The commonest sources of drinking water in the region are the rain, spring, river and stream (27.2%). About a fifth of households (19.6%) use dugouts for the collection of rainwater, followed by pipe borne water in the form of a standpipe, either inside or outside the house (22.4%) and borehole (17.0%). Other sources, constituting mainly tanker supply, represent only about 1.0 per cent of household water sources. This means that only 39.4 per cent of households have access to potable water (pipe-borne plus borehole); this has implications for water borne diseases for the region.
At the district level, the proportion of households with piped water varies from 0.9 per cent in East Mamprusi District, to 78.9 per cent in Tamale municipality. In most of the districts, the main sources of water are wells, dugouts or rainwater/rain/river/stream. The dependence on these sources of water has major implications for the health of the population. Contaminations during the process of collection may aggravate the incidence of diarrhoea and other water borne diseases. The use of the tanker supply, an important source of household water, is only prevalent in Tamale where it accounts for about 4.0 per cent of the water supply of households.
Main Toilet Facilities
For the region as a whole, 75.9 per cent of households have no toilet facilities of any sort. Among the districts, the Tamale municipality, with over a third (35.6%) of households, has the lowest proportion of households with no toilet facility. In 10 of the 13 districts, between 80.0 and 90.0 per cent of households do not have any toilet facility. About 14.0 per cent of households in the region use public facilities. In the Tamale municipality, 41.6 per cent of households use public facilities. The two other districts where the use of public toilet facilities is common, are Savelugu-Nanton (19.5%) and Yendi (20.2%).
The use of the water closets (WCs) and the KVIP is very limited. About 2.5 per cent of households in the region have water closets, while 2.3 per cent use the KVIP. Even in the Tamale municipality, only 8.3 per cent of households have access to water closets and 5.3 per cent use the KVIP.
The pit and other types of latrine are relatively uncommon in all the districts. Members of households with inadequate toilet facilities or with no toilet facility at all, are compelled to rely on alternatives such as the bush, farms, etc. This has significant implications for the transmission of infection, and consequently, for the health and well-being of communities, which, in turn, may impact productivity negatively.
Main Source Of Lighting
About 77.0 per cent of households use the kerosene lamp as source of lighting, while 22.0 per cent use electricity. At the district level, access to electricity as source of lighting, varies from 6.9 per cent in Saboba-Chereponi to 58.5 per cent in Tamale.
The distinct advantage of urban areas with regard to lighting is clearly demonstrated by the higher proportion of households in the Tamale municipality (58.5%) that have access to electricity as a source of lighting compared to less than 25.0 per cent in the remaining districts. Apart from the obvious benefits of lighting, the availability of electricity is closely associated with health, economic and social activity and living conditions; for example, cereal and grain mills require electricity.
Non-availability of electricity may influence access to television and radio and, therefore, access to information that may have direct impact on health. On the other hand, availability of electricity may facilitate the use of the refrigerator and, therefore, directly impact storage of food within the household
Main Fuel For Cooking
About 84.0 per cent of households in the region use wood as a main source of energy for cooking; 11.7 per cent use charcoal and 4.7 per cent use other forms of energy such as electricity and gas. More than 88.0 per cent of households in the districts, except Tamale (45.1%), rely on wood as a source of energy for cooking. On the other hand, 42.2 per cent of households in Tamale, compared with less than 10.0 per cent in the other districts, use charcoal as the main source of cooking fuel.
Other sources of fuel for cooking, used by households in Tamale, which are negligible, (less than 1.0%) in the other districts in the region, are L.P. Gas (4.3%) and electricity (2.7%). At least 1.0 but not exceeding 2.5 per cent of households in the districts, except East Gonja (0.0%), use kerosene as fuel for cooking or at least for starting the fire for cooking.
Electricity, (0.7%), as in general in the country (1.1%), is very rarely used as fuel for cooking, even in the Tamale municipality (2.7%), the regional capital. L.P Gas (1.0%) is equally rarely used as fuel for cooking, even in the Tamale municipality (4.3%). The low use of L.P Gas for cooking needs to be addressed with realistic programme objectives to reduce the very high use of wood and charcoal combined which constitute 95.4 per cent of all cooking fuel in the region. One of the main objectives of such a programme will be, to make available to households in the region, smaller gas cylinders which are not only affordable but will enable L.P.G. to be bought in smaller quantities.
Another element in such a programme would be to widen the use of L.PG by extending its use to lighting and the operation of such household equipments as the refrigerator while at the same time ensuring safety in LPG use. The type of fuel source used by a household may be related directly or indirectly to health outcomes. The poor may use considerably more wood, dung, and other biomass, than the rich. As a result, they may generate high-levels of indoor pollution, leading to increases in the incidence of respiratory illnesses and other health problems.
Lack of utility services implies that many women may spend several hours a day fetching firewood for the household, diverting these women from income generation and childcare activities. The proportion of households who do no cooking, and therefore do not use any cooking fuel, is low (1.4%), as in the Upper East (0.7%), Upper West (0.9%) and the Volta (1.4%), Regions, compared with the Ashanti Region (5.1%), the highest in the country, followed by the Greater Accra (4.8%) Region. The other regions have around 3.0 per cent of households with no cooking.
A cooking space is either a separate room, equipped and intended primarily for the purpose of preparing principal meals (usually referred to as a kitchen) or some other space, used for the preparation of meals.
More than half (53.8%) of households in the region use the open space in their compound for cooking, while 24.4 per cent of households use a kitchen, either exclusively or shared with other households. An additional 17.7 per cent of households use such other spaces as the veranda or a room for cooking. Apart from the 4.1 per cent of households who specifically stated they do no cooking, an additional 2.1 per cent cook but did not indicate where they cook.
At the district level, the distribution of the types of cooking space is generally similar to that at the regional level. The use of a kitchen a separate kitchen exclusive or shared, is commonest in East Mamprusi (48.6%), Bole (46.2%), West Mamprusi (41.7%) and Saboba- Chereponi (34.3%) Districts. The open space for cooking is prevalent in the other districts.
In the region as a whole, the shared separate bathroom constitutes a little over a fifth (21.0%) of bathing facilities; the own bathroom for exclusive use is 33.7 per cent and the shared open cubicle (9.1%).
The private open cubicle (14.4%) and the open space (15.5%) each constitutes about one eighth of bathing facilities. Sharing a bathing facility in the form of either a separate bathroom or an open cubicle is common (30.1%) but bathing in a public bathhouse (2.7%), in another house (3.2%) or in a river/pond (0.2%) is rare in the region. There are at least 10.0 per cent of each of the five main types of bathing facility in the districts except, the own bathroom for exclusive use in Gushiegu-Karaga (7.4%) and the open space in five other districts.
The combination of the type of bathing space varies with each district. The own bathroom for exclusive use accounts for 31.1-37.3 per cent in three districts, and 20.0 but less than 30.0 per cent in an additional five districts. On the other hand, the shared open cubicle and the shared separate bathroom, account for between half (50.0%) and over two thirds (68.9%) of bathing facilities in four districts and below a third in only two districts, Bole (30.1%) and Zabzugu-Tatale (28.9%). The private open cubicle, which exceeds a fifth of bathing facilities only in East Mamprusi (23.2%) and Nanumba (22.3%), Districts, accounts for 10.0-18.8 per cent of bathing facilities in the remaining districts. Bathing spaces are well provided for in the region, as reflected in the near absence of public bathrooms and the variety of bathing spaces in all the districts.