Assessment of Awareness on Health Impact of Drinking Unsafe Water in Hargeisa, Somaliland

Assessment of Awareness on Health Impact of Drinking Unsafe Water in Hargeisa, Somaliland | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Assessment of Awareness on Health Impact of Drinking Unsafe Water in Hargeisa, Somaliland Abdihakim Ahmed Ismail, Hassan Abdillahi Duale This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3158070/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract a cross-sectional study was conducted at Hargeisa from June to November 2019 to assess awareness and health impacts for drinking unsafe water in Hargeisa. A total of 384 respondents were participated. Out of 384 respondents participated in this study, 69% (265/384) of the respondents are aware of the health impacts for drinking unsafe water, whereas the rest 31% (119/384) are not aware health impacts for drinking unsafe water in the study area. Source of water in this study are tap water (31.8%), water tank vehicle (52.1%) and both tap water and water tank vehicle (16.1%). Education and economic status of the respondents were shown to significant association with the awareness of impacts on drinking unsafe water (P 0.05). Drinking unsafe water leads occurrence of water borne diseases, diarrhea and kidneys complications. Awareness health impact Hargeisa unsafe water water 1. INTRODUCTION Access to clean and safe water, as well as sanitation facilities, is a fundamental human right and one of the most basic human needs. However, according to the United Nations (UN), more than 1.1 billion people lack access to safe drinking water, and 2.4 billion people lack adequate sanitation facilities (Programme, 2003 ). Access to safe drinking water is crucial for human health, and the UN has declared it a human right. The "Water for Life" program was launched by the UN in 2005, and one of its targets was to halve the number of people without proper access to safe water and basic sanitation by 2015, as part of the Millennium Development Goals (Bloomfield, Exner, Signorelli, Nath, & Scott, 2012 ; Frisbie, Mitchell, & Sarkar, 2015 ). Approximately 40% of the world's population lives in areas with moderate to high water stress, with Africa and Asia being the regions most affected by the lack of access to safe water. Up to 50% of Africa's urban residents and 75% of Asians lack adequate access to safe water (Tietenberg & Lewis, 2018 ). Waste disposal and management are major challenges in urban centers worldwide, particularly in developing countries where municipal budgets are often strained due to poverty (Jordan, 1984 ). As a result, urban centers struggle to cope with the demands of spatial and demographic growth (Dow, 1992 ). Garbage heaps sometimes remain in the open for weeks due to a shortage of vehicles required to transport them to dump sites. Raw sewage can also flow in the streets due to pipe bursts and blockages, which frequently occur in some cities and take a long time to address due to the lack of equipment, spare parts, and funds required to fix them. In some cases, rivers that pass through urban centers have become polluted with waste water generated by towns and cities (Mapira, 2011 ). Diarrhea is the most common health problem associated with poor water quality. In 2000, diarrheal diseases contributed 5.7% to the global disease burden, and an estimated one and a half million children under five years old died due to diarrheal problems (Pruss-Ustun, 2008 ). A better understanding of the level of microbial water contamination can help us develop protection programs for drinking water systems. Interventions may include measures to improve the water treatment process at the household level (St Laurent & Mazumder, 2014 ). Ideally, assessments of water quality should be conducted not only at the source or piped water system intake, but also at the household level, as the quality of water at the source may not necessarily reflect the water quality consumed by people (Wright, Gundry, & Conroy, 2004 ). The main reasons for the gap in knowledge in the study area are the lack of quality monitoring stations and insufficient access to data, which, even if conducted, may not be properly disseminated. Therefore, this study aims to assess awareness of the impacts of drinking contaminated water in Hargeisa, Somaliland, to help bridge this gap. 2. METHODOLOGY 2.1 Research Area This study was carried out at Hargeisa which is a capital city of Somaliland. It is located in a valley in the northwestern part of the country. The city is situated in a mountainous area; the temperature ranges between 13 and 32 o degrees Celsius (55 and 89 degrees Fahrenheit). Hargeisa has a semi-arid climate. The city receives the bulk of its precipitation between the months of April and September, averaging just less than 400 mm of rainfall annually. 2.2 Research design A cross- sectional study was conducted at Hargeisa from May to September 2019 to assess health impacts for drinking unsafe water. 2.3 Study population Study population of the study was households in the selected districts. 2.4 Target population Target population of this study was all households in Hargeisa district. 2.5 Sample and Sampling 2.5.1 Sample Size The sample size required in the study was determined using the formula given by [12] for random sampling. n= (1.96)² Pexp (1-Pexp)/ d² Where, n = required sample size Pexp = expected prevalence d2 = desired absolute precision Expected prevalence of 50% was used since there were no prior works done in the study areas. 0.05 desired absolute precision and 95% level of confidence was used for the study. Therefore, a total of 384 respondents were used in the study. In this study 384 respondents were interviewed including poor and vulnerable population such as IDPs camps. 2.5.2 Sampling Techniques Hargeisa has 6 districts (Ibrahim Koodbur, 26 June, Gacan Libax, Ahmed Dhagah, Mohamoud Haybe and 31 May). Six clusters were divided in the population based on districts by using cluster sampling method. All six clusters were sampled by using simple random sampling, where 64 households were selected randomly from each cluster. 