Ensuring universal access to safe drinking water and sanitation, alongside the sustainable management of water resources, is one of the Sustainable Development Goals (SDGs) to be achieved by 2030. However, the sustainability of water supply infrastructures, such as boreholes, remains a major challenge, particularly in sub-Saharan Africa, where access to safe drinking water is among the lowest globally.1 In 2022, the WHO estimated that 2.2 billion people still lacked access to safe drinking water services, and nearly one billion did not have adequate access, with a significant proportion living in rural areas of Africa.2 In the Democratic Republic of Congo (DRC), despite vast freshwater reserves, only 31% of rural areas benefit from improved water sources, exacerbating regional disparities in health and well-being.3,4

The Bolobo Health Zone (HZ) in the DRC is particularly affected, with only 25% of the population covered by drinking water infrastructure. Although efforts have been made to improve coverage, limited financial resources restrict access for much of the population. The lack of functional infrastructure has contributed to recurrent cholera outbreaks, the most recent occurring in 2011.5 Several programs have been launched to reduce waterborne diseases, yet the sustainability of equipment remains problematic.6 Of the 18 boreholes installed in the region, only three remain operational, leaving the population vulnerable to a resurgence of waterborne diseases.

Numerous studies highlight that the sustainability of water supply infrastructures depends on technical, financial, and institutional factors, as well as community participation in management.7–16 Nevertheless, the scope of research remains broad, as many of these studies were conducted in regions with climatic conditions and water use patterns different from those in Bolobo. For example, research in arid regions with scarce rainfall reflects population behaviors shaped by water scarcity. In contrast, in Sahelian countries and the Horn of Africa, where agro-pastoral activities heavily depend on water, usage patterns differ significantly from those in Bolobo, an equatorial region characterized by abundant rainfall and freshwater resources, where borehole water is primarily used for domestic needs.

This study therefore aims to identify the factors influencing the sustainability of boreholes in the Bolobo Health Zone, with the objective of contributing to improved water resource management and reducing morbidity and mortality linked to waterborne diseases

II. METHODS

STUDY DESIGN

This research employed an analytical cross-sectional design, conducted between May 13 and June 13, 2023. The design was chosen to allow simultaneous measurement of exposures and outcomes, thereby identifying factors associated with the non-durability of water boreholes in the Bolobo Health Zone.

STUDY FRAMEWORK

The study was carried out in six villages of the Bolobo Health Zone, Mai Ndombe Province, Democratic Republic of Congo (DRC): Mankanza, Mankakiti, Ndwa Batende I and II, and Botanankasa I and II. These villages belong to three health areas, with populations ranging from 1,871 to 5,605 in 2023. Accessibility varied from 7 km (Mankanza) to 27 km (Ndwa Batende). Each village had at least two boreholes installed under the PNVEA program, providing a suitable context for assessing borehole durability.

STUDY POPULATION

The target population consisted of households residing in the six villages and members of local water management committees. The study focused on families using boreholes for domestic water supply, as well as community leaders directly involved in borehole management.

SAMPLING

A total of 367 households and six boreholes were included.

  • Households: The sample size was calculated using the standard formula for estimating proportions, with parameters from the DRC Demographic and Health Survey (2013–2014). Assuming 32% of households had access to potable water, a 95% confidence level (Zα = 1.96), and a 5% margin of error, the minimum required sample was 334 households. To account for non-response, 10% was added, yielding 367 households.

  • Boreholes: Six boreholes (three functional, three non-functional) were selected, representing one-third of all available units across the study area.

Selection process

  • Three health areas were chosen by convenience sampling to represent both functional and non-functional boreholes.

  • Within each, six villages with at least 50 households and boreholes were selected.

  • Households were chosen systematically, with proportional allocation based on village population size.

  • In each household, the head was interviewed; if absent, another adult was considered.

  • Boreholes were selected based on accessibility and functionality to ensure balanced representation.

This design provided a realistic overview of household water access and borehole conditions in the study area.

VARIABLES OF INTEREST

  • Dependent variable: Borehole durability, defined as functional or non-functional. – Independent variables:

    • Technical aspects: maintenance frequency, spare parts availability.

