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Evaluating a Water Quality Assurance Fund Intervention in Ghana and Kenya

Not Applicable
Recruiting
Conditions
Water Quality
Knowledge
Water Treatment
Satisfaction
Interventions
Other: Water Quality Assurance Fund
Registration Number
NCT06570005
Lead Sponsor
The Aquaya Institute
Brief Summary

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.

Detailed Description

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.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
4800
Inclusion Criteria
  • The district or county government was interested in participating in the Assurance Fund program and water systems within the district/county were accessible to a partner central laboratory that was able to provide water sample collection and testing services for a fee.
  • Water systems were functional.
  • Water systems were piped water systems (Kenya, Ghana) or mechanized boreholes with a single tapstand (Ghana).
  • Water systems could afford regular water quality testing from the selected laboratory.
Exclusion Criteria
  • Water systems did not meet above inclusion criteria.

To be eligible to participate in household surveys, participants need to be at least 18 years of age and a customer of a eligible water system.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
Assurance Fund Intervention Arm 1Water Quality Assurance FundIn this study arm, intervention activities will start after initial baseline data collection.
Assurance Fund Intervention Arm 3Water Quality Assurance FundThe intervention activities are the same as those described in Arm 1. However, in this study arm, the intervention activities will start 12 months later than those in Arm 1. This arm will serve as a controlled comparison during those initial 12 months.
Non-randomized ArmWater Quality Assurance FundIn Ghana only, there is a fourth study arm that will receive the intervention one month prior to Arm 1. This group was non-randomly selected and will primarily serve to support qualitative lessons learned from the Assurance Fund program.
Assurance Fund Intervention Arm 2Water Quality Assurance FundThe intervention activities are the same as those described in Arm 1. However, in this study arm, the intervention activities will start 6 months later than those in Arm 1. This arm will serve as a controlled comparison during those initial 6 months.
Primary Outcome Measures
NameTimeMethod
Adequate free chlorine residual in water at the point of collectionBaseline, 6-months, 12-months, 18-months, 24-months

Free chlorine residual in water at the point of collection above targeted levels of 0.2 mg/L.

Secondary Outcome Measures
NameTimeMethod
Water system operator knowledgeBaseline, 12-months, 24-months

Water system operator knowledge related to water quality (score out of 32 points on a knowledge assessment).

Consumer awarenessBaseline, 12-months, 24-months

Household respondent is aware enrolled water is tested or treated

Consumer satisfactionBaseline, 12-months, 24-months

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.

E. coli in water at the point of collectionBaseline, 6-months, 12-months, 18-months, 24-months

E. coli in water at point of collection (binary and categorical).

Detectable free chlorine residual in water at the point of collectionBaseline, 6-months, 12-months, 18-months, 24-months

Free chlorine residual in water at the point of collection above detectable levels of 0.1 mg/L.

Detectable free chlorine residual in household stored waterBaseline, 12-months, 24-months

Free chlorine residual in household stored water above detectable levels of 0.1 mg/L.

E. coli in household stored waterBaseline, 12-months, 24-months

E. coli in household stored water (binary and categorical).

Adequate free chlorine residual in household stored waterBaseline, 12-months, 24-months

Free chlorine residual in household stored water above targeted levels of 0.2 mg/L.

Willingness-to-payBaseline, 12-months, 24-months

Stated willingness-to-pay for treated and tested water for standpipe and private tap users (% increase and absolute increase in local currency).

Trial Locations

Locations (1)

The Aquaya Institute

🇰🇪

Nairobi, Kenya

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