2.6 Data Collection 2.6.1 Data Collection Methods The data used in this study was collected through a questionnaire administered to selected households in Hargeisa district. Primary data collection on awareness and impacts of drinking unsafe water was carried out using a questionnaire designed to gather qualitative information. The questionnaire included questions on the awareness of the health impacts of unsafe water, the economic status of the family, and the source of water (water systems). 2.6.2 Data Collection Instruments The following instrument was used in the study in order to achieve accurate and valuable information; paper questionnaires. The questionnaires were distributed to the respondents to fill. 2.6.3 Research Procedure After receiving an approval letter from the University, the researchers prepared questionnaires based on the specific objectives of the study. The questionnaires were then printed based on the number of respondents required for the study, plus an additional 10 forms to account for any potential missing data. The respondents were informed about the study and administered the questionnaires to fill or answer the assigned questions. After data collection, the questionnaire forms were checked for any missing information. The collected data was then sorted and entered into an Excel spreadsheet 2010. 2.7 Data Analysis The study used Microsoft Excel spreadsheet 2010 to enter the data. Descriptive statistics were used to determine the frequencies and percentages of the data, while chi-square test analysis was employed to test for the presence of an association between the awareness level of health impacts of drinking unsafe water and the risk factors such as location, gender, age, educational level, and economic status of the households. The confidence level was set at 95%, and a P-value less than 0.05 was considered significant. All statistical analyses were performed using STATA software package version 12. 3. RESULTS 3.1 Assessments of awareness level of the Health impacts of drinking unsafe water in the study area. The study found that out of the 384 respondents who participated, 69% (265/384) were aware of the health impacts of drinking unsafe water, whereas the remaining 31% (119/384) were not aware of the health impacts of drinking unsafe water in the study area, as shown in the table below. Table 1 ASSESSMENTS OF AWARENESS ON IMPACTS OF DRINKING UNSAFE WATER IN THE STUDY AREA Variables Frequency Percentage Do you aware health impact for drinking unsafe water? Yes 265 69 No 119 31 Total 384 100 3.2 Household’s water status in the study area. Water The study conducted an assessment of water status at the household level, including water source, household water satisfaction, water treatment systems, and cleaning of water tanks. Out of the 384 respondents who participated in the study, 31.8%, 52.1%, and 16.1% of the respondents used water from tap water, water tank vehicles, and both tap water and water tank vehicles, respectively. Table 2 shows that only 32.6% of the respondents were satisfied with their water conditions, whereas the majority (67.4%) were unsatisfied with the water system condition. Moreover, only 29.4% of the respondents used water treatment systems, while the rest (70.4%) did not use any water treatment, as shown in Table 2 . Table 2 HOUSEHOLD’S WATER STATUS IN THE STUDY AREA Variables Frequency Percentage What is the main source of water used in your home? Tap water 122 31.8 Water tank Vehicle 200 52.1 Both 62 16.1 Are you satisfied water condition in your District? Satisfied 125 32.6 Unsatisfied 259 67.4 Do you treat your water in any way to make it safer to drink? Yes 113 29.4 No 271 70.6 If yes, what do you usually do to the water to make it safer to drink? Boil 34 30 Add bleach/chlorine 53 46.9 Use a water filter 3 2.7 Let it stand and settle 23 20.4 Do you clean water tanks in your home for the last six month? Yes 253 65.9 No 131 43.1 If yes, how many times do you clean or check water tanks in your home? Once in a month 60 23.7 Every three month 109 43.1 Every six month 84 33.2 Total 384 100 3.3 Possible causes and health impacts for drinking unsafe water The study assessed the causes of water contamination and its health impacts on human consumption. Out of the 384 respondents interviewed, 49.5%, 13.5%, 3.1%, and 33.9% of the respondents stated that unsafe water was caused by unprotected sources, agricultural waste products, sewage, and chemicals, respectively. Similarly, the study found that 32.6%, 27.9%, and 39.5% of the respondents reported that drinking unsafe water could lead to waterborne diseases, kidney problems (complications), and diarrhea, respectively, as shown in Table 3 .. Table 3 POSSIBLE CAUSES AND HEALTH IMPACTS FOR DRINKING UNSAFE WATER Variables Frequency Percentage What are the causes of water contamination (unsafe water)? Unprotected source 190 49.5 Agricultural waste product 52 13.5 Sewages 12 3.1 Chemicals 130 33.9 What are possible health impacts for drinking unsafe water? Diseases (cholera, Typhoid) 125 32.6 Kidney complications 107 27.9 Diarrhea 152 39.5 Total 384 100 3.4 Awareness of households with the identified risk factors The study assessed the awareness of households regarding drinking unsafe water in relation to location, gender, age, educational level, and economic status of the respondents. The results showed that there was no statistically significant difference in awareness between households located in different areas (P > 0.05). Regarding gender, high unawareness was reported in females (31.7%) compared to males (29.4%), but this difference was not statistically significant (P > 0.05). Similarly, there was no statistically significant difference in awareness between different age groups (P > 0.05), although high unawareness was recorded in respondents below 25 years of age (44.7%) compared to those aged 25–50 years (28.5%) and over 50 years (33.8%). However, there was a strong statistically significant difference in awareness between different educational levels (P < 0.05), with high unawareness recorded in illiterate respondents (60%) compared to literate respondents (17%). Similarly, there was a strong statistically significant difference in awareness between different economic statuses of the households (P < 0.05), with higher unawareness reported in poor households (52.7%) compared to medium (15.7%) and rich (11.1%) households. Table 4 ASSOCIATION OF RISK FACTORS TO THE HOUSEHOLD‘S AWARENESS ASSESSMENTS Variables Household’s awareness X 2 P-value Aware (%) Un- Aware (%) Location