Determinants of Household-Level Water Treatment Practices in Southern Ethiopia

Household water treatment practice and associated factors in Ethiopia: A systematic review and meta-analysis

The provision of potable water is crucial to ensuring the health and dignity of individuals. In many developing countries, including Ethiopia, waterborne disease has become a major public health problem. There is a significant gap in accessing comprehensive national-wide evidence on Household Water Treatment (HWT) practices and associated factors in Ethiopia. Therefore, this study aims to assess the pooled HWT practice and associated factors in Ethiopia. A comprehensive search of published studies before October 15, 2022, was identified using databases and other sources. Data were extracted using Microsoft Excel, and analysis was performed using STATA 14/SE software. A random-effects model was used to estimate the pooled proportion of HWT practices and the odds ratio of associated factors. The funnel plot and Egger's regression test were used to assess publication bias, and I2 test statistics was used to assess heterogeneity. Duval and Tweedie's "trim and fill" method was performed to adjust the pooled estimate. A subgroup analysis was also conducted to identify the sources of heterogeneity. In this study, a total of 708 articles were retrieved, and 16 eligible studies were included. The pooled proportion of HWT practice in Ethiopia was found to be 21% (95% CI: 17-24). Having a formal education (OR: 2.42, 95% CI (2.11-2.74)), being male (OR: 1.32, 95% CI (1.13-1.51)), owning radio (OR: 1.33, 95% CI (1.18-1.47)), having a higher income (OR: 1.73, 95% CI (1.41-2.04)), unimproved water source (OR: 1.71, 95% CI (1.41-2.01)), fetching water at more frequently (OR: 3.31, 95% CI (1.99-4.64)), dipping methods of water drawing (OR: 2.08, 95% CI (1.66-2.51)), and taken training of water treatment (OR: 2.15, 95% CI (1.55-2.75)) were all found to be associated with HWT practice. Based on the findings of this study, the pooled proportion of HWT practice in Ethiopia was found to be one-fifth, which indicated that it was significantly low. Therefore, the authors recommend that households could better receive adequate information about HWT practices through strengthened health education and intensive training on HWT.

Access to basic drinking water services, safe water storage, and household water treatment practice in rural communities of northwest Ethiopia

Protecting water from cross contamination at source and point of use is an important strategy to improve water quality. However, water safety measures at the source and point of use may not be implemented in the rural communities. This community-based cross-sectional study was, therefore, conducted among 1190 randomly selected households in a rural setting of northwest Ethiopia to assess access to basic drinking water services, safe water storage, and household water treatment practices. Water service level was determined using JMP criteria and practices that prevent cross contamination of water at point of use were used to determine safe water storage. Results showed that 23.0% of the households had access to basic water services; 37.0% practiced safe water storage; and 15.4% practiced one or more household water treatment methods. Public taps (54.5%) and protected spring (25.1%) were the common water sources to rural communities in northwest Ethiopia. Boiling (43.2%), chlorination or water guard (26.8%), and plain sedimentation (23.0%) were among the household water treatment methods commonly practiced in the area. In conclusion, rural households in the studied region has low access to basic water services. Safe water storage practice was also low in the area and household water treatment is not commonly practiced.

Water treatment at the point-of-use and treatment preferences among households in Ethiopia: A contemporaneous systematic review and meta-analysis

BACKGROUND

Water is essential for maintaining human life, health, and dignity. Untreated water consumption causes 1.8 million deaths annually, over 99.8% of which happen in developing nations and 90% of which include children. Point-of-use water treatment enables people without reliable access to safe drinking water to reduce contamination and minimize microbial risk levels. This Systematic Review and Meta-analysis was, therefore, used to identify, select, and critically appraise relevant evidence about water treatment practices and their associated factors among Ethiopian households.

METHODS

PubMed, Science Direct, Web of Science, Scopus, Embase, Google Scholar, ProQuest, and other databases were searched for studies published before May 5, 2022. The final synthesis included twelve investigations. Microsoft Excel was used to extract the data, and STATA 16 was used for the analysis. The Joanna Briggs Institute's Critical assessment checklist for prevalence studies was used to evaluate the quality of the included studies. Egger's test and funnel plot were used to assess publication bias. I2 statistics were calculated to check for study heterogeneity. The DerSimonian and Laird random-effects model was used to analyze the pooled effect size, odds ratios, and 95% confidence intervals across studies. Analysis of subgroups was done by publication year and geographic region.

RESULTS

Of the 550 identified articles, 12 studies were eligible for analysis (n = 4849 participants). The pooled prevalence estimate of point-of-use water treatment practice among Ethiopian homes was 36.07% (95% CI: 21.94-50.19, I2 = 99.5%). Receiving training from Community health workers (OR, 1.7; 95% CI: 1.33-2.08), female headship (OR, 2.52; 95% CI: 1.60-3.44), and household wealth (OR, 1.6; 95% CI: 1.19-2.16) were significantly associated with point-of-use water treatment practice.

CONCLUSION

Despite the absence of safely managed water sources, very few homes routinely treated their drinking water. Adoption of water treatment practices necessitates ongoing communication and assistance from health extension personnel. Moreover, program planners must be aware of the many user categories that households may fall under to guarantee that ongoing training messages and treatment products reach every home.