drinking water, sanitation & hygiene in schools …...2018/11/03 · •

Drinking Water, Sanitation & Hygiene in SchoolsGlobal baseline report 2018

WHO/UNICEF Joint Monitoring Programmefor Water Supply, Sanitation and Hygiene

UNC Water & Health ConferenceChapel Hill, 31st October 2018

Tom Slaymaker [email protected] Johnston [email protected] Chatterley [email protected]

www.washdata.org

Session outline – WASH in Schools

1. JMP global baseline report on WASH in schools (30 mins) – JMP team

• Questions and comments (10 mins) - all

2. Case studies of ongoing efforts to accelerate progress strengthen monitoring (30 mins)

• Case study 1 (WaterAid, Therese Mahon)

• Case study 2 (UNICEF Nigeria, Martha Hokonya)

• Case study 3 (Save the Children, Marielle Snel)

3. Plenary discussion on how to accelerate progress on WASH in schools (20 mins) – Irene Amongin

Global goals and targets related to WASH in Schools

New JMP service ladders for WASH in schools

DRINKING WATER SANITATION HYGIENE

Basic service: Drinking water from an improved source and water is available at the school at the time of the survey

Basic service: Improved sanitation facilities at the school that are single-sex and usable (available, functional and private) at the time of the survey

Basic service: Handwashing facilities with water and soap available at the school at the time of the survey

Limited service: Drinking water from an improved source but water is unavailable at the school at the time of the survey

Limited service: Improved sanitation facilities at the school that are either not single-sex or not usable at the time of the survey

Limited service: Handwashing facilities with water but no soap available at the school at the time of the survey

No service: Drinking water from an unimproved source or no water source at the school

No service: Unimproved sanitation facilities or no sanitation facilities at the school

No service: No handwashing facilities available or no water available at the school

Basic drinking water in schools (2016)

• Estimates for 92 countries

• 69% of schools had a basic drinking water service

• Nearly 570 million children lacked a basic service at school

• Estimates for 5 out of 8 SDG regions

• <50% of schools in Oceania and had a basic service

• Nearly half of schools in sub-Saharan Africa had no service

Basic sanitation in schools (2016)


• 66% of schools had a basic sanitation service

• Over 620 million children lacked a basic service at school


• From 46% in Oceania to 100% in Australia & New Zealand

• A third of schools in SSA and ESEA had no service

Basic hygiene in schools (2016)


• 53% of schools had a basic hygiene service

• Nearly 900 million children lacked a basic service at school


• <50% in Oceania and sub-Saharan Africa had a basic service

• Half of schools in Least Developed Countries had no service

Coverage of basic drinking water in schools in 92 countries

Wide range between countries

Almost all regions have countries with <50%

SUB-SAHARAN AFRICA

OCEANIA

CENTRAL AND SOUTHERN ASIA

LATIN AMERICA AND THE

CARIBBEAN

NORTHERN AFRICA AND WESTERN

ASIA

EASTERN AND SOUTH-EASTERN

ASIA

EUROPE AND NORTHERN

AMERICA

AUSTRALIA AND NEW ZEALAND

Coverage of basic sanitation in schools in 101 countries

SUB-SAHARAN AFRICA

OCEANIA



CARIBBEAN

NORTHERN AFRICA AND WESTERN ASIA


ASIA

EUROPE AND

NORTHERN AMERICA


Wide range between countries

Almost all regions have countries with <50%

Coverage of basic hygiene in schools in 81 countries

SUB-SAHARAN AFRICA

OCEANIA



CARIBBEAN

NORTHERN AFRICA AND WESTERN

ASIA


ASIA

EUROPE AND

NORTHERN AMERICA


Many regions have countries with <25%

Many schools have facilities that do not meet the SDG criteria for a basic service

Improved vs basic drinking water Improved vs basic sanitation Any facility vs basic hygiene

Basic = improved & available

Basic = improved, usable & single-sex

Basic = facility with water & soap

Many schools have facilities that do not meet the SDG criteria for a basic service

Improved vs basic drinking water Improved vs basic sanitation Any facility vs basic hygiene

Almost all have improved source, but only 50% with water available

Basic = improved & available

Basic = improved, usable & single-sex

Basic = facility with water & soap

WASH as a key element of SDG target 4.a.1 “an effective learning environment”

Fewer countries have disaggregated data for rural, urban and pre-primary schools

Inequalities between primary and secondary schools

Total Primary Secondary

Drinking water 69 66 75

Sanitation 66 63 72

Hygiene 53 53 55

Proportion of schools with basic service

Inequalities between sub-national regions

Inequalities between public and private

No clear pattern

Progress towards universal access at home and in schools

Proportion of the population practising open defecation and proportion of schools with no sanitation facility, India, 2000–16 (%)

