Publication:
When Water Becomes a Hazard: A Diagnostic Report on The State of Water Supply, Sanitation, and Poverty in Pakistan and Its Impact on Child Stunting

Loading...
Thumbnail Image
Files in English
English PDF (9.28 MB)
1,011 downloads
English Text (635.13 KB)
122 downloads
Published
2018-11-06
ISSN
Date
2018-11-08
Author(s)
Editor(s)
Abstract
Despite a substantial decline in poverty, an increase in access to water and sanitation and a large decline in open defecation, diarrhea and stunting rates in Pakistan show few signs of a decline. This report provides evidence that the policy focus on eliminating open defecation rather than the safe management of fecal waste has been largely responsible for this. Water tests reveal shockingly high rates of E. coli contamination in both surface and ground water. To make matters worse, few households practice water treatment and untreated waste water is routinely mixed with surface and ground water for use in crop irrigation. This multiplies the channels through which the oral transmission of fecal bacteria can occur and creates strong downstream effects through food supplies headed to urban centers. Unsurprisingly, rates of diarrhea have remained stubbornly high even among the wealthiest households in metropolitan cities like Karachi. While the impact of of E. coli on diarrhea is well known, new research is showing the far more damaging impact of environmental enteropathy, a process by which fecal pathogens like E. coli can permanently damage the intestinal villi of young children making it difficult to absorb nutrients, even during periods when the child shows no signs of diarrhea. The report urges urgent action on safe sanitation and the treatment of water to combat this health crisis.
Link to Data Set
Citation
World Bank. 2018. When Water Becomes a Hazard: A Diagnostic Report on The State of Water Supply, Sanitation, and Poverty in Pakistan and Its Impact on Child Stunting. WASH Poverty Diagnostic Series;. © World Bank. http://hdl.handle.net/10986/30799 License: CC BY 3.0 IGO.
Digital Object Identifier
Associated URLs
Associated content
Report Series
Other publications in this report series
Journal
Journal Volume
Journal Issue

Related items

Showing items related by metadata.

