Water Scarcity, Hygiene and Health: A Policy Analysis of Water-Washed Disease Prevalence in the Somali Region of Ethiopia, 2021–2026

This policy analysis examines the critical nexus between protracted drought-induced water scarcity, compromised hygiene practices, and the prevalence of water-washed diseases in the Somali Region of Ethiopia from 2021 to 2026. It identifies a significant policy-practice gap: emergency water trucking programmes, while addressing direct consumption needs, fail to incorporate the additional water quantities mandated for essential hygiene practices that prevent disease. The methodology employs a rigorous desk review of national and regional policy documents, triangulated with analysis of epidemiological data and humanitarian situation reports. Findings demonstrate a measurable increase in reported cases of acute watery diarrhoea, scabies, and trachoma, correlating strongly with drought phases where per capita water availability fell below Sphere Humanitarian Charter minimum standards. The analysis contends that current crisis-response frameworks are overly biomedical, neglecting to integrate Water, Sanitation and Hygiene (WASH) interventions as foundational public health prevention within the health sector’s drought response. The significance of this work lies in its call for a paradigm shift towards ‘hygiene-sensitive’ water security planning. It concludes with urgent policy recommendations, advocating for mandatory minimum hygiene water allocations in all drought responses and the strengthening of community-led hygiene behaviour change programmes as a cost-effective strategy for mitigating the disease burden in drought-prone regions.