Ibrahim Koodbur 47 (73.4%) 17 (26.6%) 1.6682 0.893 26- June 46 (71.9%) 18 (28.1%) Gacan Libaax 45 (70.3%) 19 (29.7%) Ahmed Dhagax 43 (67.2%) 21(32.8%) Mohamoud Haybe 42 ( 65.6%) 22 (34.4%) 31- May 42 (65.6%) 22 (34.4%) Gender Male 84 (70.6%) 35 (29.4%) 0.2007 0.654 Female 181 (68.3%) 84 (31.7%) Age 50 Years 43 (66.2%) 22 (33.8%) Literacy Literate 215 (83%) 44 (17%) 72.9322 0.000 Illiterate 50 (40%) 75 (60%) Economic status Poor 80 (47.3%) 89 (52.7%) 66.7878 0.000 Medium 113 (84.3%) 15 (15.7%) Rich 72 (88.9%) 9 (11.1%) 4. DISCUSSION The present study found that 69% of the respondents were aware of the health impacts of drinking unsafe water, while 31% were not. This difference in awareness could be due to differences in perception, education level, or economic status among the respondents. The study also reported the age and economic status of the respondents. The majority of respondents (73%) were between the ages of 25 and 50, while the rest were either below 25 or above 50 years old. Additionally, most of the households were of poor or medium economic status, which could be attributed to high unemployment rates and a lack of investments in the country. The study found that households in the area received water from different sources, including tap water and water tank vehicles. The majority of households (52.1%) used water from water tank vehicles, likely due to a scarcity of tap water and an increased population in the area. However, the majority of households (67.4%) were unsatisfied with their water condition, while the rest (32.6%) were satisfied. This difference in satisfaction could be due to variations in perception, awareness, and education level among the households. Regarding water treatment, the study found that the majority of households (70.4%) did not use any water treatment, while the rest (29.4%) used treated water for drinking. Different water treatment systems were used, with 46.9% and 30% of households using chlorination and boiling, respectively. The study also found that 65.9% of respondents cleaned their water tanks, with the majority cleaning them every three months. The study identified unprotected sources and chemicals as the major causes of unsafe water, with 49.5% and 33.9% of respondents, respectively, pointing to these factors. This highlights that sources of water may not be adequately protected, and public water tanks may lack chlorination. The study also revealed that drinking unsafe water can lead to waterborne diseases, kidney problems, and diarrhea, as reported by 32.6%, 27.9%, and 39.5% of respondents, respectively. This could be due to the presence of pathogenic microorganisms, chemicals, and minerals in the water. While gender and age did not show a significant association with awareness of the impacts of drinking unsafe water, educational background and economic status did. Illiterate respondents (60%) were less aware of the impacts of drinking unsafe water than literate respondents (17%). Poor households (52.7%) were also less aware than medium (15.7%) and rich households (11.1%). This suggests that education and economic status are critical factors in raising awareness of the impacts of drinking unsafe water. 5. CONCLUSION AND RECOMMENDATION This study concludes that education and economic status of households have a significant association with awareness of the health impacts of drinking unsafe water. The water system condition in the study area was unsatisfactory, and the use of water treatment systems to make water safer for drinking was limited. However, some households practiced treating drinking water by chlorinating the water tanks or boiling it to make it safe for drinking. Unprotected sources of water and chemicals in the water were found to cause water to be unsafe and contaminated in the study area. Drinking unsafe water can cause and predispose individuals to waterborne diseases, diarrhea, and kidney complications. Based on the above concluding remarks, the following recommendations are made: The government should conduct public awareness campaigns to increase the community's awareness of the health impacts of drinking unsafe water and the importance of using water treatment. The Ministry of Water Resources and Hargeisa Water Agency should carry out water quality assessments. Sources of water should be protected and regularly checked by the Ministry of Water Resources. Every household in the study area should practice water treatment and regularly clean their water tanks. Declarations The authors declare no competing interests. References Bloomfield, S. F., Exner, M., Signorelli, C., Nath, K., & Scott, E. (2012). The chain of infection transmission in the home and everyday life settings, and the role of hygiene in reducing the risk of infection. Paper presented at the International scientific forum on home hygiene. Dow, K. (1992). Exploring differences in our common future (s): the meaning of vulnerability to global environmental change. Geoforum, 23 (3), 417-436. Fosgate, G. T. (2009). Practical sample size calculations for surveillance and diagnostic investigations. Journal of veterinary diagnostic investigation, 21 (1), 3-14. Frisbie, S. H., Mitchell, E. J., & Sarkar, B. (2015). Urgent need to reevaluate the latest World Health Organization guidelines for toxic inorganic substances in drinking water. Environmental health, 14 (1), 1-15. Jordan, J. (1984). Local government in Zimbabwe: An overview. Mapira, J. (2011). River pollution in the city of Mutare (Zimbabwe) and its implications for sustainable development. Journal of Sustainable Development in Africa, 13 (6), 181-194. Programme, W. W. A. (2003). Water for People, Water for Life: The United Nations World Water Development Report: Executive Summary : Unesco Pub. Pruss-Ustun, A., WHO. (2008). Safer water, better health: costs, benefits and sustainability of interventions to protect and promote health : World Health Organization. Soomro, A., Siyal, A. A., Mirjat, M. S., & Sial, N. B. (2014). Seasonal variations of trace elements and heavy metal concentrations in phuleli canal water (Sindh), Pakistan. Sarhad J Agric, 30 , 73-82. St Laurent, J., & Mazumder, A. (2014). Influence of seasonal and inter-annual hydro-meteorological variability on surface water fecal coliform concentration under varying land-use composition. Water Research, 48 , 170-178. Tietenberg, T., & Lewis, L. (2018). Environmental and natural resource economics : Routledge. Wright, J., Gundry, S., & Conroy, R. (2004). Household drinking water in developing countries: a systematic review of microbiological contamination between source and point‐of‐use. Tropical medicine & international health, 9 (1), 106-117. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3158070","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":217448461,"identity":"226d89fa-5d28-4f36-b7ad-6707bd93b2d0","order_by":0,"name":"Abdihakim Ahmed Ismail","email":"","orcid":"","institution":"Gollis University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Abdihakim","middleName":"Ahmed","lastName":"Ismail","suffix":""},{"id":217448462,"identity":"b4358f77-67b5-4360-868a-b68cac6e1b6f","order_by":1,"name":"Hassan Abdillahi Duale","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA8klEQVRIiWNgGAWjYBACAwjFDMKNBxgqQDRzA7FaGBsOMJwBsRlJ0cLYxgBm4NVizn788YefO6wT+9sPNhz4OK82mr8dqOVHxTacWix7cswke8+kJ844k9hwcOa247kzDjM2MPacuY3bYQdy2Bh42w4nNhxIbDjMu+1YbgNQCzNjGx4t558//vgXqGX++YcNh//OOZY7n6CWGwkG0iBbNtxIBJlfk7uBsJY3ZtKybenGG288bDjYc+xA7kagloN4/XI+/fHHt23WsvPOJx988KOmLnfe+cNARgVuLejgMJg8QLR6IKgjRfEoGAWjYBSMEAAAPpZq08sqL2UAAAAASUVORK5CYII=","orcid":"","institution":"Independent Researcher","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Hassan","middleName":"Abdillahi","lastName":"Duale","suffix":""}],"badges":[],"createdAt":"2023-07-10 21:54:32","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":true,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false,"coiExplicitlySet":false},"doi":"10.21203/rs.3.rs-3158070/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3158070/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":40009763,"identity":"c351c0b9-c7a8-4746-90eb-d2b9cc82ec2c","added_by":"auto","created_at":"2023-07-14 03:29:05","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":435469,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3158070/v1/7718ea0f-debc-4c57-8258-511daca91b25.pdf"}],"financialInterests":"","formattedTitle":"\u003cp\u003eAssessment of Awareness on Health Impact of Drinking Unsafe Water in Hargeisa, Somaliland\u003c/p\u003e","fulltext":[{"header":"1. INTRODUCTION","content":"\u003cp\u003eAccess to clean and safe water, as well as sanitation facilities, is a fundamental human right and one of the most basic human needs. However, according to the United Nations (UN), more than 1.1\u0026nbsp;billion people lack access to safe drinking water, and 2.4\u0026nbsp;billion people lack adequate sanitation facilities (Programme, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2003\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAccess to safe drinking water is crucial for human health, and the UN has declared it a human right. The \"Water for Life\" program was launched by the UN in 2005, and one of its targets was to halve the number of people without proper access to safe water and basic sanitation by 2015, as part of the Millennium Development Goals (Bloomfield, Exner, Signorelli, Nath, \u0026amp; Scott, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2012\u003c/span\u003e; Frisbie, Mitchell, \u0026amp; Sarkar, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2015\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eApproximately 40% of the world's population lives in areas with moderate to high water stress, with Africa and Asia being the regions most affected by the lack of access to safe water. Up to 50% of Africa's urban residents and 75% of Asians lack adequate access to safe water (Tietenberg \u0026amp; Lewis, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2018\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eWaste disposal and management are major challenges in urban centers worldwide, particularly in developing countries where municipal budgets are often strained due to poverty (Jordan, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e1984\u003c/span\u003e). As a result, urban centers struggle to cope with the demands of spatial and demographic growth (Dow, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e1992\u003c/span\u003e). Garbage heaps sometimes remain in the open for weeks due to a shortage of vehicles required to transport them to dump sites. Raw sewage can also flow in the streets due to pipe bursts and blockages, which frequently occur in some cities and take a long time to address due to the lack of equipment, spare parts, and funds required to fix them. In some cases, rivers that pass through urban centers have become polluted with waste water generated by towns and cities (Mapira, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2011\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDiarrhea is the most common health problem associated with poor water quality. In 2000, diarrheal diseases contributed 5.7% to the global disease burden, and an estimated one and a half million children under five years old died due to diarrheal problems (Pruss-Ustun, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2008\u003c/span\u003e). A better understanding of the level of microbial water contamination can help us develop protection programs for drinking water systems. Interventions may include measures to improve the water treatment process at the household level (St Laurent \u0026amp; Mazumder, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2014\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIdeally, assessments of water quality should be conducted not only at the source or piped water system intake, but also at the household level, as the quality of water at the source may not necessarily reflect the water quality consumed by people (Wright, Gundry, \u0026amp; Conroy, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2004\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe main reasons for the gap in knowledge in the study area are the lack of quality monitoring stations and insufficient access to data, which, even if conducted, may not be properly disseminated. Therefore, this study aims to assess awareness of the impacts of drinking contaminated water in Hargeisa, Somaliland, to help bridge this gap.