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11/14/24
OVER VIEW OF
DRINKING WATER QUALITY
EVE HOTEL; ADIGRAT
JAN 30/2020
TIGRAY REGIONAL STATE
HEALTH BUREAU

BACKGROUND
SAFE & CLEAN WATER SUPPLY IS A BASIC HUMAN RIGHT.
THE NATIONAL CONSTITUTION ARTICLES 90 (THE PROVISION OF CLEAN WATER,
HOUSING, FOOD AND SOCIAL SECURITY) INDICATES THE POLITICAL
COMMITMENT
SDG 6 CLEARLY MENTIONS THAT SUSTAINABLE, SAFE, CLEAN WATER SUPPLY
AND IMPROVED SANITATION FACILITIES FOR ALL WITH PARTICULAR FOCUS TO
WOMEN AND DISABILITY
11/14/24

57%
 OD reduction since 2000; [79% (2000) to 22 % (2017)].
CLTSH & HEP of Health section contributed significantly.
 Reduced under five mortality from 1000 births MOH 2017
166
to 67
 Encouraging achievement towards access to water
supply during MDG Period (2015)
57%
SOME OF THE ACHIEVEMENTS
11/14/24

WATER & HEALTH
11/14/24
 THE QUALITY AND QUANTITY OF DRINKING-WATER IS A MAJOR DETERMINANT OF
HEALTH.
 THE FIRST PRIORITY WATER MUST BE TO PROVIDE ACCESS FOR THE WHOLE
POPULATION
 THE QUALITY OF WATER PARTICULARLY MICROBIOLOGICAL QUALITY HAVE A
GREAT INFLUENCE ON PUBLIC HEALTH

HEALTH EFFECT OF WATER QUALITY
11/14/24
MICROBIOLOGICAL – MAINLY ACUTE HEALTH EFFECT
CHEMICAL – MAINLY CHRONIC HEALTH EFFECTS
PHYSICAL – AESTHETIC EFFECT (COLOR, TASTE, ODOR)
MANY OF THE WATER-RELATED DISEASES LEAD TO EPIDEMICS
WHICH MAY HAVE RELATIVELY HIGH MORTALITY/MORBIDITY
RATIO
 MALARIA, CHOLERA, BACILLARY DYSENTERY, ETC

WATER SOURCES
IMPROVED: includes piped water into dwelling, yard or plot, public
tap or standpipe, tube well or borehole, protected dug well, protected
spring, and rainwater collection
UNIMPROVED: includes unprotected dug well, unprotected spring,
cart with small tank or drum provided by water vendor, tanker truck
provision of water, and bottled water
SURFACE WATER SOURCES: (river, dam, lake, pond, stream, canal,
irrigation channel) 11/14/24

JMP LADDER FOR H.H DW SERVICES
11/14/24

WATER & HEALTH
INFECTIOUS DISEASES RELATED TO WATER:
WATER BORNE DISEASES: DW contamination (typhoid, cholera,
gastro-enteritis etc)
WATER WASHED DISEASES: shortage of adequate water (scabies, and
trachoma)
WATER BASED DISEASES: aquatic vectors (such as schistosomiasis)
WATER RELATED DISEASES: insects that depend on water (malaria and
yellow fever)
11/14/24

Water & Health
WATER QUALITY
•2 million tones of human waste enter water
sources every day.
•1.8 billion people use fecally contaminated water.
•Polluted water and poor sanitation practices spread
diseases such as diarrhoea, cholera
11/14/24

WATER & HEALTH
Diarrhea,
• kills around 525, 000 children under five each year
• is a leading cause of malnutrition in children under five years old
(who, 2017).
Cholera is still a big problem in third world country
( IN ETHIOPIA IT IS REPEATEDLY OCCURRED AND STILL IT IS A PROBLEM)
11/14/24

