Waltaji terfa kutane who ethiopia kutanew@who int 14 18 october 2013 university of north carolina
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Drinking Water Supply Sanitary Survey and Microbiological Water Quality Assessment from Source to Home Storage in Gambella, Ethiopia. Waltaji Terfa Kutane , WHO Ethiopia kutanew@who.int 14-18 October 2013 University of North Carolina. Outline. Introduction Study Objective Methodology

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Waltaji Terfa Kutane , WHO Ethiopia kutanew@whot 14-18 October 2013

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Drinking Water Supply Sanitary Survey and Microbiological Water Quality Assessment from Source to Home Storage in Gambella, Ethiopia

Waltaji Terfa Kutane, WHO Ethiopia


14-18 October 2013

University of North Carolina


  • Introduction

  • Study Objective

  • Methodology

  • Result and Discussion

  • Conclusion

  • Actions following the study Result at national level


  • The principal risks to human health associated with the consumption of contaminated & polluted water are microbiological in nature.

  • Dated back to Dr.John Snow's discovery of 1854 Broad Street cholera outbreak in England was spread by contaminated water.

  • Most common & widespread danger contamination is either directly or indirectly, by sewage, by other wastes, or by human or animal excrement

  • Exacerbated by poor Sanitation & hygiene behavior/practice in the water supply system including household

  • Coliform bacteria are present in large number in excrement & sensitive indicator of the presence of faecal contamination.


Poor latrine facilities and open defecation coupled with hygiene behavior are responsible for improved water supply contamination

Prüss-Üstün A, Bos R, Gore F, Bartram J. Safer water, better health: costs, benefits and sustainability of

interventions to protect and promote health. World Health Organization, Geneva, 2008.

Introduction… Ethiopia

  • Access to safe water supply was 49% (U=97%, R=39) using 2011 data

    • Piped 9%

    • Other improved 40%

    • Current coverage 54% National WASH Inventory

  • Access to improved +shared sanitation facilities was 34% % (U=69%, R=25%)

  • Access to any sanitation facilities 55% including un improved latrine facilities

    Source:2013 JMP update

Introduction… Ethiopia

Safe water supply coverage based on the national standard is:

  • Adopted from WHO GV the 2001 Ethiopia Standard:

    • Drinking-water should not contain any microorganisms known to be pathogenic—capable of causing disease—or any bacteria indicative of fecal pollution

  • Urban:

    • dwellers that can obtain at least 20 liters/person/day throughout the year from a source within 0.5 km of the household.

  • Rural:

    • dwellers that can obtain at least 15 liters/person/day throughout the year from a source with in 1.5 km of the household.

  • In both cases the water must either be collected from:

    • an improved source such as protected well, improved & protected spring, sanitary rainfall catchment, etc.; or

    • can otherwise be treated to acceptable standards

  • The national definition is in line with the five basic indicators included in the definition of safe water supply :

    • Quantity

    • Quality

    • Cost/ affordability

    • Continuity(24hours/day; 7days/week, 30 days/month, 365days/year)

    • Coverage /accessibility

Study Objective

  • To identify risk factors responsible from source to household level for poor microbiological water quality of water supply system targeted for the survey

  • To determine the level of contamination & microbiological quality of water supply system and household targeted by the survey

  • To verify whether water supply included in this study met the national definition/satandard of safe water supply

  • To inform the water supply system, health decision &development partners the importance drinking water quality incremental improvement through risk identifcation & management/ mitigation


Household have access to improved source

Observation and interview

WHO standard sanitary survey form for water source & HH risk identification

Indicator bacteria test (Total coliform and E. coli using Membrane filtration technique

Result and Discussion

  • 69.8%, 20%, 19.3%, 6.3%, 4.1% and 2.7% of the survey respondent households use municipal supply, protected wells, protected springs, river &pond respectively.

  • Only 30.6% of the surveyed households getting half(10/litter/person/day) of the WHO recommended 20 litters per person per day for developing countries; 53.4% less than 6 litter & 16% they don`t know

  • No reliable system at grass root level, which can track timely the issue of maintenance, community has to wait for more than a month from center to get back broken hand pumps.

