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. 2022 Mar 16;19(6):3507.
doi: 10.3390/ijerph19063507.

Prevalence and Correlates of Water, Sanitation, and Hygiene (WASH) and Spatial Distribution of Unimproved WASH in Nepal

Shalik Ram Dhital  1   2 , Catherine Chojenta  1 , Tiffany-Jane Evans  3 , Tri Dev Acharya  4 , Deborah Loxton  1
Affiliations

Prevalence and Correlates of Water, Sanitation, and Hygiene (WASH) and Spatial Distribution of Unimproved WASH in Nepal

Shalik Ram Dhital et al. Int J Environ Res Public Health. .

Abstract

This study aims to estimate the prevalence and correlation of household levels of water, sanitation, and hygiene (WASH), including the identification of areas where WASH facilities are unimproved in Nepal. The study population was 11,040 household heads, using the data collected in the Nepal Demographic and Health Survey 2016. Logistic regression analysis was performed and crude odds ratios (OR) with 95% confidence intervals (CI) using a 0.05 significance level are presented. Getis-Ord Gi* statistics were used to identify the hot and cold spot areas of unimproved WASH. GPS locations of WASH points were used for spatial analysis. Approximately 95% of households had an improved water source, 84% had improved sanitation facilities, 81% had a fixed place for handwashing, and 47% had soap and water. Education, wealth, and ecology were significantly associated with WASH. The people from the hills were less likely to have an improved water source (OR = 0.32; 95% CI: 0.16-0.64) than those from the plain. Households with a poor wealth index had 78% lower odds of having an improved water source compared to households with a rich wealth index. Respondents from Madhes Province had lower odds (OR = 0.15; 95% CI: 0.08-0.28) and Gandaki Pradesh had the highest odds (OR = 2.92; 95% CI: 1.52-5.61) of having improved sanitation facilities compared to Province 1. Respondents aged 35-44 years had higher odds (OR = 1.16; 95% CI: 1.04-1.29) of having soap and water available compared to those aged 45 years and older. Education and geographical disparities were the factors associated with having reduced access to WASH. These findings suggest the need to focus on advocacy, services, and policy approaches.

Keywords: Nepal; WASH; household; improved; spatial distribution; unimproved.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The study area, Nepal, with the province and ecological zones. Each dot represents WASH clusters (ward as a primary sampling unit; n = 363).
Figure 2
Figure 2
Mapping cluster in Nepal: (a) unimproved water source; (b) unimproved sanitation; (c) unavailability of soap and water; and (d) unavailability of a fixed place.
See this image and copyright information in PMC

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