A SNAPSHOT 2012 UPDATE

SANITATION AND HYGIENE

IN EAST ASIA AND THE PACIFIC

Overview
The East Asia and Pacific Region has made gains over the last 20 years:
The proportion of people using improved sanitation increased by 35 percentage points between 1990 and 2010 (more than double the rate of the world as a whole) East Asia and the Pacific is the only UNICEF region* already to have met the MDG sanitation target Regional and World Sanitation Coverage Trends The proportion of people who practice open defecation has 5 dropped to just 5 percent in Open 13 15 Defecation the region 12 25 823 million more people use Unimproved improved sanitation than Facilities 11 20 years ago, the majority of Shared 16 them in China 20 Facilities
48
11
Coverage (%)
Coverage (%)

However, significant challenges remain:

Six countries in the region are 7 Improved not on track to meet the MDG Facilities 67 sanitation target 63 671 million people are still 49 without access to improved 32 sanitation in the region, more than in sub-Saharan Africa Progress in the Pacific subregion has stalled: the 2010 1990 2010 1990 proportion of people using East Asia World Total improved sanitation has not and the Pacific Open defecation Open defecation changed in 20 years (51%) Unimproved Unimproved Coverage disparities are pronounced, with national improved sanitation rates ranging from Shared Shared less than one-third of the population (Cambodia) to more than 95 per cent in 7 countries Improved Coverage is also highly inequitable within countries: richerImproved households and urban dwellers are much more likely to use improved sanitation than poorer and rural households New data indicates that handwashing-with-soap rates are lower in rural areas and much lower in poor households in some countries Institutional monitoring data indicates that many primary schools still lack adequate sanitation facilities for school children
Information about this Snapshot This snapshot is produced by the UNICEF Regional Office for East Asia and the Pacific Unless otherwise indicated, data in this snapshot is from the WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation 2010 dataset, the latest available (see page 8 for full citations and credits) The UNICEF East Asia and Pacific Region encompasses 27 countries; 12 in East Asia and 15 in the Pacific (*UNICEF regions differ slightly from JMP and MDG regions: see last page for listing)

A Snapshot of Sanitation and Hygiene in East Asia and the Pacific 2012 Update

Progress and Challenges

Of the 823 million new sanitation users, most live in China Seven countries in the region are not on track to meet the MDG sanitation target
Sanitation Gap in Off-Track* Countries
Indonesia, 71

Papua New Guinea

23

Mongolia
Viet Nam, 42 China, 593 Philippines, 34 Rest of region, 83
Millions of people gaining access, 1990 to 2010

16
15 14 11 5

Nauru Cambodia Timor-Leste Indonesia

Samoa

Number of people who gained access to improved sanitation from 1990 to 2010, millions

Gap between the required coverage in 2010 if country were on-track and actual 2010 coverage (%). * Includes countries in the progress but insufficient JMP category.

Sanitation coverage varies significantly from country to country

100

96

96 85

93 83 75 65 57

96

98

100 100 100

80

80

Region
Coverage (%)
60

74
63 54 64

76

76

67 63

51 47
40

45

31
20

East Asia
0

Pacific

Improved sanitation coverage in East Asia and Pacific countries, 2010, national, per cent, with Region and World comparators (no data available for Kiribati, Micronesia and the Solomon Islands)

A Snapshot of Sanitation and Hygiene in East Asia and the Pacific 2012 Update

Sanitation Inequities
Urban-rural coverage gaps are shrinking in East Asia and the Pacific
6 2 1 20
16 8
Open Defecation

Despite progress there continues to be substantial disparity in some countries

The rural-urban sanitation gap in the East Asia and Pacific Region has shrunk from 36 percentage points in 1990 (57% urban, 21% rural) to 19 points in 2010 (77% urban, 58% rural), far smaller than the global gap of 32 points China, Philippines, Thailand, Palau and Fiji have made the best progress reducing the urban-rural sanitation gap; while limited or no progress has been made in Cambodia, Indonesia and several Pacific countries In 2010 the degree of disparity varies greatly from country to country (see graph below)

24

21

Unimproved

13
13
Coverage (%)

Shared

59

77 57
4 58

Improved Facilities

21

1990

2010 1990

2010

Urban
Open defecation

Rural
Open defecation

The degree of urban-rural disparity varies significantly Shared Shared

Improved
Improved
89 86 80 73 74 71 64 56 54 50 39 31 20 Urban % 29 National % Rural % 73 63 64 51 47 37 96 96 95 83 76 73 79 74 69 73 76 76 66 57 96 96

Unimproved

Unimproved

94

68

Use of improved sanitation facilities: urban-rural range in East Asia and the Pacific Countries, 2010 (in Thailand, urban coverage at 95% is slightly lower than rural coverage at 96%)

