Evidence map›Paper›PMID 41882805›Full record

ArticleJournal of health, population, and nutrition2026

Trends and factors influencing household use of unimproved water sources in Ethiopia: a multivariate decomposition analysis of EDHS data.

Gashaw Melkie Bayeh, Habitamu Mekonen, Almaw Genet Yeshiwas, Wolde Melese Ayele, Ahmed Fentaw Ahmed, Assefa Andargie Kassa, Tilahun Degu Tsega, Chalachew Abiyu Ayalew, Chalachew Yenew, Getaneh Atikilt Yemata and 15 more

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Article in Journal of health, population, and nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

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4 · The record

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5 · Who and what money

Authors and funding

25 authors.

Gashaw Melkie BayehDepartment of Environmental Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia. megashaw21@gmail.com.
Habitamu MekonenDepartment of Human Nutrition, College of Health Science, Debre Markos University, Debre Markos, Ethiopia.
Almaw Genet YeshiwasDepartment of Environmental Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.
Wolde Melese AyeleDepartment of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.
Ahmed Fentaw AhmedDepartment of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.
Assefa Andargie KassaDepartment of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.
Tilahun Degu TsegaDepartment of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.
Chalachew Abiyu AyalewDepartment of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.
Chalachew YenewLecturer at Department of Public Health, Debre Tabor University, Debre Tabor, Ethiopia.
Getaneh Atikilt YemataDepatment of Public Health, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia.
Tesfaneh ShimelsDepatment of Public Health, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia.
Rahel Mulatie AntenehDepatment of Public Health, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia.
Getasew YirdawDepartment of Environmental Health Science, College of Medicine and Health Sciences, Debre Markos University, P.O Box 269, Debre Markos, Ethiopia.
Berhanu Abebaw MekonnenDepartment of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
Meron Asmamaw AlemayehuDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Sintayehu Simie TsegaDepartment of Medical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
Zeamanuel Anteneh YigzawDepartment of Health Promotion and Behavioral Sciences, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
Amare Genetu EjiguDepartment of Midwifery, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.
Wondimnew Desalegn AddisDepatment of Public Health, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia.
Birhanemaskal MalkamuDepartment of Medical Laboratory Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
Abraham TeymDepartment of Environmental Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
Kalaab Esubalew SharewDepartment of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.
Daniel AdaneDepartment of Midwifery, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.
Aschale Shimels AlemuDepartment of Environmental Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.
Abathun TemesgenDepartment of Environmental Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccess to safe drinking water remains a major public health challenge in Ethiopia. Despite infrastructure investments, many communities still depend on unimproved water sources, exposing them to waterborne disease and slowing progress toward Sustainable Development Goal 6, which calls for universal access to clean water and sanitation.

objectiveThis study examined trends in household (HH) reliance on unimproved water sources in Ethiopia between 2005 and 2019 using the Ethiopian Demographic and Health Surveys (EDHS) data, and identified the key factors driving these patterns through multivariate decomposition analysis.

methodsThe study used data from repeated cross-sectional surveys conducted by EDHS in 2005, 2011, 2016, and 2019. Each survey employed a stratified two-stage cluster sampling technique to collect data from a representative sample of 55,736 HHs. This study assessed the proportion of HHs using unimproved water sources and applied multivariate decomposition analysis to determine how household characteristics and socio-demographic and economic factors contributed to the observed changes.

resultsThe proportion of HHs using unimproved water sources declined from 38.40% in 2005 to 31.02% in 2019, driven by both changes in household composition and stronger effects of socioeconomic factors. About 42.38% of the reduction was explained by shifts in characteristics such as fewer rural households, declines in poor households, and improvements in education, while 57.62% was due to the growing influence of these factors-especially education, wealth, and residence-on water access. Households in small peripheral regions, particularly Somali (51.84%) and Afar (45.73%), where pastoralist populations remain prevalent, continue to show high dependence on unimproved drinking water sources. Rural-to-urban transitions, rising educational attainment, and reductions in poverty contributed significantly for the decline, though increases in HHs headed by individuals with no formal education, poorer households, and communities with low literacy slowed progress.

conclusionEthiopia has made progress in reducing reliance on unimproved water sources, reflecting improvements in infrastructure and socio-economic conditions. However, persistent disparities across regions and socio-economic groups highlighted the need for targeted interventions. Strengthening rural water systems, education, and community engagement could be essential to achieve equitable access and advance Sustainable Development Goal 6.

Indexed as

Drinking WaterFamily CharacteristicsWater SupplyAdultCross-Sectional StudiesEthiopiaFemaleHealth SurveysHumansMaleMultivariate AnalysisRural PopulationSanitationSocioeconomic FactorsDrinking WaterEDHSEthiopiaHousehold water accessSocioeconomic factorsUnimproved sources

Identifiers

PMID41882805
PMCPMC13141604

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