  • Publication
    Water Supply and Sanitation in Liberia : Turning Finance into Services for 2015 and Beyond
    (Nairobi, 2011) World Bank
    The African Ministers' Council on Water (AMCOW) commissioned the production of a second round of Country Status Overviews (CSOs2) to better understands what underpins progress in water supply and sanitation and what its member governments can do to accelerate that progress across countries in Sub-Saharan Africa (SSA). AMCOW delegated this task to the World Bank's water and sanitation program and the African Development Bank who are implementing it in close partnership with United Nations Children's Fund (UNICEF) and World Health Organization (WHO) in over 30 countries across SSA. This CSO2 report has been produced in collaboration with the Government of Liberia and other stakeholders during 2009-10. The analysis aims to help countries assess their own service delivery pathways for turning finance into water supply and sanitation services in each of four subsectors: rural and urban water supply, and rural and urban sanitation, and hygiene. The CSO2 analysis has three main components: a review of past coverage; a costing model to assess the adequacy of future investments; and a scorecard which allows diagnosis of particular bottlenecks along the service delivery pathway. The CSO2's contribution is to answer not only whether past trends and future finance are sufficient to meet sector targets, but what specific issues need to be addressed to ensure finance is effectively turned into accelerated coverage in water supply and sanitation. In this spirit, specific priority actions have been identified through consultation. A synthesis report, available separately, presents best practice and shared learning to help realize these priority actions.
  • Publication
    Water Supply and Sanitation in Ghana : Turning Finance into Services for 2015 and Beyond
    (Nairobi, 2011) World Bank
    The African Ministers' Council on Water (AMCOW) commissioned the production of a second round of Country Status Overviews (CSOs) to better understands what underpins progress in water supply and sanitation (WSS) and what its member governments can do to accelerate that progress across countries in Sub-Saharan Africa (SSA). AMCOW delegated this task to the World Bank's Water and Sanitation Program and the African Development Bank who are implementing it in close partnership with United Nations Children's Fund (UNICEF) and World Health Organization (WHO) in over 30 countries across SSA. This second CSO report has been produced in collaboration with the Government of Ghana and other stakeholders during 2009-10. The analysis aims to help countries assess their own service delivery pathways for turning finance into water supply and sanitation services in each of four subsectors: rural and urban water supply, and rural and urban sanitation and hygiene. The second CSO analysis has three main components: a review of past coverage; a costing model to assess the adequacy of future investments; and a scorecard which allows diagnosis of particular bottlenecks along the service delivery pathway. The second CSO's contribution is to answer not only whether past trends and future finance are sufficient to meet sector targets, but what specific issues need to be addressed to ensure finance is effectively turned into accelerated coverage in water supply and sanitation. In this spirit, specific priority actions have been identified through consultation. A synthesis report, available separately, presents best practice and shared learning to help realize these priority actions.
  • Publication
    Guidance Note : Public Expenditure Review from the Perspective of the Water and Sanitation Sector
    (World Bank, Washington, DC, 2012-06) Manghee, Seema; van den Berg, Caroline
    The objective of this guidance note: public expenditure review from the perspective of the water supply and sanitation sector is to provide World Bank staff with a body of knowledge and good practice guidelines to help them evaluate the allocation of public resources to water and sanitation services in a consistent manner and to increase their knowledge of public expenditure issues in the sector. This guidance note discusses the challenges that are specific to public expenditure management in water and sanitation and the difficulties often involved in identifying sector expenditures. The challenges particular to this sector stem from three factors. First, countries define water and sanitation differently (e.g., drainage may or may not be included, rural services may be considered separately). Second, responsibilities for water and sanitation policy are often divided horizontally across government ministries and agencies, vertically between national and local governments and functionally among the public, private, and non-governmental sectors. Third, the roles of these multiple actors may be unclear or overlapping.
  • Publication
    Nicaragua : Poverty Assessment, Volume 1. Main Report
    (Washington, DC, 2008-05) World Bank
    Nicaragua is a small, open economy that is vulnerable to external and natural shocks. With an estimated Gross National Income (GNI) per capita of US$1000 in 2006, and a total population of 5.2 million, it is one of the poorest countries in Latin America. Forty six percent of the population lived below the poverty line in 2005 (while 15 percent lived in extreme poverty), and the incidence of poverty is more than twice as high in rural areas (68 percent) than in urban areas (29 percent). Nicaragua's social indicators also rank among the lowest in the region, commensurate with its relatively low per capita income level. Nicaragua's long-term development vision is set out in its National Development Plan (NDP), 2005-2009, which gives greater importance to economic growth than the strategy document that preceded it. This also serves as its second Poverty Reduction Strategy (PRS). The goals of the PRS incorporate the MDGs, and establish medium (2006-2010) to long term targets (2015). By 2005, the country had made satisfactory progress on meeting the PRS/MDG targets for reducing extreme poverty, increasing net primary enrollment, and reducing infant and child mortality. This National Development Plan is being revised by the new government that took office on January 2007, which has expressed interest in maintaining policy continuity in those areas that have shown progress and tackling pending development challenges. These include efforts to improve the country's growth performance while reducing poverty, macroeconomic stability as a necessary, although not sufficient, condition to stimulate growth, and reduce poverty, a special focus on social issues that impact the poorest, including the MDGs, and environmental sustainability. Programmatic priorities for the new administration include a renewed focus on poverty reduction using a multi-sector approach, implementing pragmatic solutions to the energy crisis for the short to medium term; expanding water and sanitation services with environmentally sustainable solutions; sharing economic growth more broadly to tackle hunger, malnutrition and poverty; placing greater emphasis on preventive health and continuing social protection programs; extending illiteracy programs and improving education services, and pursuing municipal decentralization, state modernization, and good governance.
  • Publication
    Global Expeiences on Expanding Water and Sanitation Services to the Urban Poor : Accompanying Volume
    (Washington, DC, 2009-08) World Bank
    In 2006-07, the Water and Sanitation Program (WSP) initiated research to identify barriers to service delivery for the urban poor. The findings of the research have been presented in the Guidance Notes on Improving Water Supply and Sanitation Services to the Urban Poor in India. The Urban Global Practice Team of WSP decided to expand the ambit of this research to a global context as the learnings were relevant to experiences across Africa, Latin America, and East Asia and the Pacific. The Guidance Notes are based on an in-depth research of various initiatives from across the world (including South Asian, African, Latin American, and East Asian and the Pacific countries) and consultations with urban poor communities. The present volume is a documentation of this research and supports the Guidance Notes on Services for the Urban Poor. Section 1 of this report consists of 19 case studies. Section 2 describes consultations with urban poor communities. The main aim of the consultations was to record the issues they confronted related to water supply and sanitation.

