Mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000–17

Journal article


Deshpande, A, Miller-Petrie, MK, Lindstedt, PA, Baumann, MM, Johnson, KB, Blacker, BF, Abbastabar, H, Abd-Allah, F, Abdelalim, A, Abdollahpour, I, Abegaz, KH, Abejie, AN, Abreu, LG, Abrigo, MRM, Abualhasan, A, Accrombessi, MMK, Adamu, AA, Adebayo, OM, Adedeji, IA, Adedoyin, RA, Adekanmbi, V, Adetokunboh, OO, Adhikari, TB, Afarideh, M, Agudelo-Botero, M, Ahmadi, M, Ahmadi, K, Ahmed, MB, Ahmed, AE, Akalu, TY, Akanda, AS, Alahdab, F, Al-Aly, Z, Alam, S, Alam, N, Alamene, GM, Alanzi, TM, Albright, J, Albujeer, A, Alcalde-Rabanal, JE, Alebel, A, Alemu, ZA, Ali, M, Alijanzadeh, M, Alipour, V, Aljunid, SM, Almasi, A, Almasi-Hashiani, A, Al-Mekhlafi, HM, Altirkawi, KA, Alvis-Guzman, N, Alvis-Zakzuk, NJ, Amini, S, Amit, AML, Amul, GGH, Andrei, CL, Anjomshoa, M, Ansariadi, A, Antonio, CAT, Antony, B, Antriyandarti, E, Arabloo, J, Aref, HMA, Aremu, O, Armoon, B, Arora, A, Aryal, KK, Arzani, A, Asadi-Aliabadi, M, Asmelash, D, Atalay, HT, Athari, SM, Athari, SS, Atre, SR, Ausloos, M, Awasthi, S, Awoke, N, Ayala Quintanilla, BP, Ayano, G, Ayanore, MA, Aynalem, YA, Azari, S, Azman, AS, Babaee, E, Badawi, A, Bagherzadeh, M, Bakkannavar, SM, Balakrishnan, S, Banach, M, Banoub, JAM, Barac, A, Barboza, MA, Bärnighausen, TW, Basu, S, Bay, VD, Bayati, M, Bedi, N, Beheshti, M, Behzadifar, M, Behzadifar, M and Herteliu, C. (2020). Mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000–17. The Lancet Global Health. 8 (9), pp. e1162-e1185. https://doi.org/10.1016/S2214-109X(20)30278-3
AuthorsDeshpande, A, Miller-Petrie, MK, Lindstedt, PA, Baumann, MM, Johnson, KB, Blacker, BF, Abbastabar, H, Abd-Allah, F, Abdelalim, A, Abdollahpour, I, Abegaz, KH, Abejie, AN, Abreu, LG, Abrigo, MRM, Abualhasan, A, Accrombessi, MMK, Adamu, AA, Adebayo, OM, Adedeji, IA, Adedoyin, RA, Adekanmbi, V, Adetokunboh, OO, Adhikari, TB, Afarideh, M, Agudelo-Botero, M, Ahmadi, M, Ahmadi, K, Ahmed, MB, Ahmed, AE, Akalu, TY, Akanda, AS, Alahdab, F, Al-Aly, Z, Alam, S, Alam, N, Alamene, GM, Alanzi, TM, Albright, J, Albujeer, A, Alcalde-Rabanal, JE, Alebel, A, Alemu, ZA, Ali, M, Alijanzadeh, M, Alipour, V, Aljunid, SM, Almasi, A, Almasi-Hashiani, A, Al-Mekhlafi, HM, Altirkawi, KA, Alvis-Guzman, N, Alvis-Zakzuk, NJ, Amini, S, Amit, AML, Amul, GGH, Andrei, CL, Anjomshoa, M, Ansariadi, A, Antonio, CAT, Antony, B, Antriyandarti, E, Arabloo, J, Aref, HMA, Aremu, O, Armoon, B, Arora, A, Aryal, KK, Arzani, A, Asadi-Aliabadi, M, Asmelash, D, Atalay, HT, Athari, SM, Athari, SS, Atre, SR, Ausloos, M, Awasthi, S, Awoke, N, Ayala Quintanilla, BP, Ayano, G, Ayanore, MA, Aynalem, YA, Azari, S, Azman, AS, Babaee, E, Badawi, A, Bagherzadeh, M, Bakkannavar, SM, Balakrishnan, S, Banach, M, Banoub, JAM, Barac, A, Barboza, MA, Bärnighausen, TW, Basu, S, Bay, VD, Bayati, M, Bedi, N, Beheshti, M, Behzadifar, M, Behzadifar, M and Herteliu, C.
