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Assessment of Health and Well-Being Effects Associated With the Challenging Drinking Water Situation in the Gaza Strip : Protocol for a Cross-Sectional Household Survey Study

Brugger, Curdin ; Dietler, Dominik LU orcid ; Abu Hamad, Bassam A. ; Gastel, Tammo van ; Sittaro, Federico ; Rossi, Rodolfo ; Owen, Branwen Nia ; Probst-Hensch, Nicole and Winkler, Mirko S. (2024) In JMIR Research Protocols 13.
Abstract

Background: The water supply in the Gaza Strip, Palestine, has been unstable and under strain for decades, resulting in major issues with drinking water quality, reliability, and acceptability. In 2018, between 25% and 30% of Gazans did not have regular access to running water. The progressive deterioration of water infrastructure and concerns over the quality of piped water have resulted in a complex mix of drinking water sources used in the Gaza Strip. The challenges of safe water provision in the Gaza Strip could potentially have severe adverse effects on the population’s health and well-being. Objective: The main objectives of this survey are to determine the quality of drinking water at the household level and to investigate the... (More)

Background: The water supply in the Gaza Strip, Palestine, has been unstable and under strain for decades, resulting in major issues with drinking water quality, reliability, and acceptability. In 2018, between 25% and 30% of Gazans did not have regular access to running water. The progressive deterioration of water infrastructure and concerns over the quality of piped water have resulted in a complex mix of drinking water sources used in the Gaza Strip. The challenges of safe water provision in the Gaza Strip could potentially have severe adverse effects on the population’s health and well-being. Objective: The main objectives of this survey are to determine the quality of drinking water at the household level and to investigate the association of various health outcomes with water quality at the household level in the Gaza Strip. Methods: We conducted a cross-sectional household survey in the North Gaza, Gaza, and Rafah governorates between January and March 2023. We selected a subsample of households from a representative cross-sectional survey conducted in the Gaza Strip in 2020 with persons aged 40 years and older. From each household in the 2023 survey, we invited 3 individuals (2 older than 40 years and 1 between 18 and 30 years) to participate. The face-to-face interview included questions on drinking water, mental health and well-being, self-reported diagnoses for selected diseases, use of antibiotics, and knowledge about antimicrobial resistance. Additionally, we measured each participant’s blood pressure. We sampled drinking water from each household and analyzed the samples for microbial contamination, nitrate, sodium, and mineral content. Results: In total, we visited 905 households and interviewed 2291 participants. In both age groups, more female participants were interviewed. A total of 56.60% (914/1615) were aged ≥40 years, and 58.9% (398/676) were aged between 18 and 30 years. We obtained water samples from nearly all households (902/905, 99.8%). The results are expected to be published in several papers in 2025. Conclusions: The extensive survey components, coupled with drinking water testing and building on an existing survey, allowed us to identify a broad set of potential impacts on health and well-being and to track changes over time. This study intends to identify humanitarian and development interventions that could impact the population served most. However, we completed data collection before the escalation of violence in October 2023. Given the impact of the still ongoing conflict, the initial intent of this work is no longer valid. However, the results emerging from the survey may still serve as a valuable baseline to assess the impacts of the current escalations on physical and mental health and on drinking water quality. In addition, our findings could provide important information for rebuilding the Gaza Strip in a more health-promoting way.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
drinking water, Gaza Strip, households survey, humanitarian crisis, noncommunicable diseases, protracted conflict, water quality, well-being
in
JMIR Research Protocols
volume
13
article number
e63415
publisher
JMIR Publications Inc.
external identifiers
  • scopus:85210988979
  • pmid:39612204
ISSN
1929-0748
DOI
10.2196/63415
language
English
LU publication?
yes
id
7db5d17c-51b9-4a14-97dd-4abab8a55e95
date added to LUP
2025-01-27 14:31:12
date last changed
2025-07-15 14:53:15
@article{7db5d17c-51b9-4a14-97dd-4abab8a55e95,
  abstract     = {{<p>Background: The water supply in the Gaza Strip, Palestine, has been unstable and under strain for decades, resulting in major issues with drinking water quality, reliability, and acceptability. In 2018, between 25% and 30% of Gazans did not have regular access to running water. The progressive deterioration of water infrastructure and concerns over the quality of piped water have resulted in a complex mix of drinking water sources used in the Gaza Strip. The challenges of safe water provision in the Gaza Strip could potentially have severe adverse effects on the population’s health and well-being. Objective: The main objectives of this survey are to determine the quality of drinking water at the household level and to investigate the association of various health outcomes with water quality at the household level in the Gaza Strip. Methods: We conducted a cross-sectional household survey in the North Gaza, Gaza, and Rafah governorates between January and March 2023. We selected a subsample of households from a representative cross-sectional survey conducted in the Gaza Strip in 2020 with persons aged 40 years and older. From each household in the 2023 survey, we invited 3 individuals (2 older than 40 years and 1 between 18 and 30 years) to participate. The face-to-face interview included questions on drinking water, mental health and well-being, self-reported diagnoses for selected diseases, use of antibiotics, and knowledge about antimicrobial resistance. Additionally, we measured each participant’s blood pressure. We sampled drinking water from each household and analyzed the samples for microbial contamination, nitrate, sodium, and mineral content. Results: In total, we visited 905 households and interviewed 2291 participants. In both age groups, more female participants were interviewed. A total of 56.60% (914/1615) were aged ≥40 years, and 58.9% (398/676) were aged between 18 and 30 years. We obtained water samples from nearly all households (902/905, 99.8%). The results are expected to be published in several papers in 2025. Conclusions: The extensive survey components, coupled with drinking water testing and building on an existing survey, allowed us to identify a broad set of potential impacts on health and well-being and to track changes over time. This study intends to identify humanitarian and development interventions that could impact the population served most. However, we completed data collection before the escalation of violence in October 2023. Given the impact of the still ongoing conflict, the initial intent of this work is no longer valid. However, the results emerging from the survey may still serve as a valuable baseline to assess the impacts of the current escalations on physical and mental health and on drinking water quality. In addition, our findings could provide important information for rebuilding the Gaza Strip in a more health-promoting way.</p>}},
  author       = {{Brugger, Curdin and Dietler, Dominik and Abu Hamad, Bassam A. and Gastel, Tammo van and Sittaro, Federico and Rossi, Rodolfo and Owen, Branwen Nia and Probst-Hensch, Nicole and Winkler, Mirko S.}},
  issn         = {{1929-0748}},
  keywords     = {{drinking water; Gaza Strip; households survey; humanitarian crisis; noncommunicable diseases; protracted conflict; water quality; well-being}},
  language     = {{eng}},
  publisher    = {{JMIR Publications Inc.}},
  series       = {{JMIR Research Protocols}},
  title        = {{Assessment of Health and Well-Being Effects Associated With the Challenging Drinking Water Situation in the Gaza Strip : Protocol for a Cross-Sectional Household Survey Study}},
  url          = {{http://dx.doi.org/10.2196/63415}},
  doi          = {{10.2196/63415}},
  volume       = {{13}},
  year         = {{2024}},
}