Report: Access to Improved Water, Sanitation in Sub-Saharan Africa Extremely Uneven

Access to improved drinking water and sanitation is extremely uneven within individual countries in sub-Saharan Africa.  That’s according to a new report by researchers with the London School of Hygiene & Tropical Medicine.  The report, published in the journal PLoS Medicine, is the first study looking at access within individual countries in the African region. 

Investigators say access to clean water is highly variable, ranging from a low 3.2 percent in some districts of Somalia to as high as 99 percent in Namibia's urban centers.  Adequate sanitation facilities are equally inconsistent.  Improved sanitation, the report notes, ranged from 0.2 percent in parts of Chad to close to 100 percent in Gambia.

Researchers used statistical models in their analysis of data from 138 national surveys conducted in 41 sub-Saharan Africa countries between 1991 and 2012.  The surveys recorded information on household use of an improved drinking water supply, improved sanitation facilities and open defecation.

According to the latest findings, rural households in the districts - with the lowest levels of access within a country - were 1.5 to eight times less likely to use improved drinking water, two to 18 times less likely to use improved sanitation and two to 80 times more likely to defecate in the open, compared to rural households in districts with the best coverage.

The authors say strategies that target the areas with the lowest coverage are essential to achieving universal access to improved sources of drinkable water and sanitation.

According to a joint report by the World Health Organization and UNICEF last year, more than two billion people - or one-third of the world’s population - will remain without access to improved sanitation by 2015.

A United Nations Millennium goal on clean water and sanitation calls for cutting in half the number of people who, in 1990, lacked potable water and clean toileting facilities.  Last year's WHO-UNICEF report noted that the world has met the target of cutting in half the proportion of people without access to improved sources of water, five years ahead of schedule.

The global assessment, however, may be masking progress toward the goal in Africa.

Matthew Freeman of Emory University's Rollins School of Public Health in Atlanta is co-author of the report on clean water and sanitation distribution in sub-Saharan Africa.

While the study did not address the U.N.’s Millennium goals, Freeman says the assessment of worldwide progress toward increased access to clean drinking water is being driven largely by progress by emerging countries in Asia.

“China and India, their rapid urbanization and infrastructure investments have led to dramatic changes in access to improved water supply.  So, globally that target was met; but, few countries in sub-Saharan Africa have met those targets," said Freeman.

Experts are quick to point out there’s still time for the U.N. goals to be met in sub-Saharan Africa.  Countries that have already achieved the clean water goal, according to experts, include Gambia, Congo, Gabon, Malawi, Uganda, Burkina Faso, Guinea Bissau and Swaziland.

The authors of the London School report say making the in-country data on sanitation and drinking water available points up inequities hidden by national statistics.  They note it is essential to improving basic infrastructure in areas with the lowest access to clean water and sanitation to prevent the spread of infectious diseases.