Result and Discussion

  • Improved vs Safe Drinking Water

  • Boreholes & tube wells…31% not safe

  • Protected springs…….37% not safe

  • Protected dug wells….. 57% not safe

  • Source http://www.undispatch.comndg.water.target.met.but.what.about.sanitation.and.darrhea

Result and Discussion

Microbiological Water Quality Test Result

Based on WHO Grading system of microbial quality

Grade A…0%

Grade B……43.3%

Grade C…53.3%

Grade D……3.3%

Improved well 4(50%) +Ve for E.coli

Household level 3 (21.4%) +Ve for E.coli

Similar Study in North Gondar…. E.Coli

Water Line Pipe (n=14) …. 7(50%)

Improved Well(n=14)……….4(28.6%)

Improved Spring(n=14) …5(37.7%)

Source: Ethiopia, JHD, 2004

Result and Discussion

  • WHO/UNICEF JMP RADWQ, 2004-2005 result for Ethiopia Compliance with national standard & WHO Guide line

    • Microbiological Quality sample from source

      • Piped…………………..87.6%

      • Protected springs …. 43.3%

      • Borehole…………………67.9%

      • Protected well………..54.9

      • Total……………………….72%

    • Microbiological Quality sample from household (n=1000)

      • Fecal contamination ……………….55%

    • Sanitary survey Result

      • Protected springs 316 inspected found spring box absent or faulty38.3% and diversion ditch above the spring absent or non-functional 87%

      • Piped water distribution system 428 inspected found cracks in the pre-filters 21.1% and mud balls or cracks in any of the filters 15.8%

Result and Discussion

Knowledge of respondent about disease prevention by using safe Water supply by educational level , Gambella, Ethiopia

Better understanding /knowledge with respect to diarrhoea, cholera and parasite

significant difference with educational level on prevention of diarrhoea with safe water compared greater than 12 grade with illiterate (X²= 10.96; P<0.001).

Result and Discussion

Knowledge of respondents on water container contamination as means of waterborne disease transmission in the home, Gambella, Ethiopia

More than half of respondent claimed that uncovered container , dirty container & use of the same cup for water drawing & drinking are responsible for disease transmission

Photo, Arto S, WASH COM

Result and Discussion

Drinking-Water Handling Practice at Home (n=635)

Result and Discussion

Latrine and hand washing facilities availability, utilization and cleanse(n= 635)


  • The aim of any safe water supply program/project is to reduce the risk of contamination at least to the lowest level. However, in the study area this objective was not achieved.

  • Four major problem areas of public water supply were identified:

    • Quality with sensitive indicators coliform and E.Coli organisms indication of contamination

    • Risk factors for contamination from source to household level

    • Knowledge gap on disease prevention using safe water and contamination of water

    • Quantity acute shortage & none functionality/lack of reliable preventive operation and maintenance system

  • Ad hoc water quality testing and absence of risk assessment/ sanitary survey in the study area


  • Finally three conclusions can be drawn from this study:

    • Though, putting in place water supply infrastructure is apriority in any water supply programme/project, the risk of contamination is all ways there regard less of the complexity of the infrastructure.

    • Availability of the water supply infrastructure does not grantee always the five basic indicators included in the definition of safe water supply :

      • Quantity

      • Quality

      • Cost/ affordability

      • Continuity(24hours/day; 7days/week, 30 days/month, 365days/year)

      • Coverage /accessibility

    • Once water supply infrastructure is in place hygienically management from source to mouth need systematical well designed and planned interventions at home to achieve the objective of Framework for safe drinking-water


Addressing Water Quality strategically

Risk identifcation, prioritization & prevention/mitigation

As integral part of the water supply system Management

As part of O&M

Actions following the study Result

Mitigation of risks based on the priority

Capacity building training and field level water quality testing equipment

National Drinking Water Quality Monitoring Surveillance Strategy developed with detail financial resource requirement and activities

Recent development WSP piloting and framework development

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