Abstract

© 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Background: Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce high-resolution geospatial estimates of access to drinking water and sanitation facilities. Methods: We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and aggregated results to policy-relevant administrative units. We estimated mutually exclusive and collectively exhaustive subcategories of facilities for drinking water (piped water on or off premises, other improved facilities, unimproved, and surface water) and sanitation facilities (septic or sewer sanitation, other improved, unimproved, and open defecation) with use of ordinal regression. We also estimated the number of diarrhoeal deaths in children younger than 5 years attributed to unsafe facilities and estimated deaths that were averted by increased access to safe facilities in 2017, and analysed geographical inequality in access within LMICs. Findings: Across LMICs, access to both piped water and improved water overall increased between 2000 and 2017, with progress varying spatially. For piped water, the safest water facility type, access increased from 40·0% (95% uncertainty interval [UI] 39·4–40·7) to 50·3% (50·0–50·5), but was lowest in sub-Saharan Africa, where access to piped water was mostly concentrated in urban centres. Access to both sewer or septic sanitation and improved sanitation overall also increased across all LMICs during the study period. For sewer or septic sanitation, access was 46·3% (95% UI 46·1–46·5) in 2017, compared with 28·7% (28·5–29·0) in 2000. Although some units improved access to the safest drinking water or sanitation facilities since 2000, a large absolute number of people continued to not have access in several units with high access to such facilities (>80%) in 2017. More than 253 000 people did not have access to sewer or septic sanitation facilities in the city of Harare, Zimbabwe, despite 88·6% (95% UI 87·2–89·7) access overall. Many units were able to transition from the least safe facilities in 2000 to safe facilities by 2017; for units in which populations primarily practised open defecation in 2000, 686 (95% UI 664–711) of the 1830 (1797–1863) units transitioned to the use of improved sanitation. Geographical disparities in access to improved water across units decreased in 76·1% (95% UI 71·6–80·7) of countries from 2000 to 2017, and in 53·9% (50·6–59·6) of countries for access to improved sanitation, but remained evident subnationally in most countries in 2017. Interpretation: Our estimates, combined with geospatial trends in diarrhoeal burden, identify where efforts to increase access to safe drinking water and sanitation facilities are most needed. By highlighting areas with successful approaches or in need of targeted interventions, our estimates can enable precision public health to effectively progress towards universal access to safe water and sanitation. Funding: Bill & Melinda Gates Foundation.

