Rainwater and Health in Developing Countries: A Case Study on Uganda

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  • 2012•10•11

    David Baguma, Syed Aljunid, Jamal Hashim, Helmut Jung and Loiskandl Willibald

    Rainwater and Health in Developing Countries

    UN Photo/Evan Schneider

    Efforts to increase water supply are not an end in themselves. Based on statistical analysis, UNU International Institute for Global Health (UNU-IIGH) researchers discuss how water management in rural households plays an important role in reducing water-related health risks in Uganda and the applicability of these findings in other developing countries.

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    Water is fundamental to all life. Thus, no one can be lifted out of extreme poverty without adequate access to water and sanitation. This is why attention is often focused on global water shortages, particularly among the world’s poorest people.

    Moreover, much work is underway towards meeting the Millennium Development Goals (MDGs) by 2015, particularly those emphasizing eradication of extreme poverty and hunger. And while the progress is such that since 1990 more than 1.8 billion people have gained access to improved sanitation, almost 780 million people remain without adequate access to improved drinking water sources.

    Rural household water sources — such as spring wells, tap water, boreholes, bottled water, ponds and swamps — are key in this challenge. In this article, we focus on rainwater harvesting in rural areas, based on a study conducted in Uganda by our team of researchers (some from UNU-IIGH and others from the University of Natural Resources and Life Sciences, Vienna).

    Rainwater harvesting is practiced worldwide. It is estimated that approximately 40% of households in South Australia use rainwater to supplement the supply of drinking water, as is done in several regions such as Southeast Asia. In Malaysia, for example, rainwater is also used for commercial purposes including car washing via the placement of plastic collection tanks in places like parking lots.

    The Ugandan case

    “Lack of access to safe water and sanitation facilities has a detrimental impact on the health, productivity and general socio-economic progress of our people, especially the children”, Uganda’s Prime Minister Amama Mbabazi said recently as he broke ground on a water infrastructure project. Indeed, according to United Nations Development Assistance Framework for Uganda 2010-2014, even though the country’s water coverage has improved, only one-third of rural populations have adequate sanitation.

    This is, in part, why the Uganda government increased its 2012-2013 budget allocation to the country’s water sector (which falls under the Ministry of Water and Environment) from 271 billion to 355 billion shillings — an increase equivalent to around US$30 million. This is expected to improve water supply to households via investment in gravity flow schemes and other water sources, such as piped water systems.

    Despite such efforts to increase access to water, the reality in most developing countries shows that there remain various obstacles. Principally, water pathogens continue to cause household challenges such that water-related diseases are contributing to morbidity rates and economic burdens in Uganda and other similar countries in the developing world. Worldwide, a primary cause of increased morbidity and premature mortality remains waterborne-related infectious (bacterial, viral and parasitic) and non-infectious (food intolerance- or intestinal disease-caused) diarrhoea, leading to about 2 million deaths each year.

    These problems are compounded by various mechanisms: the way water is distributed, via the droppings of rodents or birds that contaminate the catchment of rainwater harvesting systems, through pollution of the water during the collection process, as well as by weaknesses in the pipe systems where sewage leakages or environmental pollutants infiltrate the pipes, and lack of replacement of old water distribution systems affected by climate change over decades, coupled with poor drainage systems in cities, suburbs and slum areas.

    During periods of water shortage, most people in East Africa turn to rain-fed pots or cisterns as the alternative water supply. In Uganda, rainwater harvesting is widely practiced in most rural areas and is supported by both government and donor organizations promoting the practice. In rainwater harvesting households, we found that usage instructions (including waterborne health risks) were not sufficiently supplied to rural households. The study participants were not likely to have water and sanitation user guides, and 47.7% of respondents indicated lack of access to information on prevalent diseases. Indeed, 61.5% had not been visited by health or project officers from non-profit health education programmes since installation of water storage system.

    Rural domestic rainwater management was therefore affected by the inadequacy of information, which is also exacerbated by poor roads and insufficient resources (such as lack of rural electrification and limited access to information sources, e.g., the Internet).

    This situation arises due to the fact that development partners, donor agencies and governments tend to put more emphasis on water supply (paying particular attention to the number of constructed water storage systems) than on water management and related usage instructions and their translation into local languages.

    This happens most often because providing usage instructions to people who do not have sufficient water seems counterintuitive. Water management as a whole, particularly in communities where water shortage is severe, is not given priority. Thus, in places facing water supply shortages, the burden of waterborne health risks increases partly due to inadequate water management.

    Bridging the gap

    The goal of our study was to examine (based on data from 301 respondents) the influence of independent predictive variables. We considered personal characteristics (age, cash income and gender), participation in rainwater harvesting associations, years of water harvest experience, tank size and reference to usage instructions (including waterborne health risks) for rural domestic rainwater management.

    Logistic regression analyses of the responses revealed three statistically significant results: years of experience with water harvest, membership in rainwater harvesting associations and availing of usage instructions.

    Years of harvesting was found to be statistically significant, which is consistent with the contemporary belief that continuously affirms the value of experience as a predictor of effectiveness. Surprisingly, our investigation found that the number of years of rainwater harvesting had inadequate influence on domestic rainwater management, and that additional subsequent knowledge of risk prevention measures is necessary.

    Rainwater association in the context of the study refers to cooperation and collective participation of members with similar objectives, which tends to boost the acquisition of new water insights. However, the number of rural participants in progressive and active water associations is inadequate and the possibility of acquiring membership is mostly limited, due to low household incomes, literacy problems and insufficient information flow.

    Regarding the final variable, usage instruction, we found that study participants were not likely to have water and sanitation user guides; about 50% of the respondents indicated a lack of access to information on common health risks associated with rainwater harvesting. Indeed, 61.5% of the respondents, as mentioned above, had not been visited by health educators since installation of rainwater harvesting system.

    In summary, based on our research, we envisage that improved capacity-building in water management at the household level should supplement efforts focused on water supply and quality. Emphasis on usage instructions, including information on waterborne diseases and the persistent promotion of active local water associations can partly improve domestic water management.

    When combined with progressive intervention at local and national government levels and the efforts of non-profit organizations focused on improving access to and quality of water, this could help sustain the progress achieved towards the Millennium Development Goals and beyond.


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    Rainwater and Health in Developing Countries: A Case Study on Uganda by David Baguma, Syed Aljunid, Jamal Hashim, Helmut Jung and Loiskandl Willibald is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Based on a work at http://unu.edu/publications/articles/rainwater-and-health-in-developing-countries-a-case-study-on-uganda.html.