Public perceptions of drinking water pollution and associated health risks in eastern Nepal

Access to clean and safe drinking water remains a major challenge in Nepal in rapidly urbanizing municipalities. This study used a quantitative approach, surveying a sample comprising 69.95% males and 30.05% females aged 25–44 years (67.78%), in Nepal's two easternmost municipalities. Tube wells were the primary drinking water source for 68% of households. Only 25% had tested their water; limited knowledge (58%) was the main barrier, 69% of respondents said that they used filters, distrust and inconvenience hindered wider adoption. Eighty per cent identified perceived pollution sources and 96.63% linked perceived contamination to disease, yet no respondents had participated in awareness programs. Storage practices were inadequate; households relied on earthen pots (43%), bottles (40%), and buckets (16%) with irregular cleaning. Our analysis showed strong linkage between water color, taste, and pollution sources, whereas poor storage and lower-income levels were strong predictors of post-storage discoloration. Seventy-five per cent of households were categorized as very high risk, with diarrhea (35.59%) being the most reported disease, disproportionately affecting children (0–12 years) and the elderly (>60 years) based on the questionnaire. The study shows that there is an urgent need for community-based awareness programs, improved water quality monitoring, and targeted policy interventions aligned with Sustainable Development Goal 6.