Diarrhea accounts for about a third of total child deaths under the age of five in developing countries. Hygiene promotion and sanitation in rural programs is still predominantly seen by service providing agencies as an obligatory appendage to water supply improvements. The solution is often to provide high levels of subsidies to a limited number of households for the building of latrines. Why promote hygiene and sanitation Most of the health benefits of water supply projects stem from changes in hygiene behavior. Sanitation has to be marketed like any other consumer good.
Most people know and want toilets.
However, toilet acquisition may not be a priority item of expenditure, especially for the poor. However, the removal of excreta from living spaces has major health benefits, not just to individual families, but to their neighbors. Such externalities amply justify the use of public funds for latrine promotion. Similarly, school sanitation confers public benefits by improving health and increasing school enrollment. The World Bank is taking a leading role in addressing the sanitation challenge and in April 2000 brought together a wide range of policy planners and practitioners to address the issue at the annual Water Forum.