Water quality in Ethiopia: learning from data Kate Shields, A.J. Karon, Elizabeth Christenson, Argaw Ambelu, Kaida Liang, Jamie Bartram
Outline Background Using the Methods Results & Intro data
Background: Existing evidence • 7 water quality studies measuring E. coli or thermotolerant coliforms conducted in Ethiopia since 2004. – 5 studies had low study design quality overall – 2 studies found to be of high quality, • 1 focused on piped water in urban areas • 1 was 2004-2005 Rapid Assessment of Drinking-Water Quality (RADWQ) study by WHO and UNICEF – 56% of samples unsafe (156 containers – both rural and urban) • 3 studies had comparisons of household stored water (HSW) quality versus source water quality. Background Using the Methods Results & Intro Data
Background: SDG service ladders Sanitation Water Hygiene Safely managed Safely managed A basic sanitation facility which is not shared with other A basic drinking water source which is located on Basic households and where excreta are safely disposed in situ premises, available when needed and free or treated off-site Hand washing facility with soap and water in the of faecal and priority chemical contamination household Basic Basic Flush/pour flush to piped sewer system, septic tank or pit Piped water, boreholes or tubewells, protected dug wells, latrine, ventilated improved pit latrine, composting toilet protected springs and rainwater provided collection time or pit latrine with a slab not shared with other households is no more than 30 minutes for a roundtrip including queuing Unimproved Shared Handwashing facility without soap or water Sanitation facilities of an otherwise acceptable type Unimproved shared between two or more households Drinking water from unprotected dug wells, unprotected Unimproved springs, carts with small tank/drum, tanker trucks or Pit latrines without a slab or platform, hanging latrines basic sources with a total collection time of more than 30 and bucket latrines minutes for a roundtrip including queuing No facility Open defecation No handwashing facility Human faeces disposed of in fields, forest, bushes, open Surface water bodies of water, beaches or other open spaces or River, dam, lake, pond, stream, canal or irrigation channel disposed of with solid waste Background Using the Methods Results & Intro Data
Background: SDG service ladders Sanitation Water Hygiene Safely managed Safely managed A basic sanitation facility which is not shared with other A basic drinking water source which is located on Basic households and where excreta are safely disposed in situ premises, available when needed and free or treated off-site Hand washing facility with soap and water in the of faecal and priority chemical contamination household Safely managed Basic Basic Flush/pour flush to piped sewer system, septic tank or pit Piped water, boreholes or tubewells, protected dug wells, latrine, ventilated improved pit latrine, composting toilet A basic drinking water source which is protected springs and rainwater provided collection time or pit latrine with a slab not shared with other households is no more than 30 minutes for a roundtrip including queuing Unimproved located on premises, available when needed Shared Handwashing facility without soap or water Sanitation facilities of an otherwise acceptable type Unimproved shared between two or more households Drinking water from unprotected dug wells, unprotected and free Unimproved springs, carts with small tank/drum, tanker trucks or Pit latrines without a slab or platform, hanging latrines basic sources with a total collection time of more than 30 and bucket latrines of faecal and priority chemical minutes for a roundtrip including queuing No facility Open defecation No handwashing facility Human faeces disposed of in fields, forest, bushes, open contamination Surface water bodies of water, beaches or other open spaces or River, dam, lake, pond, stream, canal or irrigation channel disposed of with solid waste Background Using the Methods Results & Intro Data
Background and Motivation • Millennium Water Alliance – Active in Ethiopia since 2004 – Works through member organizations • 2014 endline/baseline indicated water quality challenges • Wanted to better understand water quality to improve programming • Particular interest in household stored water quality Background Using the Methods Results & Intro Data
