Health Related Issues With Insufficient Water Supply In Rural Areas

Project and Seminar Material for Public Health

Abstract

This study investigates health related issues with insufficient water supply in rural areas .Access to water, sanitation, and hygiene is a major human right necessary for achieving Sustainable Development Goals. The study examined inequalities in access to water and sanitation in rural settlements covering Apa, Ikoga, Ibeshe, Itori, Eruwa, and Lanlate in parts of Southwest Nigeria. Purposive and random sampling techniques were employed to select six settlements and administered 400 questionnaires to households respectively. Descriptive statistics, chi-square, and factor analysis were employed for data analysis. The result shows that the majority of the households interviewed are adults with secondary school certificate. The major available water supply and sanitation facilities in the study area are boreholes and an open pit latrine. About 50.8% and 48.1% of the households gained access to improved water and sanitation respectively in the study area. Badagry and Ewekoro recorded the highest access for improved water and sanitation respectively. Only 8% of the households gained access to safe water supply in the study area. The sanitary condition in the study area is poor. The chi-square shows a significant relationship between the dependent variables (water sources/types of toilet facilities) and independent variable (marital status, age, and income) at p<0.01.Factor analysis explained 68.86% of the total variance and extracted five components. The five factors revealed three major factors namely; demographic, environmental and water source as the main factors affecting household access to water and sanitation. The study is significant because it contributes to knowledge in the areas of WaSH and environmental sustainability. The study concluded that access to improved water and sanitation in Eruwa and Lanlate is poor. Sustainable rural water supply and sanitation policies that will guarantee effective environmental sanitation, monitoring and provision of safe water supply and decent sanitation facilities were recommended. The study suggests that priority is given to Eruwa and Lanlate for intervention due to its weakest water and sanitation access.

Table of Content

Title Page
Certification
Dedication
Acknowledgement
Table of Content
List of Tables
Abstract

Chapter One:

Introduction

1.1 Background of the Study
1.2 Statement of the Problem
1.3 Objective of the Study
1.4 Research Questions
1.5 Significance of the Study
1.6 Scope of the Study
1.7 Limitation of the Study
1.8 Definition of Terms
1.9 Organization of the Study

Chapter Two:

Review of Literature

2.1 Conceptual Framework
2.2 Theoretical Framework
2.3 Empirical Review

Chapter Three:

Research Methodology

3.1 Research Design
3.2 Population of the Study
3.3 Sample Size Determination
3.4 Sample Size Selection Technique and Procedure
3.5 Research Instrument and Administration
3.6 Method of Data Collection
3.7 Method of Data Analysis
3.8 Validity of the Study
3.9 Reliability of the Study
3.10 Ethical Consideration

Chapter Four:

Data Presentation and Analysis

4.1 Data Presentation
4.2 Analysis of Data
4.3 Answering Research Questions
4.4 Discussion of Findings

Chapter Five:

Summary, Conclusion and Recommendation

5.1 Summary
5.2 Conclusion
5.3 Recommendation
References
APPENDIX
QUESTIONNAIRE

Chapter One

Introduction

1.1 Background of the Study

The importance of the water supply and sanitation1 system has been a subject of serious attention reflected in the measurement of human development and in their inclusion in the Millennium Development Goals2 (MDGs). This priority treatment follows official reports estimating about one billion people in the world living without access to improved drinking water supplies while 2.6 billion people live without adequate sanitation (see Lane, 2012; WHO, 2010; WHO/UNICEF, 2010; UNICEF and WHO, 2004 and UN‐Habitat, 2003). Nearly 80% of the people using water from unimproved sources are reportedly concentrated in three regions namely, sub‐Sahara Africa, Eastern and Southern Asia. For sanitation, overall levels of use of improved facilities are noted to be far lower than for drinking water (WHO and UNICEF, 2006). These represent serious global health burdens especially when viewed in terms of the consequences associated with a lack of access to drinking water, inadequate sanitation and poor hygiene. Although some countries, especially in the less developed realm, are making significant progress in addressing the challenges of water supply and sanitation, reports on sub‐Sahara Africa is particularly not encouraging as only 36% of the population was officially estimated to have access to basic sanitation (UNICEF and WHO, 2004) while 37% of the population still relies on unimproved sources of water (Onabolu et al, 2011).

