Access to improved water and sanitation in Sub-Saharan Africa in a quarter century

This study examines the relationship between wealth inequality and water availability in Sub-Saharan Africa. This unique perspective highlights that not just scarcity harms equal access to water but also political factors such as sanitation services and political systems.

Background:

The realization of the scale, magnitude, and complexity of the water and sanitation problem at the global level has compelled international agencies and national governments to increase their resolve to face the challenge. There is extensive evidence on the independent effects of urbanicity (rural-urban environment) and wealth status on access to water and sanitation services in sub-Saharan Africa. However, our understanding of the joint effect of urbanicity and wealth on access to water and sanitation services across spatio-temporal scales is nascent. In this study, a pooled regression analysis of the compositional and contextual factors that systematically vary with access to water and sanitation services over a 25-year time period in fifteen countries across sub-Saharan Africa (SSA) was carried out. On the whole, substantial improvements have been made in providing access to improved water sources in SSA from 1990 to 2015 unlike access to sanitation facilities over the same period. Households were 28.2 percent and 125.2 percent more likely to have access to improved water sources in 2000-2005 and 2010-2015 respectively, than in 1990-1995. Urban rich households were 329 percent more likely to have access to improved water sources compared with the urban poor. Although access to improved sanitation facilities increased from 69 percent in 1990-1995 and 74 percent in 2000-2005 it declined significantly to 53 percent in 2010-2015. Urban rich households were 227 percent more likely to have access to improved sanitation facilities compared with urban poor households. These results were mediated and attenuated by biosocial, socio-cultural and contextual factors and underscore the fact that the challenge of access to water and sanitation in sub-Saharan Africa is not merely scientific and technical but interwoven with environment, culture, economics and human behaviour necessitating the need for interdisciplinary research and policy interventions.

Conclusion:

Access to improved water sources has increased over the last 25 years in the SSA countries studied. Access to improved sanitation facilities also increased from 1990-1995 to 2000e2005 however, it declined significantly in the 2010e2015 period. The study shows that the improvement observed in access to improved sani- tation facilities is gradually being eroded. The region has experienced a high popu- lation growth rate and urbanization which were not accompanied by economic growth and investment in housing, water and sanitation infrastructure. This has re- sulted in mushrooming of slum communities which lack basic amenities and social services. Access to improved water sources was not affected because of the growing use of packaged and delivered water. The combined effect of residential wellbeing (urbanicity wealth status) had magnified effect on access to improved water sources and sanitation facilities. Compositional factors such as sex, age and level of educa- tion of household head as well as the size of household are strong and significantly contribute to the magnified disparities in access to improved water sources and sani- tation facilities in SSA. This suggests that concerted policy initiatives are required to increase access to improved water sources and sanitation facilities in the households giving special attention to the underserved populations. Extensive inequalities in coverage of improved water sources and sanitation facilities among countries in the region are discernible from the results of this study. International bodies and pol- icy makers responsible for water and sanitation programmes should take note that a common intervention approach will not be favourable for all countries in sub- Saharan Africa rather; interventions should be designed to meet the peculiar needs of specific countries. On the whole, compositional and contextual factors mediated or attenuated the magnitude and direction of the relationship between residential wealth status and access to improved water sources and sanitation facilities indi- cating that access to water and sanitation facilities in SSA is a complex and multi- faceted issue that needs to be tackled holistically taking into consideration interdisciplinary research and policy interventions covering environment, culture, economics and human behaviour.