Access to safe water and basic sanitation services, along with practice of personal hygiene can reduce out of pocket expenditure related to health problems significantly. It is well established that in developing countries more than 50% of those who are poor and hospitalised sink into below poverty line because of hospital expenses. In India this is estimated to be 58%. Therefore, prevention of hospitalisation is one of the most effective measures to prevent dipping of families from poverty to extreme poverty status. WASH in such cases is a major area of providing cost effective intervention. Secondly, certain diseases that emerge out of "filth" are associated with age old stigma and discrimination. E.g. STI/RTI. Care seeking for those diseases are also less because of lack of privacy and stigma. So, prevention through maintenance of personal hygiene can improve such scenarios. From the policy perspective, political will is inclined more towards developmental interventions, rather than mere health interventions, especially where proportion of GDP allocated for health is low, like India. In such cases WASH has two pronged- advantage - easy advocacy and multipronged outcome. Therefore greater resources can be allocated for development activities for the families. WASH is also directly related to nutritional status of children and adolescents and women of reproductive age. Worm infestation can be prevented, so is anemia and malnutrition. This would increase productivity of the families and improvement in their educational attainment and employment as well as work potential. All these aspects would contribute to social well-being of the families.

Children’s health and nutritional well-being are strongly linked to their access to safe water and proper sanitation and hygiene. Across Somali, unpredictable rainfall patterns, ongoing conflict, and lack of maintenance of water sources and supply systems has resulted in only 45 per cent of the population having access to improved water sources and only a quarter of the population with improved sanitation facilities within 10 metres. Almost half the households take more than 30 minutes to collect water which determines the quantity of collected at a time. Water borne disease, such as diarrhoea, is the major cause of nearly one in five deaths (23 per cent) of children under five and is strongly correlated with child malnutrition, leading to both wasting and stunting.

Lack of sanitation, safe water facilities and services and poor hygiene are significant contributors to the high rates of disease in Somalia. A comprehensive approach to reducing malnutrition and disease must include increasing access to sanitation and safe water services and addressing hygiene behavior change. The mapping of access to water and sanitation taken from an analysis of Water, Sanitation and Hygiene (WASH) data collected during FSNAU household surveys in 2009 and 2010 shows a close correlation between areas of high malnutrition and areas with poor access to water and sanitation. Frequently poor hygiene and sanitation practices combined with the use of unsafe water cause chronic and/or acute diarrhea. Integrated interventions which include nutrition and WASH components can help reduce the incidence of diarrhea.