Water, Sanitation and Hygiene in a Conflict Area: A Cross-Sectional Study in South Kordofan, Sudan

Abstract Background The UN General Assembly recognised the human right to water and sanitation through the sixth SDG in 2010. South Kordofan, a state in southern Sudan, faces WASH challenges due to conflict, geographical factors, and inadequate services, impacting over 600,000 residents. Such confli...

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Main Authors: Rofida Asmally, Abdelmalik A. Imam, Abdullatif Eissa, Abubakr Saeed, Ahmed Mohamed, Eahaa Abdalla, Mariam Alazraa M. Esmaeel, Mariam Elbashir, Mohamed H. Elbadawi, Mohammed Omer, Raghad Eltayeb, Ranya Mohammed, Tibyan Abdalhamed, Tina Merghani
Format: Article
Language:English
Published: Springer 2025-01-01
Series:Journal of Epidemiology and Global Health
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Online Access:https://doi.org/10.1007/s44197-025-00347-4
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author Rofida Asmally
Abdelmalik A. Imam
Abdullatif Eissa
Abubakr Saeed
Ahmed Mohamed
Eahaa Abdalla
Mariam Alazraa M. Esmaeel
Mariam Elbashir
Mohamed H. Elbadawi
Mohammed Omer
Raghad Eltayeb
Ranya Mohammed
Tibyan Abdalhamed
Tina Merghani
author_facet Rofida Asmally
Abdelmalik A. Imam
Abdullatif Eissa
Abubakr Saeed
Ahmed Mohamed
Eahaa Abdalla
Mariam Alazraa M. Esmaeel
Mariam Elbashir
Mohamed H. Elbadawi
Mohammed Omer
Raghad Eltayeb
Ranya Mohammed
Tibyan Abdalhamed
Tina Merghani
author_sort Rofida Asmally
collection DOAJ
description Abstract Background The UN General Assembly recognised the human right to water and sanitation through the sixth SDG in 2010. South Kordofan, a state in southern Sudan, faces WASH challenges due to conflict, geographical factors, and inadequate services, impacting over 600,000 residents. Such conflicts are well known for spreading diseases and disrupting WASH-related practices among displaced individuals. Objectives The study aimed to evaluate the quality and availability of drinking water, as well as sanitation and hygiene practices in rural South Kordofan. It also sought to identify factors affecting community satisfaction with WASH services and to establish a data-driven basis for future interventions addressing these issues. Methods A cross-sectional study accompanied a medical mission to South Kordofan, selecting 33 villages from South Kordofan based on healthcare, population, and accessibility. Water samples, patient forms and questionnaires were collected using convenient sampling for targeted villages and for attendants of mobile clinics. Laboratory analyses were conducted on water samples. Descriptive statistics, univariate analysis and logistic regression were used to analyse the data. The used level of significance was 0.05. Results Out of 784 participants, 60.2% were female. Tube wells/boreholes were the primary water source (68.1%), and most participants (70.9%) lived near their water source (less than 30 min). Dissatisfaction with water services was reported by 56.8%, and satisfaction associated with method of delivery (OR = 0.081, CI = 0.024–0.276)), appearance (OR = 0.299, CI = 0.182–0.489), distance (OR = 0.264, CI = 0.099–0.705), water unavailability (OR = 0.477, CI = 0.297–0.765), and obligation to pay (OR = 0.351, CI = 0.185–0.665). Samples showed high levels of contamination, both microbial and physicochemical. Regarding sanitation, over a third of the participants (41.5%) disposed of children’s stool by leaving it outdoors. About 10% of the participants reported having diarrhea during the week before the study. However, about two-thirds of the participants (68.1%) showed good hygienic practices by using soap or detergents for hand washing. Conclusion The study revealed inadequate WASH services, high microbial contamination, and poor water treatment practices. Paradoxically, many participants expressed satisfaction with water services. Sanitation issues and open defecation persist, emphasizing the need for comprehensive interventions. All these negative consequences can be attributed to the armed conflict which resulted in poor awareness about the safety of drinking water, what safe water looks like and proper hygiene practices. Moreover, these conflicts led to disruption of the economical status leading to the absence of proper water purification infrastructure.
