Department of Civil Engineering, Engineering and Computer Science (ECS) 304, University of Victoria, P.O. Box 1700 STN CSC, Victoria, BC V8 W 2Y2, Canada E-mail:
Department of Environmental Health, University of Malawi, The Polytechnic, Malawi and Eawag: Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland.
J Water Health. 2020 Oct;18(5):785-797. doi: 10.2166/wh.2020.069.
Billions of people globally gained access to improved drinking water sources and sanitation in the last decades, following effort towards achieving the Millennium Development Goals. Global progress remains a general indicator as it is unclear if access is equitable across groups of the population. Agenda 2030 calling for `leaving no one behind', there is a need to focus on the variations of access in different groups of the population, especially in the context of low- and middle-income countries including Malawi. We analyzed data from Demographic Health Survey (DHS) and Multiple Indicator Cluster Survey (MICS) to describe emerging trends on progress and inequalities in water supply and sanitation services over a 25-year period (1992-2017), as well as to identify the most vulnerable populations in Malawi. Data were disaggregated with geographic and socio-economic characteristics including regions, urban and rural areas, wealth and education level. Analysis of available data revealed progress in access to water and sanitation among all groups of the population. The largest progress was generally observed in the groups that were further behind at the baseline year, which likely reflects good targeting in interventions/improvements to reduce the gap in the population. Overall, results demonstrated that some segments of the population - foremost poorest Southern rural populations - still have limited access to water and are forced to practise open defecation. Finally, we suggest including standardized indicators that address safely managed drinking water and sanitation services in future surveys and studies to increase the accuracy of national estimates.
在过去几十年中，为实现千年发展目标，全球数以十亿计的人获得了更好的饮用水源和卫生设施。全球进展仍然是一个总体指标，因为尚不清楚这种获得是否在人口群体之间是公平的。2030 年议程呼吁“不落下任何人”，因此需要关注不同人口群体在获得方面的差异，特别是在包括马拉维在内的低收入和中等收入国家的背景下。我们分析了来自人口健康调查（DHS）和多指标类集调查（MICS）的数据，以描述在 25 年期间（1992-2017 年）供水和卫生服务进展和不平等方面的新趋势，并确定马拉维最脆弱的人群。数据按照地理和社会经济特征进行了细分，包括地区、城市和农村地区、财富和教育水平。对现有数据的分析表明，所有人群在获得水和卫生设施方面都取得了进展。最大的进展通常出现在基线年份落后较大的群体中，这可能反映出干预措施/改进的目标定位良好，以缩小人口差距。总体而言，结果表明，一些人口群体——主要是最贫穷的南部农村人口——仍然难以获得水，被迫露天排便。最后，我们建议在未来的调查和研究中纳入解决安全管理饮用水和卫生服务的标准化指标，以提高国家估计的准确性。