Users also downloaded

Showing related downloaded files

  • Publication
    The Government Analytics Handbook
    (Washington, DC: World Bank, 2023-09-28) Rogger, Daniel; Schuster, Christian
    The Government Analytics Handbook presents frontier evidence and practitioner insights on how to leverage data to strengthen public administration. Covering a range of microdata sources—such as administrative data and public servant surveys—as well as tools and resources for undertaking the analytics, it transforms the ability of governments to take a data-informed approach to diagnose and improve how public organizations work. The "Handbook" is a must-have for practitioners, policy makers, academics, and government agencies. It is available as a single volume in print or digital formats, and as chapters for modular use. Additional tools, data and background information are available at worldbank.org/governmentanalytics. “Governments have long been assessed using aggregate governance indicators, giving us little insight into their diversity and how they can practically be improved. This pioneering handbook shows how microdata can be used to give scholars and practitioners granular and real insights into how states work, and practical guidance on the process of state-building.” —Francis Fukuyama, Stanford University, author of State-Building: Governance and World Order in the 21st Century - "The Government Analytics Handbook is the most comprehensive work on practically building government administration I have ever seen, helping practitioners to change public administration for the better.” —Francisco Gaetani, Special Secretary for State Transformation, Government of Brazil - “The machinery of the state is central to a country’s prosperity. This handbook provides insights and methodological tools for creating a better shared understanding of the realities of a state, to support the redesign of institutions, and improve the quality of public administration.” —James Robinson, University of Chicago, coauthor of Why Nations Fail
  • Publication
    Digital Africa
    (Washington, DC: World Bank, 2023-03-13) Begazo, Tania; Dutz, Mark Andrew; Blimpo, Moussa
    All African countries need better and more jobs for their growing populations. "Digital Africa: Technological Transformation for Jobs" shows that broader use of productivity-enhancing, digital technologies by enterprises and households is imperative to generate such jobs, including for lower-skilled people. At the same time, it can support not only countries’ short-term objective of postpandemic economic recovery but also their vision of economic transformation with more inclusive growth. These outcomes are not automatic, however. Mobile internet availability has increased throughout the continent in recent years, but Africa’s uptake gap is the highest in the world. Areas with at least 3G mobile internet service now cover 84 percent of Africa’s population, but only 22 percent uses such services. And the average African business lags in the use of smartphones and computers as well as more sophisticated digital technologies that catalyze further productivity gains. Two issues explain the usage gap: affordability of these new technologies and willingness to use them. For the 40 percent of Africans below the extreme poverty line, mobile data plans alone would cost one-third of their incomes—in addition to the price of access devices, apps, and electricity. Data plans for small- and medium-size businesses are also more expensive than in other regions. Moreover, shortcomings in the quality of internet services—and in the supply of attractive, skills-appropriate apps that promote entrepreneurship and raise earnings—dampen people’s willingness to use them. For those countries already using these technologies, the development payoffs are significant. New empirical studies for this report add to the rapidly growing evidence that mobile internet availability directly raises enterprise productivity, increases jobs, and reduces poverty throughout Africa. To realize these and other benefits more widely, Africa’s countries must implement complementary and mutually reinforcing policies to strengthen both consumers’ ability to pay and willingness to use digital technologies. These interventions must prioritize productive use to generate large numbers of inclusive jobs in a region poised to benefit from a massive, youthful workforce—one projected to become the world’s largest by the end of this century.
  • Publication
    Digital Progress and Trends Report 2023
    (Washington, DC: World Bank, 2024-03-05) World Bank
    Digitalization is the transformational opportunity of our time. The digital sector has become a powerhouse of innovation, economic growth, and job creation. Value added in the IT services sector grew at 8 percent annually during 2000–22, nearly twice as fast as the global economy. Employment growth in IT services reached 7 percent annually, six times higher than total employment growth. The diffusion and adoption of digital technologies are just as critical as their invention. Digital uptake has accelerated since the COVID-19 pandemic, with 1.5 billion new internet users added from 2018 to 2022. The share of firms investing in digital solutions around the world has more than doubled from 2020 to 2022. Low-income countries, vulnerable populations, and small firms, however, have been falling behind, while transformative digital innovations such as artificial intelligence (AI) have been accelerating in higher-income countries. Although more than 90 percent of the population in high-income countries was online in 2022, only one in