Thomas-Possee, Mair Lucy Heath (2023) Domestic drinking water availability in Sub-Saharan Africa: Investigating drivers and indicators. University of Southampton, Doctoral Thesis, 332pp.
Abstract
Domestic drinking water supplies prone to interruptions and low per capita domestic water availability have been frequently reported among sub-Saharan African (SSA) households. Despite expanded international monitoring of drinking water availability through the sixth Sustainable Development Goal (SDG), little is known about the reality households face in receiving the water they require to meet their needs, nor how service availability has been measured to date. Using a ‘three-paper format’, this thesis aims to provide an insight into the complexities and inequalities in drinking water availability across SSA, whilst shedding light on the metrics used to assess service availability and the data currently available for monitoring progress towards SDG 6.
Through a systematic literature review, the first paper examines the methods used to date to measure drinking water availability, whilst synthesising existing evidence on African domestic drinking water availability. Findings indicate households across Africa are consistently faced with inadequate quantities of water. Only 9% of the 42 included studies reported household drinking water availability that meets the World Health Organisation’s minimum benchmark of 100 litres per capita per day that is required to meet basic needs. Research has used a multitude of diverse study methods and metrics to quantify service availability which restricts the ability to compare availability between studies.
Building on these findings, a cross-sectional, multi-level regression analysis was conducted in the second paper, drawing on georeferenced Demographic and Health Surveys. This explores the determinants of household-reported interruptions to drinking water services via improved sources in Ethiopia, Gambia, Malawi, Nigeria, Sierra Leone, South Africa, Tanzania, Uganda, Zambia and Zimbabwe. Evidence shows inequalities in service availability across the study countries, which in the highest instance, in Tanzania, sees 55% of households reporting an interruption. Similarities across countries in the household and community factors associated with interruptions are evident. Households living in urban areas, under water-scarce conditions or using a piped source are most likely to report an interruption to their supply.
The third paper assesses the consistency of data from water providers, a government water regulator and household water service users, when reporting on piped drinking water service availability in urban and peri-urban Zambia. A novel methodology involving multi-level modelling and spatial linkage of a household survey with water sector databases was successfully developed to integrate the three data perspectives. The three data streams are found to correlate with one another in their reporting of service availability. Direct comparison is limited however by the variations in metrics used, with a reliance from providers and regulators on yearly mean service hours, whilst household user data uses the more specific measure of availability in the last two weeks. The paper argues that whilst regulator and service providers can generate timely sub-national indicators of water availability, the annual metrics in these reports may fail to capture local-level inequalities or seasonal water interruptions.
Overall, this thesis highlights the inequalities that households experience in drinking water service availability across SSA, and the multitude of contextual and compositional factors that are associated with service interruptions. It also shows the breadth of empirical approaches used to measure availability and the complexities of the metrics used for quantification. The study develops insights by applying public health concepts, notably composition and context, to household water availability, whilst providing methodological contributions which advance understanding using geospatial and data integration techniques. The work concludes by emphasising the importance of improving domestic drinking water availability across SSA in order that standards of living are improved, and adverse health effects reduced. Recommendations are also provided for advancing and streamlining data collection to more effectively monitor progress towards SDG 6, thus ensuring that no one is left behind.
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