Impact of Poverty Reduction on Access to Water and Sanitation in Low- and Lower-Middle-Income Countries: Country-Specific Bayesian Projections to 2030

Abstract

Background: In 2017, 785 million people globally lacked access to basic drinking water services and 2 billion people lived without basic sanitation services, mostly in low- and lower-middle-income countries. We aimed to predict the coverage of access to water and sanitation services by 2030, under two conditions: following the current trends and accelerating poverty reduction. Methods: Households reporting access to basic drinking water services, basic sanitation facilities and practicing open defecation were extracted from 210 nationally representative Demographic Health Surveys and Multiple Cluster Indicator Surveys (1994-2016) including 51 countries. A Bayesian hierarchical, mixed effect linear regression model was developed to predict the indicators in 2030 at the national, rural-urban and wealth specific levels. A Bayesian regression model with 95% reduction in poverty by 2030 was applied to assess the contribution of poverty reduction to these indicators. Findings: Out of 51 countries, only nine (Bangladesh, Bhutan, Ghana, India, Nepal, Pakistan, The Philippines, Togo and Vietnam) were predicted to reach over 90% coverage in access to basic services of drinking water by 2030. However, none achieved 90% coverage for basic sanitation services. Twenty-one countries achieved the target of less than 10% households practicing open defecation. The rural-urban and wealth disparities in access to basic water and sanitation services, especially sanitation, were more pronounced in Sub-Saharan Africa. By accelerating poverty reduction, the sanitation sector and households in rural settings benefitted considerably. Interpretation: Achieving poverty eradication targets has a substantial positive impact on access to basic water supply and sanitation services. However, many low- and lower-middle-income countries will struggle to achieve the goal of universal access to basic services, especially in the sanitation sector. Funding Statement: KTS was funded by the Ministry of Education, Culture, Sports, Science and Technology, Japan. Declaration of Interests: The authors declared there was no conflict of interest. Ethics Approval Statement: Not required.