    • Financial factors: user fees, household income.

    • Institutional elements: existence and training of management committees, external support, women’s participation.

    • Socio-demographic characteristics: household size, marital status, occupation, income source, education, and access to basic services.

Operational definitions

  • Borehole functionality: nominal (functional vs. non-functional).

  • Lifespan: measured in years, grouped into two intervals (0–5 and 6–10 years).

  • Household size: small (<5 members) vs. large (≥5 members).

  • Income: low (<$1.25/day) vs. high (≥$1.25/day).

  • Occupation: employed vs. unemployed.

  • Education: none, primary, secondary, higher.

  • Sex: binary (male/female).

These definitions ensured transparency and reproducibility.

DATA COLLECTION

Two complementary techniques were used:

  • Document review: PNVEA records and local health office reports.

  • Structured interviews: Semi-open questionnaire administered to household heads and water committee members.

Fieldwork organization:

  • Six trained interviewers, each assigned to one village.

  • Three supervisors, one per health area.

  • All were fluent in local dialects, ensuring effective communication.

  • A pre-test was conducted to validate the questionnaire and estimate interview duration.

  • Briefings were organized for each team to standardize procedures and ensure methodological rigor.

DATA ANALYSIS

Data were processed using SPSS version 25.

  • Univariate analysis:

Continuous variables summarized using measures of central tendency and dispersion.

Normally distributed variables described by mean and standard deviation.

Non-normal distributions described by median and interquartile range.

Categorical variables presented as relative frequencies in tables and charts.

  • Bivariate analysis: Chi-square test applied to assess associations between categorical variables.

  • Multivariate analysis: Logistic regression performed by including all variables with p < 0.20 in the bivariate analysis. Only variables with p < 0.05 in the multivariate model were considered significant. Odds ratios (OR) and 95% confidence intervals (CI) were calculated to evaluate the strength of associations.

Extremely high odds ratios observed in some cases were realistic given the data but may also reflect the small sample size and contextual uniqueness. These results should therefore be interpreted with caution.

ETHICAL CONSIDERATIONS

Ethical approval was obtained from the Provincial Health Ethics Committee of Mai Ndombe. Informed consent was secured from all participants prior to interviews. Confidentiality was guaranteed by anonymizing household data and restricting access to research files. Participation was voluntary, and respondents were free to withdraw at any stage without consequence.

The study adhered to ethical principles of respect, beneficence, and justice, ensuring that findings contribute to improving community health and water resource management

RESULTS

SOCIO-DEMOGRAPHIC AND ECONOMIC CHARACTERISTICS OF HOUSEHOLD HEADS

The survey population was largely male (78.6%) and concentrated in the 36–45 age group (31.9%). Education was dominated by the primary level (49.3%), while only 4% had higher or university training. Occupations were mainly agro-pastoral and fishing (52.2%), reflecting rural livelihoods. Marital status showed strong household stability, with 83% of respondents living in union compared to 17% without union. (Table 1).

Table 1.Socio-demographic and economic characteristics of heads of households.
Variables Categories Frequency %
Sex Male 288 78.6
Female 79 21.4
Age of respondent 18–25 61 16.7
26–35 89 24.3
36–45 117 31.9
46 and above 85 23.2
Don’t know 7 1.8
Education level No level 50 13.7
Primary 180 49.3
Secondary 121 33.0
Higher/University 15 4.0
Occupation No occupation/housewife/student 64 17.4
Public sector 60 16.3
Private 51 14.1
Agro-pastoral and fishing 192 52.2
Marital status Living in union 305 83.0
Living without union 62 17.0

HOUSEHOLD SIZE AND INCOME DISTRIBUTION

More than eight out of ten households (85.1%) reported low income, below USD 1.25 per day, underscoring the widespread economic precariousness in the study area. Furthermore, nearly all households (98.9%) were large, exceeding the national average of 5.3 persons per household. This reflects a typical family structure in the region, characterized by extended households with limited financial resources (Table 2).

