Indicators of improved water access in the context of schistosomiasis transmission in rural Eastern Region, Ghana

Abstract

Populations with poor access to water, sanitation and hygiene (WASH) infrastructure are disproportionately affected by the neglected tropical diseases (NTDs). As a result, WASH has gained increasing prominence in integrated control and elimination of NTDs, including schistosomiasis. In order to identify underserved populations, relevant measures of access to WASH infrastructure at sub–national or local levels are needed. We conducted a field survey of all public water sources in 74 rural communities in the Eastern Region of Ghana and computed indicators of water access using two methods: one based on the design capacity and another on the spatial distribution of water sources. The spatial method was applied to improved and surface water sources. According to the spatial method, improved water sources in the study area were well–distributed within communities with 95% (CI95%: 91, 98) of the population having access within 500 m when all, and 87% (CI95%: 81, 93) when only functional water sources were considered. According to the design capacity–based method, indicator values were lower: 63% (CI95%: 57, 69) for all and 49% (CI95%: 43, 55) for only functional sources. Surface water access was substantial with 62% (CI95%: 54, 71) of the population located within 500 m of a perennial surface water source. A negative relationship was observed between functional improved water access and surface water access within 300 m. In this context, perceived water quality of the improved sources was also important, with a 17% increase in surface water access in towns with one reported water quality problem as compared to towns with no problems. Our study offers a potential methodology to use water point mapping data to identify communities in need of improved water access to achieve schistosomiasis risk reduction.

Physicochemical parameters affecting the perception of borehole water quality in Ghana

“…Prior research in the Eastern Region suggests that groundwater sources are underutilized in part due to these WQ problems (Kosinski et al, 2016; Kulinkina et al, 2016). Undesirable organoleptic characteristics of groundwater from BHs are also likely linked to consumption of microbiologically and chemically contaminated surface water (Kulinkina et al, 2017), which can lead to substantial detrimental public health impacts. Examining geographic clustering of WQ problems and patterns in dynamic water consumption from multiple water sources using spatial analyses (Alarcon Falconi et al, 2017) can be explored in future studies.…”

“…The study was excluded from ethical review because collected information pertained to water sources and not to the survey respondents. To design the WQ sampling and survey protocol, we used information gathered during the 2014 study (Kulinkina et al, 2017), which identified a total of 238 BHs in 67 communities. Of these, 176 BHs in 61 communities were functional and constituted the sample frame for this study.…”

“…The survey about WQ complaints, developed based on previous work (Kulinkina et al, 2017), included five closed-ended yes/no format questions: 1) Do people who use this water usually think it tastes salty? 2) Do people who use this water usually think it has particles?…”

“…In a prior study of public water sources in 74 rural Eastern Region communities conducted in 2014, we found that BHs were indeed the most common public water source type, with surface water access points located on rivers and streams being just as common (Kulinkina et al, 2017). Our findings were in accordance with the most recent census (2010) that listed BHs as the most common primary source of drinking water (42.5% on average), with rivers and streams being second (21.5%).…”

“…The study suggested that organoleptic characteristics of improved water sources, concurrently with other factors such as distance and water fees, play a role in water source choice and dynamic water use from multiple available sources (Kulinkina et al, 2016, 2017). The present study was designed to follow up on the 2014 study with the following objectives:…”