Abstract
Abstract The UNICEF Multiple Indicator Cluster Survey module for water testing was included in the 2016/2017 Afghanistan Living Conditions Survey (ALCS) for 10 of the 34 provinces. The module's impact on the survey implementation was assessed through interviews and focus group discussions with survey teams. To assess the level of fecal contamination, drinking water from the source and at the point of consumption was tested for Escherichia coli using on-site membrane filtration. On-site testing of water generated significant interest from community members to receive water test results and understand how to keep their drinking water safe from contamination. The inclusion of the module in the ALCS facilitated access of the enumerators to both communities and households. Only 21.0% of households used safely managed drinking water services. A majority of households (58.2%) used water sources contaminated with E. coli, while E. coli contamination at the point of consumption was found in 77.0% of households. E. coli were more frequently detected in water sources used by households with unimproved sanitation. Beside improvement and increased protection of the water supply services, water quality deterioration between source and point of consumption calls for the promotion of safe handling and storage of water at the home.
Highlights
The indicator for the Sustainable Development Goal (SDG) target 6.1 on access to the supply of safe drinking water is the proportion of the population using ‘safely managed drinking water services’ (WHO a, b)
Lessons learned from implementing water quality testing in the Afghanistan Living Conditions Survey (ALCS) household survey None of the households refused water quality testing
Overall learning from the pilot suggests that the inclusion of the water quality module into the future household surveys seems highly feasible and even desirable by both the enumerators and households/communities
Summary
The indicator for the SDG target 6.1 on access to the supply of safe drinking water is the proportion of the population using ‘safely managed drinking water services’ (WHO a, b). A safely managed drinking water service is defined as an improved drinking water source that is located on-premises, available when needed, and free of Escherichia coli bacteria, an indicator of fecal contamination and priority chemical pollutants – arsenic and fluoride. Evidence from a systematic review suggests that 1.8 billion people use a source of drinking water contaminated with E. coli bacteria (Bain et al ). In many areas of developing countries and, in war-affected areas, the ability to conduct microbial testing is challenged by the availability of laboratory facilities, trained personnel, and essential infrastructure, such as electricity supply. Very high risk (1 E. coli per 100 mL) (>100 E. coli per 100 mL)a N
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