Exploring geographical variations and inequalities in access to improved water and sanitation in Ethiopia: mapping and spatial analysis

Azage, Muluken; Motbainor, Achenef; Nigatu, Dabere

doi:10.1016/j.heliyon.2020.e03828

Cited by 34 publications

(27 citation statements)

References 12 publications

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“…The current findings related to unimproved coverage in these regions were indicated in a national survey [ 27 ]. The spatial distribution of unimproved water sources observed among regions and wealth quintiles was similar with previous studies [ 18 , 42 ]. It also corroborates studies, which indicated variations in access to improved water attributed by wealth status [ 2 , 17 ].…”

Section: Discussionsupporting

confidence: 90%

“…But, evidence on the spatial distribution of households which depend on unimproved water sources has been incomplete or ignored in most of the studies [2,17]. In this regard, few studies were conducted in Ethiopia to locate or map areas with highest unimproved water source coverage among different wealth categories and local levels [18,19]. Moreover, data on how POU water treatment practices of populations dependent on unimproved water sources is scarce.…”

Section: Introductionmentioning

confidence: 99%

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Households with unimproved water sources in Ethiopia: spatial variation and point-of-use treatment based on 2016 Demographic and Health Survey

Damtew

Geremew

2020

Environ Health Prev Med

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Background Improved water sources are not equally available in all geographical regions. Populations dependent on unsafe water sources are recommended to treat their water at point-of-use using adequate methods to reduce associated health problems. In Ethiopia, the spatial distribution of households using unimproved water sources have been incomplete or ignored in most of the studies. Moreover, evidence on the point-of-use water treatment practice of households dependent on such water sources is scarce. Therefore, the current study is intended to analyze the spatial distribution of unimproved water sources by wealth quintiles at country level and point-of-use treatment (POU) practices using nationally representative data. Method The data of 2016 Ethiopian Demographic and Health Survey (EDHS) conducted on 16650 households from 643 clusters were used for the analysis. For spatial analysis, the raw and spatially smoothed coverage data was joined to the geographic coordinates based on EDHS cluster identification code. Global spatial autocorrelation was performed to analyze whether the pattern of unimproved water coverage is clustered, dispersed, or random across the study areas. Once a positive global autocorrelation was confirmed, a local spatial autocorrelation analysis was applied to detect local clusters. The POU water treatment is analyzed based on reported use of either boiling, chlorine (bleach), filtration, or solar disinfection (SODIS). Results There were 5005 households using unimproved water sources for drinking purposes. Spatial variation of unimproved water coverage was observed with high coverage observed at Amhara, Afar, Southern Nations Nationalities and People and Somalia regions. Disparity in unimproved water coverage between wealth quintiles was also observed. The reported point-of-use water treatment practice among these households is only 6.24%. The odds of POU water treatment among household heads with higher education status is 2.5 times higher (95% CI = 1.43-4.36) compared to those who did not attend education. Conclusion An apparent clustering trend with high unimproved water coverage was observed between regions and among wealth quintiles hence indicates priority areas for future resource allocation and the need for regional and national policies to address the issue. Promoting households to treat water prior to drinking is essential to reduce health problems.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Households with unimproved water sources in Ethiopia: spatial variation and point-of-use treatment based on 2016 Demographic and Health Survey

Damtew

Geremew

2020

Environ Health Prev Med

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“…The percentage of households with low unimproved water coverage were linked with the latter two quintiles. The spatial distribution of unimproved water sources observed among regions and wealth quintiles were similar with previous studies [17,30,31]. It also corroborates studies which indicated variations in access to improved water attributed by wealth status [15,16].…”

Section: Discussionsupporting

confidence: 90%

“…But, evidence on the spatial distribution of households which depends on unimproved water sources has been incomplete or ignored in most of the studies [15,16]. In this regard, few studies were conducted in Ethiopia to locate or map areas with highest unimproved water source coverage among different wealth categories and local level [17,18]. Moreover, data on how point-of-use water treatment practices of populations dependent on unimproved water sources look like is scarce.…”

Section: Introductionmentioning

confidence: 99%

Unimproved water sources in Ethiopia: Spatial variation and household point-of-use treatment practice based on 2016 Demographic and Health Survey