WATER & HEALTH
 Only 13% of Ethiopian used safely managed water services: drinking
water quality in ethiopia-2016/17
 32% of 1,602 water samples from improved sources did not comply
the national standards/who for microbiological quality (rapid drinking
water quality assessment-WHO/UNICEF 2010)
 High concentrations of fluoride (>1.5 mg/l) in a number of rural
and urban water supplies in the rift valley districts of oromia,
snnpr, somali and afar regions (MOWIE 2013).
11/14/24

EFFECTS
30% Disease burden attributed to poor sanitation
Under five mortality is due to diarrhea
23%
10% Even though we dropped OD, 10 % of the latrines
constructed are decent
2.1%
GDP
Poor sanitation costs ETB 13.5 Billion/year
33 % People practicing OD
11/14/24

HWTS status, DHS reports
11/14/24
Characteristic
Households
Urban Rural Total
2011 2016 2011 2016 2011 2016
Boiled 3.8 2.8 2.4 2.0 2.7 2.2
Bleach/Chlorine added 9.2 6.2 4.9 2.5 5.8 3.2
Strained through cloth 0.6 0.5 1.4 1.9 1.2 1.7
Bio-sand, composite, ceramic pot filter 0.4 1.6 0.2 0.9 0.2 1.0
Solar disinfection - 0.0 - 0.1 - 0.1
Let it stand and settle 0.0 0.0 0.2 0.3 0.1 0.3
Other 0.5 0.4 0.1 0.1 0.2 0.2
No treatment 86.9 88.4 91.1 92.1 90.2 91.3
% using an appropriate treatment method 12.3 10.5 8.2 5.5 9.1 6.5

RISK OF E. COLI
WATER SOURCE VS HH
11/14/24
HH risk
lower than
source
HH risk same
as source
HH risk higher
than source
Total Count
Total 10.2% 50.5% 39.3% 100 4,377
Un improved 11.7% 68.7% 19.6% 100 1.422
Improved 9.4% 41.0% 49.6% 100 2,955
Source: Drinking Water Quality in Ethiopia, Ethiopia Socioeconomic Survey, CSA in
collaboration with MOWIE, LSMS, World Bank, UNICEF, WHO, and JMP, Dec 2017

RESULT OF THE SURVEY FROM SUPPLY
SIDE
11/14/24
USE OF IMPROVED WATER SUPPLIES (66%) IS 35 PERCENT HIGHER IN
URBAN AREAS (94%) THAN RURAL AREAS( 59%).
IN RURAL AREAS 15% OF HH USE PIPED WATER AS COMPARED 77%
URBAN AREAS
FEMALES ARE 75% MORE RESPONSIBLE THAN MEN IN COLLECTING
WATER BOTH IN URBAN AND RURAL AREAS.
SOURCES; EDHS 2016

RESULT OF THE SURVEY FROM SUPPLY
11/14/24
OVERALL 20 PERCENT OF HOUSEHOLDS HAVE WATER ON THEIR PREMISES
(77% IN URBAN & 6% IN RURAL AREAS.).
45% OF HH SPEND 30 MINUTES OR LONGER TO OBTAIN THEIR DRINKING
WATER (53% IN RURAL 13% IN URBAN HOUSEHOLDS).
ABOUT 9 IN 10 HOUSEHOLDS (91%) DO NOT TREAT THEIR DRINKING
WATER; THIS IS MORE COMMON IN RURAL THAN IN URBAN AREAS.
SOURCES; EDHS 2016

JOINT MONITORING PROGRAM :
WATER SAFETY
Joint Monitoring Program (JMP) 2019, WHO, UNICEF
11/14/24

RESULT OF THE SURVEY FROM QUALITY SIDE
11/14/24
 E. coli risk is lower for water from improved sources and in urban
areas.
Most of the very high risk-water was from un-improved sources
(unprotected spring and surface water )
Residual chlorine was rarely found in piped water supplies
source: drinking water quality in ethiopia by csa december 2017