Nigeria is one of the countries in sub‐Sahara Africa whose records on general access to water supply and sanitation facilities by the citizens remain very poor. The Nigerian cities in particular are fraught with inexorable rise of squatter settlements, overcrowding dwellings, breakdown of waste disposal arrangements, air and water pollution and inadequate water and sanitation services. Many problems of mortality, morbidity and poverty have been reported in the literature as consequences of a lack of safe drinking water supplies as well as poor sanitation coverage (Nwankwoala, 2011; WHO, 2010; Nyong and Kanaroglou, 1999; Sodeinde et al, 1997). Given these poor pictures, the question arises of what, probably, could be the main problem of the lack of access3 to safe drinking water and basic sanitation for the population. Many studies seem to agree to the fact that a lack of political will to tackle the problem is one of the most responsible factors (see Mara, 2012; Lane, 2012; Moe and Rheingans, 2006).

One way of assessing how, probably, this hypothesis could hold some validity is by attempting an understanding of the various institutional, discursive and practical tools that have been followed in addressing the water and sanitation challenges in the country over some periods of time. As knowledge of the relationship between water and sanitation as well as how it should be managed has dramatically expanded over the past several decades through the various global knowledge channels, it is equally important to understand how various institutional domains at national and local levels are configured to take advantage of such knowledge opportunities in addressing local challenges. This paper, consequently, reviews Nigeria’s water supply and sanitation systems over the years, with an attempt to capture past practices and present reality. More emphasis will be paid on policies, policy reforms and implementation practices. The topic is discussed in sections. Immediately following the introductory section, comes the geographical background and the state of water supply and sanitation services. The third section takes a time‐sequence look on the institutional perspectives of water supply and sanitation with emphasis on policies and policy reforms. The fourth section discusses the major challenges and institutional problems confronting policy reforms and implementation in the water and sanitation sector. This is followed by the concluding remarks.

The significance of water to the existence of man cannot be overemphasized. This is because access to improved water and sanitation is a vital component for achieving the Sustainable Development Goals (SDGs) including good health, education, poverty and gender equality (Hutton and Varughese, 2016). Since the declaration of International Drinking Water Supply and Sanitation Decade in the 1980s and the Human Development Report (HDR) in 2006, access to water and sanitation has been recognized as the basic needs for human life and progress; therefore, the need for the eradication of inequality in access to water and decent sanitation across the globe has become a vital goal of the SDGs (UNDP, 2006; Calow and Mason, 2014).

Despite these giant strides, the future looks very bleak and daunting due to the disparities in access to water and sanitation services especially amongst the poor in developing countries, the rural dwellers, the ethnic and religious minorities and the women respectively (WHO/UNICEF, 2014; Aleixo et al., 2016). The disparities in access to improved water and sanitation can be attributed to several factors such as; geographical areas (region, urban/rural), social class (rich and poor), race, ethnicity and gender (Abrams et al., 2012; Ribeiro Sarmento, 2015). Poor access to water, sanitation and hygiene facilities is one of the major contributors to the global burden of diarrhea disease. This health challenge impacts significantly on the social, economic and environmental well-being of the vulnerable groups, especially children from poor families (Lim et al., 2012; Roche et al., 2017).

The SDG 6 emphasized the need for reducing the inequalities that exist among countries regarding access to safe drinking water, basic sanitation and hygiene as a basic human right (Aleixo et al., 2016). In Nigeria, the formulation of a National Water Supply Policy (NWSP) has been instrumental to the progress recorded so far in the decline in the proportion of the population without access to improved sanitation from 38% to 29% between 1990 and 2015 (WHO and UNICEF, 2017). Globally, about 1.2 billion people still lack access to safe water while 2.6 billion people do not have access to basic sanitation (Cairncross et al., 2010; WHO and UNICEF, 2014).

