Changes in childhood access to an improved water source and childhood morbidity over the period 2000-2014 in the occupied Palestinian territories
- Publication Type
- Conference Paper
- Authors
Changes in childhood access to an improved water source and childhood morbidity over the period 2000-2014 in the occupied Palestinian territories
Hugo Legge(1), Ai Milojevic(2), Ghassan Shakhsher(3), Amira Shaheen(4)
Background: Inadequate sources of drinking water are a risk factor for disease in lower and middle income settings. Since the signing of the Oslo II accords in 1995 Palestinians have seen access to safe sources of drinking water restricted. There is currently limited research on how access to water and children’s health in the occupied Palestinian territories (oPt) has changed since the Oslo II accords. This project will seek to describe changes in drinking water sources and children’s health and development between 2000-2014 in the oPt and explore the possibility of associations.
Methods: Data from five cross-sectional family and health surveys from between 2000 and 2014 was used to analyse changes over time in sources of drinking water (exposure) and prevalence of diarrhoeal disease and stunting (outcomes) in children less than 5 years of age in the oPt. Data was summarized by geographic area for each survey year. Multiple regression analysis was used to examine associations between exposure and outcomes over the study period.
Findings: Overall, access to an improved water source in Gaza decreased from 98.3% in 2000 to 10.5% in 2014, while it remained stable in the West Bank over the same period (fluctuating between 88-94%). The index of diarrhoea prevalence showed marginal increases over the study period in both Gaza and the West Bank. Prevalence of diarrhoea decreased by 0.06% (95% CI -0.116, -0.001) for every 1% increase in the use of an improved water source at the governorate locality level in Gaza.
No association was found at the territory or locality level in either the West Bank or Gaza between prevalence of stunting and use of an improved water source. However, SES was found to be highly predictive of stunting rates in rural GLAs within Gaza, with stunting prevalence increasing by 0.73% for every 1% increase in number of mother’s with less than primary level education (95% CI 0.406, 1.123; p<0.001). Evidence for an association in urban and camp GLAs was much weaker.
Interpretation: Limited access to improved water source was related with higher prevalence of diarrhoeal diseases in Gaza in 2000-2014. In terms of policy this implies that increasing use of improved water sources should remain a priority in Gaza. Future research in both Gaza and the West Bank should aim to explore in more detail how households and specifically children use and access water. Additionally, attention should be given by the PCBS to further developing indicators for water access and use. These should include data relating to expenditure of household income on drinking water, amount of water consumed per person and hygiene practices.
Keywords; Water, communicable diseases, Palestine, conflict
(1) Hugo Legge; MSc student, London School of Hygiene and Tropical Medicine, London, UK
(2) Ai Milojevic; Department of Social and Environmental Health Research, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
(3) Ghassan Shakhsher; Advisor Norwegian Representative Office to PA, Jerusalem, oPt
(4) Amira Shaheen; Division of Public Health, Faculty of Medicine, An-Najah National University, Nablus, oPt. [email protected]
Changes in childhood access to an improved water source and childhood morbidity over the period 2000-2014 in the occupied Palestinian territories
Hugo Legge(1), Ai Milojevic(2), Ghassan Shakhsher(3), Amira Shaheen(4)
Background: Inadequate sources of drinking water are a risk factor for disease in lower and middle income settings. Since the signing of the Oslo II accords in 1995 Palestinians have seen access to safe sources of drinking water restricted. There is currently limited research on how access to water and children’s health in the occupied Palestinian territories (oPt) has changed since the Oslo II accords. This project will seek to describe changes in drinking water sources and children’s health and development between 2000-2014 in the oPt and explore the possibility of associations.
Methods: Data from five cross-sectional family and health surveys from between 2000 and 2014 was used to analyse changes over time in sources of drinking water (exposure) and prevalence of diarrhoeal disease and stunting (outcomes) in children less than 5 years of age in the oPt. Data was summarized by geographic area for each survey year. Multiple regression analysis was used to examine associations between exposure and outcomes over the study period.
Findings: Overall, access to an improved water source in Gaza decreased from 98.3% in 2000 to 10.5% in 2014, while it remained stable in the West Bank over the same period (fluctuating between 88-94%). The index of diarrhoea prevalence showed marginal increases over the study period in both Gaza and the West Bank. Prevalence of diarrhoea decreased by 0.06% (95% CI -0.116, -0.001) for every 1% increase in the use of an improved water source at the governorate locality level in Gaza.
No association was found at the territory or locality level in either the West Bank or Gaza between prevalence of stunting and use of an improved water source. However, SES was found to be highly predictive of stunting rates in rural GLAs within Gaza, with stunting prevalence increasing by 0.73% for every 1% increase in number of mother’s with less than primary level education (95% CI 0.406, 1.123; p<0.001). Evidence for an association in urban and camp GLAs was much weaker.
Interpretation: Limited access to improved water source was related with higher prevalence of diarrhoeal diseases in Gaza in 2000-2014. In terms of policy this implies that increasing use of improved water sources should remain a priority in Gaza. Future research in both Gaza and the West Bank should aim to explore in more detail how households and specifically children use and access water. Additionally, attention should be given by the PCBS to further developing indicators for water access and use. These should include data relating to expenditure of household income on drinking water, amount of water consumed per person and hygiene practices.
Keywords; Water, communicable diseases, Palestine, conflict
(1) Hugo Legge; MSc student, London School of Hygiene and Tropical Medicine, London, UK
(2) Ai Milojevic; Department of Social and Environmental Health Research, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
(3) Ghassan Shakhsher; Advisor Norwegian Representative Office to PA, Jerusalem, oPt
(4) Amira Shaheen; Division of Public Health, Faculty of Medicine, An-Najah National University, Nablus, oPt. [email protected]
- Conference Title
- 8th LPHA Conference
- Conference Country
- Palestine
- Conference Date
- March 15, 2017 - March 16, 2017
- Conference Sponsor
- LPHA