Introduction Water, sanitation and hygiene (WASH) are closely connected elements that together form the foundation of public health and human well-being. Although they are often addressed separately, they are deeply interdependent. Lack of progress in one area undermines the benefits of the others. For this reason, WASH must always be planned and implemented as an integrated package. Understanding the linkages Water and sanitation Safe sanitation requires adequate water for flushing, cleaning and maintenance of facilities. Inadequate sanitation contaminates surface water and groundwater, making water unsafe for drinking. Thus, without safe sanitation, even improved water supplies can become polluted. Water and hygiene Personal hygiene, handwashing, menstrual hygiene and food hygiene depend on reliable access to sufficient water. In water-scarce areas, people often reduce water used for hygiene, increasing the risk of disease. Sanitation and hygiene Toilets and latrines reduce open defecation, but without proper hygiene practices like handwashing, disease transmission continues. Cleanliness of sanitation facilities requires users to practise good hygiene, otherwise infrastructure becomes unusable. Interlinkages with other sectors Health and nutrition Unsafe water, poor sanitation and lack of hygiene are major causes of diarrhoeal diseases and intestinal worms. These infections lead to undernutrition and stunting in children. Improved WASH reduces maternal and child mortality. (Source: WaterAid India, 2019 – Interlinkages between WASH and Nutrition) Education Schools without safe toilets and water supply see lower attendance. Girls are disproportionately affected when facilities for menstrual hygiene are absent. Healthy children miss fewer school days, improving learning outcomes. Gender and social equity Women and girls often fetch water, manage household hygiene and suffer most from inadequate facilities. Lack of safe toilets compromises privacy and safety. Providing WASH infrastructure promotes gender equality and social dignity. Environment Poor sanitation contaminates rivers, ponds and groundwater. Unsustainable water extraction reduces availability for hygiene needs. Safe waste management and water conservation protect ecosystems. Economy Lack of WASH leads to loss of workdays, increased healthcare costs and reduced productivity. Investments in WASH yield high economic returns by improving workforce health. Policy and programme integration Global framework: The Sustainable Development Goals (SDG 6: Ensure availability and sustainable management of water and sanitation for all) highlight that water, sanitation and hygiene are inseparable. Progress in SDG 6 also supports other goals such as poverty reduction, education, gender equality and health. (Source: UN-Water – Water and Sanitation Interlinkages) India's approach: The Swachh Bharat Mission (SBM) addresses sanitation coverage and behaviour change. The Jal Jeevan Mission (JJM) is providing functional household tap connections. Hygiene promotion is embedded in both programmes to ensure lasting health benefits. Challenges Fragmentation in planning and funding, where water and sanitation are treated as separate sectors. Insufficient behaviour change communication to sustain hygiene practices. Inadequate coordination between departments and institutions. Addressing inequalities – ensuring services reach rural poor, urban slums and marginalised groups. Example: The story of village Ramgarh The story of Ramgarh village illustrates the power of interlinkages. The village first received a government scheme to build individual household toilets, but a few months later, many were not being used. The problem was that the village had no nearby source of water. Without water, cleaning the toilets was impossible, and the villagers saw no benefit in using them over the open fields. A second scheme brought a new handpump to the village, but without education on handwashing, many people still spread germs by handling food with unwashed hands. It was only when a third intervention, a hygiene campaign, taught everyone about the importance of handwashing with soap after using the toilet that the full benefit was realized. The toilets were now used, the handpump's water was kept clean, and the village saw a drastic drop in cases of diarrhea and cholera. This shows that the three elements must be planned and implemented together to succeed. Conclusion Water, sanitation and hygiene are three pillars that must stand together. If one is weak, the entire system is compromised. Recognising and acting upon their interlinkages leads to better health, improved nutrition, greater school attendance, gender equality and environmental sustainability. For India and the world, integrated WASH programmes are essential to break the cycle of disease and poverty and to achieve sustainable development.