Abstract
Abstract Piped water systems are considered to provide the highest service level for drinking water supplies; however, global monitoring of safe water access pays little attention to the type of water source that piped systems draw upon, even if the water is not treated prior to distribution. This study sought to understand whether the source of water for untreated piped supplies influences the prevalence of diarrhoea among children in rural Vanuatu. The analysis was based on a dataset integrating a Demographic and Health Survey and a nationwide water supply inventory. After adjusting for a range of potential confounders, the results revealed a significant association between diarrhoea and the type of water source supplying a piped system. Compared with borehole-supplied piped systems, spring-fed piped systems were significantly associated with increased odds of diarrhoea (adjusted odds ratio [AOR] 5.8, 95% confidence interval [CI] 1.1–31, p = 0.040). No significant association between diarrhoea and piped systems drawing on surface water was observed. Increased odds of diarrhoea were significantly associated with water supply systems constructed prior to the year 2000 (AOR 4.9, 95% CI 1.9–13, p = 0.001). The results highlight the need for improvements in spring protection as well as ongoing maintenance and periodic renewal of water supply infrastructure. This article has been made Open Access thanks to the generous support of a global network of libraries as part of the Knowledge Unlatched Select initiative.
Highlights
The prevalence of diarrhoea was highest for those receiving spring-fed piped supplies (25%), compared with 14% for those receiving piped supplies drawing on surface water and 8% for those receiving borehole-supplied piped water
The generalised estimating equation (GEE) analysis found that the water source supplying a piped scheme had a significant effect on diarrhoea: compared with boreholesupplied systems, piped systems fed by springs were associated with a 5.8-fold increase in the adjusted odds of diarrhoea (95% confidence interval [CI] 1.1–31, p 1⁄4 0.040) (Table 2)
No significant association between diarrhoea and piped systems drawing on surface water was observed
Summary
There is strong evidence that access to piped water is associated with improved health, a Neither research nor global monitoring has typically distinguished between piped services based on the water source from which they draw. This may matter little for piped water systems with treatment prior to distribution; it may have major implications for piped systems supplying raw (untreated) water, as is often the case in rural areas of low- and middle-income countries. A piped water supply drawing on surface water might formally be classified as a high service level, even if the raw water it provides is from the same source that is presumed to be highly
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