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Table of Contents
ORIGINAL ARTICLE
Year : 2014  |  Volume : 2  |  Issue : 2  |  Page : 12-16

Rapid appraisal of the drinking water management practices among residents of urban field practice area of a tertiary care teaching centre in Northern India


1 Assistant Professor, Department of Community Medicine, Shaheed Hasan Khan Mewati Govt. Medical College, Haryana, India
2 Assistant Professor, Department of Microbiology, Major S D Singh Medical College and Hospital, Fathehgarh, U.P, India
3 Associate Professor, Department of General Medicine, Shaheed Hasan Khan Mewati Govt. Medical College, Haryana, India
4 Associate Professor, Department of Paediatrics, Shaheed Hasan Khan Mewati Govt. Medical College, Haryana, India
5 Professor and Head, Department of Forensic Medicine, Santosh Medical College, Ghaziabad, Uttar Pradesh, India
6 Professor and Head, Department of Community Medicine, GFIMS&R, Ballabhghar, Haryana, India
7 Assistant Professor, Department of Forensic Medicine, PGIMS, Rohtak, Haryana, India

Date of Web Publication24-Aug-2018

Correspondence Address:
A Singh
Assistant Professor, Department of Community Medicine, Shaheed Hasan Khan Mewati Govt. Medical College, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2347-6486.239541

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  Abstract 


Background - Even after more than 60 years of independence, access to safe water and sanitation facilities remains a formidable challenge in developing countries including India.
Objectives - To assess the drinking water management practices among residents of urban field practice area of a tertiary care teaching centre in northern India.
Methods - The present cross sectional survey was conducted among 405 residents of the urban field practice area of a tertiary care teaching centre located in district Farrukhabad of Uttar Pradesh. After filling the questionnaire, the free chlorine in the drinking water of the households was determined by using O-Toluidine test.
Results - Majority (85%) of the households were depending on the municipality water supply. 72.1% of the population does not use any method to treat water in their households. 6.9% of the respondents strained the water through the cloth whereas 2.7% of the houses boiled water before consumption. 43.95% of study subjects dipped a glass into the storage vessel using their hands to take water from storage vessel for drinking purpose whereas only 17.78% of the people used a tap to collect water for drinking. The OT test did not yield any positive result in surveyed households.
Conclusion - Safe sources alone do not guarantee of providing safe and healthy water supply to the houses, this should be supported by the safe treatment and storage practices of drinking water at household level. Therefore it is need of the hour to launch IEC activities so as to improve the storage and handling practices of drinking water.

Keywords: Drinking water, Management practices, Urban, Storage


How to cite this article:
Singh A, Goel S, Singh A A, Goel A K, Chhoker V K, Goel S, Chikkara P. Rapid appraisal of the drinking water management practices among residents of urban field practice area of a tertiary care teaching centre in Northern India. J Integr Health Sci 2014;2:12-6

How to cite this URL:
Singh A, Goel S, Singh A A, Goel A K, Chhoker V K, Goel S, Chikkara P. Rapid appraisal of the drinking water management practices among residents of urban field practice area of a tertiary care teaching centre in Northern India. J Integr Health Sci [serial online] 2014 [cited 2022 Aug 9];2:12-6. Available from: https://www.jihs.in/text.asp?2014/2/2/12/239541




  Introduction: Top


Even after more than 60 years of independence, access to safe water and sanitation facilities remains a formidable challenge in developing countries including India.[1],[2] An adequate supply of safe water and basic sanitation is a major element of primary health care.[3] Annually, about 4 billion cases of diarrhea occur, of which 88% is attributable to unsafe water, and inadequate sanitation and hygiene. WHO estimates that 94% of diarrhoeal cases are preventable through modifications to the environment, including methods of interventions to increase the availability of clean water, and to improve sanitation and hygiene.[4]

Millennium Development Goal 7, Target 10, calls for reducing by half the proportion of people without sustainable access to safe drinking water by 2015.[5] Water treatment assumes utmost importance in order to ensure the safety of the water consumed. Probably the best way to ensure drinking water safety at the consumer end of the supply chain is to encourage safer drinking water management practices at individual household level. The present study was therefore conducted to assess the drinking water management practices among residents of urban field practice area of a tertiary care teaching centre in northern India.


