Hotspots of unimproved sources of drinking water in Ethiopia: mapping and spatial analysis of Ethiopia demographic and health survey Data 2016

Abstract

Background: More than 35% of the Ethiopian population are using drinking water from unimproved sources. As per the United Nations' Sustainable Development Goals, Ethiopia is aspiring to achieve universal and equitable access to safe and affordable drinking water for all by 2030. For these goals to be accomplished, it is important to map the country's hotspot areas of unimproved source of drinking-water so that resource allocation and disease control can be optimized there. Therefore, the objective of this study is to map and identify hotspot areas of unimproved sources of drinking water in Ethiopia. Methods: A population based cross-sectional study was conducted in Ethiopia from January 18 to June 27, 2016. Data were collected from 10,064 households using a pretested and structured questionnaire. A stratified two-stage cluster sampling was employed where the enumeration areas were primary sampling units and households were secondary sampling units. Systematic sampling with probability proportional to size was employed to select samples. Datasets were cleaned and entered into SaTScan and ArcGIS software for mapping and analysis. The Global Moran's I and spatial scan statistical tests (Bernoulli model) were done to explore the presence of clustering in the study area and local spatial clusters (hotspots) of unimproved sources of drinking water using ArcGIS version 10.3 and Kuldorff's SaTScan version 9.4 software, respectively. Results: Unimproved sources of drinking water were spatially clustered in the study area (Moran's I: 0.35, p < 0.05). A total of 143 significant clusters was identified. Of which, eight were most likely (primary) clusters and the other 135 were secondary clusters. The first spatial window which contains primary clusters was located in Amhara and Afar regions (LLR: 78.89, at p < 0.001). The other 33 spatial windows which contain secondary clusters were found in all regions, except Gambela region and Addis Abeba city administration (with a range of LLR: 10.09-78.89, p < 0.001). Conclusions: This study allowed the identification of important non-random clusters and hotspots of unimproved sources of drinking water. Therefore, these results will be determinant to help decision makers in their geographical interventions to combat problems related to drinking water quality.

Spatiotemporal Analysis of the Proportion of Unimproved Drinking Water Sources in Rural Ethiopia: Evidence from Ethiopian Socioeconomic Surveys (2011 to 2019)

“…The result further revealed that the proportion improved source increases as the household wealth quintile index increases, especially in the third wave of ESS data, and it was consistent with a study [ 2 ]. Another study [ 4 ] also confirmed the current study as the proportions of households with lower unimproved water coverage were related to the latter two (fourth and fifth) quintiles.…”

“…Consistent to another study [ 4 ], Jimma and Hararge zone in Oromia, Sitti zone in Somali, and rural Dire-Dawa newly emerged as hotspots, whereas western Tigray, and Liben zone in Somali were reversed to risk areas of unimproved potable sources during the third wave (2015/16). During the same period, Horo Gudru, South Gondar, Wag Hemera, and South Tigray zones showed an improvement in terms of drinking water sources.…”

“…According to the WHO and UNICEF Joint Monitoring Program (JMP), an unimproved source of drinking water is defined as a source of water that cannot adequately protect the source from external pollution, especially fecal pollution due to its structural nature [ 1 ]; this includes unprotected (dug) wells; unprotected springs, small tankers, or drums; and tanker water supply, surface water (river, dam, lake, pond, stream, canal, and irrigation canal), and bottled water (because the amount of water that households can obtain from this source may be limited, not the quality) [ 2 ]. However, improved drinking water sources are protected against outside contamination, notably fecal matter, through active interventions [ 3 , 4 ], which includes tap water in residential plots or gardens, public faucets/standpipes, borehole/tube well, well digging and protection, protected spring, and rainwater collection.…”

“…In this regard, identifying highly vulnerable areas is essential in reducing the lack of improved water sources. Results of a few studies conducted in different settings of Ethiopia revealed that an unimproved source of drinking water was significantly clustered spatially [ 4 , 21 , 22 ]. However, the temporal pattern of unimproved drinking water sources was not incorporated in these studies and they used only one cross-sectional data; it may be unable to analyze the data in time and space domains [ 23 ].…”

Mapping of cholera hotspots in Kenya using epidemiologic and water, sanitation, and hygiene (WASH) indicators as part of Kenya’s new 2022–2030 cholera elimination plan

“…Notably, over 50% of the country is mapped as either high or medium WASH priority (Fig 5). Similarly, a survey in Ethiopia reported the proportion of households using unimproved water sources is high and far from the UN Sustainable Development Goal (SDG) or the national goal [19,20]. As Kenya implements interventions toward elimination, the country must invest in the expansion of WASH infrastructure to increase access to improved water and sanitation.…”