Inequalities in sanitation and drinking water in Latin America and the Caribbean

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Inequalities in sanitation and drinking water in Latin America and the A

Programme (JMP) for Water Supply and Sanitation and an inequality

UNICEF/UNI1319/Dormino WHO / UNICEF Joint Monitoring Programme for Water

1 Inequalities in sanitation and drinking water in Latin America and the A regional perspective based on data from the WHO/UNICEF Joint Monitoring Programme (JMP) for Water Supply and Sanitation and an inequality analysis using recent national household surveys and censuses UNICEF/UNI1319/Dormino WHO / UNICEF Joint Monitoring Programme for Water Supply and Sanitation Inequalities in sanitation and drinking water in Latin America and the 1

2 In Latin America and the 83% of the population used an improved sanitation facility in 2 Yet 18 million still practised open defecation Improved sanitation coverage (%) Missing value In Latin America and the 95% of the population used an improved drinking water source in 2 Yet 34 million still used unimproved drinking water sources Improved drinking water coverage (%) Missing value The boundaries and designations used on these maps do not imply official endorsement or acceptance by the United Nations 2 Inequalities in sanitation and drinking water in Latin America and the

3 Sanitation and drinking water ladders Sanitation and water ladders provide a way to show inequalities in the level of service used by households and trends in coverage across these service levels over time. For sanitation this ranges from the practice of open defecation and unimproved sanitation to the use of an improved sanitation facility. For drinking water, there are also four levels with the highest level of service being piped water on premises. Definitions and data sources are provided at the end of this snapshot. Rural sanitation ladders Urban sanitation ladders Open defecation Unimproved sanitation Shared sanitation Improved sanitation Latin America and the South America Central America and South America Latin America and the Trends in rural and urban sanitation in Latin America and the, Central America and Overall in Latin America and the, rural improved sanitation coverage increased from 36% to 64% between 199 and 2. The biggest increases were in South America and Central America and. Comparatively few households share sanitation facilities in South America but sharing of an improved facility is more widespread in the and Central America and, where it is practised by at least 1% of the population. Urban improved sanitation coverage is higher than in rural areas in all three sub-regions and was close to 9% in South America (89%) and Central America and (87%). Urban sanitation was somewhat lower in the and declined slightly between 199 and 2. Whereas one in four in rural areas practised open defecation in 199, this had dropped to just over one in ten by 2. Open defecation is most common in rural areas of South America and rural. Rural drinking water ladders Urban drinking water ladders Surface water Unimproved Other improved Piped pn premises Latin America and the South America Central America and South America Latin America and the Trends in rural and urban drinking water in Latin America and the, Central America and In rural Latin America and the large increases in improved drinking water coverage have been made since 199, driven by an expansion of piped water on premises. Whereas coverage of piped water on premises is high in South America (89%), it is considerably lower in rural Central America and (27%) and rural (38%). The use of unimproved drinking water sources is uncommon in South America but approximately one in five still rely on these sources in Central America and and the. Coverage of piped water is much higher in urban areas of LAC, with piped water on premises serving over 9 out of 1 urban dwellers in South America and the. The use of unimproved drinking water sources in urban areas is uncommon in all three sub-regions but highest in Central America and (5%). Inequalities in sanitation and drinking water in Latin America and the 3

4 Population with no water and sanitation service In Latin America and the, many people still do not have any water and sanitation services, relying on the practice of open defecation or using surface waters for drinking. The charts below show how the lack of services is distributed amongst countries in Latin America and the. Open defecation is practised by at least one in ten living in rural areas in ten countries in 2 In 2, 18 million people practised open defecation in Latin America and the Bolivia 46 Haiti 35 Other countries, 3762 Brazil, 4277 Venezuela 29 Peru 2 Suriname 18, Nicaragua Colombia Peru, 1616 Colombia, 2192 Brazil 13 Honduras Proportion of rural population practising open defecation (%), 2 Venezuela, 1686 (Bolivarian Republic of) Bolivia, 1888 (Plurinational State of) Haiti, 2 Number of people practising open defecation in Latin America and the in 2 (thousands) At least 5% of the rural population used surface water in countries in 2 In 2, 8.5 million people used surface water for drinking in Latin America and the Bolivia 2 Colombia 19 Other countries, 1612 Colombia, 2341 Peru El Salvador Suriname 12 Guatemala, 61 Venezuela Guatemala Nicaragua Bolivia, 699 (Plurinational State of) Peru, 65 Haiti Proportion of rural population using surface water (%), 2 Brazil, 929, 93 Use of surface water in Latin America and the in 2 Key facts In Latin America and the in 2, 18 million people still practised open defecation and 8.5 million people relied on surface water for drinking. In seven countries over 1 million people practiced open defecation in 2, with the largest numbers in Brazil, Colombia and Haiti. In six countries over half a million people used surface waters for drinking in 2, with the largest numbers in Colombia, Peru and. Open defecation was practised by almost half of the rural population in Bolivia in 2 and one in five used surface waters for drinking. 4 Inequalities in sanitation and drinking water in Latin America and the

