Department of Environmental Health, College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia.
Environ Health Prev Med. 2020 Dec 7;25(1):81. doi: 10.1186/s12199-020-00921-1.
Improved water sources are not equally available in all geographical regions. Populations dependent on unsafe water sources are recommended to treat their water at point-of-use using adequate methods to reduce associated health problems. In Ethiopia, the spatial distribution of households using unimproved water sources have been incomplete or ignored in most of the studies. Moreover, evidence on the point-of-use water treatment practice of households dependent on such water sources is scarce. Therefore, the current study is intended to analyze the spatial distribution of unimproved water sources by wealth quintiles at country level and point-of-use treatment (POU) practices using nationally representative data.
The data of 2016 Ethiopian Demographic and Health Survey (EDHS) conducted on 16650 households from 643 clusters were used for the analysis. For spatial analysis, the raw and spatially smoothed coverage data was joined to the geographic coordinates based on EDHS cluster identification code. Global spatial autocorrelation was performed to analyze whether the pattern of unimproved water coverage is clustered, dispersed, or random across the study areas. Once a positive global autocorrelation was confirmed, a local spatial autocorrelation analysis was applied to detect local clusters. The POU water treatment is analyzed based on reported use of either boiling, chlorine (bleach), filtration, or solar disinfection (SODIS).
There were 5005 households using unimproved water sources for drinking purposes. Spatial variation of unimproved water coverage was observed with high coverage observed at Amhara, Afar, Southern Nations Nationalities and People and Somalia regions. Disparity in unimproved water coverage between wealth quintiles was also observed. The reported point-of-use water treatment practice among these households is only 6.24%. The odds of POU water treatment among household heads with higher education status is 2.5 times higher (95% CI = 1.43-4.36) compared to those who did not attend education.
An apparent clustering trend with high unimproved water coverage was observed between regions and among wealth quintiles hence indicates priority areas for future resource allocation and the need for regional and national policies to address the issue. Promoting households to treat water prior to drinking is essential to reduce health problems.
并非所有地理区域都能同样获得改善后的水源。建议依赖不安全水源的人群在用水点使用适当的方法对水进行处理，以减少相关健康问题。在埃塞俄比亚，大多数研究都没有完整或忽略了依赖不安全水源的家庭的用水点处理实践。因此，本研究旨在利用全国代表性数据，分析全国范围内按财富五分位数划分的未改善水源的空间分布以及依赖此类水源的家庭的用水点处理（POU）实践情况。
使用了 2016 年埃塞俄比亚人口与健康调查（EDHS）的数据，该调查涉及 643 个集群中的 16650 户家庭。对于空间分析，原始和空间平滑的覆盖数据与基于 EDHS 集群识别码的地理坐标相连接。进行全局空间自相关分析，以分析未改善水源覆盖的模式是否在研究区域内呈聚类、分散或随机分布。一旦确认存在正的全局自相关，就会应用局部空间自相关分析来检测局部聚类。POU 水处理是根据报告的煮沸、氯（漂白剂）、过滤或太阳能消毒（SODIS）的使用情况进行分析的。
有 5005 户家庭使用未改善的水源作为饮用水。未改善水源覆盖的空间变化存在很大差异，阿姆哈拉、阿法尔、南部民族和人民以及索马里地区的覆盖度较高。不同财富五分位数之间的未改善水源覆盖也存在差异。这些家庭中报告的 POU 水处理实践仅为 6.24%。与未接受教育的家庭相比，具有较高教育程度的家庭负责人进行 POU 水处理的可能性高 2.5 倍（95%置信区间=1.43-4.36）。
在区域之间以及在财富五分位数之间观察到明显的聚类趋势，表明需要对未来的资源分配进行优先考虑，并需要制定区域和国家政策来解决这个问题。在饮用水之前促进家庭对水进行处理对于减少健康问题至关重要。
