict their access to safe water and sanitation or increase their exposure to unsafe environments must be recognized.

International And Bilateral Organizations

• International partnerships can strengthen the position of health as a cross cutting issue in the initiatives of water for people, water for food security and water for the environment.
• Support to interventions for short-term health gains for destitute people.
• Increasing momentum for universal access to safe water and sanitation.
• Enhance access to relevant information through direct initiatives and information collation and synthesis.

Acknowledgements - Water, Sanitation and Health at WHO