Water Engineering and Development Centre
Author(s): Hunt, CarolinePublisher: LSHTM | WEDC
Series: WELL Studies in Water, Sanitation and Environmental Health Task 509
The WHO /UNICEF Joint Monitoring Programme (JMP), to whose year 2000 Global Assessment WELL provided technical support, has collected and reviewed population-based water supply and sanitation coverage data for most of the countries in the world. This report reviews the epidemiological and related literature on safety of different levels of service and different technologies for providing service. Methodological difficulties in estimating health risk are introduced. Coverage is for the first time derived from consumer-based data taken from large nationally representative household surveys.
In the first section, there are a number of models for understanding how water supply, sanitation and hygiene affect health. They are as follows:
The second section of the report focuses on assessment methodologies and difficulties. Most epidemiological studies into the relationship between water supply, sanitation, hygiene and health are observational. Problems with these studies are around lack of control for outcomes and recall bias.
The third section of the report focuses on determinants of health impact of water supply and sanitation. These are access and use, treatment and maintenance, seasonality, pathogen specific factors, source of water, urban-rural differences and situations of conflict and natural disasters.