In sub-Saharan Africa, the situation is more worrisome due to the high inequalities observed among the low-income groups, the rural and peri-urban dwellers (WHO and UNICEF, 2014).

1.2 Statement of the Problem

Access to improved water and sanitation has a strong relationship with a healthy and productive life as well as environmental sustainability (UNICEF, 2014). Worldwide, approximately 6.3% of the deaths recorded result from poor drinking water, sanitation facilities, and hygiene practices (Emenike et al., 2017). In Nigeria, lack of access to clean water has gross implications on the socio-economic development, personal hygiene and consequently, places the health of about 40 million Nigerians at risk (Gbadegesin and Olorunfemi, 2009; UNICEF and WHO, 2012). It is estimated that about 122,000 Nigerians including 87,000 children less than 5 years die annually due to diarrhoea. Most of these deaths have been linked to poor water, sanitation, and hygiene (Sodeinde et al., 1997; Nyong and Kanaroglou, 1999; Nwankwoala, 2011). Poor sanitation in Nigeria has resulted in huge losses running to almost US$ 3 billion annually (FMWR, 2014). Therefore, for Nigeria to achieve the sustainable development goal 6 by 2030 in the rural areas, about 8 million people would be required to be reached annually (Hutton & Varughese, 2016).

1.3 Objective of the Study

The main objective of the study is to investigate the health related issues with insufficient water supply in rural areas. Specific objectives include to:

Examine the impact of social economic status on the use of water among rural dwellers.
Evaluate the access to water and sanitation among rural dwellers.
Investigate the relationship between the socio-economic status and access to water and sanitation among rural dwellers.

1.4 Research Questions

What is the impact of social economic status on the use of water among rural dwellers?
What is the degree of access to water and sanitation among rural dwellers?
What is the relationship between the socio-economic status and access to water and sanitation among rural dwellers?

1.5 Significance of the Study

This study is significant to rural dwellers, students in the field of sciences as well as stakeholders in the field of water resources. The reviewed articles and journals in this study would add significantly to existing knowledge with respect to the subject of this study, the recommendations that will be made in this study will serve as a guide line for proper policy formulation for stakeholders in the water resources field.

1.5 Scope of the Study

This research work focused on the health-related issues with insufficient water supply in rural areas. The study also investigated the impact of social economic status on the use of water among rural dwellers, the degree of access to water and sanitation among rural dwellers and the relationship between socioeconomic status and access to water and sanitation among rural dwellers.

1.7 Limitations of the Study

This study was constrained by some factors. Firstly, the time frame allocated for the completion of this study was not enough for the researcher to extensively carry out research based on the theme of this research work. On the other hand, the research participants were not willing to participate in responding to the administered questionnaire of this study. Also, the required materials like journals and articles needed for the proper completion of this study were not readily available online and offline. All these constraint put together, ultimately determined the extent to which the researcher was able to go in this study.

1.8 Definition of Terms

Water Resources:

Natural resources of water that are potentially useful for humans,[1] for example as a source of drinking water supply or irrigation water. 97% of the water on the Earth is salt water and only three percent is fresh water; slightly over two thirds of this is frozen in glaciers and polar ice caps.[2] The remaining unfrozen freshwater is found mainly as groundwater, with only a small fraction present above ground or in the air.[3] Natural sources of fresh water include surface water, under river flow, groundwater and frozen water. Artificial sources of fresh water can include treated wastewater (wastewater reuse) and desalinated seawater. Human uses of water resources include agricultural, industrial, household, recreational and environmental activities.

Water resources are under threat from water scarcity, water pollution, water conflict and climate change. Fresh water is a renewable resource, yet the world’s supply of groundwater is steadily decreasing, with depletion occurring most prominently in Asia, South America and North America, although it is still unclear how much natural renewal balances this usage, and whether ecosystems are threatened. The framework for allocating water resources to water users (where such a framework exists) is known as water rights.

