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Unimproved source of drinking water and its associated factors: a spatial and multilevel analysis of Ethiopian demographic and health survey

BACKGROUND: Drinking water quality has been a major public health concern in lower and middle income countries where access to improved water supplies is limited. Ethiopia is thought to have one of the worst drinking water infrastructures in the world. This study aimed to assess the spatial variatio...

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Autores principales: Aragaw, Fantu Mamo, Merid, Mehari Woldemariam, Tebeje, Tsion Mulat, Erkihun, Muluken Gizachew, Tesfaye, Amensisa Hailu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10388450/
https://www.ncbi.nlm.nih.gov/pubmed/37525187
http://dx.doi.org/10.1186/s12889-023-16354-8
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author Aragaw, Fantu Mamo
Merid, Mehari Woldemariam
Tebeje, Tsion Mulat
Erkihun, Muluken Gizachew
Tesfaye, Amensisa Hailu
author_facet Aragaw, Fantu Mamo
Merid, Mehari Woldemariam
Tebeje, Tsion Mulat
Erkihun, Muluken Gizachew
Tesfaye, Amensisa Hailu
author_sort Aragaw, Fantu Mamo
collection PubMed
description BACKGROUND: Drinking water quality has been a major public health concern in lower and middle income countries where access to improved water supplies is limited. Ethiopia is thought to have one of the worst drinking water infrastructures in the world. This study aimed to assess the spatial variation and determinants of using unimproved sources of drinking water in Ethiopia using recent nationally representative data. METHODS: A population-based cross-sectional study was employed with the recent EDHS data of 2019. A total of 8663 households were sampled using a stratified two-stage cluster sampling method. Kuldorff’s SaTScan version 9.6 software was used to generate spatial scan statistics. ArcGIS version 10.7 software was used to visualize the spatial patterns of unimproved drinking water sources. A multilevel multivariable mixed-effect logistic regression was used to identify factors associated with the use of an unimproved drinking water source. In the multivariable multilevel analysis, those variables with a p-value < 0.05 were considered to be significant predictors of using an unimproved source of drinking water. RESULT: Around 31% (95% CI: 30%, 32%) of the population in Ethiopia uses unimproved sources of drinking water with significant spatial variation across the country. Households aged 41–60 [AOR = 0.69; 95%CI; 0.53, 0.89] as compared to the households aged 10–25, households having middle wealth index [AOR = 0.48; 95%CI; 0.40, 0.59], and households having a rich wealth index [AOR = 0.31; 95%CI; 0.25, 0.39] as compared to the poor households, living in high community literacy level [AOR = 0.36; 95%CI; 0.16, 0.80], living in high-level community poverty [AOR = 3.03; 95%CI; 1.32, 6.98], rural residence [AOR = 7.88; 95%CI; 2.74, 22.67] were significant predictors of use of unimproved source of drinking water. Hot spot areas of use of unimproved drinking water sources were observed in Amhara, Afar, and Somalia regions and some parts of SNNPR and Oromia regions in Ethiopia. The primary clusters were found in Ethiopia’s Somalia and Oromia regions. CONCLUSION: Around one third of the Ethiopian population utilizes unimproved source of drinking water and it was distributed non-randomly across regions of Ethiopia. The age of the household head, wealth status of the household, residence, community poverty level, and community literacy level were found to be significantly associated with utilizing unimproved drinking water source. State authorities, non-governmental organizations and local health administrators should work to improve the quality of drinking water particularly for high risk groups such as communities living in high poverty and low literacy, poor households, rural residents, and hot spot areas to decrease the adverse consequences of using unimproved drinking water source.
