Water, Sanitation and Hygiene Assessment at the Household Level in the Gaza Strip, July 2017

EXECUTIVE SUMMARY

The Gaza Strip is facing immense challenges related to water, sanitation and hygiene (WASH), which pose significant health risks to its 1.8 million residents and constrain socioeconomic development. Groundwater from the coastal aquifer is the only water resource available in the Gaza Strip. However, abstraction from the aquifer stands at four times the aquifer‘s recharge rate at 200 MCM/year, and is expected to rise to 260 MCM/year by 2020. In addition, more than 96 per cent of abstracted water is polluted and not fit for human consumption due to high salinity levels from sea water intrusion and high nitrate levels from excessive use of agrochemicals and wastewater infiltration. The water supply in the Gaza Strip is estimated at 90 l/c/d, below acceptable water quantity standards of 100 l/c/d recommended by the World Health Organization (WHO). Furthermore, the absence of sufficient wastewater treatment facilities results in approximately 35 MCM/year of untreated/partially treated wastewater discharged into the sea along the Gaza coast.

The deteriorated WASH situation has been compounded by nine years of blockade and three consecutive destructive wars. The consequences of the last armed conflict in 2014 are still affecting the WASH sector in direct and indirect ways by limiting the capacity to develop and deliver basic needs and services to people living in the Gaza Strip. Fifty days of continuous attacks caused massive destruction, devastation and displacement. Extensive damage to water and wastewater facilities reported by the Coastal Municipalities Water Utilities (MWU) and the Palestinian Water Authority (PWA) has received a preliminary estimate of around US$ 34 million. The reconstruction process is going slowly.

Since the last Israeli military operation (―Protective Edge‖, 2014), there has been no household assessment carried out that focused on the operation‘s impact on WASH conditions. In light of this, the WASH Cluster needs to conduct a contextual assessment. As such, GVC and the Palestinian Hydrology Group (PHG) proposed to undertake a thorough assessment with the financial and technical support of UNICEF. They evaluated the WASH conditions in the Gaza Strip at the household level, highlighting the diverse consequences suffered by women, men, girls and boys.

The main objective was to assess WASH conditions at the household level in the Gaza Strip while generating a comparative analysis that informed the identification of critical responses and actions. These, in turn, will contribute positively and efficiently to assuring minimum WASH standards for all Gaza Strip residents and thereby reduce health risks. Assessment methodology This assessment was conducted from September 2015 to March 2016 under the framework of the WASH monitoring working group (the technical working group that is part of the WASH Cluster), which was established to coordinate the assessment proposed by GVC, PHG and UNICEF. The framework adopted for this assessment consisted of four main consequent stages: 1) preparation, 2) data collection, 3) data analysis, and 4) report writing. The preparation stage included pre-meetings with the WASH monitoring working group to agree on final objectives, structure and required outputs, and also included the selection of a work team. The data collection stage included a field survey conducted through a prepared questionnaire and supported by complementary data; focus group workshops, observatory reports; and secondary data from previous implemented assessments. The data analysis included the elaboration of indicators.

Sample size for the field survey was calculated on a statistical equation for representativeness.
According to the defined criteria, 2,382 households is representative of the total of 303,330 households in the Gaza Strip. Considering that 20 per cent of the implemented questionnaires are excluded in the cleaning process, the total minimum sample size was adjusted and rounded to 3,125 households. The sample was stratified based on governorates and localities and classified into four target groups; internally displaced persons, non-affected, war-affected and WASH-affected, of which the last was proposed by WASH-MWG during implementation of the assessment. Data collection was performed in three phases; 3,977 surveys were implemented after carrying out a testing phase including 624 surveys and 3,166 questionnaires were validated during the data cleaning process. The remaining questionnaires were excluded from the data analysis process.

Forty-seven indicators were developed to explain the findings of WASH conditions at the household level over the whole Gaza Strip with a link to the socio-economic situation before and after the 2014 armed conflict. Seven indicators were related to socio-economic conditions, 19 indicators were related to water, six indicators related to sanitation, and 15 indicators related to hygiene.