Table 2.Distribution of households by size and income
Variables Terms and conditions Frequency (n=367) %
Household income
<1.25 USD/day 312 85.1
>=1.25 USD/day 55 14.9
Household size
< 5 4 1.1
<= 5 363 98.9

BOREHOLE LIFESPAN AND NON-FUNCTIONALITY

Among the six boreholes assessed, half had a lifespan of 0–5 years, while the other half had been in use for 6–10 years, indicating a balanced distribution between short and medium lifespans. Regarding non-functionality, one third (33.3%) of boreholes aged 0–5 years had stopped working within the past year, while two thirds (66.7%) had been non-functional for more than two years. These results highlight weaknesses in maintenance and the inability of management groups to ensure long-term sustainability of installations (Table 3).

Table 3.Distribution of households according to payment and satisfaction with water service prices
Variable Modality Frequency %
Water payment (n=367)
Yes 305 83
No 62 17
Satisfaction with water price ( n=305)
Yes 299 98
No 6 2

HOUSEHOLD CONTRIBUTION AND SATISFACTION WITH WATER SERVICE FEES

Of the 367 households surveyed, 83% reported contributing financially to water services, demonstrating strong community support for infrastructure maintenance. Among the 305 contributing households, 98% expressed satisfaction with the price charged, suggesting that the tariff system is widely perceived as fair and acceptable (Table 4).

Table 4.Distribution of heads of households according to contribution to payment (FC), payment method and cost satisfaction
Variables Terms and conditions Frequency %
Payment for borehole water
Yes 305 83
No 53 17
Payment method
At the pump 307 83.7
Weekly 60 16.3
Satisfaction/Cost
Yes 298 81.2
No 69 18.8
Average price of a 25L container 50.36±4.25

PAYMENT MODALITIES AND COST SATISFACTION

The majority of household heads (83%) contributed to borehole water payments, with an average cost of 50.36 ± 4.25 Congolese Francs per 25-liter container. Most respondents (83.7%) paid directly at the pump, while 16.3% opted for weekly payments. Satisfaction levels were high, with 81.2% of respondents satisfied with the cost, although 18.8% expressed dissatisfaction (Table 5).

Table 5.Distribution of boreholes according to service life and non-functionality time
Variable Terms and conditions Frequency %
Drilling life (n=6)
0 to 5 years 3 50
6 to 10 years old 3 50
Non-functional duration (n=3)
Less than a year 1 33.3
More than two years 2 66.7

RESPONDENTS’ KNOWLEDGE OF TECHNICAL FACTORS

The survey revealed significant gaps in technical knowledge essential for effective borehole management. A large proportion (77.5%) reported that management committees had not received training, indicating limited organizational preparedness. Spare parts were almost universally unavailable (97.8%), representing a critical weakness in maintenance capacity. On a positive note, 51.1% acknowledged the presence of trained artisans capable of performing repairs, and 50.4% considered repair capacities sufficient. This suggests a mixed situation, with some technical skills available but insufficient support systems to ensure sustainability (Table 6).

Table 6.Distribution of respondents according to their knowledge of technical factors
Variables Terms and conditions Frequency %
Management group formation
Yes 83 22.5
No 284 77.5
Spare parts availability
Yes 8 2.2
No 359 97.8
Existence of trained artisans
Yes 141 51.1
No 135 48.9
Repair/Fault Capacity
Yes 188 50.4
No 179 49.6

FACTORS ASSOCIATED WITH BOREHOLE SUSTAINABILITY

Multivariate analysis confirmed several significant predictors of borehole sustainability. Low household income remained associated with reduced functionality (aOR = 1.011; 95% CI: 1.001–1.059; p = 0.021). Training of management groups strongly improved sustainability (aOR = 14.22; 95% CI: 2.45–82.1; p = 0.003), while the presence of trained repairers was the most influential factor (aOR = 124.5; 95% CI: 13.2–981.4; p < 0.001).

Household contribution to water payments also enhanced sustainability (aOR = 3.21; 95% CI: 1.54–6.68; p = 0.002). These findings highlight that borehole durability depends not only on technical capacity but also on community organization and financial participation. (Table 7).