5 Inequalities by wealth Large gaps in access to improved sanitation and drinking water exist between rich and poor. The chart below, called an equity tree shows just how much difference there is between the poorest in rural areas and the richest in urban areas of Colombia. Below, sanitation and drinking water coverage is shown by wealth quintile for urban sanitation and rural drinking water. These show that there are large difference in almost all countries with available data. Improved sanitation coverage was only 37% amongst the poorest in rural areas of Colombia in 212. Improved sanitation (%) LAC, 83 South America, 84 Central and, 82, 74 Chile, 99 Argentina, 96 Uruguay, 96 Venezuela, 94 Paraguay, 89, 85 Guyana, 84 Colombia, 81 Suriname, 79 Peru, 76 Bolivia, 5 Urban, 85 Rural, 68 Richest urban, 96 Poorest urban, 54 Richest rural, 82 Poorest rural, 37 The gap between the poorest and richest in rural areas appears to be closing in several countries in LAC Population using improved drinking water (%) Bolivia Paraguay Colombia State of Plurinational RICHEST POOREST Improved sanitation by country, location and wealth quintile (%) Trends in use of improved drinking water in the richest and poorest rural wealth quintiles, Sanitation and drinking water coverage is considerably lower for the poorest in many countries in Latin America and the Paraguay Jamaica Guatemala Dominican Rep. Belize Colombia Honduras Peru Nicaragua Haiti Belize Dominican Rep. Guatemala Paraguay Bolivia (Plurinational State of) Jamaica Peru Colombia Honduras Nicaragua Haiti 1 POOREST SECOND MIDDLE FOURTH RICHEST POOREST SECOND MIDDLE FOURTH RICHEST Use of improved sanitation by urban wealth quintile (%) Use of improved drinking water by rural wealth quintile (%) Key facts There are large gaps in access to improved sanitation and drinking water between rich and poor households in Latin America and the. Use of improved drinking water amongst the poorest in rural areas is catching up with the richest Weath quintile trends are available for only 12 countries in the region. Information on access among the poorest is essential for monitoring progressive realisation of the human rights to water and sanitation and achieving equitable access. Inequalities in sanitation and drinking water in Latin America and the 5

6 Other inequalities Insights from national censuses and national household surveys There is a wealth of nationally representative information on water and sanitation services collected by national statistical agencies in Latin America and the. In this snapshot we illustrate the potential to use this information to gain a better understanding of sub-national inequalities in access to these services. Data are drawn from publicly available censuses and household surveys conducted since 21. A total of 31 data sources were found, censuses and 2 household surveys. Where possible information on the following stratifiers was extracted: Region Literacy Education Ethnicity Language Disability Religion All national censuses and national household surveys that collect information on water and sanitation can be used to investigate disparities in access. Disaggregation is, however, only possible when censuses and surveys have collected relevant information about the household and its members. In all cases sub-national administrative regions were available and in the majority it was possible to determine the educational level (>95%) and ethnicity (71%) of at least one household member. Information on religion and language were less common and disability was exclusively included in censuses. For religion, this may reflect a lower political priority relative to other stratifiers in some countries. Language was included in comparatively few cases but may be a particularly useful measure of to assess coverage amongst indigenous population. In this snapshot each equity stratifier is treated independently. More detailed analysis for individual countries is possible and could examine the extent to which inequalities are overlapping or mutually reinforcing. Equally importantly we have focused on equity stratifiers that are considered important at a regional level but participatory approaches could be used to identify country-specific disadvantaged groups for more indepth analysis of inequalities. Whilst most censuses and surveys collect information on education and ethnicity fewer ask about literacy, religion, language and disability Disability Census Survey Language Religion Literacy Ethnicity Region Education Rural and urban Number of national census and household surveys 6 Inequalities in sanitation and drinking water in Latin America and the

