WHO & UNICEF Toolkit for Monitoring & Evaluating Household Water Treatment and Safe Storage
•Download as PPT, PDF•
3 likes•826 views
By Ryan Rowe , Water Institute at UNC. Prepared for the Monitoring sustainable WASH service delivery symposium, Addis Ababa, Ethiopia, 9-11 April 2013.
Recommended
Recommended
More Related Content
What's hot
What's hot (12)
Viewers also liked
Viewers also liked (15)
Similar to WHO & UNICEF Toolkit for Monitoring & Evaluating Household Water Treatment and Safe Storage
Similar to WHO & UNICEF Toolkit for Monitoring & Evaluating Household Water Treatment and Safe Storage (20)
More from IRC
More from IRC (20)
Recently uploaded
Recently uploaded (20)
WHO & UNICEF Toolkit for Monitoring & Evaluating Household Water Treatment and Safe Storage
- 1. WHO & UNICEF Toolkit for Monitoring & Evaluating Household Water Treatment and Safe Storage IRC Symposium: Monitoring Sustainable WASH Service Delivery Addis Ababa, Ethiopia April 9-11, 2013 Ryan Rowe Water Institute at UNC
- 2. Improving access to safe water
- 3. Looking closer UNIMPROVED | IMPROVED | PIPED Unserved Urban Rural Rural Urban Urban piped piped supplies + supplies supplies + strong weak regulation regulation Collect water from Collect Collect Water piped into house/onto (developed unprotected sources water from water from plot; supply may be irregular, countries) protected protected quality may be compromised sources sources away from away from home home 0.8 billion 0.7 1.7 1.2 billion 1.8 billion 0.8 billion people billion billion people people people people
- 4. Interim Household water Treatment and Safe Storage Facilitating access to higher levels of service for households Unserved Urban Rural Rural Urban Urban piped piped supplies + supplies supplies + strong weak regulation regulation Collect water from Collect Collect Water piped into house/onto (developed unprotected sources water from water from plot; supply may be irregular, countries) protected protected quality may be compromised sources sources away from away from home home 0.8 billion 0.7 1.7 1.2 billion 1.8 billion 0.8 billion people billion billion people people people people Improved system reliability, safety
- 5. Starting points Who really needs HWTS? •Water safety plans – example? • Target those at high risk (cholera) • People living with HIV (crypto) • Safe water plus nutrition • School-based WASH • Emergency response
- 6. Motivation for toolkit • Huge unmet need 12 • Need knowledge of failures & 20r successes be to Oc • Improve quality and in comparability of data d he • Harmonise activities by is bl governments, donors, Pu researchers, practitioners
- 7. Challenges in achieving full benefit Correct and consistent use / Effective use Chart source: Brown & Clasen, 2012. needed for health impact
- 8. Uses for the toolkit • Purpose of HWTS and proven methods • Designing and conducting M&E activities • Choosing and using 20 harmonised indicators • Case studies from the field • Annexes – Example surveys and sanitation safety plan forms – Links and resources for program design, implementation – Water quality monitoring field test options
- 9. Measure outputs & outcomes Focus is on outputs and outcomes. Focus is NOT on health impact which requires careful selection of comparison group, rigorous data collection and review, complicated statistics.
- 10. 20 recommended indicators • Research-tested, common sense, stakeholder reviewed • Sample survey available in the toolkit • Mix and match according to your needs and constraints
- 11. Reported and observed use • Self-reported data not as reliable – Did you do anything to make the water safer to drink? How … ? • Confirm through direct observation Tufts/ D Lantange – Ask to see the treatment method, stored water; Is the device wet? • % households with REPORTED, OBSERVED use provides a more reliable indicator of level of uptake
- 12. Correct and consistent use • Knowing not always doing – habits hard to change! – Do they know how to treat? Where do they draw their water? What about vulnerable members of household? • Confirm through demonstrated use • % households with CORRECT, CONSISTENT suggests knowledge and behaviour change • Multi-step products require additional training and support (Lantagne & Clasen, 2012) but may be more effective
- 13. Assessing water quality • Added element of objectivity and measure of risk • Common parameters – Turbidity, chlorine residual, bacterial indicators (e.g. presence/absence of E.coli or TTC), arsenic, fluoride • Use field-proven and Tufts/ D Lantange performance tested methods! • % of households with EFFECTIVE use derived from measuring water quality before and after Tufts/ D Lantange
- 14. Deciding which indicators to use 14
- 15. Interpreting data, share lessons What works, what does not? Share results for feedback and improvement Correct, consistent and effective use can reasonably be linked to health impact WHO/ M Montgomery WHO & UNICEF International Network on Household Water Treatment and Safe Storage Join 140 organisations and 1400 people – free membership! Learn more: http://www.who.int/household_water/en Subscribe: hwtsnetwork@unc.edu
- 16. Effective M&E of HWTS For hands-on practice, join our workshop! Correct and Consistent Use / Effective Use 20 recommended indicators Integrating M&E in program design and implementation This Friday, 9am-12:30pm, IBEX Coffee, tea, snacks, water, notepads, pens provided All participants will receive a printed, bound toolkit.
