Groundwater is widely acknowledged to be an important source of drinking water in low-income regions, and it, therefore, plays a critical role in the realization of the human right to water. However, the proportion of households using groundwater compared with other sources is rarely quantified, with national and global datasets more focused on facilities—rather than resources—used. This is a significant gap in knowledge, particularly in light of efforts to expand water services in line with the inclusive and integrated agenda of the Sustainable Development Goals. Understanding the prevalence of groundwater reliance for drinking is critical for those involved in water services planning and management, so they can better monitor and advocate for management of water resources that supports sustainable services for households. This paper contributes data that can be used to strengthen the integration of resource considerations within water service delivery and inform the work of development partners supporting this area. We approach this issue from two perspectives. Firstly, we collate data on the proportion of households using groundwater as their primary drinking water source for 10 Southeast Asian and Pacific nations, finding an average of 66% (range of 17–93% for individual countries) of households in urban areas and 60% (range of 22–95%) of households in rural areas rely on groundwater for drinking. Together, these constitute 79% of the total population across the case study countries. Secondly, we review current and emerging groundwater resource concerns within each country, using a systems thinking approach to assess how groundwater resource issues influence household water services. Findings support the case for governments and development agencies to strengthen engagement with groundwater resource management as foundational for achieving sustainable water services for all.

Rural Africa lags behind global progress to provide safe drinking water to everyone. Decades of effort and billions of dollars of investment have yielded modest gains, with high but avoidable health and economic costs borne by over 300m people lacking basic water access. We explore why rural water is different for communities, schools, and healthcare facilities across characteristics of scale, institutions, demand, and finance. The findings conclude with policy recommendations to (i) network rural services at scale, (ii) unlock rural payments by creating value, and (iii) design and test performance-based funding models at national and regional scales, with an ambition to eliminate the need for future, sustainable development goals.

The routine use of multiple water sources to meet household water needs is widely practiced and has been reported in many developing countries. However, it is typically neglected by implementers, development organizations, and researchers who tend to focus exclusively on the “main source of drinking water.” In this Perspective, we explain the nature and scope of multiple water source use (MWSU) at the household level in developing countries. We also describe the implications of MWSU for human health and water resilience, and identify key knowledge gaps, risks, and opportunities associated with MWSU. Finally, we argue that understanding MWSU is feasible for researchers and implementers and is essential for properly designing research studies and water supply projects.

This research aimed to identify systemic housing-level contributions to infectious disease transmission for Indigenous Australians, in response to the Government program to ‘close the gap’ of health and other inequalities. A narrative literature review was performed in accordance to PRISMA guidelines. The findings revealed a lack of housing maintenance was associated with gastrointestinal infections, and skin-related diseases were associated with crowding. Diarrhoea was associated with the state of food preparation and storage areas, and viral conditions such as influenza were associated with crowding. Gastrointestinal, skin, ear, eye, and respiratory illnesses are related in various ways to health hardware functionality, removal and treatment of sewage, crowding, presence of pests and vermin, and the growth of mould and mildew. The research concluded that infectious disease transmission can be reduced by improving housing conditions, including adequate and timely housing repair and maintenance, and the enabling environment to perform healthy behaviours.

Handpumps are heavily relied upon for drinking water in rural areas of low- and middle-income countries, but their operation and maintenance remain problematic. This review presents updated and expanded handpump functionality estimates for 47 countries in sub-Saharan Africa and the Asia-Pacific region. Our results suggest that approximately one in four handpumps in sub-Saharan Africa are non-functional at any point in time, which in 2015 was roughly equivalent to 175,000 inoperative water points. Functionality statistics for Asia-Pacific countries vary widely, but data gaps preclude a robust region-wide estimate. In spite of data inconsistencies and imperfections, the results illustrate the persistent and widespread nature of rural water supply sustainability concerns.