7 Ethnicity and language Most censuses and several household surveys ask household members about their ethnic group and in some cases the main languages spoken by household members. These are important characteristics in identifying the most disadvantaged populations. Below we focus primarily on data from the 21 round of censuses, comparing coverage between indigenous groups and the national average as well as between indigenous and afrodescendents. An example from Paraguay EHP 214 also shows that language can be strongly associated with sanitation coverage. Improved sanitation and improved drinking water coverage is lower among indigenous people in several countries with data Population using improved drinking water (%) Population using improved sanitation (%) Brazil Argentina Uruguay Argentina Uruguay Indigenous National Indigenous National Afrodescendents often have higher improved sanitation coverage than indigenous populations 1 In Paraguay, speaking only Guarani is strongly associated with use of unimproved sanitation 25 Population using improved sanitation (%) Population using unimproved sanitation in Paraguay (%) Agentina Uruguay Guaraní Guaraní y Castellano 1 Castellano Afrodescendent Indigenous Unimproved sanitation Source: EHP 214 Inequalities in sanitation and drinking water in Latin America and the 7

8 Regions drinking water For all countries it is possible to investigate coverage by region. In the map and chart below, differences in coverage are shown for regions of Brazil. Whilst piped water on premises was over 8% nationally according to the census in 21, coverage was much lower in several regions especially Rondonia where just over one in three used piped water on premises. Piped water on premises varies by region in Brazil, with lowest levels in Acre, Amapa, Rondonia and Para Roraima, 79 Amapa, Acre, 45 Amazonas, 62 Rondonia, 37 Piped water on premises coverage (%) Missing value The boundaries and designations used on these maps do not imply official endorsement or acceptance by the United Nations Para, 46 Mato Grosso, 74 Mato Grosso Do Sul, 83 Tocantins, 78 Maranhao, 64 Piaui, 71 Bahia, 79 Brazilia, 95 Goias, 79 Minas Gerais, 86 Sao Paulo, 95 Parana, 88 Rio Grande Do Sul, 85 Santa Catarina, 81 Ceara, 76 Espirito Santo, 83 Rio De Janeiro, 84 Rio Grande Do Norte, 85 Paraiba, 75 Pernambuco, 75 Alagoas, 67 Sergipe, 82 Population by drinking water source (%) Acre Rondonia Pará Amapa National Piped onto premises Other Improved Unimproved Surface water Substantial gaps exist in improved drinking water coverage between regions within many countries in LAC 1 Proportion of the population using improved drinking water sources (%) Argentina Barbados Belize Bolivia Brazil Chile Colombia Costa Rica Cuba Dominican Republic Guatemala Haiti Honduras Jamaica Nicaragua Paraguay Peru Suriname Uruguay Venezuela Source: 21 round of censuses and household surveys In the chart above each dot represents a region within the country. Regions with similar levels of coverage are shown side by side. We can see from the chart that the number of regions varies between countries making international comparisons challenging whereas there are 7 regions in there are 19 in Honduras and 32 in. Nevertheless, we find dramatic differences in coverage between the regions with the highest coverage and the lowest coverage in almost all countries in Latin America and the. 8 Inequalities in sanitation and drinking water in Latin America and the

9 Regions sanitation Similarly, coverage of improved sanitation varies considerably by region. In the map below, differences in coverage are shown for regions in Honduras from the recent national census (213). Improved sanitation ranges from 88% in Atlantida and Choluteca to only 3 % in Gracias A Dios, Honduras. Islas de Bahía, 83 Cortes, 74 Atlántida, 88 Colón, 63 Santa Barbara, 75 Yoro, 8 Gracias a Dios, 3 Copán, 75 Ocotepeque, 77 Intibucá, 58 Lempira, 59 Comayagua, 85 La Paz, 72 Valle, 62 Francisco Morazán, 77 Choluteca, 88 Paraíso, 72 Olancho, 7 Improved sanitation coverage (%) Missing value The boundaries and designations used on these maps do not imply official endorsement or acceptance by the United Nations In seven countries there is at least one region where less than half of the population uses an improved sanitation facility Proportion of the population using improved sanitation facilities (%) Argentina Barbados Belize Bolivia Chile Colombia Costa Rica Cuba Dominican Republic Guatemala Haiti Honduras Jamaica Nicaragua Paraguay Peru Suriname Uruguay Venezuela Source: 21 round of censuses and household surveys Use of improved sanitation also varies greatly between regions in most countries in Latin America and the. In the chart above we find that improved sanitation coverage is below 5% in at least one region in seven countries. In Haiti and Bolivia coverage of improved sanitation is below 5% in all regions of the country. Inequalities in sanitation and drinking water in Latin America and the 9