\u003c/p\u003e"},{"header":"2. METHODOLOGY","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Research Area\u003c/h2\u003e \u003cp\u003eThis study was carried out at Hargeisa which is a capital city of Somaliland. It is located in a valley in the northwestern part of the country. The city is situated in a mountainous area; the temperature ranges between 13 and 32 o degrees Celsius (55 and 89 degrees Fahrenheit). Hargeisa has a semi-arid climate. The city receives the bulk of its precipitation between the months of April and September, averaging just less than 400 mm of rainfall annually.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Research design\u003c/h2\u003e \u003cp\u003eA cross- sectional study was conducted at Hargeisa from May to September 2019 to assess health impacts for drinking unsafe water.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Study population\u003c/h2\u003e \u003cp\u003eStudy population of the study was households in the selected districts.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Target population\u003c/h2\u003e \u003cp\u003eTarget population of this study was all households in Hargeisa district.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.5 Sample and Sampling\u003c/h2\u003e \u003cdiv id=\"Sec8\" class=\"Section3\"\u003e \u003ch2\u003e2.5.1 Sample Size\u003c/h2\u003e \u003cp\u003eThe sample size required in the study was determined using the formula given by [12] for random sampling.\u003c/p\u003e \u003cp\u003en= (1.96)\u0026sup2; Pexp (1-Pexp)/ d\u0026sup2;\u003c/p\u003e \u003cp\u003eWhere,\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;required sample size\u003c/p\u003e \u003cp\u003ePexp\u0026thinsp;=\u0026thinsp;expected prevalence\u003c/p\u003e \u003cp\u003ed2\u0026thinsp;=\u0026thinsp;desired absolute precision\u003c/p\u003e \u003cp\u003eExpected prevalence of 50% was used since there were no prior works done in the study areas. 0.05 desired absolute precision and 95% level of confidence was used for the study. Therefore, a total of 384 respondents were used in the study. In this study 384 respondents were interviewed including poor and vulnerable population such as IDPs camps.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003e2.5.2 Sampling Techniques\u003c/h2\u003e \u003cp\u003eHargeisa has 6 districts (Ibrahim Koodbur, 26 June, Gacan Libax, Ahmed Dhagah, Mohamoud Haybe and 31 May). Six clusters were divided in the population based on districts by using cluster sampling method. All six clusters were sampled by using simple random sampling, where 64 households were selected randomly from each cluster.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e2.6 Data Collection\u003c/h2\u003e \u003cdiv id=\"Sec11\" class=\"Section3\"\u003e \u003ch2\u003e2.6.1 Data Collection Methods\u003c/h2\u003e \u003cp\u003eThe data used in this study was collected through a questionnaire administered to selected households in Hargeisa district. Primary data collection on awareness and impacts of drinking unsafe water was carried out using a questionnaire designed to gather qualitative information. The questionnaire included questions on the awareness of the health impacts of unsafe water, the economic status of the family, and the source of water (water systems).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section3\"\u003e \u003ch2\u003e2.6.2 Data Collection Instruments\u003c/h2\u003e \u003cp\u003eThe following instrument was used in the study in order to achieve accurate and valuable information; paper questionnaires. The questionnaires were distributed to the respondents to fill.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section3\"\u003e \u003ch2\u003e2.6.3 Research Procedure\u003c/h2\u003e \u003cp\u003eAfter receiving an approval letter from the University, the researchers prepared questionnaires based on the specific objectives of the study. The questionnaires were then printed based on the number of respondents required for the study, plus an additional 10 forms to account for any potential missing data.\u003c/p\u003e \u003cp\u003eThe respondents were informed about the study and administered the questionnaires to fill or answer the assigned questions. After data collection, the questionnaire forms were checked for any missing information. The collected data was then sorted and entered into an Excel spreadsheet 2010.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e2.7 Data Analysis\u003c/h2\u003e \u003cp\u003eThe study used Microsoft Excel spreadsheet 2010 to enter the data. Descriptive statistics were used to determine the frequencies and percentages of the data, while chi-square test analysis was employed to test for the presence of an association between the awareness level of health impacts of drinking unsafe water and the risk factors such as location, gender, age, educational level, and economic status of the households. The confidence level was set at 95%, and a P-value less than 0.05 was considered significant. All statistical analyses were performed using STATA software package version 12.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. RESULTS","content":"\u003cp\u003e \u003cb\u003e3.1 Assessments of awareness level of the Health impacts of drinking unsafe water in the study area.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe study found that out of the 384 respondents who participated, 69% (265/384) were aware of the health impacts of drinking unsafe water, whereas the remaining 31% (119/384) were not aware of the health impacts of drinking unsafe water in the study area, as shown in the table below.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eASSESSMENTS OF AWARENESS ON IMPACTS OF DRINKING UNSAFE WATER IN THE STUDY AREA\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eDo you aware health impact for drinking unsafe water?\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e265\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e69\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e119\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e384\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e100\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Household\u0026rsquo;s water status in the study area.\u003c/h2\u003e \u003cp\u003eWater The study conducted an assessment of water status at the household level, including water source, household water satisfaction, water treatment systems, and cleaning of water tanks. Out of the 384 respondents who participated in the study, 31.8%, 52.1%, and 16.1% of the respondents used water from tap water, water tank vehicles, and both tap water and water tank vehicles, respectively.