The objective of this study is to evaluate the effects of a novel financial and capacity strengthening intervention (the 'Water Quality Assurance Fund' program) on water safety management in rural Ghana and Kenya. The investigators hypothesize the intervention will improve water system operator knowledge, chlorination practices, and water quality at the point of collection, as well as improve consumer satisfaction, awareness, and willingness-to-pay for water that is tested and treated.
Regular water quality monitoring by water suppliers is essential for maintaining adequate treatment processes and verifying safe water quality to protect public health. Yet, many small water suppliers are unable to conduct regular water quality tests due to financial, logistical, and capacity constraints. The goals of the Water Quality Assurance Fund program are to address these constraints by incentivizing established laboratories to extend their services to these smaller water systems and, in parallel, promote the use of water quality data for better water safety management. The objective of this study is to evaluate the effects of a novel financial and capacity strengthening intervention (the 'Water Quality Assurance Fund' program) on water safety management in rural Ghana and Kenya. As part of the intervention, written legal agreements between water systems, centralized laboratories, and the organization facilitating the Assurance Fund will provide water systems with regular water quality testing and provide laboratories a guarantee of payments if water systems fail to pay for testing services on time. The Assurance Fund program will also deliver capacity strengthening, technical guidance, and community sensitization activities. The investigators hypothesize the intervention will improve water system operator knowledge, chlorination practices, and water quality at the point of collection, as well as improve consumer satisfaction, awareness, and willingness-to-pay for water that is tested and treated. A secondary aim is to assess implementation challenges and enabling factors associated with the expansion of water testing services by existing professional water quality laboratories to rural water suppliers.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
4,800
* At the water system level: Written legal agreements between water systems, centralized laboratories, and the organization facilitating the Assurance Fund will provide water systems with regular water quality testing and provide laboratories a guarantee of payments if water systems fail to pay for testing services on time (for up to three concurrent unpaid invoices). Regular debrief meetings will be held with water operators and local government authorities to discuss test results and water treatment options, and to encourage water systems to share water quality information with their consumers. Technical guidance to improve water treatment will be provided, if requested by water system operators or local government authorities. * At the community level: Community engagement, primarily at the onset, to inform the community about the water quality testing program and answer questions.
The Aquaya Institute
Accra, Ghana
RECRUITINGThe Aquaya Institute
Nairobi, Kenya
RECRUITINGAdequate free chlorine residual in water at the point of collection
Free chlorine residual in water at the point of collection above targeted levels of 0.2 mg/L.
Time frame: Baseline, 6-months, 12-months, 18-months, 24-months
Detectable free chlorine residual in water at the point of collection
Free chlorine residual in water at the point of collection above detectable levels of 0.1 mg/L.
Time frame: Baseline, 6-months, 12-months, 18-months, 24-months
E. coli in water at the point of collection
E. coli in water at point of collection (binary and categorical).
Time frame: Baseline, 6-months, 12-months, 18-months, 24-months
Water system operator knowledge
Water system operator knowledge related to water quality (score out of 32 points on a knowledge assessment).
Time frame: Baseline, 12-months, 24-months
Consumer awareness
Household respondent is aware enrolled water is tested or treated
Time frame: Baseline, 12-months, 24-months
Consumer satisfaction
Household respondent is satisfied with water supplier. They will be considered satisfied if they report they are either very satisfied or somewhat satisfied with the water supplier. They will be considered dissatisfied if they report they are either very dissatisfied or somewhat dissatisfied with the water supplier.
Time frame: Baseline, 12-months, 24-months
Willingness-to-pay
Stated willingness-to-pay for treated and tested water for standpipe and private tap users (% increase and absolute increase in local currency).
Time frame: Baseline, 12-months, 24-months
Adequate free chlorine residual in household stored water
Free chlorine residual in household stored water above targeted levels of 0.2 mg/L.
Time frame: Baseline, 12-months, 24-months
Detectable free chlorine residual in household stored water
Free chlorine residual in household stored water above detectable levels of 0.1 mg/L.
Time frame: Baseline, 12-months, 24-months
E. coli in household stored water
E. coli in household stored water (binary and categorical).
Time frame: Baseline, 12-months, 24-months
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