The Relationship Between Distance to Water Source and Moderate-to-Severe Diarrhea in the Global Enterics Multi-Center Study in Kenya, 2008–2011

Abstract

Abstract. In the developing world, fetching water for drinking and other household uses is a substantial burden that affects water quantity and quality in the household. We used logistic regression to examine whether reported household water fetching times were a risk factor for moderate-to-severe diarrhea (MSD) using case-control data of 3,359 households from the Global Enterics Multi-Center Study in Kenya in 2009-2011. We collected additional global positioning system (GPS) data for a subset of 254 randomly selected households and compared GPS-based straight line and actual travel path distances to fetching times reported by respondents. GPS-based data were highly correlated with respondent-provided times (Spearman correlation coefficient = 0.81, P < 0.0001). The median estimated one-way distance to water source was 200 m for cases and 171 for controls (Wilcoxon rank sums/Mann-Whitney P = 0.21). A round-trip fetching time of > 30 minutes was reported by 25% of cases versus 15% of controls and was significantly associated with MSD where rainwater was not used in the last 2 weeks (odds ratio = 1.97, 95% confidence interval = 1.56-2.49). These data support the United Nations definition of access to an improved water source being within 30 minutes total round-trip travel time.

The association of water supply, sanitation and hygiene interventions and childhood malnutrition in Kersa and Omo Nada districts of Jimma Zone, Ethiopia: A case-control study

“…This study was supported by other studies done in rural Ethiopia and Kenya [31,34] This analysis shows there was the inverse association between household access to a toilet facility and childhood malnutrition. Our study finding incline to confirm the findings of other studies carried out in Ethiopia and other parts of the world [19,31,35].…”

Measuring the resilience of health systems in low- and middle-income countries: a focus on community resilience

“…These indicators are regarded as primary indicators because they could be further operationalised to elicit the dynamic attributes of their constructs. For example, the percentages of household with year-round access to clean water elicit information about the physical resources needed for survival and could be further operationalised to consider the percentage of households with access over multiple years (robustness), whether there are multiple sources for clean water or not (redundancy) or whether clean water is delivered directly to the point of use or the round-trip time for fetching water is less than 30 minutes [ 48 ] (rapidity).…”

An Analysis of Water Collection Labor among Women and Children in 24 Sub-Saharan African Countries

“…The researchers found that self-reported data were poorly correlated with route distance and they noted that more research is needed to determine the best proxy measures for quantifying water collection times [ 23 ]. More recently, Nygren et al found that self-reported water collection times correlated well with GPS coordinate data [ 13 ].…”

“…The authors noted that this level of reduction in diarrheal disease morbidity is on par with reductions associated with sanitation, hand washing, and water disinfection interventions [ 12 ]. More recently, a case-control study in Kenya found that water collection time greater than 30 minutes was associated with an increased risk of moderate-to-severe diarrhea among children, which supports the use of 30 minutes as a metric in the United Nations’ definition of an improved water source [ 13 ].…”