India has made rapid progress in increasing access to sanitation in schools

New JMP service ladders for WASH in schools

DRINKING WATER SANITATION HYGIENE

Advance service: Additional criteria may include quality, quantity, continuity, and accessibility to all users

Advanced service: Additional criteria may include student per toilet ratios, menstrual hygiene facilities, cleanliness, accessibility to all users, and excreta management systems

Advanced service: Additional criteria may include hygiene education, group handwashing, menstrual hygiene materials, and accessibility to all users

Basic service: Drinking water from an improved source and water is available at the school at the time of the survey

Basic service: Improved sanitation facilities at the school that are single-sex and usable (available, functional and private) at the time of the survey

Basic service: Handwashing facilities with water and soap available at the school at the time of the survey

Limited service: Drinking water from an improved source but water is unavailable at the school at the time of the survey

Limited service: Improved sanitation facilities at the school that are either not single-sex or not usable at the time of the survey

Limited service: Handwashing facilities with water but no soap available at the school at the time of the survey

No service: Drinking water from an unimproved source or no water source at the school

No service: Unimproved sanitation facilities or no sanitation facilities at the school

No service: No handwashing facilities available or no water available at the school

Enhanced monitoring and advanced service levelsAccessibility

In most countries <50% of schools have toilets accessible to students with limited mobility

Enhanced monitoring and advanced service levels

Availability

The ratio of students to toilets often exceeds national guidelines, for both girls and boys


Quality

In Lebanon, different levels of E. coli were detected in school supplies


Acceptability

Zambia has included MHM in the EMIS: <50% provide MHM educationData from 11 countries

New JMP country files for WASH in schools x 152

Drinking water Sanitation Hygiene

National Urban Rural Pre-primary Primary Secondary National Urban Rural Pre-primary Primary Secondary National Urban Rural Pre-primary Primary Secondary

2016 2016 2016 2016 2016 2016 2016 2016 2016 2016 2016 2016 2016 2016 2016 2016 2016 2016

Basic Service 47 - - 34 46 80 Basic Service 45 - - 43 44 69 Basic Service 10 6 8 11 10 14

Limited Service 5 - - 6 5 5 Limited Service 16 - - 19 16 12 Limited Service 43 44 42 42 43 41

No Service 48 - - 60 49 15 No Service 39 - - 38 39 19 No Service 47 50 50 48 47 45

Source: WHO/UNICEF JMP (2018)

Water, sanitation and hygiene ladders for schools

Sanitation HygienePapua New

Guinea

Drinking waterPapua New

Guinea

Papua New

Guinea

10 6 8 11 10 14

4344 42

42 4341

47 50 50 48 47 45

0

20

40

60

80

100

National Urban Rural Pre-primary Primary Secondary

Pro

port

ion o

f S

chools

(%

)

Basic Service Limited Service No Service

47

34

46

80

5

6

5

5

48

6049

15

0

20

40

60

80

100


Pro

port

ion o

f S

chools

(%

)


45 43 44

69

16 19 16

1239 38 39

19

0

20

40

60

80

100


Pro

port

ion o

f S

chools

(%

)


Available at washdata.org/monitoring/schools

New JMP country files for WASH in Schools x 152

25

Summary of data from national surveys and censuses [values in square brackets not used] Drinking water Sanitation Hygiene

National Urban Rural Pre-primary Primary Secondary National Urban Rural Pre-primary Primary Secondary National Urban Rural Pre-primary Primary Secondary

Source Type Year Facil

ity

Imp

roved

Basic

(Im

pro

ved &

availa

ble

)

Facil

ity

Imp

roved

Basic

(Im

pro

ved &

availa

ble

)

Facil

ity

Imp

roved

Basic

(Im

pro

ved &

availa

ble

)

Facil

ity

Imp

roved

Basic

(Im

pro

ved &

availa

ble

)

Facil

ity

Imp

roved

Basic

(Im

pro

ved &

availa

ble

)

Facil

ity

Imp

roved

Basic

(Im

pro

ved &

availa

ble

)

Facil

ity

Imp

roved

Basic

(Im

pro

ved,

usable

& s

ingle

-sex)

Facil

ity

Imp

roved

Basic

(Im

pro

ved,

usable

& s

ingle

-sex)

Facil

ity

Imp

roved

Basic

(Im

pro

ved,

usable

& s

ingle

-sex)

Facil

ity

Imp

roved

Basic

(Im

pro

ved,

usable

& s

ingle

-sex)

