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 Table of Contents  
Year : 2022  |  Volume : 2  |  Issue : 1  |  Page : 10

Water, sanitation and hygiene from One Health perspective

1 Department of Public Health Science; Center for One Health Education, Research, and Development, Indian Institute of Public Health Gandhinagar (IIPHG), 382042 Gandhinagar; School of Epidemiology & Public Health, Datta Meghe Institute of Medical Sciences, 442004 Wardha, India
2 Parul Institute of Public Health, Parul University, 391760 Waghodia, India
3 Parul Institute of Public Health, Parul University, 391760 Waghodia, India; One Health Graduate School, Center for Development Research, University of Bonn, 53117 Bonn, Germany

Date of Submission06-May-2022
Date of Decision06-Jun-2022
Date of Acceptance27-Jun-2022
Date of Web Publication23-Aug-2022

Correspondence Address:
Sandul Yasobnat
Department of Public Health Science; Center for One Health Education, Research, and Development, Indian Institute of Public Health Gandhinagar (IIPHG), 382042 Gandhinagar; School of Epidemiology & Public Health, Datta Meghe Institute of Medical Sciences, 442004 Wardha
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2773-0344.350691

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How to cite this article:
Yasobnat S, Tadvi R, Patel K, Saxena D. Water, sanitation and hygiene from One Health perspective. One Health Bull 2022;2:10

How to cite this URL:
Yasobnat S, Tadvi R, Patel K, Saxena D. Water, sanitation and hygiene from One Health perspective. One Health Bull [serial online] 2022 [cited 2023 Sep 28];2:10. Available from: http://www.johb.info/text.asp?2022/2/1/10/350691

  1. Introduction Top

Water, sanitation, and hygiene (WASH) are essential for basic health and wellbeing; however, there is inadequacy in its services and access[1]. Each component of WASH is interdependent and good hygiene cannot be achieved without access to safe water and sanitation[2]. Unsafe WASH is linked to various infectious diseases and is responsible for many non-communicable diseases[3]. It is indeed that safe water and hygienic conditions are necessary not only in health facilities but also in homes and communities for disease prevention and transmission[4].

According to global statistics 2020, around 1 in 4 people lack safe drinking water at home, nearly half the world’s population lacks safely managed sanitation, and 494 million people still practice open defecation[2]. In 2016, globally, 3.3% of death and 4.6% of disability-adjusted life years were due to inadequate WASH services. In low and middle-income countries, 60% of deaths are attributed to diarrhoea, of which 35%, 31% and 12% are due to inadequate drinking water, sanitation and hygiene, respectively. However, 9% of deaths due to diarrhoea are attributed to a lack of hygiene in high- income countries[5]. The sources like surface water, unprotected contaminated wells etc. are potential sources for those people without access to improved drinking water[2]. Open defecation without improved sanitation has remained a challenge across many parts of the globe[2]. In addition, building new toilets and creating access to them do not guarantee substantial open defecation reduction, as adopting the new practice requires behaviour change and the local community’s acceptance. Further, toilets are not sufficient to reduce disease transmission. Attention must also be paid to toilet (or septic tank) emptying, transport, treatment and reuse/disposal. Otherwise, pathogens end up right back in the environment.

  2. Negotiating “WASH for ALL” beyond the general human population Top

Evidence indicates that 60% of known infectious diseases and up to 75% of new or emerging diseases in the human species come from animals[6],[7]. Livestock is a very crucial element of the global food system as 1.3 million people around the globe rely on animal for food[8],[9]. However, the management of animal faeces, slaughterhouse cleanliness, and livestock farmers’ hand hygiene are not given enough attention. As WASH is interrelated with the food systems[10], sanitation management is crucial to prevent many diseases transmitted via the feco-oral route. Although human sanitation management is given enough attention, there has to be a keen focus on the safe management of animal faeces and hygiene across this interface to prevent many infectious diseases in the human population, such as diseases occurring at early life stages like diarrhoea and stunting[11]. Adequate attention should be paid to management of animal waste, improvement of sanitation and hygiene practices while contacting animals such as milking, feeding, birthing, and cleaning of the animal barn. Additionally, WASH- related zoonotic diseases transmission at human-animal and our shared environment should be addressed.

Literature has a dearth of information on how much hygiene is adequate to minimise the spread of disease[2]. A cross-sectional study was done by V. Khadayata and D. Aggarwal on 100 livestock keepers in India, which showed that 72% of all livestock keepers did not know that disease can transmit from animal to human, and about 48% showed a negative attitude toward hygiene[12]. A study by Swai et al. in Tanzania found that 92% of smallholder dairy keepers had significantly higher knowledge about zoonotic diseases than traditional livestock keepers[13]. However, even when people know good hygiene behaviour, they lack access to sanitation materials like soap, safe water, and washing facilities, which hinders their positive changes or protection[2].

