illustration for the drivers of inequality

Driver Category 1.2

Unequal access to clean water, adequate sanitation and good nutrition

This main driver category captures unequal access to clean water, sanitation and good nutrition which are so critical to health status and avoidance of premature death.

Guiding Questions

General questions

  • What are the most urgent challenges with regard to the provision of universal clean water and sanitation?
  • Which locations have particular infrastructure gaps?
  • Is there a comprehensive national nutrition policy and/or a malnutrition prevention programme?
  • Is there sufficient cross-sectoral coordination to implement policies effectively?
  • Are broader aspects such as a food security strategy and nutrition-sensitive agriculture and water and sanitation policies considered in an integrated fashion?
  • What is the nature of the problem of obesity in your country?
  • Is the incidence of obesity, including in children of different age groups, growing?
  • In which geographical locations and which profile of households is the problem most notable?
  • What steps is the government taking to prevent obesity?

Public budgets

  • What are the different levels and adequacy of investment in water and sanitation infrastructure in different regions in the country?
  • Is there pronounced inequality between locations and is there evidence that the pattern of investment takes into account inequalities between locations?
  • What is the level of public investment in nutrition?
  • Is budget information available on the different programmes and interventions?
  • What proportion of the most relevant programmes is the government financing and how much is reliant on donors?

Regulation

  • What legislation is in place related to the food industry’s manufacturing standards with the aim of tackling obesity?
  • Are there regulations to stop companies manufacturing ultra-processed foods?
  • What standards exist limiting the salt, saturated fats, artificial trans-fats and sugar in processed foods and soft drinks?
  • How is the privatised market regulated?
  • Is the regulatory body appropriately staffed and trained, and sufficiently funded?
  • How is the regulatory framework structured to ensure water and sanitation services are made more accessible to the poor?
  • What are the incentives or obligations for dominant operators to extend services to areas without coverage?

Indicators

Potential indicators to monitor the drivers of inequalities in this main driver category

  • % of national budget / % of GDP spent on water and sanitation
  • Amount of water and sanitation investment per region (public and private)
  • Amount invested in rural water and sanitation services (public and private)
  • Number of staff employed by utilities’ regulator and annual budget
  • Amount of time taken to get to a clean water source
  • Cost of subsidies provided to enable access of poor households to water and sanitation
  • % of health budget spent on nutrition and amount of budget spent on different nutrition interventions
  • Nutritional content of typical (widely available, unhealthy, cheap) food
  • Ratio of community health workers to population (national and per region)

Candidate Policies

To see related Candidate Policies in this main driver category please click here.