Sanitation is a foundational public health condition concerned with creating and maintaining hygienic environments, primarily by managing human excreta and sewage safely. The World Health Organization defines it as the provision of facilities and services for the safe disposal of human urine and feces, coupled with the maintenance of clean surroundings through services like wastewater disposal and garbage collection. This system is designed to prevent contact between people and hazardous waste materials, which is the primary mechanism for breaking the chain of disease transmission. Effective sanitation interrupts the fecal-oral route of infection, which is responsible for spreading illnesses such as cholera, typhoid, and diarrheal diseases, thereby safeguarding community health.
Essential Elements of Sanitation Infrastructure
Sanitation is realized through a complex network of physical and systemic components, the most visible being the infrastructure designed to manage waste streams. The collection, transport, treatment, and ultimate disposal or reuse of human waste, known as excreta and wastewater management, represents the core of this infrastructure. In urban environments, this often involves centralized sewer systems that convey wastewater through underground pipes and pumping stations to a treatment facility. These systems require extensive treatment plants where biological, chemical, and physical processes remove contaminants before the treated effluent can be safely returned to the environment.
In less dense or rural settings, on-site sanitation systems are more common, such as septic tanks or improved pit latrines. Septic systems contain and partially treat wastewater underground, while pit latrines hygienically separate excreta from human contact, often requiring periodic emptying, which produces fecal sludge. For both centralized and on-site systems, the safe treatment of the waste or sludge before it is released or reused is required for protecting public health and preventing environmental contamination. This treatment ensures that pathogens are inactivated and nutrients are managed, preventing the pollution of local water sources.
Beyond human waste, the systematic collection and disposal of non-hazardous household refuse, or solid waste management, is an integral component of sanitation. Regular garbage collection prevents the accumulation of waste that can attract and harbor disease vectors like flies, mosquitoes, and rodents. Proper disposal sites, such as regulated landfills, are designed to contain waste and manage any resulting leachate, preventing ground and surface water contamination. The management of stormwater and surface drainage is the final infrastructure element, which prevents the pooling of stagnant water and controls runoff. Stagnant water creates breeding grounds for vector-borne diseases and can mix with and spread contaminants from improperly contained waste.
Hygiene Practices as a Component
While infrastructure provides the physical means for safe waste management, sanitation remains incomplete without the adoption of specific hygiene practices. Hygiene is the set of behaviors and actions that individuals take to maintain health and prevent disease transmission, acting as a direct barrier against pathogens. This behavioral component is interdependent with the physical infrastructure, as even a functioning sewer system cannot prevent disease if people do not practice appropriate handwashing. Promoting good hygiene is a necessary complement to providing facilities, ensuring that the health benefits of the infrastructure are fully realized.
The most impactful hygiene practice is handwashing with soap and water at important times throughout the day, which can reduce the incidence of diarrheal illness significantly. Important moments include washing hands after using the toilet or cleaning a child’s bottom and before handling food or eating. Other essential hygiene behaviors include the safe handling and storage of drinking water to prevent recontamination after it is sourced. Safely preparing and storing food limits the spread of foodborne pathogens, which often enter the food chain through unhygienic practices.
The synergy between hygiene and infrastructure is often referred to as WASH (Water, Sanitation, and Hygiene), reflecting the integrated nature of these public health efforts. This combined approach recognizes that technology and facilities must be paired with knowledge and behavioral change to achieve long-term disease prevention.
Global Benchmarks for Safe Sanitation Access
International organizations, primarily the WHO/UNICEF Joint Monitoring Programme (JMP), use a “service ladder” to measure and track progress toward global sanitation goals. This ladder moves from the lowest level, open defecation, up through various degrees of service to the highest standard. The first benchmark is Basic Sanitation, defined as the use of an improved sanitation facility that is not shared with any other household. An improved facility hygienically separates excreta from human contact, such as a flush toilet connected to a sewer, a septic system, or a ventilated improved pit latrine.
The ultimate global target is Safely Managed Sanitation, which represents a much higher level of service. To meet this standard, a household must first have access to a basic (improved and non-shared) sanitation facility. Crucially, the excreta from that facility must then be safely contained on-site or transported off-site and treated. This requirement means that the entire sanitation chain—from collection to disposal or reuse—must be managed to prevent human and environmental exposure to untreated waste.
The distinction between basic and safely managed service is the treatment and disposal component, which directly addresses environmental health risks. Failure to achieve safely managed sanitation means that untreated human waste is likely re-entering the environment, contaminating water sources and contributing to the transmission of infectious diseases. Global monitoring efforts emphasize that providing a toilet is only the first step; effective sanitation requires the complete, safe management of the waste stream.