Trends in access to water and sanitation in Malawi: progress and inequalities (1992-2017)

A multilevel analysis of improved drinking water sources and sanitation facilities in Ethiopia: Using 2019 Ethiopia mini demographic and health survey

Background

Access to water, sanitation, and hygiene is an important element for communicable disease control including the existing COVID-19 pandemic. This is due to the growing water demand and decreasing water availability, because of shrinking resources, increased urbanization, and pollution. This problem is higher, particularly among least developed countries like Ethiopia. This study, therefore, aimed at investigating the level of improved water sources and sanitation as well as their predictors in Ethiopia using EMDHS-2019.

Method

Mini Ethiopian Demographic and Health Surveys 2019 database survey was used in this study. Data collection took place over 3 months, from 21 March 2019 to 28 June 2019. A total of 9,150 households were selected for the sample, of which 8,794 were engaged. Among involved households, 8,663 were successfully interviewed at a response rate of 99%. The dependent variables measured in this study were improved drinking water sources and sanitation facilities. Due to the nested nature of DHS data, multilevel binary logistic regression analysis was done using Stata-16.

Results

The majority (72.62%) of household heads were men, and 69.47% of participants were from rural areas. Close to half (47.65%) of study participants did not have any form of formal education, while the lowest proportion (9.89%) of them had higher education. Approximately 71.74 and 27.45% of the households have accessed improved water sources and sanitation, respectively. Based on the final model results, wealth index, educational status, and having a television individual-level variables while community-level poverty, community-level education, community-level media exposure, and place of residence were statistically significant predictors of getting improved water source and sanitation.

Conclusion

The level of access to improved water sources is moderate but it lacks progress, while access to improved sanitation was lower. Based on these findings, great improvements should be made in providing access to an improved water source and sanitation facilities in Ethiopia. Based on these findings, great improvements should be made in providing access to improved water source and sanitation facilities in Ethiopia.

Perceptions of Inclusivity and Sustainability in Urban Sanitation in Global South Cities

Citywide Inclusive Sanitation (CWIS) calls for sustainable urban sanitation services for all, but the definitions of "inclusion" and "sustainability" within the framework leave room for interpretation. This study aims to provide an initial understanding of how these terms are currently interpreted by a range of sanitation actors in six cities of the Global South. Urban sanitation professionals from private (n = 16), public (n = 28), non-governmental (n = 43), and academic (n = 10) institutions were interviewed using a standardized tool, and data was analyzed to identify themes and trends. Terms such as "everyone" or "for all" shed little light on how to ensure inclusion, though disabled people, women, children, and the poor were all highlighted when probed. Greater specificity of beneficiary groups in policy is likely to enhance their visibility within sanitation service provision. All three pillars of sustainability identified within CWIS were referenced, with different stakeholders focusing more closely on environmental, social, or economic sustainability, based on their organizational goals and interests. Greater collaboration may foster a balanced view across the pillars, with different organizations acting as champions for each one. The findings can facilitate discussions on a shared understanding of multi-stakeholder engagement in achieving inclusive and sustainable sanitation service provision.

Household practices in accessing drinking water and post collection contamination: A seasonal cohort study in Malawi

Lack of access to safe drinking water on premises remains widespread in low- and middle-income countries. Interventions to improve access to safe water at the point of collection are essential, but water safety at the point of consumption is also an important consideration. This research aimed to 1) improve understanding of household practices in collecting water with respect to seasonality, and 2) to further assess risk associated with post-collection contamination from the point of collection to the point of consumption. A seasonal cohort study, including 115 households, was conducted in Malawi. Along with household surveys and observations, samples of water were tested for microbial water quality at four different stages of water collection: water source, collection container, storage container, cup of drinking water. Using E. coli as an indicator of contamination (cfu/100 ml), the risk of post-collection contamination was assessed. The results indicate that most water sources were free from contamination; contamination was proportionally lower in the dry season when more sources were found to be classified as having a very low risk of contamination. However, the level of risk of contamination was more likely to increase following collection in water sources that were initially free from contamination. Results show that the degradation in water quality from the point of collection to the point of consumption was more important in the rainy season, which is likely to be driven by the effect of seasonality on the household environment. Filling the collection container at the point of collection and storage at the point of consumption were found to be critical stages for an increased risk of E. coli contamination. Understanding household practices in accessing and handling water during both rainy and dry season is necessary to target appropriate interventions to reduce post-collection contamination.

Evaluating self-reported measures and alternatives to monitor access to drinking water: A case study in Malawi

Monitoring access to drinking water is complex, especially in settings where on premises water supply is not available. Although self-reported data are generally used to estimate coverage of access to drinking water, the relationship between self-reported time travelled and true time travelled is not well known in the context of water fetching. Further, water fetching is likely to impact the quantity and quality of water a household uses, but data and measures supporting this relationship are not well documented. The objective of this study was to appraise the validity and reliability of self-reported measurements used to estimate access coverage. A case study was conducted in Malawi to enhance understanding of the self-reported measures and alternatives available to assess and monitor access to drinking water in view of generating global estimates. Self-reported data were compared with objective observations and direct measurements of water quantity, quality and accessibility. Findings from this study highlight the variations between different measures such as self-reported and recorded collection time and raise awareness with regard to the use of self-reported data in the context of fetching water. Alternatives to self-reported indicators such as GPS-based or direct observations could be considered in surveys in view of improving data accuracy and global estimates.