Ghana: Saving lives through diarrhoea reductions

Kweku Quansah, Programme Officer - Local Government Ministry

By Patrick Baidoo

Government, UNICEF promote household water treatment

The act of boiling fresh and stored water as a means of purification before consumption used to be a daily ritual in many households and communities across Ghana but this practice in households seem to have dwindled for unknown reasons.

This, notwithstanding, the trend of storing water in many communities for later use, is still prevalent in many homes.

In contemporary times some tablets have also been introduced on to the market to help with the treatment of water before usage but this new paradigm is also not widespread among the populace.

Un-known to many people and the current generation, research conducted by UNICEF and the World Health Organization (WHO) has shown that this traditional manner of treating water to rid it of contaminants before drinking is the second most efficient way of fighting or reducing diarrhoea diseases. Hand washing with soap is touted the most efficient means of reducing death from diarrhoea. 

According to available statistics, Ghana has made significant progress in extending the coverage of improved water sources, with an estimated 91% of urban populations and 80% of rural dwellers having access to “improved water supplies” according to the Joint Monetary Platform (2010).

However, while 90% urban households have access to improved water source about 31% of the rural population do not have access to safe water and about 22% of these rely directly on water from rivers, irrigation canals and dug-outs (MICS 2011). 

In that vein, the Government of Ghana with support from UNICEF under a project termed “UNICEF WASH Project” is introducing a national strategic document to roll back the practice of Household Water Treatment and Storage (HWTS) to promote water treatment and safe storage at the household level before use because water from traditional sources in the rural areas do not meet national standards whiles water from urban water supply sources also leaves much to be desired.

The document which will be out in July, 2013, critically takes three things into consideration: water from the source, distribution, storage and at the time of consumption to ensure safety. It also considers that although Ghana has exceeded the MDG water provision target of 78%, treatment and safe storage is still important due to re-contamination at the household level before it is used for drinking, cooking and personal and domestic purposes.

This document is being finalized after broad consultations with other stakeholders like the community water and sanitation agency, civil society, private sector organizations, ministry of water resources, works and housing, etc.

More over current policy documents on potable water and sanitation delivery does not provide any clear cut guidelines to inculcate household water treatment and safe storage hence this timely initiative.

In that same light a West- Africa (Anglophone) sub-regional work to sought views on best practice approaches to be factored into the final document before implementation will be held in May, 2013 in Accra.

Speaking to the Ghana WASH Times in Accra recently, Mr. Kweku Quansah, Programs Officer, Ministry of Local Government and Rural Development (MLGRD), notes that drinking contaminated water contributes to an estimated 10,000 deaths annually from diarrhoea diseases and it’s the third largest killer of children under 5 years of age in Ghana, hence the need for such a policy to promote the act on a large scale and also ensure its sustainability.

He further said that hand washing with soap helps in reducing diarrhoea diseases by 44 % whiles safe water treatment and storage also has a 39 % reduction rate so the need for all these interventions to be promoted at the same time to achieved a more desirable results in this direction.

"Just providing potable water at source without treating it before usage even from proper water points reduces diarrhoea at a 25% rate. So imagine the rate of contamination from water unsuitable water points like rivers and streams.”

Mr. Quansah states that the intervention to treat and maintain the quality of water at the household level is most promising of these approaches and has to be encouraged. “Take into consideration much of Northern Ghana and other communities, where populations have access to insufficient quantities of water, and also the water is micro biologically unsafe.

Effective household water treatment and safe storage (HWTS) interventions - if used correctly and consistently—can significantly improve the microbiological and chemical integrity of the water at the point of ingestion, and thus deliver significant health benefits for those without access to safe and reliable potable water supplies.

HWTS communication module

In line with the strategy which basically is to ensure behaviour change, the HWTS promotion under the Government of Ghana - UNICEF WASH Programme would be based on the establishment of a clear linkage between the practice and disease reduction. To that end, the intervention, would, as much as possible, be linked to Community Lead Total Sanitation and Hand Washing with soap awareness creation campaigns, as a post –triggering activity.

“Environmental Health Assistants, Community Development Officers, Civil Society and the private sector will be involved in the communication approach to ensure holistic results from the household levels at the national, regions and districts”, Mr. Quansah emphasized.

The communication strategy is national but will be tilted a bit towards open defection communities, communities with less than 50% latrine coverage and areas requiring emergency interventions, based on risk assessment.

Public-private partnership

Allowing the private sector to also fully own the initiative forms part of the bases the strategic document. “Any distribution, selling, promotion of technology in this direction will be championed by the private sector because they have the economic or business know-how”, the Program Coordinator intimated.

Based on the findings of the 2010 HWTS Assessment, the need to scale - up HWTS in Ghana using a solid sustainable approach has been is necessary. A combined social marketing and social intervention would see about 700,000 people benefitting from this initiative. 

Background

An estimated 780 million people drink water from unimproved sources, and millions more drink contaminated water from improved sources (UNICEF/WHO, 2012).  Unsafe drinking-water, along with inadequate hygiene and sanitation contributes to an estimated 1.9 million annual deaths, primarily in children under 5 years.

While countries work to provide universal access to safe, reliable, piped-in water, WHO and UNICEF have called for targeted, interim approaches that will accelerate the heath gains associated with safe drinking-water for those whose water supplies are unsafe.

One such approach is household water treatment and safe storage (HWTS) to prevent contamination during collection, transport, and use in the home. A growing body of evidence demonstrates that the use of HWTS methods improves the microbiological quality of household water and reduces the burden of diarrhoea disease in users hence the introduction of the Household Water Treatment and Safe Storage Strategy.