Facil

ity

Imp

roved

Basic

(Im

pro

ved,

usable

& s

ingle

-sex)

Facil

ity

Imp

roved

Basic

(Im

pro

ved,

usable

& s

ingle

-sex)

Han

dw

ash

ing

facil

ity

Han

dw

ash

ing

facil

ity w

ith

wate

r

Basic

(F

acili

ty w

ith w

ate

r and s

oap)

Han

dw

ash

ing

facil

ity

Han

dw

ash

ing

facil

ity w

ith

wate

r

Basic

(F

acili

ty w

ith w

ate

r and s

oap)

Han

dw

ash

ing

facil

ity

Han

dw

ash

ing

facil

ity w

ith

wate

r

Basic

(F

acili

ty w

ith w

ate

r and s

oap)

Han

dw

ash

ing

facil

ity

Han

dw

ash

ing

facil

ity w

ith

wate

r

Basic

(F

acili

ty w

ith w

ate

r and s

oap)

Han

dw

ash

ing

facil

ity

Han

dw

ash

ing

facil

ity w

ith

wate

r

Basic

(F

acili

ty w

ith w

ate

r and s

oap)

Han

dw

ash

ing

facil

ity

Han

dw

ash

ing

facil

ity w

ith

wate

r

Basic

(F

acili

ty w

ith w

ate

r and s

oap)

EMIS10 EMIS 2010 92 81 #N/A 96 96 #N/A 92 80 #N/A #N/A #N/A #N/A 92 79 #N/A 93 88 #N/A 93 63 58 95 79 72 92 61 57 #N/A #N/A #N/A 93 60 56 93 76 69 37 #N/A #N/A 45 #N/A #N/A 36 #N/A #N/A #N/A #N/A #N/A 39 #N/A #N/A 27 #N/A #N/A

UIS10 Other 2010 #N/A [79] #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A [78] #N/A #N/A [87] #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A


UIS11 Other 2011 #N/A [87] #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A [88] #N/A #N/A [84] #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A [84] #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A


UIS12 Other 2012 #N/A [89] #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A [90] #N/A #N/A [88] #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A


UIS13 Other 2013 #N/A [84] #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A [85] #N/A #N/A [82] #N/A [91] #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A [92] #N/A #N/A [83] #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A



UIS15 Other 2015 #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A [93] #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A [100] #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A


UIS16 Other 2016 #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A [37] #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A [37] #N/A #N/A #N/A #N/A #N/A

Available at washdata.org/monitoring/schools

New JMP country files for WASH in Schools x 152

26

Data sources for 2018 baseline report

A total of 616 national data sources were used

Priority Next Steps

• Harmonizing definitions and addressing data gaps

DRINKING WATER

SANITATION HYGIENE

Advanced Advanced Advanced

Basic Basic Basic

Limited Limited Limited

No service No service No service

Priority Next Steps


• Extending basic WASH services to all schools

DRINKING WATER

SANITATION HYGIENE


Basic Basic Basic



Priority Next Steps


• Extending basic WASH services to all schools

• Progressively improving WASH services in schools

DRINKING WATER

SANITATION HYGIENE


Basic Basic Basic



Thank [email protected]

Session outline – WASH in Schools

1. JMP global baseline report on WASH in schools (30 mins) – JMP team

• Questions and comments (10 mins) - all

2. Case studies of ongoing efforts to accelerate progress strengthen monitoring (30 mins)

• Case study 1 (WaterAid, Therese Mahon)

• Case study 2 (Save the Children, Marielle Snel)

• Case study 3 (UNICEF, Nigeria, Martha Hokonya)

3. Plenary discussion on how to accelerate progress on WASH in schools (20 mins) – Irene Amongin

Background

Strengthening WASH in schools monitoring: Experiences from WaterAid

Establishing SDG Baselines for WASH in Schools and Health Care Facilities, Water and Health 2018 UNC

WaterAid/ Behailu Shiferaw

WaterAid’s vision for school WASH is of a world where every child in every school has access to adequate, inclusive, sustainable and quality WASH services to ensure a healthy environment for learning, better educational attainment, an improved health status and dignity for the school population.

WaterAid’s

approach to

WASH in Schools

Protecting WaterAid’s

reputation and credibility

Ensuring safety and

managing risk

Experiences from South Asia

National WASH in Schools Procedure

• Supporting Centre for Education and Human Resource Development for updating WinS procedure

• Revising indicators in the procedure aligning with JMP ladders for WinS

• Preparing template/format for self evaluation/monitoring of indicators by schools

• Once it is updated, it will be published and oriented at federal and provincial governments. WAN is supporting for the publication and orientation in one Province.

• We have included the indicators in WAN Social Accountability tools.