- 17. Thank you. Ameseginalehu. Questions? Acknowledgements: Aquaya, Daniele Lantagne (Tufts), Maggie Montgomery (WHO) Download the toolkit: http://www.who.int/household_water/en Join the Network hwtsnetwork@unc.edu
Editor's Notes
- Engage the audience with a couple of questions to start [1 minute] Walk into the audience and ask for a show of hands as to how many people have experience with HWTS, either in funding, implementation, and/or M&E. Some of you are familiar with the issues affecting M&E of HWTS, right? Are there any brave souls who’d like to volunteer and identify some of these?
- So, this is a familiar slide, right? Can anyone tell me what’s wrong with it? Still 780 million people using unimproved sources of water. Improved sources of water are not a guarantee of quality. Once infrastructure has been built, there are risks such as pipe breaks, supply discontinuities, poor drainage, and proximity to latrines and animal waste, which can contaminate the water supply.
- If we look a little closer, we know that those living in rural and urban areas with access to improved sources still often face the risk of consuming contaminated water as a result of unsafe practices around the transportation, handling and storage of that drinking water. Yesterday, I heard from one WASH Program Manager who was lamenting that his organisation had constructed 240 boreholes in Uganda to provide safe drinking-water but that people were still turning up with dirty jerry-cans. Even those with piped water supplies face interrupted supplies or weak regulation which can lead to water quality being compromised. [1 minute]
- So, we have this entire group of people here which, while waiting for improved service delivery and water safety, must depend on treating their own water in the interim period. Is it a stretch to say that as many as 6 billion people may be the target group for organisations working on HWTS. Perhaps. But I think that its important to realise that the need for safe water encompasses a range of populations, income groups and service levels.
- One of the key starting points for HWTS is identifying the households and individuals who need it the most. At a high level, the WHO has proposed Water Safety Plans as a framework for assessing and managing risks and ensuring drinking water safety from catchment to consumer. HWTS is one of those mitigation mechanisms. Can someone volunteer an example of a risk to the water supply that would create the need for HWTS? If no one volunteers, use the example of leaky pipes and low pressure which allows bacteria to seep into the system. Great. Here are some other examples. HWTS is a mechanism for preventing and controlling the spread of cholera. It is an essential intervention for people living with HIV, for whom cryptosporidosis can be a fatal infection. It can also help to interrupt the vicious cycle of diarrhoea and malnutrition. It’s also important in schools, where kids can be change agents. And emergency response is one that many are familiar with.
- [1 minute] So we know there is a huge unmet need. But there are many complexities in implementing HWTS, relating to which product to pick, training people to use it the right way, every time they need drinking water, and making sure the product works. Then there are issues with spare parts and cost which also affect sustainability. There have many been many studies on HWTS, but there have been criticisms, such as a reliance on self-reported data, a short study time, or unrealistic conditions. There are also various challenges in conducting user-blinded studies to effectively evaluate use. So this toolkit has been organised to provide a set of methods, tools and indicators that can organise donors, researchers and practitioners, so that data becomes more comparable, results are more bankable, and greater investment in HWTS as an interim safe water solution can be justified.
- Correct, consistent, sustained use [Brown J, Clasen T (2012) High Adherence Is Necessary to Realize Health Gains from Water Quality Interventions. PLoS ONE 7(5)]
- Overview of the document [1 minute]
- Another familiar slide. only thing missing here that was in the background paper is a box for “throughput” which refers to sector capacity to deliver services.
- Developed using indicators developed out of the USAID Hygiene Improvement Project and the PSI POUZN Project. Reviewed by stakeholders from private sector, research institutions, development agencies and NGOs/practitioners. Behaviour change factors such as user aspirations and social norms. Economic factors, such as cost-effectiveness or willingness to pay. Quality of implementation – ie process monitoring relating to the amount of time you spend with your users, fidelity, etc.
- Improving water quality to reduce diarrheal diseases is the ultimate goal of HWTS. Some organisations may wish to monitor improved quality as an outcome of their programs. Here are some common parameters. The turbidity of the source water is an important one because it influences the choice of treatment method. Some methods, such as chlorine based or solar disinfection, are less effective in turbid water because pathogens attach can attach themselves to the particles and “hide”. For other methods, such as filters and flocculation, turbidity reduction is an important performance metric. Reducing microbiological contamination is another common goal. Methods for measuring this range from the simple to the costly and complicated. Effective use: The effective use metric clearly identifies whether the people using the HWTS method were at risk of waterborne disease; and whether use was effective in reducing exposure to microbial contaminants. In order to have effective use of a HWTS method, 1) the method must be used by a household that needs it (i.e. a household with contaminated water); 2) the method must effectively remove pathogens; and 3) households must use the method correctly to reduce the contamination to internationally accepted levels.
- This decision tree will allow users to select which indicators are the most important for evaluating their program effectiveness and achieving their goals, within the time and resource constraints faced by their organisation. The decision tree sets out key program M&E questions, and allows you to choose essential indicators and add others as needed. For example, an organisation conducting community demonstrations may wish to monitor, in real-time, whether households are acquiring the knowledge to perform HWTS. In this scenario, requesting demonstrations may be too time-consuming.
- The toolkit is a resource for designing, implementing, monitoring and evaluating household water treatment projects and programmes and focusing efforts on ensuring that those programs are designed to achieve correct, consistent and effective use of household water treatment. The
- We won’t be slave drivers but come prepared to work your brain a little bit.
- Potential questions: Is a household water indicator intended to be included in the new indicators post-2015? Is a water quality indicator going to be included post-2015?