\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows that only 32.6% of the respondents were satisfied with their water conditions, whereas the majority (67.4%) were unsatisfied with the water system condition. Moreover, only 29.4% of the respondents used water treatment systems, while the rest (70.4%) did not use any water treatment, as shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eHOUSEHOLD\u0026rsquo;S WATER STATUS IN THE STUDY AREA\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eWhat is the main source of water used in your home?\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTap water\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWater tank Vehicle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAre you satisfied water condition in your District?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e125\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnsatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e259\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDo you treat your water in any way to make it safer to drink?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e271\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIf yes, what do you usually do to the water to make it safer to drink?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBoil\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdd bleach/chlorine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e46.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUse a water filter\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLet it stand and settle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDo you clean water tanks in your home for the last six month?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e253\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e65.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e131\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIf yes, how many times do you clean or check water tanks in your home?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOnce in a month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEvery three month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e109\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEvery six month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e384\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e100\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003e3.3 Possible causes and health impacts for drinking unsafe water\u003c/h2\u003e \u003cp\u003eThe study assessed the causes of water contamination and its health impacts on human consumption. Out of the 384 respondents interviewed, 49.5%, 13.5%, 3.1%, and 33.9% of the respondents stated that unsafe water was caused by unprotected sources, agricultural waste products, sewage, and chemicals, respectively.\u003c/p\u003e \u003cp\u003eSimilarly, the study found that 32.6%, 27.9%, and 39.5% of the respondents reported that drinking unsafe water could lead to waterborne diseases, kidney problems (complications), and diarrhea, respectively, as shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e..\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePOSSIBLE CAUSES AND HEALTH IMPACTS FOR DRINKING UNSAFE WATER\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eWhat are the causes of water contamination (unsafe water)?\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnprotected source\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e190\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAgricultural waste product\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSewages\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChemicals\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWhat are possible health impacts for drinking unsafe water?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiseases (cholera, Typhoid)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e125\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKidney complications\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e107\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiarrhea\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e152\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e384\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003e3.4 Awareness of households with the identified risk factors\u003c/h2\u003e \u003cp\u003eThe study assessed the awareness of households regarding drinking unsafe water in relation to location, gender, age, educational level, and economic status of the respondents. The results showed that there was no statistically significant difference in awareness between households located in different areas (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003eRegarding gender, high unawareness was reported in females (31.7%) compared to males (29.4%), but this difference was not statistically significant (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Similarly, there was no statistically significant difference in awareness between different age groups (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05), although high unawareness was recorded in respondents below 25 years of age (44.7%) compared to those aged 25\u0026ndash;50 years (28.5%) and over 50 years (33.8%).\u003c/p\u003e \u003cp\u003eHowever, there was a strong statistically significant difference in awareness between different educational levels (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), with high unawareness recorded in illiterate respondents (60%) compared to literate respondents (17%). Similarly, there was a strong statistically significant difference in awareness between different economic statuses of the households (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), with higher unawareness reported in poor households (52.7%) compared to medium (15.7%) and rich (11.1%) households.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eASSOCIATION OF RISK FACTORS TO THE HOUSEHOLD\u0026lsquo;S AWARENESS ASSESSMENTS\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eHousehold\u0026rsquo;s awareness\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eAware (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUn- Aware (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLocation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c7\" namest=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIbrahim Koodbur\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e47 (73.