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spelling doaj-art-c1c73bf98f5546b2a8483e499ad945962025-01-26T12:13:14ZengSpringerJournal of Epidemiology and Global Health2210-60142025-01-0115111810.1007/s44197-025-00347-4Water, Sanitation and Hygiene in a Conflict Area: A Cross-Sectional Study in South Kordofan, SudanRofida Asmally0Abdelmalik A. Imam1Abdullatif Eissa2Abubakr Saeed3Ahmed Mohamed4Eahaa Abdalla5Mariam Alazraa M. Esmaeel6Mariam Elbashir7Mohamed H. Elbadawi8Mohammed Omer9Raghad Eltayeb10Ranya Mohammed11Tibyan Abdalhamed12Tina Merghani13Faculty of Medicine, University of KhartoumFaculty of Medicine, University of KhartoumFaculty of Medicine, University of KhartoumFaculty of Medicine, University of KhartoumFaculty of Medicine, University of KhartoumFaculty of Medicine, University of KhartoumFaculty of Medicine, University of KhartoumFaculty of Medicine, University of KhartoumFaculty of Medicine, University of KhartoumFaculty of Medicine, University of KhartoumFaculty of Medicine, University of KhartoumFaculty of Medicine, University of KhartoumFaculty of Medicine, University of KhartoumFaculty of Medicine, University of KhartoumAbstract Background The UN General Assembly recognised the human right to water and sanitation through the sixth SDG in 2010. South Kordofan, a state in southern Sudan, faces WASH challenges due to conflict, geographical factors, and inadequate services, impacting over 600,000 residents. Such conflicts are well known for spreading diseases and disrupting WASH-related practices among displaced individuals. Objectives The study aimed to evaluate the quality and availability of drinking water, as well as sanitation and hygiene practices in rural South Kordofan. It also sought to identify factors affecting community satisfaction with WASH services and to establish a data-driven basis for future interventions addressing these issues. Methods A cross-sectional study accompanied a medical mission to South Kordofan, selecting 33 villages from South Kordofan based on healthcare, population, and accessibility. Water samples, patient forms and questionnaires were collected using convenient sampling for targeted villages and for attendants of mobile clinics. Laboratory analyses were conducted on water samples. Descriptive statistics, univariate analysis and logistic regression were used to analyse the data. The used level of significance was 0.05. Results Out of 784 participants, 60.2% were female. Tube wells/boreholes were the primary water source (68.1%), and most participants (70.9%) lived near their water source (less than 30 min). Dissatisfaction with water services was reported by 56.8%, and satisfaction associated with method of delivery (OR = 0.081, CI = 0.024–0.276)), appearance (OR = 0.299, CI = 0.182–0.489), distance (OR = 0.264, CI = 0.099–0.705), water unavailability (OR = 0.477, CI = 0.297–0.765), and obligation to pay (OR = 0.351, CI = 0.185–0.665). Samples showed high levels of contamination, both microbial and physicochemical. Regarding sanitation, over a third of the participants (41.5%) disposed of children’s stool by leaving it outdoors. About 10% of the participants reported having diarrhea during the week before the study. However, about two-thirds of the participants (68.1%) showed good hygienic practices by using soap or detergents for hand washing. Conclusion The study revealed inadequate WASH services, high microbial contamination, and poor water treatment practices. Paradoxically, many participants expressed satisfaction with water services. Sanitation issues and open defecation persist, emphasizing the need for comprehensive interventions. All these negative consequences can be attributed to the armed conflict which resulted in poor awareness about the safety of drinking water, what safe water looks like and proper hygiene practices. Moreover, these conflicts led to disruption of the economical status leading to the absence of proper water purification infrastructure.https://doi.org/10.1007/s44197-025-00347-4Drinking waterHygieneSanitationWater-borne diseasesConflictSudan
spellingShingle Rofida Asmally
Abdelmalik A. Imam
Abdullatif Eissa
Abubakr Saeed
Ahmed Mohamed
Eahaa Abdalla
Mariam Alazraa M. Esmaeel
Mariam Elbashir
Mohamed H. Elbadawi
Mohammed Omer
Raghad Eltayeb
Ranya Mohammed
Tibyan Abdalhamed
Tina Merghani
Water, Sanitation and Hygiene in a Conflict Area: A Cross-Sectional Study in South Kordofan, Sudan
Journal of Epidemiology and Global Health
Drinking water
Hygiene
Sanitation
Water-borne diseases
Conflict
Sudan
title Water, Sanitation and Hygiene in a Conflict Area: A Cross-Sectional Study in South Kordofan, Sudan
title_full Water, Sanitation and Hygiene in a Conflict Area: A Cross-Sectional Study in South Kordofan, Sudan
title_fullStr Water, Sanitation and Hygiene in a Conflict Area: A Cross-Sectional Study in South Kordofan, Sudan
title_full_unstemmed Water, Sanitation and Hygiene in a Conflict Area: A Cross-Sectional Study in South Kordofan, Sudan
title_short Water, Sanitation and Hygiene in a Conflict Area: A Cross-Sectional Study in South Kordofan, Sudan
title_sort water sanitation and hygiene in a conflict area a cross sectional study in south kordofan sudan
topic Drinking water
Hygiene
Sanitation
Water-borne diseases
Conflict
Sudan
url https://doi.org/10.1007/s44197-025-00347-4
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