28 September 2021

New publication examines water quality patterns for 27 countries

The water quality module was developed as part of a collaboration between the Multiple Indicator Cluster Survey (MICS) programme and the WHO/UNICEF Joint Monitoring Programme (JMP) for Water Supply, Sanitation and Hygiene.

Since the first pilot in Bangladesh in 2012, over 25 countries have included the new water quality module in MICS in addition to new questions on the availability of drinking water. These data have enabled countries to set baselines for the new SDG indicator “safely managed drinking water services” and to examine patterns in water quality at the point of collection (household’s water source) and point of use (a glass of water). In surveys that have included the water quality module, field teams have collected water samples and conducted tests for WHO’s recommended indicator of faecal contamination of drinking water (E. coli) using portable equipment.

In a recent research article published in the journal Environmental Health Perspectives “Monitoring Drinking Water Quality in Nationally Representative Household Surveys in Low- and Middle-Income Countries: Cross-Sectional Analysis of 27 Multiple Indicator Cluster Surveys 2014–2020” members of the JMP and MICS team summarize the results from water quality testing to-date and examined risk factors for E. coli contamination across the most recent national MICS survey in 27 countries. The study documents widespread E. coli contamination and inequalities between and within countries and finds that water quality is often the limiting factor for safely managed services. Risk factors for E. coli contamination at the point of use included low community sanitation coverage (<75% improved sanitation in the household survey cluster), rural residence and livestock ownership. The evidence generated in MICS surveys highlights the urgent need for better risk management to reduce widespread exposure to fecal contamination through drinking water services.


Inequalities in water quality by wealth quintile

E. coli contamination of drinking water at point of collection and point of use by wealth quintile in 27 low- and middle-income countries, 2014–2020. Wealth quintiles from 1 (poorest) through 5 (richest). Wealth quintiles reflect a relative measure of inequality within each country based on asset ownership.



Further information on the water quality module refer to the methodological work and the WHO/UNICEF JMP thematic report on Integrating water quality testing in household surveys