METHODS Background Using the Methods Results & Intro Data
Design: Sampling plan All MWA program areas from 2011-2017. Stratified by completed projects (2011-2014) and new projects (2014-2017). 44 kebeles selected at random from each stratum. Up to 4 gots selected at random from each kebele. 6 households selected at random per got. All community water sources selected per got. Background Using the Methods Results & Intro Data
Design: Study tools • Community survey • Water point survey (WaSH MEL field kit) – Arsenic – Fluoride – pH – Conductivity – E. coli • Household survey – E. coli • Sanitation facility survey Background Using the Methods Results & Intro Data
Surveys collected by region Household Village Water source Amhara 908 149 235 Benishangul 129 21 32 Oromia 549 87 84 SNNPR 351 55 73 Total 1937 316 425 Background Using the Methods Results & Intro Data
Map of surveyed villages Background Using the Methods Results & Intro Data
National DESCRIPTIVE STATISTICS Background Using the Methods Results & Intro Data
Water source Percentage of water sources 0 10 20 30 40 50 60 70 80 90 100 147 Managed by WaSH committee 127 163 Functional on day of survey 203 In the past year, water system been broken down for more than 55 one day 41 150 Water is avaliable from source at all times 187 112 Water is available from this source at all hours of the day 125 Background Using the Methods Results Completed projects & Intro New projects Data
Water source: Quality 100 90 80 70 Percentage of Sources 67 60 50 55 54 52 46 40 30 32 32 30 28 26 20 16 10 13 8 7 9 5 6 9 6 0 0 Public tap/standpipe Borehole with manual Protected spring (37) Unprotected spring (69) Surface water (18) (60) pump (149) Source type Conformity (<1 CFU/100 mL) Low risk (1-10 CFU/100 mL) Background Using the Methods Results & Intro Data Intermediate risk (11-100 CFU/100mL) High risk (>100 CFU/100 mL)
Household: Water access Completed projects Percentage of households 0 5 10 15 20 25 30 35 40 45 50 New projects 4 Piped water into dwelling 0 13 Piped water to yard/plot 1 209 Public tap/standpipe 141 334 Borehole with manual pump 390 1 Protected dug well 9 10 Unprotected dug well 35 109 Protected spring 69 127 Unprotected spring 182 1 Pay another person/buy filled containers 0 1 Cart with small tank/drum 0 7 Background Using the Surface water Methods Results 109 & Intro Data
Household: Water treatment and storage Percentage of households 0 10 20 30 40 50 60 70 80 90 100 16 Household practices water treatment 36 616 Storage container has lid 879 468 Storage container has a narrow opening 386 4 Storage cotainer has a tap or spigot 9 50 Storage container is above reach of animals 42 43 Storage container is clean 14 Background Using the Methods Results Completed projects & Intro New projects Data
Household: Stored water quality 100 90 80 83 76 Percentage of Households 70 71 60 60 50 54 40 30 20 23 17 15 10 13 12 12 11 11 10 9 6 6 7 2 6 0 Public tap/standpipe Borehole with manual Protected spring (168) Unprotected spring Surface water (121) (351) pump (709) (335) Source type Conformity (<1 CFU/100 mL) Low risk (1-10 CFU/100 mL) Background Using the Methods Results & Intro Data Intermediate risk (11-100 CFU/100mL) High risk (>100 CFU/100 mL)
Sanitation: Latrine usage Background Using the Methods Results & Intro Data
Hygiene: Handwashing times Completed projects Percentage of households reporting handwashing time 0 20 40 60 80 100 New projects 552 after defecation 587 106 after changing a baby 97 586 before preparing food 606 645 before eating 790 109 before feeding a child 101 2 in the afternoon 4 2 when hands are dirty 4 5 after eating 10 0 in evening 10 13 in morning 27 0 before going outside the home 3 3 before prayer 9 Background Using the 7 Methods Results after work, cleaning, dealing with animals, farming & Intro 17 Data
National REGRESSION ANALYSIS Background Using the Methods Results & Intro Data
Regression analysis: Source water safety No human excreta External support within 10m available OR: 2.5 (1.0-5.9) OR: 1.7 (1.0-2.8) Safe source water Background Using the Methods Results & Intro Data
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