KeywordsLocal Burden of Disease WaSH Collaborators; Humans; Diarrhea; Models, Statistical; Bayes Theorem; Sanitation; Developing Countries; Socioeconomic Factors; Drinking Water; Geographic Mapping
Year2020
JournalThe Lancet Global Health
Journal citation8 (9), pp. e1162-e1185
PublisherElsevier BV
ISSN2214-109X
Digital Object Identifier (DOI)https://doi.org/10.1016/S2214-109X(20)30278-3
Publication dates
Print01 Sep 2020
Publication process dates
Deposited01 Dec 2020
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Open
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Changes in disease burden in Poland between 1990–2017 in comparison with other Central European countries: A systematic analysis for the Global Burden of Disease Study 2017
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Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017
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Health sector spending and spending on HIV/AIDS, tuberculosis, and malaria, and development assistance for health: progress towards Sustainable Development Goal 3
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Liquidity transmission and the subprime mortgage crisis: a multivariate GARCH approach
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Sustainable consumption behaviours in P2P accommodation platforms: an exploratory study
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Mapping child growth failure across low- and middle-income countries
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Mapping disparities in education across low- and middle-income countries
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Intriguing behavior when testing the impact of quotation marks usage in Google search results
Ileanu, B.V., Ausloos, M., Herteliu, C. and Cristescu, M.P. (2019). Intriguing behavior when testing the impact of quotation marks usage in Google search results. Quality & Quantity. 53 (5), pp. 2507-2519. https://doi.org/10.1007/s11135-018-0771-0
The influence of Lent on marriages and conceptions explored through a new methodology
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Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2017
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Evidence regarding external financing in manufacturing MSEs using partial least squares regression
Ceptureanu, E.G., Ceptureanu, S. and Herteliu, C. (2019). Evidence regarding external financing in manufacturing MSEs using partial least squares regression. Annals of Operations Research. pp. 1-14. https://doi.org/10.1007/s10479-019-03291-2
Past, present, and future of global health financing: a review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995–2050
Chang, AY, Cowling, K, Micah, AE, Chapin, A, Chen, CS, Ikilezi, G, Sadat, N, Tsakalos, G, Wu, J, Younker, T, Zhao, Y, Zlavog, BS, Abbafati, C, Ahmed, AE, Alam, K, Alipour, V, Aljunid, SM, Almalki, MJ, Alvis-Guzman, N, Ammar, W, Andrei, CL, Anjomshoa, M, Antonio, CAT, Arabloo, J, Aremu, O, Ausloos, M, Avila-Burgos, L, Awasthi, A, Ayanore, MA, Azari, S, Azzopardi-Muscat, N, Bagherzadeh, M, Bärnighausen, TW, Baune, BT, Bayati, M, Belay, YB, Belay, YA, Belete, H, Berbada, DA, Berman, AE, Beuran, M, Bijani, A, Busse, R, Cahuana-Hurtado, L, Cámera, LA, Catalá-López, F, Chauhan, BG, Constantin, MM, Crowe, CS, Cucu, A, Dalal, K, De Neve, JW, Deiparine, S, Demeke, FM, Do, HP, Dubey, M, El Tantawi, M, Eskandarieh, S, Esmaeili, R, Fakhar, M, Fazaeli, AA, Fischer, F, Foigt, NA, Fukumoto, T, Fullman, N, Galan, A, Gamkrelidze, A, Gezae, KE, Ghajar, A, Ghashghaee, A, Goginashvili, K, Haakenstad, A, Haghparast Bidgoli, H, Hamidi, S, Harb, HL, Hasanpoor, E, Hassen, HY, Hay, SI, Hendrie, D, Henok, A, Heredia-Pi, I, Herteliu, C, Hoang, CL, Hole, MK, Homaie Rad, E, Hossain, N, Hosseinzadeh, M, Hostiuc, S, Ilesanmi, OS, Irvani, SSN, Jakovljevic, M, Jalali, A, James, SL, Jonas, JB, Jürisson, M, Kadel, R, Karami Matin, B, Kasaeian, A, Kasaye, HK and Kassaw, MW (2019). Past, present, and future of global health financing: a review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995–2050. The Lancet. 393 (10187), pp. 2233-2260. https://doi.org/10.1016/S0140-6736(19)30841-4
