Water and Sanitation Challenges in Poor African Communities: Impact on Health Outcomes

This essay discusses the impact of lack of water and sanitation on the health outcomes of poor African communities. It highlights the social determinants of health, negative health impacts, and strategies to address and improve health outcomes.

Running head: HEALTHCARE
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Name of the student
Name of the university
Author note

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Introduction
The concept of the health related promotions is based over the social determinants that is
aligned with certain principles related to the human rights like the accountability, social
participation, nondiscrimination and the transparency. As per the legislation and the declaration
of the year 2010, the human rights to the water and sanitation (HRWS) by the General Assembly
by United Nations and the Human Rights Council aimed for ensuring aces to proper water and
sanitation without any discrimination for all (Boisson et al., 2016). With the development of the
first International Conference on Health Promotion, the concept regarding the promotion of
health is based over the expanded concept of health that has developed by various actors for
bringing some of the new ways regarding the practices and thinking. According to Corburn and
Hildebrand (2015) illness has come to be understood as the procedure that generally involves
the behavioral, economic, biological, cultural, social and the environmental concepts. The
concept regarding the promotion of health promotion tends to values the connection among the
popular and the technical knowledge and furthermore proposes increased dialogue among the
communities and the institutions. As per the statements and the declaration by the Human Rights
Council of the United Nations, the theoretical framework that has been developed behind the
human rights towards the sanitation and water has been derived from other rights like the right
towards adequate living standard, right towards the mental and the physical health and the right
towards the dignity and the life (Wolf et al., 2018). The thesis stamen of the essay argues with
the water and the sanitation challenges within the community of the Africa poor population
towards their health outcomes. The essay elaborates towards the context of the social
determinant of the poor African population together with the strategic model for the

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recommendation regarding the suggested improvement of the health condition of the targeted
population.
Social determinant of health
The social determinants regarding health are the procedures and the certain conditions
where individual grow, born, live, work for and age. The circumstances of the social
determinants are generally shaped by the effective distribution of the power, money and the
resources within the national and the global levels. According to Bartram et al. (2015) the social
determinants of health are the responsible factors for the inequalities of health which are the
avoidable differences at the status of health and the unfair stats within and among the countries.
Figure – The social determinant of health

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Source - (Pega et al., 2017)
The figure above explains the factors of the social determinant of health that influences
the health and the standards of living of the individual. These factors contribute to the basic
necessities of an individual to live peacefully in the world. According to Thornton et al. (2018)
there are various of factors that have influence over the health. In the addition to the genetics and
the choices of the lifestyle, individuals are born, work and also have some of the essential
effluence on the health. The determinants of the health and the social determinants of health
includes a broad range of social, personal , economic and environmental factors that tends to
determine the population and the individual health. The social determinant of the health signifies
to a specified group of the economic and social factors among the wider determinants of the
health (Taylor et al., 2016). These are connected to the people’s position in the society like the
education, income and employment. The essay highlights on the social determinant of the lack of
water and sanitation among the poor population in Africa. The experiences related to the
historical trauma or the discrimination are some of the essential social determinants of the health
towards the certain community in Africa who are under poverty.
Name the social determinant chosen
The links among the water and the issue or the problems of the health are well established
within various debates. According to Jennings, Larson and Yun (2016) an approximately 1.4
million deaths per year are due to the reason for the diarrhea specifically that affects the children
who belongs under the age five. Water and proper sanitation is one of the essential social
determinant of health affecting the living status of community people living under threatening
environmental conditions and under poverty level. According to Corburn and Hildebrand (2015),

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there lies four of the major categories of the water related health outcomes. These includes the
water washed, waterborne, water related insect vectors and the water based challenges. The
issues of the sanitation and the diseases that are connected to the hygiene cut across these
categories. As per the report of development by United Nations, on the global basis, the water
related diarrheal diseases accounted more than 5 percent of the total loss regarding the disability
adjusted life years. According to UNESCO, there lies several indicators relevant to the health
and the water which are well defined and well established and are backed by the databases with
the global coverage updated annually on a legal basis (Scott et al., 2017). The role of water in the
context of health is often been taken for granted. Though this relationship is difficult for
measurement and the quantify with some of the ambiguities for the contributing towards the slow
progress for the maximization of the sanitation and the water related health gains. According to
Prasad et al. (2015) through the world statistics, not only the improved sanitation and water , but
also they have been cost effective towards the measurement of the health. The WHO report
regarding the social determinants of the health asserts the lack of health is the cause of the huge
international burden of the water borne and the sanitation disease.
Impact of the chosen social determinants of health over the selected population
At the present the estimated of 1.2 billion people lacks the access to improved facilities
and the supply of water and more than 2.6 billion people which consist of more than half of the
developing world lives in the rural areas who lives without proper access and sanitation
(Umuhoza & Ataguba, 2018).
Due to the reason of the alarming growth in the size of population and the prevalence of
the drought in Africa, the pressure has been mounting over the demand of the fresh resources

