rapid assessment of drinking-water quality in the republic of tajikistan

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Foreword Among the infectious diseases, diarrhoeal diseases are the second major cause of death, killing an estimated 2.2 million people annually, the vast majority children in developing countries. In 2000, heads of state adopted the Millennium Development Declaration at a special session of the United Nations General Assembly, and this led to the universal adoption of eight Millennium Development Goals (MDGs). One of the targets under MDG 7, environmental sustainability, is to halve, by 2015, the proportion of people without sustainable access to safe drinking-water and basic sanitation; this target links to targets under MDGs 4, 5 and 6 (the so-called “health MDGs” –reduction of child mortality, improvement of maternal and child health and reduction of the burden of HIV/AIDS, malaria and tuberculosis-) in that it creates the basis for sustained progress in the overall reduction of the burden childhood illness. Since 2000, the WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation (JMP) is the formal instrument to measure progress towards achieving MDG 7 target C. The JMP builds on monitoring experience gained during the International Drinking Water Supply and Sanitation Decade of the 1980s. In 2000 it took a major methodological departure from its past practice, and started to base its estimates on household surveys and censuses. The definitions of drinking-water and sanitation facilities are categorized as “improved” and “not improved”. This refers to the probability that “improved” water sources give access to safe drinking-water and that improved sanitation facilities effectively separate human waste from drinking-water sources. The JMP statistics on water and sanitation do not, however, provide specific evidence about the quality of water being provided to communities, households and institutions through direct measurements; so far, in these statistics, the safety of the drinking-water can only be inferred. There is, therefore, an urgent need to obtain independently verifiable water-quality data, using reliable, lowcost methods that ideally can be correlated with the datasets on access obtained through the household surveys and censuses. On the basis of such data, governments will be able to make informed decisions to further improve the situation with respect to drinking-water supply in their countries, actions to accelerate progress towards achieving MDG 7 target C can be better targeted and the evidence base on the correlation between lack of access to safe drinking-water and the burden of water-borne disease will be further strengthened. The data are also expected to reveal the extent of major water-quality problems at national, regional and global levels and inform future investment priorities. A possible method to obtain the data on drinking-water quality could be a rapid, low-cost, field-based technique for assessing water quality. As a result, at a consultative meeting in Bangkok in 2002 organized by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) six countries were selected to implement pilot projects on the Rapid Assessment of Drinking-Water Quality (RADWQ). The countries were China, Ethiopia, Jordan, Nicaragua, Nigeria and Tajikistan. The project was initiated in Tajikistan in June 2004 with the collection of statistical data needed to develop the survey. To plan and oversee the project, a project steering committee was established, made up of representatives of government institutions (Ministry of Health, Ministry of Melioration and Water Resources, and the State Committee for Environmental Protection), the State Statistics Committee, UNICEF and WHO. The Republican Sanitary Epidemiological Service (SES) was designated by the Ministry of Health as the lead agency for implementing the RADWQ project in Tajikistan. Dr Samaridin Aliev, Chief Doctor of the Republican SES, was appointed national project coordinator and Dr Pirnazar Shodmonov, Head of the Sanitary Department at the Republican SES, as his deputy. International consultants provided the training on survey methodology, field implementation, use of the field-test equipment and sanitary inspection methods during September 2004. Between October 2004 and April 2005 1780 water samples were taken in the four oblasts (i.e. regions)of Tajikistan that were visited. A final review meeting was organized in Dushanbe during a second consultants’ visit in November 2005. At the meeting, the results of the RADWQ survey were shared and recommendations made as to how to improve the RADWQ methodology, these recommendations are included in this current report. viii
Acknowledgements The RADWQ project involved years of planning, months of fieldwork, and weeks of data entry and analysis. Successful project implementation would not have been possible without the hard work and dedication of project coordinators, international consultants, statistical experts, field teams, drivers and data-entry clerks, and the support of various individuals. Special thanks are due: to the heads and personnel of the oblast and district SES, as well as to the operators of water supplies visited during the survey, for their collaboration and advice to the field teams on the regional and local level; to all members of the field teams for their continuous and dedicated work under sometimes challenging field conditions; and to Mr Gulom Erdanov for maintaining the accuracy of the SanMan database. Thanks are also due to Ms Yukie Mokuo, Mr Murat Sahin, Mr Ikram Davronov and Ms Nargis Babakhanova, all of UNICEF Tajikistan, for their continuous support throughout project; and to Mr Michael Jackman for conducting the trainings. Finally, the financial support received from the Department for International Development/UKAID of the United Kingdom is gratefully acknowledged. ix
Page 1: RAPID ASSESSMENT OF DRINKING-WATER
Page 4 and 5: WHO Library Cataloguing-in-Publicat
Page 6 and 7: Annexes Annex 1. Rayon database of
Page 10 and 11: Acronyms GBAO Gorno-Badakhshan Auto
Page 13 and 14: 1 Introduction 1.1 The WHO/UNICEF J
Page 15 and 16: Measuring gender disparities. Data
Page 17 and 18: Microbial parameters. This involves
Page 19 and 20: 2 Methods 2.1 Survey design The met
Page 21 and 22: Figure 2.2 Steps in the design of t
Page 23 and 24: Cluster size. Cluster sizes ranged
Page 25 and 26: Table 2.2 Country-specific survey d
Page 27 and 28: Throughout the field visits, field
Page 29 and 30: 3 Results 3.1 Microbiological param
Page 31 and 32: Faecal streptococci Faecal streptoc
Page 33 and 34: Water sources were tested for fluor
Page 35 and 36: Table 3.8 Compliance with the Tajik
Page 37 and 38: Table 3.11 Compliance with WHO sugg
Page 39 and 40: Table 3.13 Results of sanitary insp
Page 41 and 42: Faecal contamination (thermotoleran
Page 43 and 44: comparison was possible, 42.5% show
Page 45 and 46: Table 3.23 Compliance of household
Page 47 and 48: protecting the spring (37.7%). Sani
Page 49 and 50: quality. The Republican SES hopes t
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Rayon Water supply Working conditio
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Rayon Water supply Working conditio
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Annex 4. Primary stratification a S
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Rayons included in the RADWQ survey
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Annex 6. Example of a sampling plan
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Annex 7. Initial fieldwork plan Fie
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Annex 8. Example of a monthly progr
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Table 3. # Total number of analyses
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The following analyses are planned
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Remarks: The Sughd team is continui
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No. Description of expense Expense
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RADWQ Daily Report Sheet Chemical d
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rapid assessment of drinking-water quality in the republic of tajikistan

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