Drinking water and sanitation: progress in 73 countries in relation to socioeconomic indicators

Abstract

Data sourcesWe obtained estimates of the percentage of national populations with access to improved sanitation and water -for various years between 2000 and 2012 -from the 2013 Country Files of the Joint Monitoring Programme for Water Supply and Sanitation 12 -which were the most up-to-date information available at the time of analyses.This World Health Organization/United Nations Children's Fund programme compiles the results of nationally representative surveys, including Demographic and Health Surveys, Multiple Indicator Cluster Surveys, World Health Surveys and national censuses.We considered only data from 2000 onwards to reflect the progress countries made since the MDGs were set in the year 2000.We included shared toilet facilities in our improved-sanitation category because data for both shared sanitation and total improved sanitation including shared sanitation -i.e. the two data sets needed to investigate total improved sanitation excluding shared sanitation -were only available for four of our study countries.The Joint Monitoring Programme currently discounts shared sanitation from total improved sanitation by applying a fixed ratio for each country.13 However, since these ratios are based on data that may have been collected before 2000 and, for some countries, are based on a single data point, we decided not to use them -or any other similar correction factor -in our analyses.We included countries with at least five data points that covered at least three different years.Multiple survey data points from any one year were treated independently.Objective To assess progress in the provision of drinking water and sanitation in relation to national socioeconomic indicators.Methods We used household survey data for 73 countries -collected between 2000 and 2012 -to calculate linear rates of change in population access to improved drinking water (n = 67) and/or sanitation (n = 61).To enable comparison of progress between countries with different initial levels of access, the calculated rates of change were normalized to fall between -1 and 1.In regression analyses, we investigated associations between the normalized rates of change in population access and national socioeconomic indicators: gross national income per capita, government effectiveness, official development assistance, freshwater resources, education, poverty, Gini coefficient, child mortality and the human development index.Findings The normalized rates of change indicated that most of the investigated countries were making progress towards achieving universal access to improved drinking water and sanitation.However, only about a third showed a level of progress that was at least half the maximum achievable level.The normalized rates of change did not appear to be correlated with any of the national indicators that we investigated.Conclusion In many countries, the progress being made towards universal access to improved drinking water and sanitation is falling well short of the maximum achievable level.Progress does not appear to be correlated with a country's social and economic characteristics.The between-country variations observed in such progress may be linked to variations in government policies and in the institutional commitment and capacity needed to execute such policies effectively.