The effect of water supply, handling and usage on water quality in relation to health indices in developing communities

This study was designed to help develop policy guidelines for water provision in developing communities in South Africa. It investigates the quality of water supplied compared to the quality of water consumed in relation to health indices in Khayelitsha, a peri-urban settlement on the eastern outskirts of Cape Town. Various categories of services were included, namely: no formal water supply, communal taps used by more 100 people, outdoor taps on individual plots and in-house taps. Although water provided to the study population was of good microbiological quality, it was significantly more contaminated after handling and storage than at the source. No statistically significant association was found between poor in-house water quality and diarrhoea among pre-school children. A strong association was found between a child's attendance at a day care centre or creche and diarrhoea. An increased risk of diarrhoea was associated with poor knowledge regarding food handling and hygiene; as well as a lower level of knowledge regarding the causes and prevention of diarrhoea and poor kitchen hygiene. Poorer water quality was observed where communal taps were used. The number of diarrhoea cases was higher in areas where communal taps are used than those where a tap is available on-site. This indicates that a private outdoor tap (as opposed to shared facilities) appears to minimize the risk associated with water-related disease.