Abstract
BACKGROUND AND OBJECTIVE: Access to clean drinking water is essential for health and development. Despite global and national initiatives, many regions in India continue to face inadequate water access. This study assesses progress, sociodemographic determinants and geographic disparities in access to drinking water in India, aligning with Sustainable Development Goal (SDG) 6.1. DESIGN: This study used secondary data from five rounds of the National Family Health Survey (NFHS-1 to NFHS-5; 1992-2021), nationally representative surveys conducted across India. Logistic regression was employed to examine the association between household sociodemographic characteristics and access to improved drinking water. A Water Access Index (WAI) was constructed using Principal Component Analysis (PCA) based on four indicators: access to improved sources, on-premises availability, 5-minute round-trip access and household water treatment. The scores were normalised to a 0-100 scale. SETTING AND PARTICIPANTS: The study used household data from NFHS-1 (88 562 households), NFHS-2 (92 477), NFHS-3 (109 041), NFHS-4 (601 506) and NFHS-5 (636 699), covering all 36 states/union territories in India. RESULTS: There has been a notable improvement in access to improved sources, on-premises water and timely availability. Factors such as higher educational attainment, pucca housing and the absence of a below poverty line card were positively associated with better access. Based on WAI scores, 343 districts (49%) were categorised as front runners (65-99%), 142 districts (20%) as performers (50-64%) and 221 districts (31%) as aspirants (0-49%). Only one district (0.1%) achieved universal access. Many districts in West Bengal, Bihar, Odisha, Jharkhand and other states still exhibit low-to-moderate water access. CONCLUSION: While access to improved drinking water has advanced, regional and socioeconomic disparities remain stark. Targeted, multisectoral policies are essential to ensure equitable progress towards SDG 6.1 across all districts and population groups in India.