Rural Area:

A geographic area that is located outside towns and cities.[1] Typical rural areas have a low population density and small settlements. Agricultural areas and areas with forestry typically are described as rural. Different countries have varying definitions of rural for statistical and administrative purposes.

In rural areas, because of their unique economic and social dynamics, and relationship to land-based industry such as agriculture, forestry and resource extraction, the economics are very different from cities and can be subject to boom and bust cycles and vulnerability to extreme weather or natural disasters, such as droughts. These dynamics alongside larger economic forces encouraging to urbanization have led to significant demographic declines, called rural flight, where economic incentives encourage younger populations to go to cities for education and access to jobs, leaving older, less educated and less wealthy populations in the rural areas. Slower economic development results in poorer services like healthcare and education and rural infrastructure. This cycle of poverty in some rural areas, means that three quarters of the global population in poverty live in rural areas according to the Food and Agricultural Organization.

Some communities have successfully encouraged economic development in rural areas, with some policies such as giving increased access to electricity or internet, proving very successful on encouraging economic activities in rural areas. Historically development policies have focused on larger extractive industries, such as mining and forestry. However, recent approaches more focused on sustainable development are more aware of economic diversification in these communities.

Community:

social unit (a group of living things) with commonality such as place, norms, religion, values, customs, or identity. Communities may share a sense of place situated in a given geographical area (e.g. a country, village, town, or neighbourhood) or in virtual space through communication platforms. Durable good relations that extend beyond immediate genealogical ties also define a sense of community, important to their identity, practice, and roles in social institutions such as family, home, work, government, society, or humanity at large.[1] Although communities are usually small relative to personal social ties, “community” may also refer to large group affiliations such as national communities, international communities, and virtual communities.[2]

1.9 Organisations of the Study

This research work is categorized in five chapters, for easy understanding, as follows.

Chapter one is concern with the introduction, which consist of the (overview, of the study), background to the study, statement of problem, objectives of the study, research questions, significance of the study, scope and limitation of the study, definition of terms.
Chapter two encompasses the conceptual review theoretical review and empirical reviews on which the study is based.
Chapter three deals on the research design and methodology adopted in the study.
Chapter four concentrate on the data collection and analysis and presentation of finding.
Chapter five gives summary, conclusion, and recommendations made of the study.

Chapter Five

Summary, Conclusion and Recommendation

5.1 Summary

The available sanitation facilities in the study area revealed that open-pit latrine predominates representing 23.0% while simple pit latrine is the least with 3.3%. The result is consonance with the findings of Akpabio et al. (2015) and Alepu et al. (2016) and where the majority of the households in Akwa-Ibom and Calabar rely more on pit latrine system respectively. Across the study area, the result shows that the majority of the households from Eruwa and Lanlate relied on OPL and PSL sanitation facilities. The practice of OPL poses a greater health risk to feco-oral transmission and waterborne diseases, such as cholera, diarrhea, and dysentery (TuyetHanh et al. 2016). Hopewell and Graham (2014) also noted the continuous rise in open defecation among the major sub-Saharan African cities is responsible for some of the reasons for the slow progress made in SDG 6.

Similarly, the agrarian nature of the communities around Lanlate and Eruwa supports open pit latrine. Around Apa and Ikoga in Badary LGA, PFL, SPL and BL sanitation facilities predominate. The dominance of BL sanitation can be attributed to the riverine nature of the area which allows for the use of BL that can later be emptied in the surrounding water body. This method is common in most riverine communities in developing countries. Considering the current executive order 009 signed by the president to tackle open defecation and other related matters in Nigeria, it will go a long way in addressing the problem of poor sanitation in the country.