Tefera

Geremew

2020

Preprint

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Background Improved water sources are not equally available in all geographical regions. Populations dependent on unsafe water sources are recommended to treat their water at point-of-use using adequate methods to reduce associated health problems. In Ethiopia, the spatial distribution of households using unimproved water sources have been incomplete or ignored in most of the studies. Moreover, evidence on the point-of-use water treatment practice of households dependent on such water sources is scarce. Therefore, the current study is intended to analyse the spatial distribution of unimproved water sources by wealth quintiles at country level and point-of-use treatment practices using nationally representative data. Method: The data of 2016 Ethiopian Demographic and health survey (EDHS) conducted on 16650 households from 643 clusters were used for the analysis. For spatial analysis, the raw and spatially smoothed coverage data was joined to the geographic coordinates based on DHS cluster identification code. Global spatial autocorrelation was performed to analyse whether the pattern of unimproved water coverage is clustered, dispersed, or random across the study areas. Once a positive global autocorrelation was confirmed, a local spatial autocorrelation analysis was applied to detect local clusters. The point-of-use water treatment is analysed based on reported use of either boiling, bleach, filtration or SODIS. Result There were 5005 households using unimproved water sources for drinking purpose. Spatial variation of unimproved water coverage was observed with high coverage observed at Amhara, Afar, Southern Nations Nationalities and People and Somalia regions. Disparity in unimproved water coverage between wealth quintiles was also observed. The reported point-of-use water treatment practices among these households is only 6.24%. The odds of point-of-use water treatment among household heads with higher education status is 2.5 times high (95%CI = 1.43–4.36) compared to those who did not attend education. Conclusion An apparent clustering trend with high unimproved water coverage was observed between regions and among wealth quintiles hence indicates priority areas for future resource allocation and the need for regional and national policies to address the issue. Promoting households to treat water prior to drinking is essential to reduce health problems.

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“…The purpose of this study was to explore the multi-layered factors influencing the adoption and utilization of latrine facilities in the rural Wonago district of Ethiopia. A recent survey of the availability and utilization of improved sanitation facilities unearthed that, while the coverage of improved sanitation facilities in the study area was 27.3%, the number of people who utilized improved sanitation facilities stood at 64.5% [ 26 ]. In the study, it was found that the availability and use of improved latrine facilities were correlated with the educational status of household head, receiving any assistance (monetary or material) from non-governmental organizations, ever receiving educational messages about improved latrine facilities, and frequent supervision by a health extension worker.…”

Section: Discussionmentioning

confidence: 99%

Exploring barriers to the adoption and utilization of improved latrine facilities in rural Ethiopia: An Integrated Behavioral Model for Water, Sanitation and Hygiene (IBM-WASH) approach

Tamene¹,

Afework

2021

PLoS ONE

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Background Even though evidence shows that access to and use of improved latrines is related to healthful families and the public, obstacles to the adoption and use of improved latrine facilities remain. Globally, not many inquiries appear to have been carried out to satisfactorily inform us regarding the multi-level barriers influencing the adoption and utilization of improved latrines facilities. Related studies in Ethiopia are even fewer. Methods Two qualitative data gathering methods, viz., key informant interviews and focus group discussions, were employed to collect data for this study. A total of fifteen focus group discussions were conducted with members of the community in the rural Wonago district of Ethiopia. Similarly, ten key informant interviews were conducted with water, sanitation, and hygiene officers, and health extension workers responsible for coordinating sanitation and hygiene activities. Open code software 4.03 was used for thematic analysis. Result Barriers to adoption and use of improved latrine facilities were categorized into Contextual factors (e.g. Gender, educational status, personal preference for using the field, limited space, population density, the status of land ownership), Psychosocial factors (Culture, beliefs, attitudes, and perceptions of minimal health threat from children's feces), and Technological factors (inconveniences in acquiring materials and cost of constructing a latrine). Conclusion There are a series of multi-leveled barriers to the sustained adoption and use of latrines. Providing funding opportunities for the underprivileged and offering training on the engineering skills of latrine construction at the community level based on the contextual soil circumstances could expand the latrine coverage and use. Similarly, taking into account the variability in motivations for adopting and using latrines among our study in Ethiopia and other studies, we implore public health experts to recognize behaviors and norms in their target communities in advance of implementing sanitation interventions.

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Exploring geographical variations and inequalities in access to improved water and sanitation in Ethiopia: mapping and spatial analysis

Cited by 34 publications

References 12 publications

Households with unimproved water sources in Ethiopia: spatial variation and point-of-use treatment based on 2016 Demographic and Health Survey

Households with unimproved water sources in Ethiopia: spatial variation and point-of-use treatment based on 2016 Demographic and Health Survey

Unimproved water sources in Ethiopia: Spatial variation and household point-of-use treatment practice based on 2016 Demographic and Health Survey

Exploring barriers to the adoption and utilization of improved latrine facilities in rural Ethiopia: An Integrated Behavioral Model for Water, Sanitation and Hygiene (IBM-WASH) approach

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