ACTIVITIES DONE SO FAR
11/14/24
 Water access and safety become one of the eight strategic domains and
specific focus area
 National drinking water quality surveillance and household water
treatment and safe storage guideline prepared

ACTIVITIES DONE SO FAR …..
11/14/24
TWG from different go & NGO working in wash established
 Gap assessment was carried out in the area of water quality
management.
 Portable water test kit usage manual with video and audio prepared
by cd

OPPORTUNITIES
11/14/24
CONSTITUTION: ARTICLES 90 (THE PROVISION OF CLEAN WATER,
HOUSING, FOOD AND SOCIAL SECURITY)
POLICIES, PROCLAMATION AND STRATEGIES
HEP-HEWS AND HDA + SOCIAL MOBILIZATION
THE SIGNED MOU
ONE WASH NATIONAL PROGRAMME

CHALLENGES
11/14/24
CROSS CONTAMINATION DUE TO POOR JOINT & DAMAGED
WATER SUPPLY LINES ESPECIALLY IN URBAN SIDE
WEAK COORDINATION AND COLLABORATION BETWEEN
THE HEALTH SECTOR AND THE WATER SECTOR.

CHALLENGES
11/14/24
EVEN THOUGH WATER QUALITY ISSUE BECOME ONE OF THE
HEALTH EXTENSION PROGRAM, THE PACKAGES
IMPLEMENTATIONS LIMITED TO LATRINE AND HW PROMOTION
LACK OF TRAINED MAN POWER & PORTABLE WATER TEST KIT IN
MOST WOREDAS TO UNDERTAKE THE ACTIVITIES.
LACK OF REGENTS AND RUNNING COST TO PERFORM THE TEST

CHALLENGES
11/14/24
LACK OF STRUCTURE AND HUMAN POWER FROM THE REGION UP TO PHCU
LEVEL EVEN AT HP LEVEL.
LACK OF ATTENTION FOR WATER QUALITY BY HIGHER OFFICIALS, PARTNERS
AND PROFESSIONALS.
WEAK COORDINATION BETWEEN LAB AND THE WOREDA HEALTH OFFICE
REGIONAL PUBLIC HEALTH LAB ARE GIVING MORE ATTENTION TO CLINICAL
LAB. SERVICES.

WAY FORWARD
11/14/24
COORDINATION/ INTEGRATION AMONG STAKEHOLDERS SHOULD BE
ESTABLISHED/STRENGTHENED WITH ACCOUNTABILITY
MORE ATTENTION FOR WQM SHOULD BE GIVEN FROM GOVERNMENT
OFFICIAL'S AND PARTNER SIDE
REGIONAL LABORATORY (WATER & PUBLIC) SHOULD BE STRENGTHENED
STRUCTURE AND PROFESSIONALS GAP STARTING FROM REGION DOWN TO
PHCU SHOULD BE FULFILLED

WAY FORWARD
11/14/24
CAPACITY BUILDING SHOULD BE GIVEN AT ALL LEVELS
EQUIP ALL WOREDAS WITH PORTABLE WATER QUALITY TEST KIT
MECHANISM SHOULD BE CREATED TO FULFILL REGENTS AND
RUNNING COST PROBLEM. (IN ALL SECTORS AT EACH LEVEL)
SANITATION MARKETING SHOULD BE STRENGTHEN

WAY FORWARD
11/14/24
 Because Water Quality testing alone could not surely confirm water
safety as;
 Water testing could not prevent from health risk as the water could be
consumed before testing (Sampling takes time – response delayed)
 Ensure safe drinking-water first by knowing the system thoroughly
 Identifying where and how problems could arise
 Putting barriers and management systems in place to stop the problems
before they happen

WAY FORWARD
11/14/24
 Testing of the water at different point
 Apply important strategy in providing safe drinking-water for the
consumer
 Multiple barriers in water supply system are prevention at
source, treatment, prevention during distribution and safe storage
@ home and, in some circumstances, treatment at the point of
use

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