Mapping Geographical Inequalities in Access to Drinking Water and Sanitation Facilities in Low-Income and Middle-Income Countries, 2000–17

Background Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards...

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Main Authors: Deshpande, Aniruddha, Reiner, Robert C, Jr, Pepito, Veincent Christian F, Amit, Arianna Maever L, Collaborators, Local Burden of Disease WaSH, co-authors, 665
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Published: Archīum Ateneo 2020
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Online Access:https://archium.ateneo.edu/asmph-pubs/77
https://archium.ateneo.edu/cgi/viewcontent.cgi?article=1079&context=asmph-pubs
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spelling ph-ateneo-arc.asmph-pubs-10792022-06-23T01:06:21Z Mapping Geographical Inequalities in Access to Drinking Water and Sanitation Facilities in Low-Income and Middle-Income Countries, 2000–17 Deshpande, Aniruddha Reiner, Robert C, Jr Pepito, Veincent Christian F Amit, Arianna Maever L Collaborators, Local Burden of Disease WaSH co-authors, 665 Background Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce high-resolution geospatial estimates of access to drinking water and sanitation facilities. Methods We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and aggregated results to policy-relevant administrative units. We estimated mutually exclusive and collectively exhaustive subcategories of facilities for drinking water (piped water on or off premises, other improved facilities, unimproved, and surface water) and sanitation facilities (septic or sewer sanitation, other improved, unimproved, and open defecation) with use of ordinal regression. We also estimated the number of diarrhoeal deaths in children younger than 5 years attributed to unsafe facilities and estimated deaths that were averted by increased access to safe facilities in 2017, and analysed geographical inequality in access within LMICs. Findings Across LMICs, access to both piped water and improved water overall increased between 2000 and 2017, with progress varying spatially. For piped water, the safest water facility type, access increased from 40·0% (95% uncertainty interval [UI] 39·4–40·7) to 50·3% (50·0–50·5), but was lowest in sub-Saharan Africa, where access to piped water was mostly concentrated in urban centres. Access to both sewer or septic sanitation and improved sanitation overall also increased across all LMICs during the study period. For sewer or septic sanitation, access was 46·3% (95% UI 46·1–46·5) in 2017, compared with 28·7% (28·5–29·0) in 2000. Although some units improved access to the safest drinking water or sanitation facilities since 2000, a large absolute number of people continued to not have access in several units with high access to such facilities (>80%) in 2017. More than 253 000 people did not have access to sewer or septic sanitation facilities in the city of Harare, Zimbabwe, despite 88·6% (95% UI 87·2–89·7) access overall. Many units were able to transition from the least safe facilities in 2000 to safe facilities by 2017; for units in which populations primarily practised open defecation in 2000, 686 (95% UI 664–711) of the 1830 (1797–1863) units transitioned to the use of improved sanitation. Geographical disparities in access to improved water across units decreased in 76·1% (95% UI 71·6–80·7) of countries from 2000 to 2017, and in 53·9% (50·6–59·6) of countries for access to improved sanitation, but remained evident subnationally in most countries in 2017. Interpretation Our estimates, combined with geospatial trends in diarrhoeal burden, identify where efforts to increase access to safe drinking water and sanitation facilities are most needed. By highlighting areas with successful approaches or in need of targeted interventions, our estimates can enable precision public health to effectively progress towards universal access to safe water and sanitation. 2020-09-01T07:00:00Z text application/pdf https://archium.ateneo.edu/asmph-pubs/77 https://archium.ateneo.edu/cgi/viewcontent.cgi?article=1079&context=asmph-pubs Ateneo School of Medicine and Public Health Faculty Publications Archīum Ateneo Demography, Population, and Ecology Health Policy Public Health Water Resource Management
institution Ateneo De Manila University
building Ateneo De Manila University Library
continent Asia
country Philippines
Philippines
content_provider Ateneo De Manila University Library
collection archium.Ateneo Institutional Repository
topic Demography, Population, and Ecology
Health Policy
Public Health
Water Resource Management
spellingShingle Demography, Population, and Ecology