four people in low-income countries used the internet, and the speed of their connection was typically only a small fraction of that in wealthier countries. As businesses in technologically advanced countries integrate generative AI into their products and services, less than half of the businesses in many low- and middle-income countries have an internet connection. The growing digital divide is exacerbating the poverty and productivity gaps between richer and poorer economies. The Digital Progress and Trends Report series will track global digitalization progress and highlight policy trends, debates, and implications for low- and middle-income countries. The series adds to the global efforts to study the progress and trends of digitalization in two main ways: · By compiling, curating, and analyzing data from diverse sources to present a comprehensive picture of digitalization in low- and middle-income countries, including in-depth analyses on understudied topics. · By developing insights on policy opportunities, challenges, and debates and reflecting the perspectives of various stakeholders and the World Bank’s operational experiences. This report, the first in the series, aims to inform evidence-based policy making and motivate action among internal and external audiences and stakeholders. The report will bring global attention to high-performing countries that have valuable experience to share as well as to areas where efforts will need to be redoubled.
  • Publication
    Working Without Borders
    (Washington, DC: World Bank, 2023-07-24) Datta, Namita; Rong, Chen; Singh, Sunamika; Stinshoff, Clara; Iacob, Nadina; Nigatu, Natnael Simachew; Nxumalo, Mpumelelo; Klimaviciute, Luka
    Online gig work poses both opportunities and challenges for governments and workers. On the upside, it offers prospects for income generation, especially in developing countries, where most people work in low-productivity, low-quality, often informal jobs. The virtual and often temporary nature of gig work also provides flexibility for often neglected groups such as women, youth, migrants, and people with disabilities. These jobs could be a stepping-stone to bet¬ter-quality jobs for low-skilled workers by helping them learn critical digital skills and close the digital divide. But most gig jobs offer little to no protection for workers, with uncertain income streams and no clear career pathways. Depending on local labor regulations, many gig workers are not protected against unfair practices, abuse or injuries while working. Gig work also raises challenges for managing data security and privacy. The report examines how countries can navigate the promise and perils of online gig work. It reveals that the online gig workforce is much larger than previously assumed with an estimated 154 million to 435 million Online gig workers around the globe. For the first time ever, the report mapped and tracked regional platforms and gig workers who work in languages other than English. Key messages are: • Online gig work is expanding, accounting for up to 12% of the global labor force and is a growing source of income for millions. • Demand for online gig workers is rising faster in developing countries than in industrialized countries. • Local gig platforms play a vital role in the local labor market, but they face challenges in establishing a viable business model, and opportunities for long-term growth. • Online gig work can support inclusion by providing work opportunities for youth, women, and low-skilled workers. • Gig workers, like most other informal sector workers in developing countries, are often outside the purview of labor regulations. • The gig economy can offer opportunities locally to build digital skills, increase income-earning opportunities, and facilitate social protection coverage of informal workers.
  • Publication
    Reboot Development: The Economics of a Livable Planet
    (Washington, DC: World Bank, 2025-09-01) Damania, Richard; Ebadi, Ebad; Mayr, Kentaro; Russ, Jason; Zaveri, Esha
    “Reboot Development: The Economics of a Livable Planet” explores how the foundational natural endowments of land, air, and water—long taken for granted—are under growing threat, putting at risk the very progress they helped create. For generations, natural resources have powered development, supporting health, food, energy, and economic opportunity. Today, strains on these resources are intensifying. This report argues that failing to maintain a livable planet is not merely a distant environmental concern, but a present economic threat. Drawing on new data, the report shows that over 90 percent of the world is exposed to poor air quality, degraded land, or water stress. Loss of forests cuts rainfall, dries soils, and worsens droughts, costing billions of dollars. The nitrogen paradox emerges—fertilizers boost yields but overuse in some regions harms crops and ecosystems. Meanwhile, air and water pollution silently damage health, productivity, and cognition, sapping human potential. The report warns that these hidden costs are too large to ignore. Yet the message is not one of constraint but of possibility. Nature, when wisely stewarded, can drive growth, create jobs, and build resilience. The report shows that more efficient resource use—like better nitrogen management and forest restoration—yields benefits that far exceed the costs. It also urges a shift to cleaner sectors and producing “better things,” noting that these provide new sources of growth, creating more jobs per dollar invested. The findings are clear: Investing in nature is not only good for the planet, it is smart development.