Page heading

Nepal

Experiences from East Africa

Page heading

Rwanda -

Generation

Water

Outcome 1: Improved access to water and

sanitation services in schools.

Outcome 2: Enhanced hygiene behaviour

practices among school populations.

Outcome 3: Inclusive and gender sensitive

WASH embedded in schools.

Outcome 4: Improved integration and

coordination of school WASH interventions at

national level and in Bugesera and Nyamagabe

Districts.

School WASH

Management

Information

System (MIS)

developed and

installed in two districts

Page heading

WASH in

Schools

Baseline

Uganda

The study sought to

generate evidences on the

cause of service failures

and low sustainability of

school WASH services,

which in turn adversely

impact the quality of

education.

1. Assess blockages to service

sustainability of WASH in Kampala’s

public schools

2. Define cause-effect relationship of

WASH service failures

3. Recommend appropriate models for

sustainable delivery of WASH

services in schools

Objectives of the studyUganda

• WASH blockages analysis -

visual representation of

challenges & barriers to

sustainable access to school

WASH

Analysis categories:

a) Enabling environment

b) WASH infrastructure

c) Sustaining services.

Data analysis

Colour Code Description

No blockages

No need for further interventions. Existing interventions are sufficient to achieve

effective school WASH.

Some

blockages

There are some bottlenecks to school WASH, and stakeholders need to address or

remove these bottlenecks at effective school WASH.

Major

blockages

These are major blockages to effective school WASH, and KCCA should take the lead

to remove those blockages.

Traffic light Description

Findings (City level) – Enabling Environment Catego

ryPerformance Measure Traffic light Evaluation of Existing Situation

Policy

Is WinS included in KCCA’s development

plans or strategies? (Availability of WinS

strategy)

WinS strategy not in place, but covered in WASH

strategy (ends 2019)

Are there clear roles and responsibilities for

WinS at city-level? (Directorate-specific WinS

roles and responsibilities)

DESS gets technical support from DPHE depending

on intervention (solid waste, WASH, environment

mgt). No Focal Point for WinS.

Are there agreed minimum KCCA standards

for WinS?

Minimum standards for sanitation technologies in

draft, awaiting KCCA Council approval

Planni

ng

Are there clear KCCA WinS targets?

(Availability of WinS operational plan)

Investment targets (pupil:stance ratio) exist, but

achievement constrained due to inadequate

resources

Is there a dedicated WinS monitoring and

evaluation system?

Education Officers (DoESS) conduct inspections, but

WASH is not targeted in appraisal tool

Reflections •Assess gaps to determine approach: e.g. working from bottom up and top down

•Need to address standards, systems and processes

•Need for harmonisation across ministries

•Critical gaps in hygiene and equity

• Importance of social accountability tools and platforms to validate data with ground realities

WASH in Health Care FacilitiesGlobal monitoring indicators

and baselines

Rick Johnston [email protected] Tom Slaymaker [email protected]

www.washdata.org

WHO/UNICEF Joint Monitoring Programmefor Water Supply, Sanitation and Hygiene

UNC Water and Health, Chapel HillOctober 2018

WASH in HCF: Status (coverage)

• In 66,000 HCF from 54 countries (WHO/UNICEF, 2015)

– 38% of HCF lack water within 500 m

– 19% lack sanitation facilities

– 35% lack hand hygiene facilities

• In 130,000 HCF from 78 countries (Cronk, 2017)– 50% lack piped water

– 33% lack sanitation

– 39% lack hand hygiene facilities

– 39% lack infectious waste disposal

• Only 2% provide ALL WASH Services: water, sanitation, hygiene and waste

50

51

“Today, I am using the launch of the Water Action Decade to make a global call to action for water, sanitation and hygiene in all health care facilities.

We must work to prevent the spread of infections. Improved water, sanitation and hygiene in health facilities is critical to this effort.”António Guterres, UN Secretary General

“WASH in health care facilities is critical for

achieving Universal Health Coverage and ought

to be a priority in health systems strengthening."Dr Tedros Ghebreyesus, WHO Director General

WASH in HCF: 2018 Call to Action

Responding to the Call to ActionVision

Every health facility has the necessary WASH services and practices in order to provide essential, quality health services for everyone, everywhere.

TargetsAt least 50% of all health care facilities globally and in each SDG region have basic WASH services by 2022, and 80% by 2025, with the ultimate aim of 100% by 2030.

By 2020, all countries have completed and reported baseline WASH in HCF assessments, have set national targets that identify and act to reduce sub-national disparities and are developing or have developed and are implementing national standards.

