Tesfanesh Eba, a 6th grade student at Lideta Limat school in Addis Ababa, recalls the previous arrangement of shared toilets for both male and female students. “The boys used the ones on the left and the girls used the ones on the right,” she says. This setup was particularly uncomfortable for girls during menstruation, leading many to stay home and miss school.
The construction of new toilets and Menstrual Hygiene Management (MHM) spaces under a multi-sectoral Water Sanitation and Hygiene (WaSH) program, supported by the World Bank and seven other development partners in Ethiopia, has improved this situation. In Phase II of the One WaSH National Program-Consolidated WaSH Account (One WaSH-CWA), 1,074 schools installed a full WaSH package out of a target of 1,453. Additionally, 227 new MHM rooms have been built since the program's inception in 2019, enhancing school attendance among girls.
Initially, the World Bank focused on designing infrastructure projects to aid menstrual health and hygiene. The current focus includes integrating learning into school curricula and addressing menstrual stigma and norms.
One WaSH CWA channels donor funding through Ethiopia’s ministries of finance, water and energy, health, and education. It is scheduled to run until 2025 before transitioning into another ten-year multi-phased approach for which the Ethiopian government is seeking $1.5 billion. Tesfanesh notes that other schools can learn from her school's experience in prioritizing female students' hygiene needs.
Despite these advancements, significant challenges remain. Poor menstrual hygiene poses serious health risks such as reproductive and urinary tract infections that can lead to infertility or complications during childbirth. Washing hands after changing menstrual products can prevent infections like Hepatitis B and thrush; however, about 39% of schools in Ethiopia lack sanitation facilities and 76% do not have access to an improved water supply.
One WaSH financing supports constructing water supplies, building latrines, handwashing sinks and taps (faucets), and MHM rooms. Rahel Abdella, a 7th grade student at Lideta Limat School, highlights that facilities were also built for students with disabilities: “What you see here is the cleaning room; this is the room for the disabled; that one is the changing room.”
The budget also encourages forming school gender and WaSH clubs. Tesfanesh mentions how her teacher taught them about menstrual hygiene: “I signed my friends up to join the club... We celebrate World Menstrual Hygiene Day every year.”
The Second Ethiopia Urban Water Supply and Sanitation Project is part of One WaSh National Program (OWNP), aiming to increase access to safely managed water services while strengthening Ethiopia’s capacity for water resources management.
A study by Global Water Security and Sanitation Partnership (GWSP) links inadequate access to clean water with over 60% of communicable diseases in Ethiopia. Only 8% of Ethiopia’s population has handwashing facilities with soap and water. Issues like surface water pollution exacerbate these problems. Inadequate WASH services are estimated by WHO to contribute significantly to death rates related to diarrhea in Ethiopia.
GWSP continues building on World Bank initiatives by providing technical assistance for fast-tracking Ethiopia’s One WaSH national program.