  Materials and Methods Top


The present cross sectional survey was conducted among the residents of the urban field practice area of the Department of Community Medicine, Major S.D. Singh Medical College and Hospital, Fatehgarh, Uttar Pradesh during June to December 2013. The sample size was calculated (n = 1.962 p*q/d2) with an anticipated proportion of subjects following correct drinking water management practices as 50%, 5% absolute precision, 95% confidence interval and 10% non-response error - as 422 participants. About 17 subjects were either non-cooperative hence remaining 405 eligible study subjects were contacted and interviewed. Study subjects were selected from ten wards coming under the urban field practice area of the department. It has been adopted by this tertiary medical centre for urban training of under graduate students in community medicine and for providing preventive, promotive, curative, rehabilitative health services to the population.

Study subjects were selected by multistage systematic random sampling technique. In the first stage, five wards were randomly selected. List of all the blocks from the five selected wards was then obtained. In the second stage, three blocks were selected randomly from each ward. In the third stage, door to door survey was conducted and around 30 individuals (households) were interviewed from each block. Houses were numbered first. Team member spun a pen in the center of block. Then every fifth house was selected from the direction indicated by pen. Next house was included if the selected house was found locked. Information was collected using a structured questionnaire. It was ensured that respondents understand the meaning of questions well.

After filling the questionnaire, the free chlorine in the drinking water of the households was determined by using O-Toluidine testing method, wherein a sample (about 8mL) of the drinking water of the household was collected in a test tube and two drops of O-Toluidine reagent was added to it. The colour change, if any, was noted and quantity of free chlorine assessed using the Lovibond's comparator. Ethical committee of Major S.D. Singh Medical College approved the study. Informed written consent was obtained from the study participants.

After compilation of collected data, analysis was done using Statistical Package for Social Sciences (SPSS), version 20. The results were expressed as proportions.


  Results Top


Of the 422 patients approached, 17 patients refused to participate and 405 patients were interviewed giving a response rate of 95.97%. Majority of the elderly were Hindus (98%) and the remaining (2%) belonged to other religions (Muslims, Sikhs and Christians). Almost 47% elderly people were illiterate. Majority of the houses (41%) were pucca houses. Of total, 32%, 27% and 20% of the subjects belonged to lower middle, upper lower and lower class of Kuppuswamy's Socioeconomic Status Scale respectively.

The majority (85%) of the households were depending on the municipality water supply. 9% of the subjects were using public tap as main source of drinking water. [Figure 1]
Figure 1: Pie diagram showing main sources of drinking water among the households surveyed (n=405)

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Out of total, majority (72.1%) of the population does not use any method to treat water in their households. 2.7% of the houses boiled water, 7.2% used water purifier, 11.1% used water filter and remaining 6.9% of the respondents strained the water through the cloth. [Table 1]
Table 1: Distribution of study subjects according to water treatment methods adopted by them.

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Regarding practices of taking water from storage vessel for drinking purpose, most of them 178 (43.95%) dipped a glass into the storage vessel using their hands, followed by 155 (38.27%) drank the water by pouring it to a glass from the storage vessel. Remaining 72 (17.78%) of the people had a tap from which the water was taken for drinking. [Figure 2].
Figure 2: Distribution of subjects according to their practices of taking water from storage vessel for drinking purpose

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Among the people using water filters, only 35% of them cleaned it once a week or more frequently. Among the households using water purifier, only 30% of them got it checked by technicians once every 3 months.

The free chlorine test conducted using O-Toluidine reagent in the 405 households did not yield any positive result. That means there was no free chlorine available in the drinking water among any of the households tested.


  Discussion Top


In this study, drinking water management practices were assessed to get an idea regarding the safety of the water consumed by the residents of the urban field practice area of a tertiary care teaching hospital located in rural Uttar Pradesh. It was found in this study that, the majority (85%) of the households were depending on the municipality water supply. Household survey conducted by Abdul Shaban et al showed that a majority of households, as high as 92%, in major cities in India depended on the municipal water supply for their daily needs.[5] Of this 92% of the population, 9.5% were dependent on community taps.