Table 7.Bivariate and multivariate regression analysis
Variables Categories ORb (95% CI) p aOR (95% CI) p
Household income < 1.25 USD/day 1.028 (1.020 ; 1.061) 0.018 1.011 (1.001; 1.059) 0.021
≥ 1.25 USD/day 1 1
Household size < 5 members 1.028 (0.996 ; 1.061) 0.031 1.004 (0.98 ; 1.02) 0.734
≥ 5 members 1 1
Management group training Yes 61.13 (8.32 ; 449.14) 0.000 14.22 (2.45 ; 82.1) 0.003
No 1 1
Existence of trained repairer Yes 265.58 (61.89 ; 1139.6) 0.000 24.5 (13.2 ; 981.4) 0.000
No 1 1
Contribution to payment Yes 4.21 (2.15 ; 8.24) 0.000 3.21 (1.54 ; 6.68) 0.002
No 1 1

DISCUSSION

KEYS RESULTS

This study highlights the vulnerability of drinking water systems in the Bolobo Health Zone, where 66.7% of boreholes have been non-functional for over two years. Household heads were mainly middle-aged men engaged in agropastoralism and fishing, with low education levels. Economic precariousness was widespread, as more than 85% of households lived below $1.25 per day, and most families were large. Borehole infrastructure showed limited durability due to weak maintenance and management, though community participation was notable, with many households contributing financially. Technical capacity remained insufficient, with untrained committees and scarce spare parts, despite the presence of trained artisans. Multivariate analysis confirmed sustainability was strongly linked to household contributions, management groups, and repair artisans, while low income reduced durability. Improving borehole sustainability requires reinforcing technical systems, ensuring spare part supply chains, strengthening community organization, and addressing economic vulnerability to secure long-term access to safe water.

FUNCTIONALITY, MAINTENANCE, AND MANAGEMENT OF BOREHOLES

The analysis reveals that boreholes in the Bolobo Health Zone have a limited lifespan, with one third ceasing to function within the past year and two thirds remaining non-functional for more than two years. This situation raises critical concerns about water infrastructure planning, which often appears poorly adapted to local contexts.1–3 Inadequate maintenance is a major cause of dysfunction, as only a minority of boreholes are serviced regularly. Delays in repairs, frequently due to the absence of qualified technicians, further extend downtime. Similar challenges have been reported in Cameroon, where 36% of boreholes lacked repair services,17–20 and in broader sub-Saharan Africa, where up to 40% of rural water points are non-functional at any given time.21 Professionalization of drilling and technical supervision has been emphasized as essential to long-term functionality.17

Community management and governance also play decisive roles. Studies show that participation and local leadership directly influence durability,22 and training of water committees improves performance.23 In Kenya, active management groups facilitated regular maintenance,7 while in West Africa, weak financial governance compromised sustainability.21,24 In Bolobo, the absence of training and spare parts limits community response, despite the presence of trained artisans. These findings align with evidence linking spare part supply chains to water point functionality.25

It is important to note that some odds ratios observed in this study were extremely high, which may reflect contextual uniqueness or analytical limitations such as overfitting due to small sample size. These results should therefore be interpreted with caution. Overall, borehole sustainability depends on technical quality, reliable maintenance resources, and strong community organization. A holistic approach integrating professional technical support, spare part supply chains, and capacity building for local management structures is indispensable to guarantee long-term access to safe drinking water.2,11,13,14

SOCIO-ECONOMIC, TECHNICAL, AND FINANCIAL FACTORS

Socio-economic conditions play a decisive role in borehole sustainability in Bolobo. Low-income households were twice as likely to negatively affect durability, as they lacked the financial capacity to contribute to maintenance. This finding aligns with evidence that poverty undermines rural communities’ ability to sustain water systems.12 User contributions are critical, with payment mechanisms increasing sustainability by fourfold.11 Economic vulnerability thus limits affordability and weakens community ownership, which is essential for long-term management.

Technical factors also emerged as major determinants. The absence of repair technicians and scarcity of spare parts were critical obstacles. The presence of trained artisans was strongly associated with improved durability, underscoring the importance of local expertise. Spare part availability has been directly linked to water point functionality,25 confirming that maintenance capacity depends on reliable supply chains. Without adequate technical support, even well-constructed boreholes are prone to breakdowns.15,16 Strengthening local repair networks and ensuring spare part access are therefore indispensable.

