Geographical heterogeneity and inequality of access to improved drinking water supply and sanitation in Nepal
Abstract Background Per United Nations’ Sustainable Development Goals, Nepal is aspiring to achieve universal and equitable access to safe and affordable drinking water and provide access to adequate and equitable sanitation for all by 2030. For these goals to be accomplished, it is important to und...
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| Format: | Article |
| Language: | English |
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BMC
2018-04-01
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| Series: | International Journal for Equity in Health |
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| Online Access: | http://link.springer.com/article/10.1186/s12939-018-0754-8 |
| _version_ | 1811192147155615744 |
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| author | Wen-Jun He Ying-Si Lai Biraj M. Karmacharya Bo-Feng Dai Yuan-Tao Hao Dong Roman Xu |
| author_facet | Wen-Jun He Ying-Si Lai Biraj M. Karmacharya Bo-Feng Dai Yuan-Tao Hao Dong Roman Xu |
| author_sort | Wen-Jun He |
| collection | DOAJ |
| description | Abstract Background Per United Nations’ Sustainable Development Goals, Nepal is aspiring to achieve universal and equitable access to safe and affordable drinking water and provide access to adequate and equitable sanitation for all by 2030. For these goals to be accomplished, it is important to understand the country’s geographical heterogeneity and inequality of access to its drinking-water supply and sanitation (WSS) so that resource allocation and disease control can be optimized. We aimed 1) to estimate spatial heterogeneity of access to improved WSS among the overall Nepalese population at a high resolution; 2) to explore inequality within and between relevant Nepalese administrative levels; and 3) to identify the specific administrative areas in greatest need of policy attention. Methods We extracted cluster-sample data on the use of the water supply and sanitation that included 10,826 surveyed households from the 2011 Nepal Demographic and Health Survey, then used a Gaussian kernel density estimation with adaptive bandwidths to estimate the distribution of access to improved WSS conditions over a grid at 1 × 1 km. The Gini coefficient was calculated for the measurement of inequality in the distribution of improved WSS; the Theil L measure and Theil T index were applied to account for the decomposition of inequality. Results 57% of Nepalese had access to improved sanitation (range: 18.1% in Mahottari to 100% in Kathmandu) and 92% to drinking-water (range: 41.7% in Doti to 100% in Bara). The most unequal districts in Gini coefficient among improved sanitation were Saptari, Sindhuli, Banke, Bajura and Achham (range: 0.276 to 0.316); and Sankhuwasabha, Arghakhanchi, Gulmi, Bhojpur, Kathmandu (range: 0.110 to 0.137) among improved drinking-water. Both the Theil L and Theil T showed that within-province inequality was substantially greater than between-province inequality; while within-district inequality was less than between-district inequality. The inequality of several districts was higher than what is calculated by regression of the Gini coefficient and our estimates. Conclusions This study showed considerable geographical heterogeneity and inequality not evidenced in previous national statistics. Our findings may be useful in prioritizing resources to reduce inequality and expand the coverage of improved water supply and sanitation in Nepal. |
| first_indexed | 2024-04-11T23:47:58Z |
| format | Article |
| id | doaj.art-af9db25ef4ce44c5b66ca7184e35a86c |
| institution | Directory Open Access Journal |
| issn | 1475-9276 |
| language | English |
| last_indexed | 2024-04-11T23:47:58Z |
| publishDate | 2018-04-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal for Equity in Health |
| spelling | doaj.art-af9db25ef4ce44c5b66ca7184e35a86c2022-12-22T03:56:36ZengBMCInternational Journal for Equity in Health1475-92762018-04-0117111410.1186/s12939-018-0754-8Geographical heterogeneity and inequality of access to improved drinking water supply and sanitation in NepalWen-Jun He0Ying-Si Lai1Biraj M. Karmacharya2Bo-Feng Dai3Yuan-Tao Hao4Dong Roman Xu5Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen UniversityDepartment of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen UniversityDivision of Cardiology, University of WashingtonDepartment of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen UniversityGuangdong Key Laboratory of Health Informatics, Health Information Research Center, Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen UniversitySun Yat-sen Global Health Institute, Sun Yat-sen UniversityAbstract Background Per United Nations’ Sustainable Development Goals, Nepal is aspiring to achieve universal and equitable access to safe and affordable drinking water and provide access to adequate and equitable sanitation for all by 2030. For these goals to be accomplished, it is important to understand the country’s geographical heterogeneity and inequality of access to its drinking-water supply and sanitation (WSS) so that resource allocation and disease control can be optimized. We aimed 1) to estimate spatial heterogeneity of access to improved WSS among the overall Nepalese population at a high resolution; 2) to explore inequality within and between relevant Nepalese administrative levels; and 3) to identify the specific administrative areas in greatest need of policy attention. Methods We extracted cluster-sample data on the use of the water supply and sanitation that included 10,826 surveyed households from the 2011 Nepal Demographic and Health Survey, then used a Gaussian kernel density estimation with adaptive bandwidths to estimate the distribution of access to improved WSS conditions over a grid at 1 × 1 km. The Gini coefficient was calculated for the measurement of inequality in the distribution of improved WSS; the Theil L measure and Theil T index were applied to account for the decomposition of inequality. Results 57% of Nepalese had access to improved sanitation (range: 18.1% in Mahottari to 100% in Kathmandu) and 92% to drinking-water (range: 41.7% in Doti to 100% in Bara). The most unequal districts in Gini coefficient among improved sanitation were Saptari, Sindhuli, Banke, Bajura and Achham (range: 0.276 to 0.316); and Sankhuwasabha, Arghakhanchi, Gulmi, Bhojpur, Kathmandu (range: 0.110 to 0.137) among improved drinking-water. Both the Theil L and Theil T showed that within-province inequality was substantially greater than between-province inequality; while within-district inequality was less than between-district inequality. The inequality of several districts was higher than what is calculated by regression of the Gini coefficient and our estimates. Conclusions This study showed considerable geographical heterogeneity and inequality not evidenced in previous national statistics. Our findings may be useful in prioritizing resources to reduce inequality and expand the coverage of improved water supply and sanitation in Nepal.http://link.springer.com/article/10.1186/s12939-018-0754-8SanitationDrinking waterHeterogeneityInequalityNepal |
| spellingShingle | Wen-Jun He Ying-Si Lai Biraj M. Karmacharya Bo-Feng Dai Yuan-Tao Hao Dong Roman Xu Geographical heterogeneity and inequality of access to improved drinking water supply and sanitation in Nepal International Journal for Equity in Health Sanitation Drinking water Heterogeneity Inequality Nepal |
| title | Geographical heterogeneity and inequality of access to improved drinking water supply and sanitation in Nepal |
| title_full | Geographical heterogeneity and inequality of access to improved drinking water supply and sanitation in Nepal |
| title_fullStr | Geographical heterogeneity and inequality of access to improved drinking water supply and sanitation in Nepal |
| title_full_unstemmed | Geographical heterogeneity and inequality of access to improved drinking water supply and sanitation in Nepal |
| title_short | Geographical heterogeneity and inequality of access to improved drinking water supply and sanitation in Nepal |
| title_sort | geographical heterogeneity and inequality of access to improved drinking water supply and sanitation in nepal |
| topic | Sanitation Drinking water Heterogeneity Inequality Nepal |
| url | http://link.springer.com/article/10.1186/s12939-018-0754-8 |
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