Deciphering the fluctuations of high frequency birth rates
Herteliu, C, Richmond, P and Roehner, BM (2018). Deciphering the fluctuations of high frequency birth rates. Physica A: Statistical Mechanics and its Applications. 509, pp. 1046-1061. https://doi.org/10.1016/j.physa.2018.06.057
Day of the week submission effect for accepted papers in Physica A, PLOS ONE, Nature and Cell
Boja, CE, Herteliu, C., Dârdală, M and Ileanu, BV (2018). Day of the week submission effect for accepted papers in Physica A, PLOS ONE, Nature and Cell. Scientometrics. 117 (2), pp. 887-918. https://doi.org/10.1007/s11192-018-2911-7
Quantitative methods to analyze the severe obesity in Romania and its impact over public administration health expenditures
Andrei, CL, Sinescu, RD, Herteliu, C. and Mirică, A (2018). Quantitative methods to analyze the severe obesity in Romania and its impact over public administration health expenditures. Transylvanian Review of Administrative Sciences. 14 (55), pp. 5-17. https://doi.org/10.24193/tras.55E.1
Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017
Roth, GA, Abate, D, Abate, KH, Abay, SM, Abbafati, C, Abbasi, N, Abbastabar, H, Abd-Allah, F, Abdela, J, Abdelalim, A, Abdollahpour, I, Abdulkader, RS, Abebe, HT, Abebe, M, Abebe, Z, Abejie, AN, Abera, SF, Abil, OZ, Abraha, HN, Abrham, AR, Abu-Raddad, LJ, Accrombessi, MMK, Acharya, D, Adamu, AA, Adebayo, OM, Adedoyin, RA, Adekanmbi, V, Adetokunboh, OO, Adhena, BM, Adib, MG, Admasie, A, Afshin, A, Agarwal, G, Agesa, KM, Agrawal, A, Agrawal, S, Ahmadi, A, Ahmadi, M, Ahmed, MB, Ahmed, S, Aichour, AN, Aichour, I, Aichour, MTE, Akbari, ME, Akinyemi, RO, Akseer, N, Al-Aly, Z, Al-Eyadhy, A, Al-Raddadi, RM, Alahdab, F, Alam, K, Alam, T, Alebel, A, Alene, KA, Alijanzadeh, M, Alizadeh-Navaei, R, Aljunid, SM, Alkerwi, A, Alla, F, Allebeck, P, Alonso, J, Altirkawi, K, Alvis-Guzman, N, Amare, AT, Aminde, LN, Amini, E, Ammar, W, Amoako, YA, Anber, NH, Andrei, CL, Androudi, S, Animut, MD, Anjomshoa, M, Ansari, H, Ansha, MG, Antonio, CAT, Anwari, P, Aremu, O, Arnlov, J, Arora, A, Arora, M, Artaman, A, Aryal, KK, Asayesh, H, Asfaw, ET, Ataro, Z, Atique, S, Atre, SR, Ausloos, M, Avokpaho, EFGA, Awasthi, A, Ayala Quintanilla, BP, Ayele, Y, Ayer, R, Azzopardi, PS, Babazadeh, A, Bacha, U, Badali, H, Badawi, A and Herteliu, C. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet. 392 (10159), pp. 1736-1788. https://doi.org/10.1016/S0140-6736(18)32203-7
Quantitative and qualitative analysis of editor behavior through potentially coercive citations
Herteliu, C, Ausloos, M, Ileanu, BV, Rotundo, G and Andrei, T (2017). Quantitative and qualitative analysis of editor behavior through potentially coercive citations. Publications. 5 (2), pp. 15-15. https://doi.org/10.3390/publications5020015
Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016
Naghavi, Mohsen, Abajobir, Amanuel Alemu, Abbafati, Cristiana, Abbas, Kaja M, Abd-Allah, Foad, Abera, Semaw Ferede, Aboyans, Victor, Adetokunboh, Olatunji, Afshin, Ashkan, Agrawal, Anurag, Ahmadi, Alireza, Ahmed, Muktar Beshir, Aichour, Amani Nidhal, Aichour, Miloud Taki Eddine, Aichour, Ibtihel, Aiyar, Sneha, Alahdab, Fares, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore, Alam, Tahiya, Alene, Kefyalew Addis, Al-Eyadhy, Ayman, Ali, Syed Danish, Alizadeh-Navaei, Reza, Alkaabi, Juma M, Alkerwi, Ala'a, Alla, François, Allebeck, Peter, Allen, Christine, Al-Raddadi, Rajaa, Alsharif, Ubai, Altirkawi, Khalid A, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amini, Erfan, Ammar, Walid, Amoako, Yaw Ampem, Anber, Nahla, Andersen, Hjalte H, Andrei, Catalina Liliana, Androudi, Sofia, Ansari, Hossein, Antonio, Carl Abelardo T, Anwari, Palwasha, Ärnlöv, Johan, Arora, Megha, Artaman, Al, Aryal, Krishna Kumar, Asayesh, Hamid, Asgedom, Solomon W, Atey, Tesfay Mehari, Avila-Burgos, Leticia, Avokpaho, Euripide 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