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17 (26.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.6682\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.893\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e26- June\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e46 (71.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18 (28.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGacan Libaax\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e45 (70.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19 (29.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAhmed Dhagax\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e43 (67.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21(32.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMohamoud Haybe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e42 ( 65.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22 (34.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e31- May\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e42 (65.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22 (34.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e84 (70.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35 (29.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e0.2007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.654\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e181 (68.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e84 (31.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;25 Years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21 (55.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e17 (44.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e4.4403\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.109\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e25\u0026ndash;50 Years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e201(71.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e80 (28.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;50 Years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43 (66.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e22 (33.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLiteracy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLiterate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e215 (83%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e44 (17%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e72.9322\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIlliterate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e50 (40%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e75 (60%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEconomic status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80 (47.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e89 (52.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e66.7878\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e113 (84.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e15 (15.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRich\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e72 (88.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e9 (11.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"4. DISCUSSION","content":"\u003cp\u003eThe present study found that 69% of the respondents were aware of the health impacts of drinking unsafe water, while 31% were not. This difference in awareness could be due to differences in perception, education level, or economic status among the respondents.\u003c/p\u003e \u003cp\u003eThe study also reported the age and economic status of the respondents. The majority of respondents (73%) were between the ages of 25 and 50, while the rest were either below 25 or above 50 years old. Additionally, most of the households were of poor or medium economic status, which could be attributed to high unemployment rates and a lack of investments in the country.\u003c/p\u003e \u003cp\u003eThe study found that households in the area received water from different sources, including tap water and water tank vehicles. The majority of households (52.1%) used water from water tank vehicles, likely due to a scarcity of tap water and an increased population in the area. However, the majority of households (67.4%) were unsatisfied with their water condition, while the rest (32.6%) were satisfied. This difference in satisfaction could be due to variations in perception, awareness, and education level among the households.\u003c/p\u003e \u003cp\u003eRegarding water treatment, the study found that the majority of households (70.4%) did not use any water treatment, while the rest (29.4%) used treated water for drinking. Different water treatment systems were used, with 46.9% and 30% of households using chlorination and boiling, respectively. The study also found that 65.9% of respondents cleaned their water tanks, with the majority cleaning them every three months.\u003c/p\u003e \u003cp\u003eThe study identified unprotected sources and chemicals as the major causes of unsafe water, with 49.5% and 33.9% of respondents, respectively, pointing to these factors. This highlights that sources of water may not be adequately protected, and public water tanks may lack chlorination.\u003c/p\u003e \u003cp\u003eThe study also revealed that drinking unsafe water can lead to waterborne diseases, kidney problems, and diarrhea, as reported by 32.6%, 27.9%, and 39.5% of respondents, respectively. This could be due to the presence of pathogenic microorganisms, chemicals, and minerals in the water.\u003c/p\u003e \u003cp\u003eWhile gender and age did not show a significant association with awareness of the impacts of drinking unsafe water, educational background and economic status did. Illiterate respondents (60%) were less aware of the impacts of drinking unsafe water than literate respondents (17%). Poor households (52.7%) were also less aware than medium (15.7%) and rich households (11.1%). This suggests that education and economic status are critical factors in raising awareness of the impacts of drinking unsafe water.