A Snapshot of Sanitation and Hygiene in East Asia and the Pacific 2012 Update

100 Economic inequities are pronounced in 80 East Asia and the Pacific

100 98 80

60 The poorest households have much lower access to improved sanitation facilities than richer households in 40 many countries in the region (such as in Lao PDR where 20 coverage is only 7% in the poorest quintile but 98% in the richest) 0 Open defecation levels are generally much higher for Poorest 2nd 3rd 4th Richest poorer households, such as in Indonesia and Lao PDR
Improved
100 98 80 85 100

60
40 36 20 21

65

7 Poorest 2nd 3rd 4th Richest

Unimproved

Open Defecation
100 95 80 100 100

Lao PDR MICS 2006

96

80 76
60 56 57 40 31 45

60
40 20

66

60
40 20 0

64

42

20
0

0
Poorest 2nd 3rd 4th Richest

11 Poorest 2nd 3rd 4th Richest

Poorest 2nd

3rd

4th

Richest

Viet Nam MICS 2011

Indonesia DHS 2007

Mongolia MICS 2010

Use of improved sanitation facilities, unimproved facilities, and open defecation by wealth quintiles, with improved figures highlighted (%). Data sources as shown. The shared facilities category is not included for multi-study comparison. In the Mongolia chart, unimproved includes both open defecation and other unimproved. Wealth quintiles are based on the asset indices used by the household surveys, divided into five categories.

Regional and country averages mask large disparities within countries

This equity tree example from the Philippines shows that the poorest households in rural areas have much lower coverage levels than many national, regional and global averages
98 Samoa 96 Malaysia 93 Tokelu 85 CEE/CIS 79 Urban 74 Philippines 69 Rural 67 East Asia & the Pacific 64 China 63 World 57 Vanuatu 51 Mongolia 47 Timor-Leste 45 Papua New Guinea 38 South Asia 30 Sub S Africa 31 Cambodia 39 Poorest 20% Rural 75 Poorest 20% Urban 100 Richest 20% Urban 100 Richest 20% Rural

Use of Improved sanitation in the Philippines, per cent. Sources: JMP 2012 and Philippines DHS, 2008; CEE/CIS is Central, Eastern Europe and the Commonwealth of Independent States

A Snapshot of Sanitation and Hygiene in East Asia and the Pacific 2012 Update

Focus on the Pacific Sub-Region

Progress has stalled in the Pacific Sub-Region* overall
In 1990 the Pacific sub-region had much higher national sanitation coverage levels than the East Asia sub-region and many other parts of the world By 2010 the Pacific had been passed by East Asia and by other regions of the world for national and rural coverage All regions have made much better progress than the Pacific sub-region
Urban Improved Rural Improved National Improved

The East Asia subregion has passed the Pacific sub-region

East Asia
1990 2000 2010
54 65 76 20 39 57 29 48 66

Pacific
1990
82 81 81 44 43 45 51 50 51

Use of improved sanitation facilities, per cent

2000 2010

Gains have been made in all UNICEF regions, but not in the Pacific
Percentage point gain in national improved sanitation facility use, 1990 to 2010. Pacific and East Asia subregions compared to UNICEF regions.

East Asia sub-region

South Asia Middle East & North Africa Americas and Caribbean 12 12 16

37

Sub-Saharan Africa
CEE/CIS Pacific sub-region 0 0

5
4

10

20 30 % point change 1990-2010

40

However, some Pacific countries have made good progress

Six Pacific countries have achieved over 90 per cent sanitation coverage by 2010 (Tokelau, Tonga, Samoa, Cook Islands, Niue and Palau) Nine Pacific countries are either on track to meet the MDG sanitation target, or have already achieved it The urban-rural sanitation coverage gap was significantly reduced in Fiji (from a gap of 50 percentage points in 1990 to just 23 points in 2010) and Palau (from a 42 point gap in 1990 to parity in 2010)
* In this snapshot, Papua New Guinea is in the Pacific sub-region in conformance with MDG classification practices (the MDG Oceania region). This means that coverage levels and progress rates in that country heavily influence sub-regional averages due to its large population relative to Pacific Island Nations.