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that are suitable for the consumption of human. As per the current reports by the South African
Water Caucus over the state of the department of sanitation and water, there has been various
several water borne disease and health challenges among the poor communities in Africa.
Furthermore due to the social determinant of the lack of access towards proper health care
facilities followed by poor economic conditions has resulted in various issues and challenges
among the communities in Africa (Mumm et al., 2017). According to the report, there has been
exposed and dysfunction and the institutional paralysis on the department of sanitation and
water. It has furthermore revealed that there lies some of the deep concerning governance and
instructional challenge in the department of sanitation and water. It furthermore lays a bare
situation regarding the institutional paralysis within the process and the association with
deterioration in the financial management, the policy coherence and performance. The effects
and the cost of the unsafe drinking water and sanitation are high. As per the WHO reports, the
estimated mortality due to the sanitation hygiene and unsafe drinking water is associated with
lots of disease (Heaton et al., 2016). The ingestion regarding the contaminated water tends to
lead to several category of illness that furthermore includes the typhoid, cholera and dysentery.
As per the statistics of Africa, there has been 2.2 million deaths due to the diarrhea disease which
are attributable towards the water, sanitation and hygiene. 90 percent of the risk factor occurs
among the children who are under the age of five. Furthermore the malnutrition that
accompanies the disease targets greater chance regarding the susceptibility towards death as
compared to other disease (Hassan et al., 2017).

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Figure – Effects of social determinant of health - water and sanitation
Source - (Salami et al., 2019)
The figure above highlights the areas that are majorly targeted within the context of
Africa followed up by the challenges related to water and improper sanitation. Factors such as
education, HIV and health has been highlighted to explain the consequences faced by the rural
population of Africa towards their health challenges and the reservation of the sustainable
development goals.
There are has numerous reports regarding the diseases due to the lack of the access
towards proper drinking water, unimproved sanitation facilities and the poor hygiene that causes
more than 4% of all the deaths and more than 5.8% of all the issues and the challenges related to
disability in the Africa.

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Negative health impacts
The contamination of the drinking water and the unhealthy and unsafe hygiene have
devastating effects towards the community individual living in the rural societies of the Africa.
Figure - High mortality due to the social determinants of water and sanitation in Africa
Source - (Ndikumana & Pickbourn, 2017)
The figure above highlights the high rate of mortality among the African continent as
compared to the other places in the world. This is due to the lack of proper water for drinking
and sanitation in the under developed country of Africa where more than 67% of the population
are struggling with their financial conditions, among which 43.78% are under poverty line
residing in the rural places within the southern subcontinent of Africa (World Health

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Organization, 2015). There lies some of the major negative effects of the targeted social
determinants of health within the poor community of the Australian population. According to the
data, more than 81% of the urban dwellers have access towards the piped drinking water and
more than 96.34% have access towards improved drinking water resources. As per the data given
by the government of Africa, the bacteriological quality of the water in Africa is very poor and
more than 50.45% of the community of people residing under poverty are affected by the related
diseases and faces insufficient aces towards the safe drinking water and improved process and
place of sanitation.
Some of the negative factors of this social determinant within the African subcontinent
includes the increase chance of the health risks are often exacerbated by the process of the poor
and unhygienic sanitation. According to the data, 25.67% of the urban population in Africa still
lacks the proper access towards the improved process of sanitation highlighting millions of the
community people practicing open defecation which are some of the major threats for the women
and the girls during their puberty (World Health Organization. 2014). In Africa, within the poor
communities, the disposal of the urban solid wastes are another sanitation related issues or
challenge. Furthermore the lack of the access towards the proper water for drinking and
sanitation targets all the women and the girls in the poor communities of Africa to travel long
distance for the collection of water for their house. This costs them numerous of time, which is
an essential factor in the current world.
Some of the water related diseases within the subcontinent of Africa includes the following.

