Health for Productivity


Human feces left in the open from unimproved pits and latrines at home, in school, or at the workplace or from open defecation or sewage flushed into shared waterways, often find their way into drinking water supplies and onto the hands of people before they eat, resulting in myriad diseases. For instance, inadequate sanitation is one of the main causes of diarrhea, which causes roughly 500,000 deaths among children under age five every year (UN IGME 2013) and accounts for the malnutrition and stunting of countless others.

Interventions that improve sanitation coverage and promote proper usage mitigate these impacts. The F-diagram shown in the fgure below depicts the pathways whereby fecal bacteria are transmitted to people and food, and how sanitation can prevent such transmissions. Recent studies show that sanitation interventions reduce the risk of diarrhea by more than 30 percent, often proving more effective than water-related interventions (Cairncross et al. 2010, Fewtrell et al. 2005, Waddington et al. 2009).

The F-diagram: Primary routes and solutions to fecal-oral diseases

(Sources: Wagner and Lanoix 1959, World Bank Group 2013)


Such human health impacts can have a devastating effect on a wide range of people, including the employees of major businesses, their suppliers, and the communities in which they operate. Interviews with companies and non-governmental organizations have indicated a belief that companies often have a clear business interest in their employees having reliable access to improved sanitation in the workplace, in their communities, and in their homes.

Ensuring access to improved sanitation at the workplace and sanitation interventions in employees’ communities result in workers spending less time staying at home sick or tending to sick children and spending more time in the workplace, where they can contribute to the business and earn money for their families. Improved sanitation gives every covered household an additional estimated 1,000 hours a year to work, study, care for children, and so on (UN-Water 2009). One study puts forth that one disability-adjusted life year, or DALY (that is, one year of productivity), is achieved for every US$270 invested in the construction and promotion of basic sanitation and for every US$11.15 invested in the promotion of sanitation (education campaigns, training, etc.) alone (Cairncross and Valdmanis 2006). Estimates suggest that achieving the MDG water and sanitation targets will lead to an overall increase of 3.2 billion productive days, while achieving only the water target would result in less than 1 billion productive days (see figure below) (Hutton and Haller 2004). Therefore, for companies, improved sanitation throughout their value chain can greatly reduce absenteeism and improve productivity.


Productivity gained due to less diarrheal disease by achieving water and sanitation targets

(Source: Hutton and Haller 2004)

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