Household access to improved water and sanitation in the study area shows that approximately 50.8% and 48.1% have access to water and sanitation respectively (Table 3). The statistics on the members of the household who have access to improved water and sanitation service is very poor. This calls for a major concern in order to avert outbreak of epidemics in the area. Lack of access to potable water and poor sanitation services pose significant health challenges for school children. According to WHO (1999), poor water supply, sanitation, and hygiene pose serious health hazards for human populations since many vector diseases tend to thrive where these services are not available. Studies have shown that most school children miss classes because they get sick due to water-borne illnesses such as dysentery, diarrhea, typhoid, and malaria. (Bhargava, 2006; Oloruntoba et al. 2014; Alam et al. (2017) and Angoua et al. 2018). Similarly, Hutton and Chase (2016) noted that poor WaSH facilities have significant health and socio-economic consequences which may result in poor nutritional status, child growth and low school performance.

The variations in access to improved water source across the LGAs shows that settlements around Badagry LGA recorded the highest access to improved water with about 71.5% Unlike Ibarapa East LGA, the majority representing 92% of the households from Eruwa and Lanlate relied on unimproved sources. Access to safe water supply indicates that only 8% of the households gained access to safe water supply in the study area as indicated in asterisk. Satterthwaite (2003) noted that inadequate piped water and decent sanitation constitute one of the major problems affecting rural dwellers in developing countries. Previous studies have shown that access to safe water supply reduces the problem of waterborne diseases. It also reduces the time spent and the frequency of water collection in household (Sullivan et al. 2003). This result is in consonance with the findings of Nketiah-Amponsah et al. (2009) who observed that owning a decent sanitation facility correlates with a higher likelihood of access to piped water connection compared to other sources of water. Similarly, Hunter et al. (2010) noted that inadequacies in water supply affect human health adversely both directly and indirectly. They argued that improvements in various aspects of water supply and sanitation services are vital for enhanced public health.

Concerning access to sanitation across the LGAs, Ewekoro recorded the highest for improved sanitation with 63%, while a greater proportion of the households representing 69% relied on unimproved sanitation in Ibarapa East (Table 3). Furthermore, the sanitary conditions in the study area show that approximately 66 and 12% of the households reported the presence of solid waste piles and stagnant water around their dwelling. The result is in agreement with the findings of Cookey et al. (2008) and Tadesse et al. (2013).

5.2 Conclusion

Inequality in access to water and sanitation in rural settlements in parts of Southwest Nigeria. Purposive sampling technique was adopted in the selection of six settlements while questionnaire was administered to households using a random sampling method. The result shows that 45.3% of the households interviewed are adult i.e. above 35 years with about 42.3% having secondary school certificates. The dominant occupation is trading representing 45.5% while more than one-quarter ofthe households are low-income earners. The household size was generally low with about 64.5% in the category of 1-5 persons/ household.

The major water supply source is borehole in the study area. The variations across the LGAs, indicate that settlements from Badagry recorded the highest for piped household water connection, borehole, unprotected dug well and rainwater harvesting. The predominant water supply source around Eruwa and Lanlate is vendor-provided. The main sanitation facility in the study area is the open-pit latrine. The disparity across the settlements shows that households from Eruwa and Lanlate use open-pit latrine/ public or shared latrine.

Approximately 50.8% and 48.1% of the households have access to water and sanitation respectively in the study area. The variations across the settlements indicate that Apa and Ikoga in Badagry LGA recorded the highest access to improved water while the majority of the households from Eruwa and Lanlate in Ibarapa East LGA, relied on unimproved source. Access to safe water supply indicates that only 8% of the households gained access in the study area. Regarding access to sanitation facilities across the specific settlements, 63% of households from Ibeshe and Itori in Ewekoro LGA recorded the highest access to improved sanitation while 69% of the households from. Eruwa and Lanlate use unimproved sanitation facilities. The chi-square test between water sources and socio-economic characteristics show a significant association between marital status, age, education, occupation and income of the household. Also, a significant relationship was established between toilet facilities and marital status, age, and income of the households at p<0.05)