A Snapshot of Sanitation and Hygiene in East Asia and the Pacific 2012 Update

Handwashing with Soap and Water

New standardized hygiene indicators
A standardized set of proxy indicators for handwashing with soap is now included in some DHS and MICS surveys Surveyors use observation to establish whether or not households have a specific place for handwashing and whether or not water and soap is available at that place This methodology is more robust than past hygiene surveys that relied mainly on selfreported behaviour As more surveys are carried out, regional and global datasets on handwashing will become available: currently two national surveys in East Asia have incorporated the indicators

Results from Cambodia and Mongolia

In both countries urban dwellers are about twice as likely as rural dwellers to have handwashing facilities with soap and water available In Mongolia there is a pronounced difference across household wealth quintiles, especially between the poorest households (with only 10 per cent having a handwashing place with water, soap and other cleansing agents) and other households In Cambodia there is a major difference between the richest households and all the other households

Percent Households

Cambodia, DHS 2010 Handwashing with water, soap or other cleansing agents
Proportion of households where a place for handwashing was observed with water and soap or other cleansing agent (e.g., ash) present, by household wealth quintile and urban/rural

100 80

100

85

80 60

83

60

55
40

41
20
0 Poorest 2nd

46

40
20 0

44

30

3rd
Water and soap

4th

Richest

Urban

Rural

Percent Households

Mongolia, Summary MICS 2010 Handwashing with water, soap or other cleansing agents
Proportion of households where a place for handwashing was observed with water and soap or other cleansing agent present, by household wealth quintile and urban/rural

100

100

96
80 60

86

80

70 48

77
60

40 20
0

40

37
20

10
Poorest 2nd 3rd
Water and soap

4th

Richest

Urban

Rural

A Snapshot of Sanitation and Hygiene in East Asia and the Pacific 2012 Update

Sanitation in Schools
A large proportion of schools do not have adequate sanitation in many countries in the region (estimated figures)
100 100 80 78 60 63 65 65 45 35 25 30 23 62 100 100

40 20
0

Estimated proportion of primary schools with adequate sanitation facilities, nationally. Data* gathered by UNICEF Country Offices from institutional sources in 13 countries.

Poor Sanitation in schools is a cause for concern

Available data* shows that sanitation coverage is low in primary schools in the region In some countries fewer than half of schools have adequate facilities Evidence shows that functioning sanitation facilities are necessary for education achievement, health and gender equality

Sanitation coverage in schools may be lower than at home

100
100

80

Population using sanitation at home, %

Schools with adequate sanitation, %

80 72

60

63

60

40

40

*Data on water and sanitation in schools presented here is from a variety of government institutional reporting systems (compiled by UNICEF country offices), and generally not from surveys. School coverage data is based on national standards, which vary from country to country. Criteria defining the adequacy of facilities in schools can include the ratio of boys and of girls to toilets available, whether or not girls and boys toilets are separate and private, the existence of toilets for teachers, the type of toilet/latrine, and others.

20

20

0
Sanitation in Schools

0 Sanitation in Households

Adequate facilities in primary schools, non-weighted average of 13 countries (1st graph); national coverage average in the same countries (2nd graph). (These datasets are not directly comparable: one is from household surveys the other from institutional sources.)

A Snapshot of Sanitation and Hygiene in East Asia and the Pacific 2012 Update

Sanitation Coverage in East Asia and the Pacific

Mongolia

DPR Korea

China

Micronesia Myanmar Lao PDR Viet Nam Thailand Cambodia Malaysia Philippines Nauru

Marshall Islands

Kiribati

Palau
Tuvalu Tokelau Solomon Islands TimorLeste Papua New Guinea Vanuatu

Indonesia Less than 50% 50% to 75% 76% to 90% 91% to 100% Insufficient data

Samoa
Cook Islands Fiji Tonga Niue

Improved sanitation coverage in East Asia and Pacific countries, 2010, national. Only countries in the UNICEF East Asia and Pacific region are shown. This map does not reflect a position by UNICEF on the legal status of any country or territory or the delimitation of any frontiers.

Data Sources and Notes

Main sanitation dataset: from Progress on Drinking Water and Sanitation: 2012 Update (with supplemental data from wssinfo.org), from WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation (JMP) Country-specific DHS data: from published Demographic and Household Surveys available at measuredhs.com, from USAID and national statistics bureaus Country-specific MICS data: from published Multiple Indicator Cluster Surveys available at childinfo.org, from UNICEF, other UN agencies and national statistics bureaus Cover photo credits, clockwise from top right: UNICEF CBDA2008-00026/Noorani, NYHQ2009-2063/Estey, NYHQ2004-1269/Pirozzi, NYHQ2008-1274/Estey, MGLA2007-00886/Holmes. UNICEF does not warrant that the information contained in this publication is complete and correct and shall not be liable for any damages incurred as a result of its use.

