Poor sanitation is costing Nigeria N455 billion annually (equivalent to $2.7 billion), according to a report by World Bank’s Water and Sanitation Program (WASP). While this loss represents 1.3 percent of the country’s Gross Domestic Product (GDP) ($20 per person in Nigeria annually), open defecation is costing Nigeria $1 billion annually as the nation would require less that 6.5 million latrines to be built and used as a measure towards eliminating the practice of open defecation.
The WASP report titled “Economic impacts of poor sanitation in Africa-Nigeria” revealed that approximately 121,800 Nigerians, including 87,100 children under 5, die annually from diarrhoea –nearly 90 percent of which is directly attributed to poor water, sanitation and hygiene (WASH).
With costs associated with health seeking behaviour such as consultation, medication, transport and in some cases hospitalization placing a huge burden on households and government spending, poor sanitation remains a contributing factor to other leading causes of child mortality including malaria and measles, diarrhoeal diseases, and indirectly as well as its consequences for other diseases such as respiratory infections and malaria which are leading causes of morbidity.
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According to the report “The costs of poor sanitation are inequitably distributed with the highest economic burden falling disproportionately on the poorest. The average cost associated with poor sanitation, constitutes a much greater proportion of a poor person’s income than that of a wealthier person. Sanitation or lack thereof is a public health issue – people are affected by their neighbours and communities sanitation status as well as their own, and the costs of open defecation are felt throughout the community.
“70 million Nigerians use unsanitary or shared latrines and 32 million have no latrine at all and defecate in the open. The poorest quintile is 10 times more likely to practice open defection than the richest. Open defecation also has considerable social costs. Faecal contamination of the environment is the root cause of an annual average of 5,400 cases of cholera affecting Nigeria. The cost of the necessary WASH response is estimated to be $3.5 million annually.”
Bisi Agberemi, UNICEF WASH specialist stated that why it is sad to note that Nigeria was still among the top 10 countries practising open defecation, there is the need by the Federal Government to hasten efforts to eliminate open defecation in the country as it remains a leading cause of preventable child deaths.
With calls for the review of obsolete public health laws and implementation of policies to meet the year 2025 target of eliminating open defecation nationwide, Agberemi called for increased funding of sanitation issues.
A peep into the 2013 National Demographic Health Survey reveal that only 28.7 million Nigerians had access to basic sanitation facilities. This, stakeholders believe needed to be scaled-up through continued sustainability of practices, such as hand washing, to achieve an open defecation-free Nigeria.
Presently, Nigeria is lagging far behind the 2015 targets for Millennium Development Goals (MDG 7) which seeks to address access to safe drinking water and improved sanitation, Nigeria 2013 MDG report reveal. The report showed that access to an improved drinking water source is about 19.6 percent below the 2015 target of 77 percent, while access to improved toilets/latrines is 36.3 percent as against the 2015 target of 70 percent.
The United Nations Education Fund (UNICEF) had demonstrated that it is possible to improve the sanitation situation in Nigeria, especially in rural areas, by engaging the communities through a Community Led Total Sanitation (CLTS) approach.
CLTS is a new approach to sanitation promotion that encourages community self-analysis of existing defecation patterns and threats, and promotes local solutions to reduce and ultimately eliminate the practice of open defecation. The ultimate goal of CLTS is communities that achieve and maintain open defecation-free status and improved hygiene practices.
Currently, UNICEF had implemented CLTS in 30 states, in partnership with relevant government ministries and stakeholders. This initiative has resulted in over 4,000 open defecation-free claimed communities, with over 2.5 million inhabitants now using toilets.
While economic implications of cholera outbreak go beyond immediate health system response to costs related to productivity loss and premature death, diverting expenditures from other essential items and losses in trade and tourism revenue, stakeholders believe that increased investments in sanitation and hygiene promotion are required not only to realise health and welfare benefits of sanitation but alsoto avert large economic losses.
It will be recalled that in April 2014, Nigeria joined 44 other developing countries at the Sanitation and Water for All High Level Meeting and committed itself, once again, to achieving universal access to water and sanitation, and eliminating open defecation nationwide by 2025.
Alexander Chiejina
