ABSTRACT
In most low- and middle-income countries, wealth is strongly correlated with access to water and sanitation services; the poorer a household, the less likely they are to enjoy safe and sustainable water and sanitation. This inequality is well documented and has influenced the formulation of the newly agreed Sustainable Development Goal 6 for Water and Sanitation, which calls for universal and equitable access to these services by 2030, and Sustainable Development Goal 10, which calls for the progressive elimination of inequalities across all the goals and targets, including water and sanitation. At the same time, wealth is strongly correlated with other factors such as undernutrition and poor access to healthcare that may exacerbate the effects of poor WASH by making children more susceptible to diarrhoeal disease, in the case of undernutrition, or more likely to die because of diarrhoeal disease, in the case of limited healthcare access. In this chapter, we describe how the interrelated risks of poor WASH, poor nutrition and poor healthcare access are co-distributed, discuss the policy implications of these overlapping inequalities, and how these multiple inequalities might be addressed in a coordinated fashion. The chapter is divided broadly into four sections: (1) a description of how lessons from Millennium Development Goals shaped the new Sustainable Development Goals (SDGs) for each factor; (2) an analysis of how these factors are co-distributed by wealth group for six low income countries; (3) a literature review concerning the potentially negative synergistic effects resulting from these interactions, or overlapping inequalities; (4) policy recommendations for the SDG era.
