Spatial disparities in drinking water access and household water treatment practices in India

Scarcity and poor quality of water pose significant risks, particularly in low- and middle-income countries. This study assesses the source of drinking water and the treatment practices adopted for purifying the water in India using the fifth round of National Family Health Survey (2019–21). Information on the primary source of drinking water and its treatment was collected from 6,36,699 households. Drinking water sources were classified into three categories: Piped water, Other Improved sources and Unimproved sources, while treatment methods were classified as No treatment, Rudimentary treatment and Improved treatment. Findings indicated a gradual increase in piped water access over the years in India, particularly in rural areas, where coverage rose from 19.6 percent in 1993 to 38.0 percent in 2021. However, only 47.86 percent of households nationally had piped water access as of 2019–21, while 46.3 percent relied on other improved sources and 5.8 percent on unimproved sources. The subnational-level analysis showed that states such as Goa (92.61%), Chandigarh (94.38%) and Delhi (81.48%) had the highest percentage of households with access to piped drinking water facilities. Water treatment practices remain inadequate, with 58.3 percent of households reporting no treatment method. Rudimentary treatment methods that offer no meaningful pathogen reduction were reported by 15.8 percent of households and Improved treatment was practised by only 25.9 percent. States such as Bihar (92.0%), Uttar Pradesh (88.2%) and West Bengal (86.8%) recorded the highest proportions of untreated water consumption, while Kerala (93.3%), Nagaland (94.0%) and Lakshadweep (89.4%) recorded the highest uptake of effective treatment. A multivariate logistic regression analysis identified rural residence, lower wealth index, Scheduled Tribe category and lower educational attainment as significant predictors of reliance on other improved and unimproved water sources, as well as reduced uptake of effective treatment. Significant district-level spatial disparities were identified across India. These findings underscore the urgent need for targeted, sub-national policy interventions aligned with the Jal Jeevan Mission and SDG 6.1.