Tufts University School of Engineering, Medford, MA, USA; Tufts University Friedman School of Nutrition Science and Policy, Boston, MA, USA.
Tufts University School of Arts and Sciences, Medford, MA, USA.
Int J Hyg Environ Health. 2020 Jun;227:113514. doi: 10.1016/j.ijheh.2020.113514. Epub 2020 Apr 2.
Sustainable Development Goal (SDG) 6 aims to achieve universal access to safe drinking water sources. However, the health benefits of meeting this goal will only be fully realized if improved sources are used to the exclusion of unimproved sources. Very little is known about how rural African households balance the use of improved and unimproved water sources when multiple options are present. We assessed parallel use of untreated surface water and unimproved hand-dug wells (HDWs) in the presence of boreholes (BHs) using a semi-quantitative water use survey among 750 residents of 15 rural Ghanaian communities, distributed across three BH water quality clusters: control, high salinity, and high iron. Multivariate mixed effects logistic regression models were used to assess the impact of water quality cluster on the use of BHs, HDWs, and surface water, controlling for distance to the nearest source of each type. Reported surface water use was significantly higher in the high salinity and high iron clusters than in the control cluster, especially for water-intensive activities. Respondents in the non-control clusters had approximately eight times higher odds of clothes washing with surface water (p < 0.01) than in the control. Respondents in the high salinity cluster also had 4.3 times higher odds of drinking surface water (p < 0.05). BH use was high in all clusters, but decreased substantially when distance to the nearest BH exceeded 300 m (OR = 0.17-0.25, p < 0.001). Water use from all sources was inversely correlated with distance, with the largest effect observed on HDW use in multivariate models (OR = 0.02, p < 0.001). Surface water and HDW use will likely continue despite the presence of BHs when perceived groundwater quality is poor and other water sources are in close proximity. It is essential to account for naturally-occurring but undesirable groundwater quality parameters in rural water planning to ensure that SDG 6 is met and health benefits are realized.
可持续发展目标 6 旨在实现人人享有安全饮用水源。然而，如果改善后的水源被用于替代未改善的水源，那么实现这一目标将带来的健康益处才会得到充分体现。在存在多种选择的情况下，农村非洲家庭如何平衡使用改良和未改良的水源，这方面的了解非常有限。我们在加纳的 15 个农村社区中，对 750 名居民进行了半定量用水调查，评估了在存在钻孔 (BH) 的情况下，未经处理的地表水和未改良的手挖井 (HDWs) 的平行使用情况，这些社区分布在 BH 水质的三个集群中：对照组、高盐度组和高铁组。使用多变量混合效应逻辑回归模型，控制每种水源的最近距离，评估水质集群对 BH、HDW 和地表水使用的影响。报告的地表水使用率在高盐度和高铁集群中明显高于对照组，尤其是在用水密集型活动中。非对照组的受访者用地表水洗衣服的可能性比对照组高约 8 倍（p<0.01）。高盐度组的受访者饮用地表水的可能性也高出 4.3 倍（p<0.05）。所有集群中 BH 的使用率都很高，但当最近的 BH 距离超过 300 米时，使用率会大幅下降（OR=0.17-0.25，p<0.001）。所有水源的用水量都与距离呈反比，在多变量模型中，HDW 用水量的影响最大（OR=0.02，p<0.001）。尽管存在 BH，但如果地下水水质较差且其他水源较近，地表水和 HDW 的使用仍可能继续。在农村水规划中，必须考虑到自然存在但不理想的地下水质量参数，以确保实现可持续发展目标 6 并实现健康效益。
