Policy Analysis pubs.acs.org/est
Water Safety and Inequality in Access to Drinking-water between Rich and Poor Households Hong Yang,*,† Robert Bain,‡ Jamie Bartram,§ Stephen Gundry,‡ Steve Pedley,∥ and James Wright† †
Geography and Environment, University of Southampton, Southampton, SO17 1BJ, U.K. Water and Health Research Centre, Merchant Venturers Building, University of Bristol, Bristol, BS8 1UB, U.K. § The Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States ∥ Robens Centre for Public and Environmental Health, University of Surrey, Guildford, GU2 7XH, U.K. ‡
S Supporting Information *
ABSTRACT: While water and sanitation are now recognized as a human right by the United Nations, monitoring inequality in safe water access poses challenges. This study uses survey data to calculate household socio-economic-status (SES) indices in seven countries where national drinking-water quality surveys are available. These are used to assess inequalities in access as indicated by type of improved water source, use of safe water, and a combination of these. In Bangladesh, arsenic exposure through drinking-water is not significantly related to SES (p = 0.06) among households using tubewells, whereas in Peru, chlorine residual in piped systems varies significantly with SES (p < 0.0001). In Ethiopia, Nicaragua, and Nigeria, many poor households access nonpiped improved sources, which may provide unsafe water, resulting in greater inequality of access to “safe” water compared to “improved” water sources. Concentration indices increased from 0.08 to 0.15, 0.10 to 0.14, and 0.24 to 0.26, respectively, in these countries. There was minimal difference in Jordan and Tajikistan. Although the results are likely to be underestimates as they exclude individual-level inequalities, they show that use of a binary “improved”/”unimproved” categorization masks substantial inequalities. Future international monitoring programmes should take account of inequality in access and safety.
■
INTRODUCTION The United Nations has recognized the human right to safe water and sanitation and it is reflected in national legislation in some countries.1−3 This provides a legal framework and political momentum that supports equality and nondiscrimination to ensure safe water is accessible to all, including the poor and marginalized groups. 3,4 These developments have generated an impetus to incorporate equality into the monitoring of safe water access for new targets being planned for post-2015, when the current Millennium Development Goals (MDGs) expire. This raises questions as to how to define “safe” water access and how the definition of “safe” may interact with the measurement of inequality in access. MDG target 7c calls on countries to “halve, by 2015, the proportion of people without sustainable access to safe drinking-water and basic sanitation”.5 Without an integrated international system to collate water quality data with coverage back to the MDG baseline year of 1990, the World Health Organization and United Nations Children’s Fund (WHO/ UNICEF) Joint Monitoring Programme for Water Supply and Sanitation (JMP) adopted a pragmatic indicator, use of an “improved” source. This distinguishes between sources that, by © 2012 American Chemical Society
nature of their construction or through active intervention, are protected from outside contamination (including piped water, tubewells or boreholes, protected dug wells and springs, and rainwater) and those that are unprotected (such as rivers, streams, and unprotected wells). In doing so it addresses, to a variable extent, the notions of access and of safety, now recognized as normative components of the human right to water and sanitation which “entitles everyone to sufficient, safe, acceptable, physically accessible and affordable water for personal and domestic uses”.1 However, it is increasingly recognized that water from improved sources may contain chemical and microbial contaminants well above national standards or the guidelines of WHO6,7 and thus be unsafe. This has led to several international and multicountry studies that reexamined patterns of safe water access, applying more stringent indicators that incorporate water safety.8−10 Received: Revised: Accepted: Published: 1222
August 17, 2012 December 26, 2012 December 31, 2012 December 31, 2012 dx.doi.org/10.1021/es303345p | Environ. Sci. Technol. 2013, 47, 1222−1230
Environmental Science & Technology
Policy Analysis
of improved supplies nationally. They excluded those improved sources used by only a small proportion (
