Water, Sanitation and Hygiene and Neglected Tropical Disease (WASH & NTD)


Our Purpose

We believe that health is a basic human right. Everything we do ensures lasting health change for all.


The Challenge

Globally, about 500 million people have no access to safe drinking water. In addition, 2.6 billion people lack access to basic sanitation services, and 892 million practice open defecation.  The lack of safe water, sanitation and hygiene (WASH) services contributes to about 10% of the annual global disease burden. Unfortunately, 1.4 million people die of diarrhoea, and an additional 1.5 million more deaths occur from respiratory infections related to poor hygiene practices. Additionally, the COVID-19 pandemic, which is largely preventable through proper handwashing has led to devastating social, economic and political disruptions highlighting the need for improved hygiene as a global practice. Women and children suffer the most majorly through the indignity brought about by lack of privacy, loss of productive time and gender-based violence in their search for safe and clean water and sanitation. More evidence shows a strong linkage between poor WASH services, undernutrition and stunting in children. For instance, every year, diarrheal diseases lead to about 860,000 undernutrition-related child deaths; more than AIDS, tuberculosis and Measles related deaths combined for this age group. There is a correlation between insufficient WASH services and Neglected Tropical Diseases (NTDs) such as trachoma. NTDs thrive under conditions of poverty where drinking water is unsafe, causes of disease are constant, sanitation is poor, and access to health care is limited.

It is estimated that Sub-Saharan Africa losses about $73 billion every year due to poor WASH services. In Kenya, only 41% and 32% of the urban and rural population have access to improved WASH services, respectively. This, therefore, calls for disruptive, business linked and compact approaches to accelerate access to WASH services and reverse the discouraging trends.


The Opportunity

Kenya has a golden opportunity to attain SDG 6 (Ensure access to water and sanitation for all) by the year 2030 by increasing WASH investments from 0.75% to 5%. This would alleviate an estimated loss of 27 billion shillings (US$ 270M) that occurs annually due to poor sanitation. If WASH investments remain where they are, it will take Kenya 133 years to attain SDG 6.

To sustainably address WASH challenges, various stakeholders need to adopt innovative, integrated, cost-effective, business-oriented and scalable approaches. Put together, targeted WASH interventions have the potential to generate multiple positive impacts such as health, economic growth, job creation, curb indignities and above all, improve the overall quality of life. Kenya can leverage its strong innovation and technology infrastructure to incentivise its youthful, digitally-savvy population to launch tech-powered solutions to address the WASH challenges.

The United Nations General Assembly recognised that clean drinking water and sanitation is a human right. The Resolution called for financial investments, capacity-building and application of technology to provide safe, clean, accessible and affordable drinking water and sanitation for all. To operationalise these commitments, Kenya developed the Kenya Environmental Sanitation and Hygiene Policy (KESH) whose goal is to ensure universal access to improved sanitation, clean and healthy environment by 2030. The national water master plan targets to attain 100% water coverage for both urban and rural areas consistent with the country’s social and economic development plans by the year 2030.

Although the Kenyan government has created a robust enabling environment with supportive policies to promote access to WASH services, there exist several challenges key among them: (i) insufficient resources to meet the demands of ever-increasing populations; (ii) shortage of skilled personnel for operations and maintenance; (iii); weak WASH business cases to attract private sector investments (iv); weak sector accountability and governance; and  (v) poor uptake of technologies and innovations (including Digital technology-based solutions) to increase efficiencies. In addressing these challenges, Amref Health Africa in Kenya has developed a cocktail of innovative solutions described below.


Our Approach

Building on our track record, Amref Health Africa in Kenya is determined to reverse the negative impacts of poor WASH services and aspires to Make WASH Everyone’s Business. Amref in Kenya is deploying three innovative systems change models to accelerate access to safely managed WASH services.

Financial Inclusion Improves Sanitation and Health (FINISH) is an innovative model to address challenges facing sanitation markets sustainably. The model engages transformative partnerships that encompass four domains (communities, governments, entrepreneurs and financiers) to strengthen both sanitation value and service chains. We create demand and mobilise the supply side while facilitating access to credit for communities and sanitation entrepreneurs. Through FINISH, $12 million commercial funding has been generated and over 40,000 toilets built reaching about 680,000 with improved sanitation in Busia and Kilifi counties alone. We have since expanded FINISH to Uganda, Ethiopia and Tanzania and seek to involve other African countries incrementally.

The ‘WaterStarters’ is an innovative social enterprise model geared towards empowering 1.5 million households to access sustainable, safe water in Kenya by 2025. We do this by professionalising community water resources management through (i) blended financing solutions to increase investments; (ii) digital technology solutions and Internet of Things (IoT) to increase business efficiency such as reduction of non-revenue water(NRW) losses; (iii) reduction of downtime by performance-based maintenance; (iv) improve governance and oversight management of water resources and (v) enhance water quality control.

The WASH 3600 integrated WASH services delivery model combines several tried and tested WASH models to strengthen service delivery in communities, schools and health facilities. The model brings together several approaches in one package of intervention including (i) Community-Led Total Sanitation Plus (CLTS+) marketing (ii) Menstrual Health Management (MHM), (iii) Multiple Water Use Services allowing the use of water for health facilities, schools, institutions, domestic and productive purposes.

Based on our successes in implementing scalable social commercial models in WASH, we believe that Amref can contribute to the reduction of WASH-related diseases and contribute to economic development by implementing targeted systems change activities. This is through (i) making WASH markets work for all, (ii) attracting private investments by communities (invest their monies), (iii) facilitate commercial lending for WASH, (iv)strengthen WASH systems by building implementation capacities and (v) strategic use of grant funds to unlock other funds. We do this by engaging key stakeholders on public-private partnerships with the government, civil societies, financial institutions, local communities and local businesses.


Our Ask

We seek solid multi-stakeholder partnerships with donors, governments, civil societies and others to attain our ambition of universal access to water and sanitation services to all in Kenya.

We invite social impact investors to invest in small and medium WASH enterprises (the missing middle). We invite the philanthropic organisations to provide us with grant funding which we know will unlock other investments. We value the contributions of corporate organisations in delivering shared value to the communities we serve and work within. Every Kenyan has a duty to improve our health and the environment. We, therefore, urge every individual to contribute towards making the lives of all Kenyans better.

Together, we believe that we will create sustainable solutions for lasting health change in Kenya.