Financial governance within water committees further explains fragility. Only 5% maintained savings accounts, and nearly all managers were unpaid, reducing accountability. Similar challenges have been observed in West Africa, where weak financial management compromised infrastructure.21 Transparent governance and fund management are crucial for sustainability.22 In Bolobo, the lack of structured financial mechanisms undermines committees’ ability to respond to breakdowns, despite households’ willingness to contribute.

These findings underscore the need for a holistic approach that combines economic empowerment, technical reinforcement, and transparent financial governance to ensure long-term access to safe drinking water and reduce vulnerability to waterborne diseases.2,13,14

WOMEN’S PARTICIPATION IN BOREHOLE MANAGEMENT

Although women often represent the majority of members in community water management committees, their role in strategic decision-making remains limited. This reflects broader gender inequalities in governance, where women are frequently relegated to subordinate or operational tasks rather than leadership positions. In Burkina Faso, women’s involvement was largely symbolic, with little influence over financial or technical decisions.19 Comparable findings show that gendered power relations restrict women’s agency, even when they are numerically dominant.17 Exclusion from decision-making undermines sustainability, as women’s perspectives on household water use and community needs are often overlooked.18,24 More recently, empowering women in leadership roles has been shown to enhance accountability and ensure that governance reflects the priorities of all users.26,27

In Bolobo, strengthening women’s participation in strategic functions of committees could improve transparency, foster inclusiveness, and ultimately contribute to the long-term sustainability of borehole infrastructure. Addressing gender imbalances is therefore not only a matter of equity but also a practical strategy for improving water governance and ensuring reliable access to safe drinking water.

STRENGTHS AND LIMITATIONS

This study’s strengths lie in its multidimensional approach, examining socio-economic, technical, and institutional factors together to provide a comprehensive understanding of borehole sustainability in rural DRC. Guided interviews with household heads and water committee members captured local perspectives, while statistical analysis added rigor.

However, the small sample size of six villages limits generalizability, and the cross-sectional design prevents causal or long-term conclusions. Reliance on self-reported data may have introduced recall or social desirability bias. Extremely high odds ratios observed should be interpreted cautiously, as they may reflect contextual uniqueness or analytical limitations such as overfitting.

Despite these limitations, the study offers a valuable foundation for future longitudinal and comparative research to strengthen rural water governance and infrastructure sustainability.

CONCLUSION

Borehole sustainability in Bolobo is undermined by socio-economic constraints, technical challenges, and weak governance. Low household income limits contributions to maintenance, while scarce spare parts and few trained repairers compromise durability. Financial committees lack accountability, despite community willingness to contribute. Strengthening repair networks, supply chains, and inclusive management, especially women’s leadership, can improve transparency and ensure long-term safe water access. Larger, longitudinal studies are needed to validate findings and guide sustainable rural water governance.

ACKNOWLEDGEMENTS

The authors express their sincere gratitude to all those who contributed their time and expertise to the development of this study. Special thanks are extended to the field investigators, supervisors, and key informants, whose support was indispensable to the successful completion of this research.

ETHICS STATEMENT

This study was approved by the Ethics Committee of the School of Public Health, University of Kinshasa, ensuring compliance with prevailing ethical standards. Informed consent was obtained from all participants prior to data collection.

DATA AVAILABILITY

The datasets generated and analyzed during this study are available from the corresponding author upon reasonable request. Access to these data by third parties will only be granted in cases of extreme necessity and with the express authorization of the key informants. Readers may contact the corresponding author for further information.

FUNDING

This research received no external funding.

AUTHORSHIP CONTRIBUTIONS

  • André Asuka: Conceptualization, methodology, data collection, and drafting of the manuscript.

  • Tshefu Kitoto Antoinette: Data analysis, interpretation, and critical revision of the manuscript.

  • Miyalu Junior: Literature review, validation, and editing. All authors have read and approved the final version of the manuscript and meet the ICMJE authorship criteria.

DISCLOSURE OF INTEREST

The authors completed the ICMJE Disclosure of Interest Form (available upon request) and declare that there are no conflicts of interest related to this study