52

Norms and Global monitoring

53

54

Monitoring Ladders

Plans for WASH in Health Care Facilities report 2019

55

May Jun Jul Aug Sep Oct Nov Dec Jan Feb

Data drive

Consultation Publish

Draft estimates

Finalize estimates

Data collected so far

• All are facility assessments

– SARA, SPA, SDI, PMA2020, …

– Emergency Obstetric and Neonatal Care (EmONC)

– National Statistical Office assessments

• 406 assessments

– 225 nationally representative

– 194 have report or data

– 152 of these since 2012

• 109 country files

– 62 with nationally-representative report or data since 2012

56

National datasets dominated by SSA

57

132

38

16

15

1210 2

Sub-Saharan Africa

Latin America and the Caribbean

Eastern South-Eastern Asia

Central Asia and Southern Asia

Europe and North America

Northern Africa and Western Asia

Oceania

N=225

Stratifiers

• National

• Urban, Rural

• Hospital, Non-hospital

• Government, Non-government

• (Service areas)

58

Water

• Some surveys only ask about piped water

• Rarely ask if water is actually available, or on premises

59

1. Basic drinking water

Water is available from an improved source located on premises.

Water estimates (national)

Basic: ~25

Improved and available ~30

Improved on premises ~40

Improved: ~60

Country file: 109

60

Peru, 2017PAHO Protocol

61

9283

75

10092

7572 73

54 58 56

45

Improved Available Improved & available

On premises Improved & on premises

Basic

Hospital Non-hospital

Water quality

62

Sanitation

• Many elements, many data gaps

63

2. Basic sanitation

Improved sanitation facilities are usable with at least one toilet dedicated for staff, at least one sex-separated toilet with menstrual hygiene facilities, and at least one toilet accessible for people with limited mobility.

Sanitation estimates (national)

Basic: ~15

MHM or limited mobility ~20

Improved and usable ~40

Improved: ~60

Country file: 109

64

Tanzania, 2014Service Delivery Indicators

65

Maldives, 2018WHO questionnaire

67

99

79

40

12

28

2

100

87

78

39

48

22

99

80

45

15

30

5

Improved Staff Limitedmobility

Women MHM Basic

Non-hospital Hospital Total

Sex-separated or gender-neutral

Recommended numbers of toilets are 1:20 for inpatients and at least two toilets for outpatient settings (one toilet dedicated for staff and one gender-neutral toilet for patients that has menstrual hygiene facilities and is accessible for people with limited mobility)

68

• Often collect information on soap or alcohol rub at points of care

• Rarely check for soap and water in toilets

69

3. Basic hand hygiene

Functional hand hygiene facilities (with water and soap and/or alcohol-based hand rub) are available at points of care, and within 5 meters of toilets.

Egypt, 2002Service Provision Assessment

70

51

35

34

23

16

15

12

61

1

11

Room for family planning exams

Room for ANC and PNC

Room for exams for RTIs or STIs

Exams for sick children

Room where normal deliveries are conducted

Room where injections are given to sick children

Room where immunizations are provided

Any point of care

All points of care

At toilets

Soap and water at points of care

Health Care Waste Management

• Fairly high data coverage

• Limited questions on segregation

– Sometimes only “presence of sharps container”

• Treatment responses are often ambiguous

– “Treated”, “Burned”, “Offsite”

71

4. Basic health care waste management

Waste is safely segregated into at least three bins and sharps and infectious waste are treated and disposed of safely.

Sierra Leone, 2012Service Availability & Readiness Assessment

72

97

71 68

56

4135

99

36 36

54

40

15

98

47 4655

41

22

Sharpscontainers

Wastereceptacles

Segregation Treatment -sharps

Treatment -infectious

Basic

Urban Rural Total

73

5. Basic environmental cleaning

Basic protocols for cleaning available, and staff with cleaning responsibilities have all received training.

Maldives, 2018WHO questionnaire

74

60

4238

18

1

17

83

33 33 33

0

33

61

4238

19

1

18

Protocols Sometrained

Nonetrained

All trained Nocleaning

staff

Basic

Rural Urban Total

75

Thank [email protected]

Regional estimates?

76

SDG Region Countries Status

Central Asia and Southern Asia 7 Possible regional estimate (India)

Eastern Asia and South-eastern Asia 5 Need China

Latin America and the Caribbean 7 Need Brazil, Mexico

Northern America and Europe 9 Unlikely

Oceania 2 Possible regional estimate (PNG)

Sub-Saharan Africa 28 Likely regional estimate

Western Asia and Northern Africa 4 Unlikely

TOTAL 62 Unlikely global estimate

drinking water, sanitation & hygiene in schools …...2018/11/03 · •

Documents