Underreporting of high-risk water and sanitation practices undermines progress on global targets

PMA2020 Investigators

Research output: Contribution to journalArticle

Abstract

Water and sanitation indicators under the Millennium Development Goals failed to capture high-risk practices undertaken on a regular basis. In conjunction with local partners, fourteen rounds of household surveys using mobile phones with a customized open-source application were conducted across nine study geographies in Asia and Africa. In addition to the main water and sanitation facilities, interviewees (n = 245,054) identified all water and sanitation options regularly used for at least one season of the year. Unimproved water consumption and open defecation were targeted as high-risk practices. We defined underreporting as the difference between the regular and main use of high-risk practices. Our estimates of high-risk practices as the main option matched the widely accepted Demographic and Health Surveys (DHS) estimates within the 95% confidence interval. However, estimates of these practices as a regular option was far higher than the DHS estimates. Across the nine geographies, median underreporting of unimproved water use was 5.5%, with a range of 0.5% to 13.9%. Median underreporting of open defecation was much higher at 9.9%, with a range of 2.7% to 11.5%. This resulted in an underreported population of 25 million regularly consuming unimproved water and 50 million regularly practicing open defecation. Further examination of data from Ethiopia suggested that location and socio-economic factors were significant drivers of underreporting. Current global monitoring relies on a framework that considers the availability and use of a single option to meet drinking water and sanitation needs. Our analysis demonstrates the use of multiple options and widespread underreporting of high-risk practices. Policies based on current monitoring data, therefore, fail to consider the range of challenges and solutions to meeting water and sanitation needs, and result in an inflated sense of progress. Mobile surveys offer a cost-effective and innovative platform to rapidly and repeatedly monitor critical development metrics.

Original languageEnglish (US)
Article numbere0176272
JournalPLoS One
Volume12
Issue number5
DOIs
StatePublished - May 1 2017

Fingerprint

Sanitation
sanitation
Defecation
Water
defecation
Geography
water
geography
monitoring
Demography
demographic statistics
Cell Phones
Ethiopia
household surveys
socioeconomic factors
Monitoring
Drinking Water
Drinking
Mobile phones
drinking water

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Underreporting of high-risk water and sanitation practices undermines progress on global targets. / PMA2020 Investigators.

In: PLoS One, Vol. 12, No. 5, e0176272, 01.05.2017.

Research output: Contribution to journalArticle

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AU - Schwab, Kellogg

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