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Water washed diseases – These are generally caused by the poor personal hygiene and the eye or
the skin contact due to the contaminated water. Some of the threatening diseases included in this
category are the trachoma, scabies and tick borne disease.
Waterborne diseases- These are the resultant of the ingestion of the contaminated water by the
animal and the human faeces. The ingestion of the water including urine that contain the viruses
or the pathogenic viruses affects the health of the poor population. Amoebic, diarrheal disease
and bacillary dysentery are some of the main diseases under the category.
Water related insect vector diseases- In Africa, within the poor community, these are caused by
the insects that breed in the water. This furthermore includes the filariasis, trypanosomiasis and
malaria.
Water based diseases – These are caused due to the living parasites or the intermediate organism
that lives in the water. Disease includes schistosomiasis, dracunculiasis and helminthes.
Figure -The Water crisis in Africa

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Source - (World Health Organization, 2015)
The figure above highlights the rate of the challenges due to sanitation and the clear
water crisis within the subcontinent of Africa. As per the graphical representation the population
living in the south Africa are the major sufferers of the social determinants of health, the proper
access to water and sanitation. The graph highlights the major portion of the crisis faced by the
south African states which consist of the rural, under developed and poor community people.
Strategies to address and improve health outcomes
In several of the regions in Africa, the plans, the policies and the strategies are there for
reaching towards the vulnerable groups like those who resides under the poverty. According to ()
the monitoring progress towards the access and the provision of the services for the people under
the poverty level is carried out less than 40% of the countries sanitation and drinking water.
There lies some of the major considerable progress regarding the recognition of the right to the
sanitation and water with the resolution of the UN Right to sanitation and water (World Health
Organization, 2015). Though proper and effective implementation of the policies and the
strategies are still a long way to go, some of the recommendation that can be highlighted within
the particular context are as follows.
 Modification regarding the Australian institutional structure of the drinking water supply
and the sanitation sector. The reforms that invariable includes the institutional framework
of the functions related to the economic regulation and the public policy making needs to
be revised.
 Reaching the poor population through the water development fund that was developed for
the water supply for the urban public.

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 Development of the low pressure water tank systems in the South Africa with the
extension of the water supply services to the poor (Hassan et al., 2017). This furthermore
needs to include the semi pressure system with ground tanks and the securing of the
tenure that plays an essential role towards the determination of whether the poor people
in Africa have access to water and sanitation
 Agreement by the government regarding the provision of aces to water and the facilities
of sanitation irrespective of their location and their status (Jennings, Larson & Yun,
2016). This is because inequality among the social standards within Africa plays an
important role in the poor sanitation and the lack of the access to water.
 The government of the country should ensure global funding and financial network for
the low income settlements for the development of new water tanks and projects of the
building of the hygiene sanitation facilities for the poor communities of Africa
 The WHO must ensure programs and projects to help the rural population in Africa who
are under poverty towards their proper access to health care services (Umuhoza &
Ataguba, 2018). The reason of the inequality and the poverty has been one of the main
reason behind the lack of the access to the health care services which are resulting
numerous of the children and the individuals to death due to water borne diseases.
 The changing regarding this ace of the crisis requires the impart of the knowledge and
proper education .This will help the people to motivate in new behaviors and the health
challenges for the consumption and the ingest of the contaminated water.
 The government of the country together with the UNESCO in the collaborative project
should initiate in the development of the energy efficient desalination plants for
improvement of the water catchment and the harvesting techniques.

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Conclusion
This from the above analysis, can be deducted that with the development of the first
International Conference on Health Promotion, the concept regarding the promotion of health is
based over the expanded concept of health that has developed by various actors for bringing
some of the new ways regarding the practices and thinking. Access to proper and healthy water
and a healthy living is the basic right of each and every individual residing in the world. Africa
has been under the focus of debate for the issues of the lack of water and sanitation followed by
the degrading level of poverty which has been contributing the country towards not meeting the
sustainable development goals. The links among the water and the issue or the problems of the
health are well established within various debates. The effects and the cost of the unsafe drinking
water and sanitation are high. As per the WHO reports highlighted above, the estimated mortality
due to the sanitation hygiene and unsafe drinking water is associated with lots of disease. There
lies various negative factors of this social determinant within the African subcontinent includes
the increase chance of the health risks are often exacerbated by the process of the poor and
unhygienic sanitation. The assignment furthermore explains the relevant strategies and the
recommended measures that needs to be taken by the United Nations and the government of the
country towards addressing the social determinants of health regarding the lack of proper water
and hygiene within the country. This is because the report highlighted the cost of the lack of
proper water which is the high mortality rate within Africa. The report finishes off with the

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positive steps and the actions that WHO have taken and also initiatives in implementing for the
benefit of the rural people in Africa who are under the poverty level.

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