There are also disparities between urban and rural areas in access to these services in Africa. If sustained, this adverse trend could undermine the achievement of the United Nations’ Sustainable Development Goal 6 to ensure access to safe drinkable water and sanitation for all by 2030.
Among the sub-indexes of globalization, social globalization enhances access to drinkable water and improved sanitation for the total, urban and rural population. However, social globalization widens the urban-rural gap in access to improved sanitation while its effect on disparities in access to drinkable water is not significant.
Economic globalization reduces the share of the population with access to improved sanitation while its effects on access to drinkable water and the urban-rural disparities in access in both social services are not statistically significant. Finally, some differences are found when distinguishing between de facto and de jure aspects of globalization. Policy implications are discussed.
Improving access to safe drinkable water and adequate sanitation provides direct health gains and has economic and social benefits. In fact, according to the World Health Organization (WHO), improving water, sanitation, and hygiene (WASH) in health care facilities is an urgent priority (WHO, 2013).
The accessibility to improved water and sanitation is a crucial mechanism to save infants and children from adverse health outcomes –including respiratory ailments, malaria, and diarrhea which are leading causes of infant and child mortality (Armah et al., 2018; Pullan et al., 2014). The lack of access to water and sanitation in health care facilities may discourage women from giving birth in these facilities or cause delays in care-seeking (Velleman et al., 2014). The implications of insufficient or no access to a safe water source and sanitation are devastating for achieving Sustainable Development Goal five in Africa, specifically in educational attainment and labor market participation. According to UNICEF (2016), fetching water is an immense waste of time for women and girls, and it can affect their health, security, education, and their overall productivity.
The number of people without access to safe drinkable water and improved sanitation facilities has declined significantly over the past two decades. According to the United Nations (2019), the proportion of the world population without access to safe drinkable water decreased from 39% to 29% between 2000 and 2015.
Similarly, the proportion of the population using improved sanitation increased from 28% to 43% over the same period (United Nations, 2019). Despite these significant improvements, 2.4 billion people around the world lack access to safe drinkable water, 4.2 billion do not have access to safely managed sanitation, while 673 million are still practicing open defecation in 2017 (UNICEF and WHO, 2019).
These statistics are worse in Sub-Saharan Africa (SSA) where most countries have less than 40% and 70% access rates to improved sanitation and safe drinkable water; respectively. Also, large disparities exist within SSA countries. For example, access to water is higher in urban areas (84%) than in rural areas (45%). Similar findings are registered for sanitation where 44% of the urban population has access to improved sanitation compared to 22% of the rural population (UNICEF and WHO, 2019).
These trends in access to safe drinkable water and improved sanitation lead to serious health outcomes. For instance, the under-five mortality has significantly decreased in the world, and SSA has the lowest progress (WHO, 2019). Also, SSA is witnessing rapid urban growth– its urban population is expected to increase from 345 million in 2014 to 1.3 billion people by 2050.
For the health community, globalization offers opportunities but also poses important challenges. Globalization is defined by Rennen and Martens (2003) as “the intensification of cross-national interactions that promote the establishment of transnational structures and the global integration of cultural, economic, ecological, political, technological and social processes on a global, supra-national, national, regional and local level.”
A Guest Editorial