According to the UN convention on the rights of the child, a child is defined as anyone under the age of 18 years. Children under five represent between 15-20% of the population. They are frequently neglected in WASH responses although they are often the most vulnerable to WASH-related diseases and malnutrition. Recent research has confirmed that the first 1000 days of a child’s life from conception to two years old are critical to lifelong health. Children under 18 years can represent up to 50% of the population and are therefore major stakeholders in a WASH response. 

In emergencies children are often affected by the change in routine; anxiety, fear and stress can affect their mental health and wellbeing. Bedwetting may become an issue or be exacerbated in some children. Schools may be damaged or destroyed or lessons interrupted; parents may be grieving or unable to respond to their children’s needs in the same way as they did before. Children’s space and time for play may have been reduced significantly. WASH activities can play a role in providing a voice for children and supporting their mental health.

The specific age of the child has important implications for WASH programming and children should not be treated as a homogenous group. The age that young children start to use an adult toilet varies from one culture to another, but most children will not be potty trained until they are at least two years old. They will probably not use an adult toilet or latrine until they are over three or four years old and then only if accompanied by an older sibling or another caretaker. Even older children (between the ages of five and seven) may be prevented from using a latrine because it is thought to be too dangerous (due to its location or because the squatting hole is too large) or because they are afraid to go to the toilet in the dark. Babies and young children under 18 months will usually need nappies - either disposable or washable. Disposing of or washing nappies is difficult in many situations where people are displaced and it can become a health risk – especially in communities that believe children’s faeces are not harmful. Ensuring child-friendly WASH facilities and promoting hygiene is also important as children are often responsible for collecting water and caring for younger siblings or other hygiene-related tasks in the household.

Babies, children and their carers therefore represent a very important target group and every effort should be made to understand the specific issues facing these groups and to identify opportunities for working with them. Baby WASH F.13 is a relatively new approach focusing on pregnant women and children from conception to two years. Schools E.6, women’s groups, community centres, crèches, youth groups and sports clubs E.8 can all offer important entry points for working with children and young people.

Participation is a fundamental right and children should be given the chance to meaningfully participate in decisions that affect them – including those relating to the provision of WASH. It is also critical that Gender E.3 and Disability E.5 are considered when responding to children’s needs and rights. The Children’s Participation Ladder (see figure below) illustrates different levels of child participation.

Child protection is essential when working with children and every agency must have policies and procedures in place to ensure safeguarding. All staff working with children must know how to ensure children’s and adolescents’ safety and what to do if a child discloses abuse.

 

Process & Good Practice

• Work with children in all WASH programmes where possible. This should include both software and hardware components such as staffing, child-friendly latrines, hygiene materials and colourful and fun IEC materials T.19 for different age groups.

• Collaborate with others working in health, food security and nutrition P.9 to ensure a coordinated approach to supporting children and to understand the diseases affecting babies and children in a given context. This may involve working with nutritionists, midwives and lactation support workers amongst others.

• Identify ways to integrate WASH into health, nutrition and education interventions. Examples include child-friendly facilities in health centres, integrated hygiene promotion (HP) and health materials that address key risks for children of all ages in schools and the community, safe and secure access to WASH for adolescent girls and boys as well as training staff to recognise symptoms of serious ill health such as pneumonia or mental health problems.

• Develop a strategic approach to HP at an institutional level; HP school activities should not be confined to schoolchildren. Aim for a sustainable and integrated vision of WASH in schools, working with parents, carers, teachers and authorities to ensure a programme that integrates the software and hardware aspects of WASH (F.1, F.2, F.8, F.10, F.11, F.12 and T.29).

• Work with girls and boys of different ages rather than with ‘children’ as a homogenous group. Identify the different barriers they face as well as the different contributions they can make. Initially prioritise the children most at risk (those under two years old) which may require dedicated staff. It may be useful to identify male and female children’s WASH champions or ‘inclusion advocates’ T.22 to promote greater awareness of vulnerability and exclusion and ensure integration of children’s issues into WASH programmes.

• Promote the meaningful participation of children in WASH programme by giving them a say about how facilities and services are designed and by asking for feedback on the facilities and their preferences. 

• Collect detailed and systematic assessment information (chapter  A ) which should include a) what barriers children of different ages, gender and disabilities face when using WASH facilities and b) how mothers manage the excreta of babies and young children and how they can be supported in this (include questions about bedwetting).

• Work with monitoring and evaluation (M&E) teams to ensure that child-centred WASH indicators are included in M&E frameworks. 

• Work with both children, teachers and parents on HP interventions to encourage the care and correct use of facilities E.7 e.g. ensuring that WASH facilities are not damaged during play (climbing on tap stands or putting covers down toilets) and preventing misuse and wastage of water.

• Support the teaching and learning of children’s self-hygiene tasks. Children's personal hygiene needs change dramatically as they grow and learn how to manage their own hygiene needs. 

• Ensure the provision of accessible handwashing facilities at all latrines (e.g. make sure children can use them comfortably) and the safe siting of toilets so they are as close as possible to home. Consider providing torches and sandals for children’s use in latrines as part of a hygiene kit.

• Consider children’s comfort in latrine design e.g. lighting, cubicle width and height (consider if a parent needs to help a child to use a latrine), the position of foot plates and hole size, so that children are not afraid of using the latrines.

• Address the distinct needs of girls: incorporate Menstrual Health and Hygiene P.7 and consider laundry or disposal requirements for sanitary products when designing toilets. 

• Keep children safe: work in pairs and always ask for parents’ consent. It is preferable to work with groups of children rather than a child on their own and children should know that they can refuse to answer questions or can withdraw from the process at any time. Make sure you know what to do if a child discloses abuse of any kind.

• All staff including contractors or partner organisations must adhere to health and safety regulations and child safeguarding policies when carrying out construction projects or using vehicles (including water tankers) or machinery. These regulations must be enforced.