This mixed methods research, conducted in January-June 2019, sampled 22 districts from food-insecure areas in the Amhara and Afar regions of Ethiopia. From the 22 districts, which represent nearly one third of all districts in each region, 111 water services classified as \"basic\" were randomly selected. For each selected water service, research included: water quality sample testing, visual observation of water services, interviews and focus group discussions with the associated water managerial committee members. Descriptive statistics frequency, percent, mean, median, standard deviations, normal tables, cross-tables and graphs are used to present the data.
Although the international water standard for thermotolerant coliform (TTC) levels is 0 CFU/100ml, in our sample of 111 water services, the maximum TTC counts were 71 CFU/100 ml and the mean was 4 CFU/100 ml. Thermotolerant coliform counts were above the permissible standard values for nearly 40% (n = 111) of the basic water services. TTC was detected in 44 (39.64%) (n = 111) basic water services. Of these, 38 (34.23%) were operationally functional while 6 (5.41%) were not functional. Approximately one third of the basic water services sampled, deemed \"functional\" by international standards, do not provide potable water due to thermotolerant coliform (TTC) levels.
Our findings from the Amhara and Afar regions of Ethiopia demonstrate that water quality parameters are not currently considered in classifying basic water services. This suggests that international efforts to address SDG 6 should incorporate water quality as a key parameter to better track international progress toward \"clean water and sanitation\" efforts. We discuss two potential pathways for stronger inclusion of water quality parameters in international definitions: (1) to mandate water quality within \"functional\" and \"non-functional\" definitions or (2) to add a ladder rung titled \"safe basic water services\" to the international drinking water ladder. Our findings from Ethiopia suggest that additional research should be undertaken in development contexts to assess whether or not \"functional\" basic water services provide safe drinking water to users.