  3. WASH from One Health perspective Top

The One Health High-Level Expert Panel (OHHLEP) defines “One Health as an integrated, unifying approach that aims to sustainably balance and optimise the health of people, animals and ecosystems. It recognises the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and interdependent. The approach mobilises multiple sectors, disciplines and communities at varying levels of society to work together to foster wellbeing and tackle threats to health and ecosystems, while addressing the collective need for clean water, energy and air, safe and nutritious food, taking action on climate change, and contributing to sustainable development”[8]. The One Health perspective also calls attention to ancient philosophy that places and the environment are closely linked with human and animal health[8]. The One Health approach would allow exploring risks and interdependent priorities for households while considering livestock production and social value for optimal health for humans and animals[14]. The same microbes infect animals and humans within their shared ecosystems; thus, the efforts by just one sector of One Health cannot prevent or eliminate the problem[15].

The problem with zoonoses is that a continuous reservoir of pathogens exists outside humans. Zoonotic pathogens are viral, bacterial, or parasitic and transmitted directly or through food, water or the environment[16]. Considering a hypothetical situation of all human infections were cured and transmission to people stopped, the presence of an animal reservoir would remain a continuous risk to people[17]. Managing the waste disposal of humans and animals is directly linked with environmental contamination. Open defecation and animal faeces contain certain chemicals and zoonotic pathogens that are noxious to humans and the environment. Even in high- income countries, for example, in Canada, mortality was reported due to drinking water contamination by livestock waste[18]. Further, livestock waste could act as a reservoir for many pathogens because pores can carry and transmit the pathogens to groundwater, surface water runoff, deterioration of the earth’s biological structure, and catastrophic spills[19].

  4. Why we should not neglect “Animal” within the WASH? Top

Sustainable Development Goal (SDG) 6 aims to ensure the availability and sustainable management of water and sanitation for all. Target 6.1 assesses universal and equitable access to safe and affordable drinking water for all, and target 6.2 assesses adequate and equitable sanitation and hygiene for all and ends open defecation, paying particular attention to the needs of women and girls and those in vulnerable situations[20]. WASH for all includes availability and accessibility of water, sanitation and hygiene facility, and services at schools, households, public places, and healthcare facilities. Currently, water access to animals is least explored and understood. Within WASH, sanitation is targeted towards the human aspect, neglecting animal waste management. Drinking water for all includes water suitability for men, women, girls and boys of all ages, including people living with disabilities, whereas the “all” missed the animals. Hygiene could be indicated to both conditions and practices that help maintain health and prevent the spread of diseases, whereas personal and environmental hygiene practice at human-animal interference is poorly understood. Considering the risk of spillover effect, WASH remained an important component that needs to be explored well, especially in the context of One Health.

Human hygiene practices and guidelines are currently limited to handwashing with water and soap before eating, after eating and using the toilet, contacting animals, and cooking and feeding the child[21]. However, WASH practices are also required at the interface of humans-animals to prevent and control zoonotic disease transmission and neglected tropical diseases. Beyond the scope of hand hygiene, foot hygiene and respiratory hygiene are equally important and need protection while interacting with animals (i.e., soil-based Helminth, Guinea-worm). Sanitation also needs to be addressed in the safe management and disposal of animal faeces, urine, and other waste products.

  5. Conclusion Top

The One Health perspective in WASH require urgent attention to conduct further research and WASH intervention in the human-animal interface to prevent and control zoonotic disease transmission. Further, there is a need to develop tools to assess the WASH status emphasising the missing component as part of the comprehensive risk assessment. The sanitation and hygiene program from the One Health perspective is highly recommended for higher human-animal density population areas.


The authors contributed to this article in their personal capacity. The views expressed are their own and do not necessarily represent the view of the institutions they are affiliated with.

Conflict of interest statement

The authors claim there is no conflict of interest.


The study received no extramural funding.

Authors’ contributions

Yasobant S, Patel K, Saxena D conceptualized this article. Tadvi R, Patel K reviewed the guidelines and ensured the data extraction. Yasobant S, Tadvi R analyzed the data. Tadvi R wrote the first draft. Yasobant S, Patel K, Saxena D reviewed and edited the content of the whole paper.

