Proven WASH Best Practices for Emergency Response

When disasters strike, securing access to clean water and sanitation becomes a matter of survival. Every year, millions of people affected by emergencies face heightened risks of waterborne diseases, malnutrition, and other health threats due to inadequate WASH (water, sanitation, and hygiene) services. Fortunately, decades of humanitarian experience have yielded proven best practices that save lives and restore dignity. These approaches go beyond simply installing latrines or distributing water-they empower communities, integrate across sectors, and leverage local knowledge to create sustainable solutions.

Community-Led Total Sanitation: putting ownership at the centre 🔗

One of the most transformative approaches to sanitation in humanitarian settings is Community-Led Total Sanitation (CLTS). Unlike traditional sanitation programmes that relied heavily on subsidies and externally-designed latrines, CLTS facilitates communities to analyse their own sanitation situation and take collective action to eliminate open defecation.

The approach works by enabling communities to recognise the health consequences of open defecation and motivate themselves to change behaviour. Rather than providing pre-designed toilet models, CLTS encourages households to build latrines using locally available materials according to their own capacity. This creates genuine ownership and responsibility for maintaining facilities long after humanitarian organisations have departed.

Success in fragile contexts 🔗

CLTS has spread across more than 70 countries, and at least 35 nations have incorporated it into their national sanitation policies. Perhaps most remarkably, the approach has demonstrated success even in post-emergency and fragile state settings. In Somalia, where previous subsidised latrine programmes had achieved limited results, UNICEF’s CLTS intervention helped the country go from zero Open Defecation Free (ODF) villages to 144 self-declared ODF villages by August 2014.

Organisations including Oxfam, the International Federation of Red Cross and Red Crescent Societies, Plan International, and Save the Children have championed CLTS implementation. Oxfam’s work in Southern Africa has been particularly influential, with research exploring both successes and challenges across multiple countries. Their findings emphasise that CLTS works best in communities with strong local leadership and social cohesion.

Adaptations for emergency settings 🔗

Emergency contexts require thoughtful adaptation of the CLTS approach. The methodology has been successfully applied in post-earthquake Haiti through collaborative efforts between Oxfam America, Oxfam Spain, Oxfam Quebec, and Action Against Hunger. Research indicates that CLTS effectiveness increases in post-emergency situations when it forms part of an integrated health services approach rather than being implemented in isolation.

School-Led Total Sanitation (SLTS) represents another powerful adaptation, using schools as entry points to reach entire communities. Children serve as agents of change, carrying hygiene messages back to their households-a strategy that multiplies programme impact while building lifelong healthy habits.

Integrating WASH with health, nutrition, and protection 🔗

Standalone WASH interventions, while valuable, achieve far greater impact when integrated with health, nutrition, and protection programming. This multi-sectoral integration represents one of the most significant shifts in humanitarian practice over recent decades.

The WASH-nutrition connection 🔗

The relationship between WASH and nutrition is particularly critical. According to Action Against Hunger’s WASH’Nutrition guidebook, millions of deaths from undernutrition and diarrhoea could be prevented through targeted joint action on water, sanitation, hygiene, and nutrition. Safe drinking water and adequate sanitation are just as vital as food in safeguarding the wellbeing of crisis-affected communities.

Poor sanitation contributes to a condition called environmental enteropathy, which damages the intestinal lining and prevents proper nutrient absorption in young children. This helps explain why children in areas with inadequate sanitation often remain malnourished even when food is available. Studies across multiple regions confirm that village-wide sanitation coverage correlates with protection against this syndrome, making WASH interventions essential for addressing child stunting.

Health sector synergies 🔗

The World Health Organization emphasises that reinforcing infection prevention and control (IPC) alongside WASH capacities is essential for maintaining continuity of care during emergencies. This integration is particularly crucial in humanitarian settings where basic IPC and WASH systems are often lacking or disrupted. Healthcare facilities require minimum WASH-related infection prevention standards, and WASH actors play an important support role in meeting these standards during disease outbreaks.

UNICEF’s emergency WASH programming exemplifies this integrated approach, working across health, nutrition, HIV, and WASH to achieve optimal outcomes through both facility-based and community-based services. During emergencies, their efforts provide a first line of defence against both disease and malnutrition.

Protection considerations 🔗

WASH services must also integrate protection considerations, particularly around gender-based violence (GBV) risks. When displaced people lack safe access to water and sanitation, they may be exposed to serious protection risks. Women and girls walking long distances to water points or accessing toilets in unlighted areas face heightened vulnerability to violence.

