Predictors of water quality in rural healthcare facilities in 14 low- and middle-income countries
Predictors of water quality in rural healthcare facilities in 14 low- and middle-income countries
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DOI：
10.1016/j.jclepro.2019.117836
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发表时间：
2019-11-10
影响因子：
11.1
通讯作者：
Bartram, Jamie K.
中科院分区：
文献类型：
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作者：
Guo, Amy Z.;Bartram, Jamie K.
中低收入国家(LMIC)农村地区的许多医疗设施(HCF)缺乏安全、充足的水供应。我们试图了解哪些因素影响LMICs中农村HCF的水质。在埃塞俄比亚、加纳、洪都拉斯、印度、肯尼亚、马拉维、马里、莫桑比克、尼日尔、卢旺达、坦桑尼亚、乌干达、赞比亚和津巴布韦，医生和护士在2000多个门诊HCFS接受了关于他们的水源、工作人员培训和管理实践的采访。水样也进行了大肠杆菌污染检测。我们生成了描述性分析和逻辑回归。总体而言，52%的接受调查的社区卫生服务中心至少使用了基本的水服务，23%的人使用了有限的水服务，25%的人没有按照世卫组织/儿童基金会联合监测方案的定义提供水服务。使用改进的水源类型(OR约为1.4-1.7)、水处理(OR=1.26)、由受过医学培训的人员进行管理(OR约3.4-8.9)以及有操作和管理规程(OR=1.29)与更安全的水有关。这些结果表明，除了解决水源、储存和处理问题外，利益攸关方还应该针对组织因素，以改善HCFS的水质。(C)2019爱思唯尔有限公司。保留所有权利。
Many healthcare facilities (HCFs) in rural areas of low- and middle-income countries (LMICs) lack safe, sufficient water supplies. We sought to understand which factors affect water quality in rural HCF in LMICs. In Ethiopia, Ghana, Honduras, India, Kenya, Malawi, Mali, Mozambique, Niger, Rwanda, Tanzania, Uganda, Zambia, and Zimbabwe, doctors and nurses were interviewed at over 2000 outpatient HCFs about their water source, staff training, and management practices. Water samples were also tested for contamination with E. coli. We generated descriptive analyses and logistic regressions. Overall, 52% of surveyed HCFs used at least a basic water service, 23% used a limited water service, and 25% had no water service as defined by the WHO/UNICEF Joint Monitoring Programme. Use of an improved water source type (OR approximate to 1.4-1.7), treatment of water (OR = 1.26), management by a person with medical training (OR approximate to 3.4-8.9), and presence of a protocol for operations and management (OR = 1.29) were associated with safer water. These results suggest that in addition to addressing water source, storage, and treatment, stakeholders should also target organizational factors in order to improve water quality in HCFs. (C) 2019 Elsevier Ltd. All rights reserved.