Acknowledgements
UNICEF thanks Greg Keast, who developed and produced this snapshot under the guidance of Chander Badloe, UNICEF East Asia and the Pacific Regional Office. Special appreciation also to the following reviewers for their valuable inputs: Almud Weitz from the Water and Sanitation Program; James Wicken from WaterAid; Hilda Winartasaputra from Plan International; and Ramesh Bhusal, Therese Dooley, Nguyen Thanh Hien, Libbet HornPhathanothai, Dara Johnston, Janine Kandel, Rolf Luyendijk, Nadarajah Moorthy, Henk van Norden, Marjolein Oijevaar, Michael Emerson P. Gnilo and David Parker from UNICEF.

A Snapshot of Sanitation and Hygiene in East Asia and the Pacific 2012 Update

Sanitation Coverage by Country

Country estimates by type of sanitation practice, 1990, 2010
Country Year
Total Population (x 1,000)

Urban
Improved Shared Other Unimproved Open Defecation Improved Shared

Rural
Other Unimproved Open Defecation Improved

National
Shared Other Unimproved Open Defecation

1990 2010 1990 China 2010 1990 Cook Islands 2010 1990 DPR Korea 2010 1990 Fiji 2010 1990 Indonesia 2010 1990 Kiribati 2010 1990 Lao PDR 2010 1990 Malaysia 2010 Marshall 1990 Islands 2010 1990 Micronesia 2010 1990 Mongolia 2010 1990 Myanmar 2010 1990 Nauru 2010 1990 Niue 2010 1990 Palau 2010 Papua New 1990 Guinea 2010 1990 Philippines 2010 1990 Samoa 2010 Solomon 1990 Islands 2010 1990 Thailand 2010 1990 Timor-Leste 2010 1990 Tokelau 2010 1990 Tonga 2010 1990 Tuvalu 2010 1990 Vanuatu 2010 1990 Viet Nam 2010 1990 Region 2010 Cambodia

9,532 14,138 1,145,195 1,341,335 18 20 20,143 24,346 728 861 184,346 239,871 72 100 4,192 6,201 18,209 28,401 47 54 96 111 2,193 2,756 39,268 47,963 9 10 2 1 15 20 4,158 6,858 61,629 93,261 161 183 310 538 57,072 69,122 743 1,124 2 1 95 104 9 10 147 240 67,102 87,848 1,615,493 1,965,479

36 73 48 74 100 100 86 90 94 56 73 36 89 88 96 77 83 55 64 83 66 65 100 100 78 100 78 71 69 79 100 98 98 98 94 95 73 98 98 86 88 64 63 94 57 77

5 10 15 24 6 8 10 7 5 4 4 11 12 31 12 31 31 15 17 5 5 11 33 4 5 13 20

10 2 34 2 0 0 8 10 6 17 3 16 3 7 0 12 1 45 2 4 3 4 0 0 22 0 19 24 8 1 0 2 2 2 0 0 3 2 2 14 10 3 10 1 24 1

49 15 3 0 0 0 0 0 19 14 41 3 1 4 3 1 0 0 0 0 3 5 8 3 0 0 1 0 13 2 0 23 0 6 2

5 20 15 56 91 100 71 40 71 21 39 21 50 81 95 41 53 20 29 73 100 100 36 100 42 41 45 69 99 98 80 96 37 41 93 96 96 76 81 54 30 68 21 58

1 4 4 14 3 6 12 2 1 3 4 9 12 22 14 10 16 3 4 4 15 2 4 4 13

5 4 72 28 9 0 26 52 28 25 13 12 8 7 1 50 0 80 23 5 0 0 64 0 42 41 22 3 1 2 0 0 16 59 7 4 4 24 12 29 25 22 59 21

89 72 9 2 0 8 1 48 36 65 41 9 35 26 8 0 0 0 16 18 23 12 0 17 0 43 7 2 43 6 16 8

9 31 24 64 96 100 80 61 83 32 54 26 63 84 96 64 75 29 51 76 66 65 100 100 65 100 47 45 57 74 99 98 84 96 47 41 93 96 96 80 85 57 37 76 32 67

2 5 7 19 5 7 11 4 2 3 4 10 12 28 13 31 31 12 16 4 4 6 20 2 4 7 16

5 3 62 16 4 0 15 35 17 22 9 13 7 8 0 25 0 71 9 5 3 4 0 0 35 0 39 39 15 2 1 2 0 0 12 59 7 4 4 20 11 22 22 16 48 12

84 61 7 1 0 5 0 39 26 57 28 5 13 12 6 0 0 0 0 14 16 16 8 0 12 0 35 4 1 39 4 13 5

August 2012
UNICEF East Asia and Pacific Regional Office (EAPRO) 19 Phra Atit Road, Bangkok, 10200 Thailand Website: http://www.unicef.org/eapro/ Email: asiapacificinfo@unicef.org Twitter: twitter.com/unicefasiapac

A Snapshot of Sanitation and Hygiene in East Asia and the Pacific 2012 Update