  References Top

Weber N, Rajasingham A, Patrick M, Martinsen A, Handzel T. Water, Sanitation, and Hygiene (WASH). In: Townes D.(Ed.) Health in humanitarian emergencies: Principles and practice for public health and healthcare practitioners. Cambridge: Cambridge University Press; 2018. pp. 136-160.  Back to cited text no. 1
WHO, UNICEF. Water, Sanitation and Hygiene 2019. [Online] Available from: https://www.unwater.org/water-facts/water-sanitation-and-hygiene/. [Accessed on 22 Mar 2022].  Back to cited text no. 2
WHO. Estimating WASH-related burden of disease 2022. [Online] Available from: https://www.who.int/activities/estimating-WASH-related- burden-of-disease. [Accessed on 11 Jun 2022].  Back to cited text no. 3
UNICEF. Hygiene: Better hygiene leads to beter health, confidence an overall growth. 2020. [Online] Available from: https://www.unicef.org/wash/ hygiene. [Accessed on 1 Apr 2022].  Back to cited text no. 4
WHO. (2019). Safe Water, Better Health. In World Health Organization. [Online] Available from: https://apps.who.int/iris/bitstream/handle/10665/329905/9789241516891-eng.pdf. [Accessed on 1 Apr 2022].  Back to cited text no. 5
Jones KE, Patel NG, Levy MA, Storeygard A, Balk D, Gittleman JL, et al. Global trends in emerging infectious diseases. Nature 2008; 451: 990–993.  Back to cited text no. 6
Centers for Disease Control and Prevention. One Health: Zoonotic Diseases. 2017. [Online] Available from: https://www.cdc.gov/onehealth/ basics/zoonotic-diseases.html. [Accessed on 28 Mar 2022].  Back to cited text no. 7
Prendergast AJ, Gharpure R, Mor S, Viney M, Dube K, Lello J, et al. Putting the “A” into WaSH: A call for integrated management of water, animals, sanitation, and hygiene. Lancet Planet Heal 2019; 3: e336–e337.  Back to cited text no. 8
Bircham JS, Crouchley G, Wright DF. Animal production. New Zealand J Agric Res 1977; 5: 349–355.  Back to cited text no. 9
European Commission. Water for Food Systems and Nutrition 2021. [Online] Available from: https://knowledge4policy.ec.europa.eu/publication/ water-food-systems-nutrition_en. [Accessed on 10 June 2022].  Back to cited text no. 10
Amebelu A, Ban R, Bhagwan J, brown J, Chilengi R, Chandler C, et al. The Lancet Commission on water, sanitation and hygiene, and health. Lancet (London, England). 2021; 398: 1469–1470.  Back to cited text no. 11
Khadayata V, Aggarwal D. Knowledge, attitude, and practice about hygiene among livestock keepers in peri-urban area of Vadodara District, Gujarat. Indian J Community Med 2020; 45 Suppl 1: S16–S20.  Back to cited text no. 12
Swai ES, Schoonman L, Daborn CJ. Knowledge and attitude towards zoonoses among animal health workers and livestock keepers in arusha and Tanga, Tanzania. Tanzan J Health Res 2010; 12(4): 272-277.  Back to cited text no. 13
Evans BR, Leighton FA. A history of One Health. OIE Rev Sci Tech 2014; 33: 413–420.  Back to cited text no. 14
Chen Y, He ZJ, Lu JH, Hao YT, Zhang DM. Reform and innovation of public health education in my country under the concept of One Health. [Online] Available from: https://www.who.int/news-room/questions- and-answers/ item/one-health. [Accessed on 15 Mar 2022]  Back to cited text no. 15
FAO-OIE-WHO. Taking a Multisectoral One Health Approach : A Tripartite Guide to Addressing Zoonotic Diseases in Countries 2019. [Online] Available from: http://www.fao.org/3/ca2942en/ca2942en.pdf. [Accessed on 24 March 2021]  Back to cited text no. 16
Lindahl JF, Grace D. The consequences of human actions on risks for infectious diseases: a review. Infect Ecol Epidemiol 2015; 5: 30048.  Back to cited text no. 17
Catelo MAO, Dorado MA, Agbisit E. Living with livestock: Dealing with pig waste in the Philippines 2001. [Online] Available from: http://www.eepsea. org/pub/pb/117198.pdf. [Accessed on 31 Mar 2022].  Back to cited text no. 18
Sakar S, Yetilmezsoy K, Kocak E. Anaerobic digestion technology in poultry and livestock waste treatment - A literature review. Waste Manag Res 2009; 27: 3–18.  Back to cited text no. 19
UNICEF. WASH in the 2030 Agenda, New global indicators for drinking water, sanitation, and hygiene 2017. [Online] Available from: http://www. unwater.org/gemi/en/. [Accessed on 31 Mar 2022]  Back to cited text no. 20
UNICEF. Water, Sanitation and Hygiene (WASH) 2020. [Online] Available from: https://www.unicef.org/wash. [Accessed on 11 Jun 2022].  Back to cited text no. 21


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