Effective WASH programming addresses these risks through thoughtful facility design: proper lighting, locks on doors, gender-segregated facilities, and location consultations with women users. In South Sudan, USAID supports an integrated WASH and GBV project that combines life-saving water and sanitation services with women-friendly spaces for discussions on health, violence prevention, and empowerment activities.

Leveraging local resources and knowledge 🔗

Cost-effective, sustainable WASH interventions draw heavily on local materials, skills, and cultural understanding. This approach reduces costs, shortens supply chains, builds local capacity, and creates solutions that communities can maintain independently.

Culturally appropriate design 🔗

The Sphere humanitarian standards emphasise that an effective WASH programme relies on information exchange with disaster-affected populations to identify culturally appropriate solutions. The type of sanitation facility adopted should depend on user preferences, existing infrastructure, local soil characteristics, available construction materials, and water availability.

Toilets must provide privacy in line with the cultural norms of users. Some communities require facilities for ritual washing; others have specific requirements for menstrual hygiene management. Bathing facilities should be designed in consultation with users, particularly women, adolescent girls, and persons with disabilities, to ensure they are culturally appropriate and meet dignity requirements.

Building with local materials 🔗

The International Organization for Migration recommends using local materials to reduce carbon emissions from transport while creating more sustainable solutions. This includes using gravity and hybrid water supply systems where possible, implementing decentralised sanitation solutions like twin pit latrines, and considering renewable energy for water pumping systems.

Local construction also supports livelihoods. Training community members as latrine builders, water system operators, and hygiene promoters creates employment while ensuring that maintenance expertise remains within the community. Women’s equal representation in water management committees-not just in numbers but in decision-making power-strengthens programme sustainability and ensures facilities meet diverse needs.

Environmental sustainability 🔗

Sustainable WASH programming must also consider environmental impacts. This includes acquiring good hydrogeological knowledge to ensure sustainable water provision without over-exploiting aquifers, using local reforestation to protect water catchments, and ensuring appropriate management of hazardous waste. In arid zones where culturally appropriate, wastewater can be reused in sub-surface irrigation systems for household gardening.

UNHCR notes that refugees often live in climate-vulnerable areas, facing water scarcity, contamination, and infrastructure damage from floods and droughts. Climate-resilient WASH systems incorporate early warning mechanisms and adapt to local climate impacts, building long-term community resilience alongside immediate emergency response.

Making integration work in practice 🔗

Successfully implementing these best practices requires careful coordination. Hygiene promotion activities must accompany infrastructure development-simply providing facilities without education rarely achieves desired health outcomes. Representatives from all user groups should participate in planning, training, implementation, and monitoring.

Global Communities and similar organisations demonstrate how to combine emergency and sustainable development WASH interventions. They train community-based water management committees to plan for operations and maintenance from the outset, ensuring that emergency investments transition into long-term development gains.

The ultimate goal is not merely surviving an emergency but building systems that serve communities well into the future. When CLTS fosters genuine ownership, when WASH connects with nutrition and protection, and when local resources and knowledge drive solutions, humanitarian response transforms from temporary relief into lasting change.

What do you think? How might your community or organisation better integrate WASH with other sectors during emergency response? What local resources or traditional practices in your region could enhance sanitation and hygiene programmes?

References

1. https://en.wikipedia.org/wiki/Community-led_total_sanitation
2. https://www.cltsfoundation.org/wp-content/cache/all/human-rights-day-wash-during-emergencies/index.html
3. https://policy-practice.oxfam.org/resources/addressing-southern-africas-sanitation-challenges-through-community-led-total-s-600623/
4. https://www.emergency-wash.org/hygiene/en/frameworks/5-community-led-total-sanitation-clts
5. https://www.washroadmap.org/34-multi-sectoral-integration-and-coordination-of-wash.html
6. https://sanitationlearninghub.org/resource/wash-nutrition-2017-guidebook-integrating-water-sanitation-hygiene-and-nutrition-to-save-lives/
7. https://www.who.int/emergencies/operations/ipc-wash
8. https://www.unicef.org/wash/emergencies
9. https://emergency.unhcr.org/emergency-assistance/water-sanitation-and-hygiene/wash-emergencies
10. https://www.globalwaters.org/HowWeWork/Activities/integrated-emergency-wash-response-and-gender-based-violence
11. https://pmc.ncbi.nlm.nih.gov/articles/PMC4910130/
12. https://emergencymanual.iom.int/cross-cutting-themes-within-wash
13. https://www.unhcr.org/us/what-we-do/respond-emergencies/water-sanitation-and-hygiene
14. https://globalcommunities.org/our-work/humanitarian-assistance/emergency-response/emergency-wash/