\u003c/p\u003e"},{"header":"5. CONCLUSION AND RECOMMENDATION","content":"\u003cp\u003eThis study concludes that education and economic status of households have a significant association with awareness of the health impacts of drinking unsafe water. The water system condition in the study area was unsatisfactory, and the use of water treatment systems to make water safer for drinking was limited. However, some households practiced treating drinking water by chlorinating the water tanks or boiling it to make it safe for drinking. Unprotected sources of water and chemicals in the water were found to cause water to be unsafe and contaminated in the study area. Drinking unsafe water can cause and predispose individuals to waterborne diseases, diarrhea, and kidney complications.\u003c/p\u003e \u003cp\u003eBased on the above concluding remarks, the following recommendations are made: The government should conduct public awareness campaigns to increase the community's awareness of the health impacts of drinking unsafe water and the importance of using water treatment. The Ministry of Water Resources and Hargeisa Water Agency should carry out water quality assessments. Sources of water should be protected and regularly checked by the Ministry of Water Resources. Every household in the study area should practice water treatment and regularly clean their water tanks.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBloomfield, S. F., Exner, M., Signorelli, C., Nath, K., \u0026amp; Scott, E. (2012). \u003cem\u003eThe chain of infection transmission in the home and everyday life settings, and the role of hygiene in reducing the risk of infection.\u003c/em\u003e Paper presented at the International scientific forum on home hygiene.\u003c/li\u003e\n\u003cli\u003eDow, K. (1992). Exploring differences in our common future (s): the meaning of vulnerability to global environmental change. \u003cem\u003eGeoforum, 23\u003c/em\u003e(3), 417-436. \u003c/li\u003e\n\u003cli\u003eFosgate, G. T. (2009). Practical sample size calculations for surveillance and diagnostic investigations. \u003cem\u003eJournal of veterinary diagnostic investigation, 21\u003c/em\u003e(1), 3-14. \u003c/li\u003e\n\u003cli\u003eFrisbie, S. H., Mitchell, E. J., \u0026amp; Sarkar, B. (2015). Urgent need to reevaluate the latest World Health Organization guidelines for toxic inorganic substances in drinking water. \u003cem\u003eEnvironmental health, 14\u003c/em\u003e(1), 1-15. \u003c/li\u003e\n\u003cli\u003eJordan, J. (1984). Local government in Zimbabwe: An overview. \u003c/li\u003e\n\u003cli\u003eMapira, J. (2011). River pollution in the city of Mutare (Zimbabwe) and its implications for sustainable development. \u003cem\u003eJournal of Sustainable Development in Africa, 13\u003c/em\u003e(6), 181-194. \u003c/li\u003e\n\u003cli\u003eProgramme, W. W. A. (2003). \u003cem\u003eWater for People, Water for Life: The United Nations World Water Development Report: Executive Summary\u003c/em\u003e: Unesco Pub.\u003c/li\u003e\n\u003cli\u003ePruss-Ustun, A., WHO. (2008). \u003cem\u003eSafer water, better health: costs, benefits and sustainability of interventions to protect and promote health\u003c/em\u003e: World Health Organization.\u003c/li\u003e\n\u003cli\u003eSoomro, A., Siyal, A. A., Mirjat, M. S., \u0026amp; Sial, N. B. (2014). Seasonal variations of trace elements and heavy metal concentrations in phuleli canal water (Sindh), Pakistan. \u003cem\u003eSarhad J Agric, 30\u003c/em\u003e, 73-82. \u003c/li\u003e\n\u003cli\u003eSt Laurent, J., \u0026amp; Mazumder, A. (2014). Influence of seasonal and inter-annual hydro-meteorological variability on surface water fecal coliform concentration under varying land-use composition. \u003cem\u003eWater Research, 48\u003c/em\u003e, 170-178. \u003c/li\u003e\n\u003cli\u003eTietenberg, T., \u0026amp; Lewis, L. (2018). \u003cem\u003eEnvironmental and natural resource economics\u003c/em\u003e: Routledge.\u003c/li\u003e\n\u003cli\u003eWright, J., Gundry, S., \u0026amp; Conroy, R. (2004). Household drinking water in developing countries: a systematic review of microbiological contamination between source and point‐of‐use. \u003cem\u003eTropical medicine \u0026amp; international health, 9\u003c/em\u003e(1), 106-117. \u003cstrong\u003e\u003c/strong\u003e\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Gollis University","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Awareness, health impact, Hargeisa, unsafe water, water","lastPublishedDoi":"10.21203/rs.3.rs-3158070/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3158070/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003ea \u003cem\u003ecross-sectional study was conducted at Hargeisa from June to November 2019 to assess awareness and health impacts for drinking unsafe water in Hargeisa. A total of 384 respondents were participated. Out of 384 respondents participated in this study, 69% (265/384) of the respondents are aware of the health impacts for drinking unsafe water, whereas the rest 31% (119/384) are not aware health impacts for drinking unsafe water in the study area. Source of water in this study are tap water (31.8%), water tank vehicle (52.1%) and both tap water and water tank vehicle (16.1%). Education and economic status of the respondents were shown to significant association with the awareness of impacts on drinking unsafe water (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), where location, gender and age were not shown statistical significant association (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Drinking unsafe water leads occurrence of water borne diseases, diarrhea and kidneys complications.\u003c/em\u003e\u003c/p\u003e","manuscriptTitle":"Assessment of Awareness on Health Impact of Drinking Unsafe Water in Hargeisa, Somaliland","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-07-14 03:28:53","doi":"10.21203/rs.3.rs-3158070/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a0335d02-f9b8-469d-96e7-354267c20ae1","owner":[],"postedDate":"July 14th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2023-07-14T03:28:53+00:00","versionOfRecord":[],"versionCreatedAt":"2023-07-14 03:28:53","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3158070","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3158070","identity":"rs-3158070","version":["v1"]},"buildId":"WrCJVZZCHTDjtuVLN7oU0","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}