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spelling pubmed-103884502023-08-01 Unimproved source of drinking water and its associated factors: a spatial and multilevel analysis of Ethiopian demographic and health survey Aragaw, Fantu Mamo Merid, Mehari Woldemariam Tebeje, Tsion Mulat Erkihun, Muluken Gizachew Tesfaye, Amensisa Hailu BMC Public Health Research BACKGROUND: Drinking water quality has been a major public health concern in lower and middle income countries where access to improved water supplies is limited. Ethiopia is thought to have one of the worst drinking water infrastructures in the world. This study aimed to assess the spatial variation and determinants of using unimproved sources of drinking water in Ethiopia using recent nationally representative data. METHODS: A population-based cross-sectional study was employed with the recent EDHS data of 2019. A total of 8663 households were sampled using a stratified two-stage cluster sampling method. Kuldorff’s SaTScan version 9.6 software was used to generate spatial scan statistics. ArcGIS version 10.7 software was used to visualize the spatial patterns of unimproved drinking water sources. A multilevel multivariable mixed-effect logistic regression was used to identify factors associated with the use of an unimproved drinking water source. In the multivariable multilevel analysis, those variables with a p-value < 0.05 were considered to be significant predictors of using an unimproved source of drinking water. RESULT: Around 31% (95% CI: 30%, 32%) of the population in Ethiopia uses unimproved sources of drinking water with significant spatial variation across the country. Households aged 41–60 [AOR = 0.69; 95%CI; 0.53, 0.89] as compared to the households aged 10–25, households having middle wealth index [AOR = 0.48; 95%CI; 0.40, 0.59], and households having a rich wealth index [AOR = 0.31; 95%CI; 0.25, 0.39] as compared to the poor households, living in high community literacy level [AOR = 0.36; 95%CI; 0.16, 0.80], living in high-level community poverty [AOR = 3.03; 95%CI; 1.32, 6.98], rural residence [AOR = 7.88; 95%CI; 2.74, 22.67] were significant predictors of use of unimproved source of drinking water. Hot spot areas of use of unimproved drinking water sources were observed in Amhara, Afar, and Somalia regions and some parts of SNNPR and Oromia regions in Ethiopia. The primary clusters were found in Ethiopia’s Somalia and Oromia regions. CONCLUSION: Around one third of the Ethiopian population utilizes unimproved source of drinking water and it was distributed non-randomly across regions of Ethiopia. The age of the household head, wealth status of the household, residence, community poverty level, and community literacy level were found to be significantly associated with utilizing unimproved drinking water source. State authorities, non-governmental organizations and local health administrators should work to improve the quality of drinking water particularly for high risk groups such as communities living in high poverty and low literacy, poor households, rural residents, and hot spot areas to decrease the adverse consequences of using unimproved drinking water source. BioMed Central 2023-07-31 /pmc/articles/PMC10388450/ /pubmed/37525187 http://dx.doi.org/10.1186/s12889-023-16354-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Aragaw, Fantu Mamo
Merid, Mehari Woldemariam
Tebeje, Tsion Mulat
Erkihun, Muluken Gizachew
Tesfaye, Amensisa Hailu
Unimproved source of drinking water and its associated factors: a spatial and multilevel analysis of Ethiopian demographic and health survey
title Unimproved source of drinking water and its associated factors: a spatial and multilevel analysis of Ethiopian demographic and health survey
title_full Unimproved source of drinking water and its associated factors: a spatial and multilevel analysis of Ethiopian demographic and health survey
title_fullStr Unimproved source of drinking water and its associated factors: a spatial and multilevel analysis of Ethiopian demographic and health survey
title_full_unstemmed Unimproved source of drinking water and its associated factors: a spatial and multilevel analysis of Ethiopian demographic and health survey
title_short Unimproved source of drinking water and its associated factors: a spatial and multilevel analysis of Ethiopian demographic and health survey
title_sort unimproved source of drinking water and its associated factors: a spatial and multilevel analysis of ethiopian demographic and health survey
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10388450/
https://www.ncbi.nlm.nih.gov/pubmed/37525187
http://dx.doi.org/10.1186/s12889-023-16354-8
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