Regarding water treatment methods, as practiced by study population, we found that majority (72.1%) of the population does not use any method to treat water in their households. 6.9% of the respondents strained the water through the cloth whereas 2.7% of the houses boiled water before consumption. Other studies are also in concordance with our observations. The study done by Joint Monitoring Programme (WHO)[6] showed that 67% of the households surveyed in India did not follow any water treatment practices, 9% of the households boiled their water, 2% of the household's added bleaching powder/ chlorine to prevent contamination of water and 17% of the respondents strained the water through the cloth. National Family Health Survey-3 also showed that 66% of households did not treat drinking water.[7]

A good number (72.1%) of households did not use any method to treat water before consumption. These households were from lower socio-economic status and hence illiteracy could be another determinant. Illiterate subjects may not be aware about the potential hazards of consumption of unsafe water. The population not practicing any methods of water treatment should be educated about the ‘adequate’ water treatment practices, so that the water they drink would be safe for consumption.

The present study revealed that, 43.95% of study subjects dipped a glass into the storage vessel using their hands to take water from storage vessel for drinking purpose whereas only 17.78% of the people used a tap to collect water for drinking. This is in contrast to another study from south India[8] where 34% dipped glass into vessel using hands, 23% had tap system to collect water from storage vessel for drinking purpose. This finding can be attributed to better literacy level and socio-economic status of south Indian population studied.

The OT test did not yield any positive result in surveyed households. That means there was no free chlorine available in the drinking water among any of the households tested. The chances of future contamination of the drinking water remain high in the absence of free chlorine in the drinking water. It is worthwhile to note that the source alone is not sufficient to provide safe and healthy water supply to the population. This should be supported by the treatment practices and storage practices of drinking water. The results are comparable with the international and national surveys.[9] Water treatment assumes paramount importance in order to make sure the safety of the water to be consumed. At the community level, it is the accountability of the municipalities to chlorinate the water being supplied to the households. Last but not the least; it is up to the individual household to ensure that the drinking water they going to consume is adequately safe and this can only be ensured by adoption of safe water management practices.[10]


  Conclusion Top


In spite of having access to improved water sources, households lacked appropriate storage and handling practices of drinking water in this study. Safe sources alone do not guarantee of providing safe and healthy water supply to the houses, this should be supported by the safe treatment and storage practices of drinking water at household level. Absence of free chlorine at the consumer end would provide evidence to the concerned authorities. Therefore it is need of the hour to launch IEC activities so as to improve the storage and handling practices of drinking water.



 
  References Top

1.
Manikutty S., Community Participation: So What? Evidence from a Comparative Study of Two Rural Water Supply and Sanitation Projects in India. Development Policy Review 1997; 15: 115–40.  Back to cited text no. 1
    
2.
Bhardwaj A, Surana A, Mithra P, Singh A, Panesar S, Chikkara P. A Community based cross sectional study on use of sanitary latrines in a rural setup in Maharashtra. Healthline 2013; 4(1): 89-93.  Back to cited text no. 2
    
3.
Park K. Park's textbook of preventive and social medicine. 19th ed. Jabalpur: M/s Banarsidas Bhanot; 2008.  Back to cited text no. 3
    
4.
Combating waterborne disease at the household level / International Network. To Promote Household Water Treatment and Safe Storage, WHO, 2011. Available from URL: http://www.who.int (Accessed on July 17th, 2012)  Back to cited text no. 4
    
5.
Shaban A. Tata Institute of Social Science, Mumbai-Water Poverty in Urban India: A Study of Major Cities. Seminar Paper UGC-Summer Programme 2008. Available from URL: http://www.tiss.edu (Accessed on 12-01-2014).  Back to cited text no. 5
    
6.
WHO/UNICEF Joint Monitoring Programme (JMP) for Water Supply and Sanitation. Available from URL: http://www.who.int (Accessed on 15-01-2014).  Back to cited text no. 6
    
7.
National Family Health Survey (NFHS-3) India. Available from URL: http://www.nfhsindia.org (Accessed on 1501-2014)  Back to cited text no. 7
    
8.
Mithra P, Unnikrishnan B, Rekha T, Prithvishree R, Alok S, Ahemad T, Kumar S, Naseeba S, Samal S. Drinking water in an urban area in South India – A community based cross sectional study. AMJ 2010; 3 (5): 295-98.  Back to cited text no. 8
    
9.
Karn SK, Shikura S, Harada H. Living environment and health of urban poor: A study in Mumbai. Economic and Political Weekly 2003;38(34):3575-86.  Back to cited text no. 9
    
10.
Mintz ED, Reiff FM, Tauxe RV. Safe water treatment and storage in the home - A practical new strategy to prevent waterborne disease. JAMA.1995;273(12):948-53.  Back to cited text no. 10
    


    Figures

  [Figure 1], [Figure 2]
 
 
    Tables

  [Table 1]


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