Health Policy
Public Health
Water Resource Management
Deshpande, Aniruddha
Reiner, Robert C, Jr
Pepito, Veincent Christian F
Amit, Arianna Maever L
Collaborators, Local Burden of Disease WaSH
co-authors, 665
Mapping Geographical Inequalities in Access to Drinking Water and Sanitation Facilities in Low-Income and Middle-Income Countries, 2000–17
description Background Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce high-resolution geospatial estimates of access to drinking water and sanitation facilities. Methods We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and aggregated results to policy-relevant administrative units. We estimated mutually exclusive and collectively exhaustive subcategories of facilities for drinking water (piped water on or off premises, other improved facilities, unimproved, and surface water) and sanitation facilities (septic or sewer sanitation, other improved, unimproved, and open defecation) with use of ordinal regression. We also estimated the number of diarrhoeal deaths in children younger than 5 years attributed to unsafe facilities and estimated deaths that were averted by increased access to safe facilities in 2017, and analysed geographical inequality in access within LMICs. Findings Across LMICs, access to both piped water and improved water overall increased between 2000 and 2017, with progress varying spatially. For piped water, the safest water facility type, access increased from 40·0% (95% uncertainty interval [UI] 39·4–40·7) to 50·3% (50·0–50·5), but was lowest in sub-Saharan Africa, where access to piped water was mostly concentrated in urban centres. Access to both sewer or septic sanitation and improved sanitation overall also increased across all LMICs during the study period. For sewer or septic sanitation, access was 46·3% (95% UI 46·1–46·5) in 2017, compared with 28·7% (28·5–29·0) in 2000. Although some units improved access to the safest drinking water or sanitation facilities since 2000, a large absolute number of people continued to not have access in several units with high access to such facilities (>80%) in 2017. More than 253 000 people did not have access to sewer or septic sanitation facilities in the city of Harare, Zimbabwe, despite 88·6% (95% UI 87·2–89·7) access overall. Many units were able to transition from the least safe facilities in 2000 to safe facilities by 2017; for units in which populations primarily practised open defecation in 2000, 686 (95% UI 664–711) of the 1830 (1797–1863) units transitioned to the use of improved sanitation. Geographical disparities in access to improved water across units decreased in 76·1% (95% UI 71·6–80·7) of countries from 2000 to 2017, and in 53·9% (50·6–59·6) of countries for access to improved sanitation, but remained evident subnationally in most countries in 2017. Interpretation Our estimates, combined with geospatial trends in diarrhoeal burden, identify where efforts to increase access to safe drinking water and sanitation facilities are most needed. By highlighting areas with successful approaches or in need of targeted interventions, our estimates can enable precision public health to effectively progress towards universal access to safe water and sanitation.
format text
author Deshpande, Aniruddha
Reiner, Robert C, Jr
Pepito, Veincent Christian F
Amit, Arianna Maever L
Collaborators, Local Burden of Disease WaSH
co-authors, 665
author_facet Deshpande, Aniruddha
Reiner, Robert C, Jr
Pepito, Veincent Christian F
Amit, Arianna Maever L
Collaborators, Local Burden of Disease WaSH
co-authors, 665
author_sort Deshpande, Aniruddha
title Mapping Geographical Inequalities in Access to Drinking Water and Sanitation Facilities in Low-Income and Middle-Income Countries, 2000–17
title_short Mapping Geographical Inequalities in Access to Drinking Water and Sanitation Facilities in Low-Income and Middle-Income Countries, 2000–17
title_full Mapping Geographical Inequalities in Access to Drinking Water and Sanitation Facilities in Low-Income and Middle-Income Countries, 2000–17
title_fullStr Mapping Geographical Inequalities in Access to Drinking Water and Sanitation Facilities in Low-Income and Middle-Income Countries, 2000–17
title_full_unstemmed Mapping Geographical Inequalities in Access to Drinking Water and Sanitation Facilities in Low-Income and Middle-Income Countries, 2000–17
title_sort mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000–17
publisher Archīum Ateneo
publishDate 2020
url https://archium.ateneo.edu/asmph-pubs/77
https://archium.ateneo.edu/cgi/viewcontent.cgi?article=1079&context=asmph-pubs
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