Five factors representing 68.86% of the total variance were extracted based on the FA. Factor I has high positive loadings on household size while income and educational status loaded positively on factor II. Factors III and IV have high loading on gender and wastewater network respectively. Factor V has a high loading on water supply source. The five factors were grouped into three major factors namely demographic, environmental and water supply source. The study contributes to the literature and a gap in knowledge in the areas of WaSH and environmental sustainability. It also provides information on specific WaSH intervention needs for prioritization purposes in the study area. The study concluded that the sanitary condition, access to improve water supply andsanitation facilities in Eruwa and Lanlate is poor. Regular and effective environmental sanitation, provision of safe water supply and decent sanitation facilities were recommended with priority given to Eruwa and Lanlate in Ibarapa East LGA for intervention in the areas of WaSH because of its weakest water and sanitation access.

5.3 Recommendation

The following recommendations are made in line with the analysis carried out in this study:

Conjunctive water

Conjunctive Water development is a means by which water from reservoirs or rivers recharge the ground water during the rains to be used during the period of drought (Agu, 1997). This appears to be the prototype of the conventional impounding of water in shallow wells and reservoirs during the rainy season but it has a major drawback which Ayoade 1998 (cited in Agu 1997) suggests that it involves coordinated and planned development and operation of both surface water and ground water resources to meet water requirements in a manner whereby water is conserved and optimal beneficial use is obtained. In the same light, the meteorological issues has always been the issues with the unpredictability of the annual rainfall distribution, the cultural practice and the literacy level of the class involved. Furthermore, UNEP (1983) suggested that storage facilities can be above or below the ground. Whichever type is used, it is recommended that the container selected be fully covered to prevent contamination arising from dust, humans and animals as well as to prevent algal growth and the breeding of mosquito larvae. Open containers or household ponds are not recommended for reasons of health and because of high loss due to evaporation.

Boiling

Owamah et al (2014) recommended that the community dwellers are therefore advised to always treat their drinking water by boiling and or water guard before consumption as it is risky and unhealthy to consume water contaminated with coliform bacteria due to the possibility of the outbreak of water borne diseases and infections. As some of the water in the rural areas contains hardness, boiling could also be used in removing the temporal hardness of water.
Increase health awareness and community participation

There should be a step-up level of awareness on the rural dwellers on the management of water, diseases, pollutions, efficient waste disposals and other healthy cultural practices of water resources. There should also be an organized efforts of the dwellers in provision and maintenance of tentative boreholes and wells as remedies for the scarcity of potable water or in taking care of the government water facilities. Agunwamba (2002) suggested on this that there should be a sustained public enlightenment to educate the public on water conservation so as to curtail wasteful practices, better catchment practices and to preserve water quality, and rightful use of public facilities.
Government and Private sector participation in water provision.

There is need to organize sensitization and advocacy workshop for policy makers in the focus states on the provisions of National Water Supply and Sanitation. This will enable them to properly appreciate the position and roles of Rural Water Supply and Sanitation Agency (RWSSA) in rural 8 | P a g e water supply and sanitation service delivery (Ahmed and Bashir, 2011). The absence or low interest of private sector investments in water sector is mostly due to the lack of enabling laws to invest in the sector, especially in the provision and management of community systems either through private technicians or supply of spare parts (Ahmed et al 2011). Sharma et al (2015) suggested that government agencies should create a framework for collective action with nongovernmental agencies and civil society at large for conserving and provision of water. Also, on the part of the government, it should strengthen strong financial stimulus so as to increase water services delivery in locally understood conditions and technologies (Jidda, 2011) in the investigation, sinking and maintenance of water facilities.

Maintenance

There should be an organized framework in planning to ensure sustainability of the water supply projects. This should involve the routine servicing of boreholes, clearing of grasses, inspection pipes and reservoirs and constant check about the possible outbreak of diseases. There also be some training with some of the dwellers in case of emergency and other basic hygiene practices.

Ecosystem

A step in maintaining ecosystem should be prioritized. This would help in reduction of the emission of greenhouse gas into the atmosphere and its effect. This could be achieved through the help of all in championing the course of awareness of the effects of bush burning, tree falling and combustion of fuels.