Rural community water supply schemes: functionality status, sustainability, and associated factors in eastern Ethiopia: a mixed-methods study

ABSTRACT Water, sanitation, and hygiene profoundly impact low- and middle-income countries, shaping public health outcomes, educational attainment, gender equality, and overall economic growth. In Ethiopia, the widespread presence of nonfunctional water points significantly restricts access to safe and adequate water and sanitation services, undermining national efforts to achieve sustainable development and improve quality of life. In Gursum District, a study of 120 water schemes and 400 households found that 71% of the schemes were functional, with a low average sustainability score of 33% (24–42%). Despite the relatively promising performance of physical infrastructure (34.9% (22.7–47.1%)), system reliability was adversely affected by low willingness to pay and a limited sense of ownership (31.9% (19.0–44.8%)), low customer satisfaction (31.5% (20.3–42.7%)), inadequate operation and maintenance (31.3% (20.8–41.8%)), and weak financial management (31.4% (19.6–43.2%)). Key challenges included inadequate training, costly spare parts, poor-quality materials, weak institutional support, and limited community engagement. Addressing these technical, institutional, and social barriers is essential to improving the sustainability of rural water systems and safeguarding public health.