10 Literacy and education Literate and more educated households often have greater access to services and may also be more aware of the benefits of higher levels of water and sanitation services. They can be more empowered and have greater political voice to demand access to services as one of their basic rights. The charts below show differences in the practice of open defecation by literacy and the gap in coverage between the national level and households where the household head has no formal education. Illiteracy is associated with lower coverage of improved sanitation and piped water on premises in several countries in Latin America and the 1 1 Population using improved sanitation (%) Illiterate Literate Population using piped water on premises (%) Illiterate Literate Bolivia Dominican Republic Argentina Uruguay Costa Rica Dominican Republic Bolivia Brazil Argentina Costa Rica Where a household head has no formal education improved drinking water and sanitation coverage can be much lower than the national average Chile CASEN 213 Chile CASEN 213 Costa Rica MICS 2 3 Costa Rica MICS 2 Belize MICS 2 8 Belize MICS 2 1 Argentina MICS Argentina MICS Honduras DHS Honduras DHS Colombia DHS Colombia DHS 21 Nicaragua ENDESA 2 14 Nicaragua ENDESA 2 12 Dominican Republic DHS Dominican Republic DHS Peru DHS Peru DHS Suriname MICS Suriname MICS 21 MICS MICS Difference in improved sanitation coverage among educated household heads (% pt.) Difference in improved drinking water coverage among educated household heads (% pt.) 1 Inequalities in sanitation and drinking water in Latin America and the

11 Religion Religion of a household head may be a barrier to accessing services in some countries. It is also possible that particular religions are associated with where households live (rural vs urban), their education level and ethnicity. The MICS survey in Suriname illustrates how big differences can be. Sanitation coverage is much lower for households that practise a traditional religion. Practising a traditional religion is associated with lower sanitation coverage in Suriname 1 9 Proportion of the population by sanitation facility (%) Hinduism Islam Christianity Other religion No religion Traditional religion Open defecation Unimproved sanitation Shared sanitation Improved sanitation Source: MICS 213 Disability In households with a disabled person, water and sanitation coverage appears to be similar to the national average as shown in the table below. The surveys and censuses, however, do not collect information on specific challenges faced by disabled people and the definitions of disability vary considerably between countries. Country Indicator Disabled National Costa Rica (any disability) ( permanent disability) (physical or mental) (any disability in list) Improved water Improved sanitation Improved water Improved sanitation Improved water Improved sanitation Improved water Improved sanitation Definitions Improved drinking water. An improved drinking water source is one that, by the nature of its construction, adequately protects the source from outside contamination, particularly faecal matter. Improved sources include: Piped household water connection located inside the user s dwelling, plot or yard, public taps or standpipes, tube wells or boreholes, protected dug wells, protected springs, rainwater collection. Bottled water is considered improved when the household uses an improved source for cooking and personal hygiene. The definition of Improved drinking water does not capture accessibility, availability and quality of the service; the Sustainable Development Goal indicator safely managed drinking water will consider all of these elements. Improved sanitation. An improved sanitation facility is one that hygienically separates human excreta from human contact. Improved sanitation facilities include: Flush/pour flush to piped sewer system, septic tank or pit latrine, ventilated improved pit (VIP) latrine, pit latrine with slab or composting toilet. Only facilities that are not shared or not public are considered improved. The definition of Improved sanitation does not address the management of the sanitation chain which is a priority for the Sustainable Development Goal indicator safely managed sanitation. Data This snapshot is drawn from the WHO/ UNICEF Joint Monitoring Program for Water Supply and Sanitation (JMP) 2 Update and further analysis of household survey and census data (21-2) in Latin America and the. The JMP exclusively based the estimates for Latin America and the on nationally representative data from National Statistics Offices, such as household surveys and national censuses. For more data and information on the JMP and monitoring of water and sanitation and hygiene (WASH) during the Sustainable Development Goal period visit: Inequalities in sanitation and drinking water in Latin America and the

A woman from the indigenous Rama community carries buckets filled with water that she just fetched from an underground well, on the island of Rama Cay, in the eastern coastal Bluefields Lagoon, in

12 A woman from the indigenous Rama community carries buckets filled with water that she just fetched from an underground well, on the island of Rama Cay, in the eastern coastal Bluefields Lagoon, in South Atlantic Autonomous Region, Nicaragua. The well s water, which is not safe for drinking, is only used for household purposes such as washing clothes or cleaning. UNICEF/UNI131919/Dormino JMP website: 12 Inequalities in sanitation and drinking water in Latin America and the

Fieldwork Dates AmericasBarometer

Fieldwork Dates AmericasBarometer 2004-2014 This document contains information regarding fieldwork s for the AmericasBarometer project, 2004-2014. Some information may be incomplete and we will up the