The World Health Organization (WHO) and United Nations Children’s Fund (UNICEF), through the Joint Monitoring Programme (JMP), are responsible for global monitoring of the Sustainable Development Goal (SDG) targets for drinking water, sanitation and hygiene (WASH). The SDGs represent a fundamental shift in household WASH monitoring with a new focus on service levels and the incorporation of hygiene. This article reflects on the process of establishing SDG baselines and the methods used to generate national, regional and global estimates for the new household WASH indicators. The JMP 2017 update drew on over 3000 national data sources, primarily household surveys (n = 1443), censuses (n = 309) and administrative data (n = 1494). Whereas most countries could generate estimates for basic drinking water and basic sanitation, fewer countries could report on basic handwashing facilities, water quality and the disposal of waste from onsite sanitation. Based on data for 96 and 84 countries, respectively, the JMP estimates that globally 2.1 billion (29%) people lacked safely managed drinking water services and 4.5 billion (61%) lacked safely managed sanitation services in 2015. The expanded JMP inequalities database also finds substantial disparities by wealth and sub-national regions. The SDG baselines for household WASH reveal the scale of the challenge associated with achieving universal safely managed services and the substantial acceleration needed in many countries to achieve even basic services for everyone by 2030. Many countries have begun to localise the global SDG targets and are investing in data collection to address the SDG data gaps, whether through the integration of new elements in household surveys or strengthening collection and reporting of information through administrative and regulatory systems.
The inclusion of water, sanitation and hygiene (WASH) in non-household settings in the Sustainable Development Goals (SDGs) elicits the need for data to track progress over time. This review focuses on schools and health care facilities, and seeks to: (1) assess the availability of SDG baseline data for ten case study countries; (2) evaluate the extent to which existing national data allow monitoring against the SDG criteria; and (3) identify opportunities to improve the availability and quality of data for SDG monitoring. While none of the ten countries could provide all of the data needed to establish comprehensive SDG baselines, every country had information on at least some of the indicators. Education Management Information Systems (EMIS) currently provide the majority of national data on WASH in schools and, in many cases, could be aligned with the SDG criteria with only minor changes. Far fewer data are available for health care facilities. Health Management Information Systems (HMIS) provide a potential entry point for national monitoring. However, where HMIS are administered monthly, annual data collection instruments, such as facility inventory surveys, may be more appropriate. These findings have implications for monitoring WASH in other settings, such as workplaces and prisons.
Background. The Sustainable Development Goals set an ambitious new benchmark for safely managed drinking water services (SMDW), but many countries lack data on the availability and quality of drinking water. Objectives. To quantify the availability and microbiological quality of drinking water, monitor SMDW and examine risk factors for E. coli contamination in 20 low-and middle-income countries. Methods. A new water quality module for household surveys was implemented in Multiple Indicator Cluster Surveys. Teams used portable equipment to measure E. coli at the point of collection (PoC, n=48323) and at the point of use (PoU, n=51345) and asked respondents about the availability and location of drinking water services. E. coli levels were classified into risk categories and SMDW was calculated at the household- and domain-levels. Multilevel modified Poisson regression was used to explore pre-selected risk factors for contamination. Results. E. coli contamination was commonly detected at PoC (range: 16- 90%) and was even more likely at PoU (range 20-97%). Coverage of SMDW was 56 % points lower than improved drinking water and water quality was the limiting factor for SMDW in 14 out of 20 countries. Detection of E. coli at PoC was associated with use of improved water sources (RR = 0.63 [0.54-0.75]) and accessibility on premises (RR = 0.81 [0.70-0.95]) but not with availability (RR = 0.94 [0.84-1.06]). Households in the richest quintile (RR = 0.67 [0.50-0.90]) and in communities with high (>75%) improved sanitation coverage (RR = 0.95 [0.92-0.99]) were less likely to use contaminated water at PoU whereas animal ownership (RR = 1.08 [1.03-1.14]) and rural residence (RR = 1.11 [1.04-1.18]) increased risk of contamination. Discussion. Water quality data can be reliably collected in household surveys and can be used to assess inequalities in service levels, to track the SDG indicator of safely managed drinking water services, and to examine risk factors for contamination. There is an urgent need to implement scalable and sustainable interventions to reduce exposure to faecal contamination through drinking water.
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