Access to safe drinking-water, sanitation and hygiene (WASH) is fundamental to health, well-being and social development. Inadequate WASH remains a major cause of disease, contributing to diarrhoea, respiratory infections, undernutrition, schistosomiasis, soil-transmitted helminth infections and trachoma. In 132 low- and middle‑income countries, an estimated 829 000 deaths and 49.8 million DALYs from diarrhoeal diseases were attributable to inadequate WASH in 2016, equivalent to 60% of all diarrhoeal deaths (Prüss-Ustün et al., 2019[1]). Recent evidence also shows that moving households up the WASH service ladder, including through improved water available on premises and higher-quality sanitation, can substantially reduce the risk of childhood diarrhoea (Wolf et al., 2023[2]). Expanding access to at least basic services therefore remains both a public health priority and an important component of more inclusive living standards.
Access to basic sanitation improved across LAC between 2014 and 2024, although rural areas continue to lag behind urban ones (Figure 4.16). On average across LAC24, urban coverage rose from 86.8% to 90.8%, while rural coverage increased from 73.0% to 81.0%, narrowing the urban-rural gap but not closing it. By 2024, Chile had reached universal access in both urban and rural areas, while Antigua and Barbuda, Costa Rica, Paraguay and Uruguay were also at or near universal coverage. At the other end of the distribution, Haiti remained the clear outlier, with only 32.4% of the urban population and 24.1% of the rural population having access to basic sanitation, and Bolivia also remained well below the regional average, especially in rural areas (53.3%). Progress was strongest where starting levels were lowest, particularly in rural Bolivia, Paraguay and Peru, and in urban Bolivia and Panama. Even so, wide territorial disparities persisted in several countries, notably Brazil, Panama, Bolivia, Peru and Guatemala.
Access to basic drinking water was consistently higher than access to sanitation and was close to universal in most urban areas (Figure 4.17). Across LAC26, urban coverage increased only marginally, from 97.0% in 2014 to 97.7% in 2024, suggesting that most gains in cities now come from reaching the last uncovered groups. In rural areas, progress was more substantial, with coverage rising from 85.3% to 90.6% over the same period. By 2024, a number of countries had already reached or nearly reached universal access for both urban and rural populations, including Brazil, Costa Rica, Paraguay, Trinidad and Tobago and Uruguay. Nonetheless, important rural deficits remained, particularly in Haiti (54.8%), Bolivia (78.7%), El Salvador (80.4%), Ecuador (81.4%) and Colombia (83.7%). The fastest rural improvements were observed in Peru, El Salvador, Paraguay, Brazil and Haiti, while Jamaica was the only country in the figure showing declines in both urban and rural drinking water coverage over the decade.
These indicators show steady progress in expanding basic WASH services across LAC over the past decade, with faster gains in rural areas helping to narrow longstanding territorial gaps. Yet sanitation still lags behind drinking water in many countries, and sizeable rural deficits persist. These gaps matter because health benefits rise as households reach higher service levels, while unsafe WASH remains a major source of preventable disease. Sustained investment in rural infrastructure, service quality, and targeted support for underserved communities will be essential to convert recent gains into universal, equitable access to both drinking water and sanitation (UNICEF/WHO, 2025[3]).
