Meeting and missing targets: the public health dynamics of water and sanitation in Ghana.

Background Access to clean water and good sanitation are very important barometers of a healthy nation as the two are sine qua non to reducing many diseases. The interaction between water and sanitation on the one hand and the public health issues arising from in(efficient) systems of water and sanitation on the other hand have been well encapsulated in the Millennium Development Goals (MDGs) 7c. However, very little is known about the public health dynamics of water and sanitation and the rural–urban divide in accessing these services. This article analyses the trends and distributional concerns of the two MDGs to inform public health policy. Methods The study is a survey of secondary data on water and sanitation obtained from the World Development Indicators of the World Bank and the Joint Monitoring Programme (JMP) of UNICEF and WHO. An unobserved component model was used to decompose the data into its permanent and temporal components. Forecasts are then carried out to ascertain the ability of Ghana to meet the targets of MDG 7c. Results The results of the study showed that Ghana has achieved the MDG target of access to improved water. The sanitation target has been missed, and there is no evidence that it would be met in the short to medium term. Conclusions An integrated approach to bridging the rural–urban divide in access to improved water and sanitation in Ghana is recommended.