Research Center for Health Policy and Economics, Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan.
Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Trop Med Int Health. 2021 Jul;26(7):760-774. doi: 10.1111/tmi.13580. Epub 2021 Apr 25.
In 2017, 785 million people globally lacked access to basic services of drinking water and 2 billion people lived without basic sanitation services. Most of these people live in low- and lower-middle-income countries in South Asia, Southeast Asia and sub-Saharan Africa. To monitor the progress towards universal access to water and sanitation, this study aimed to predict the coverage of access to basic drinking water supply and sanitation (WSS) services as well as the reduction in the practice of open defecation by 2030, under two assumptions: following the current trends and accelerated poverty reduction.
Households reporting access to basic WSS services and those practising open defecation were extracted from 210 nationally representative Demographic Health Surveys and Multiple Cluster Indicator Surveys (1994-2016) from 51 countries. A Bayesian hierarchical mixed effect linear regression model was developed to predict the indicators in 2030 at national, urban-rural and wealth-specific levels. A Bayesian regression model with accelerated reduction in poverty by 2030 was applied to assess the impact of poverty reduction on these indicators. Out of 51 countries, only nine (Bangladesh, Bhutan, Ghana, India, Nepal, Pakistan, The Philippines, Togo and Vietnam) were predicted to reach over 90% coverage in access to basic services of drinking water by 2030. However, none of the countries were projected to achieve equivalent coverage for access to basic sanitation services. By 2030, 21 countries were projected to achieve the target of less than 10% households practising open defecation. Urban-rural and wealth-derived disparities in access to basic WSS services, especially sanitation, were more pronounced in sub-Saharan Africa than South Asia and Southeast Asia. Access to basic sanitation services was projected to benefit more from poverty reduction than access to basic drinking water services. Households residing in rural settings were predicted to receive greater benefit from poverty reduction than urban populations in access to both basic WSS services.
Achieving poverty eradication targets may have a substantial positive impact on access to basic water supply and sanitation services. However, many low- and lower-middle-income countries will struggle to achieve the goal of universal access to basic services, especially in the sanitation sector.
2017 年，全球有 7.85 亿人无法获得基本饮用水服务，20 亿人没有基本卫生服务。这些人大多生活在南亚、东南亚和撒哈拉以南非洲的低收入和中低收入国家。为了监测普及供水和卫生服务的进展情况，本研究旨在根据两种假设，即按照当前趋势和加速减贫，预测到 2030 年基本饮用水供应和卫生服务（WSS）的覆盖范围以及露天排便的减少情况：
从 51 个国家的 210 次全国代表性人口与健康调查和多指标类集调查（1994-2016 年）中提取了报告获得基本 WSS 服务和露天排便的家庭。开发了贝叶斯层次混合效应线性回归模型，以在国家、城乡和特定财富层面预测 2030 年的指标。应用贝叶斯回归模型加速到 2030 年减贫，评估减贫对这些指标的影响。在 51 个国家中，只有 9 个国家（孟加拉国、不丹、加纳、印度、尼泊尔、巴基斯坦、菲律宾、多哥和越南）预计到 2030 年将获得基本饮用水服务的覆盖率超过 90%。然而，没有一个国家预计将实现基本卫生服务的同等覆盖率。到 2030 年，预计 21 个国家将实现家庭露天排便比例低于 10%的目标。与南亚和东南亚相比，撒哈拉以南非洲的城乡和财富来源的基本 WSS 服务，特别是卫生服务，差异更为明显。与基本饮用水服务相比，基本卫生服务预计将从减贫中受益更多。与城市人口相比，居住在农村地区的家庭预计将从减贫中获得更多的基本 WSS 服务。
实现消除贫困目标可能对普及基本供水和卫生服务产生重大积极影响。然而，许多低收入和中低收入国家将难以实现普及基本服务的目标，特别是在卫生部门。
