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| Name | Class |
|---|---|
| United States Agency for International Development (USAID) | FED |
| Conrad N. Hilton Foundation | OTHER |
| The Leona M. and Harry B. Helmsley Charitable Trust | OTHER |
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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Assurance Fund Intervention Arm 1 | Experimental | In this study arm, intervention activities will start after initial baseline data collection. |
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| Assurance Fund Intervention Arm 2 | Experimental | The 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. |
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| Assurance Fund Intervention Arm 3 | Experimental | The 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. |
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| Non-randomized Arm | Experimental | In 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. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Water Quality Assurance Fund | Other |
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| Measure | Description | Time Frame |
|---|---|---|
| Adequate 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. | Baseline, 6-months, 12-months, 18-months, 24-months |
| Measure | Description | Time Frame |
|---|---|---|
| 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. | Baseline, 6-months, 12-months, 18-months, 24-months |
| E. coli in water at the point of collection |
| Measure | Description | Time Frame |
|---|---|---|
| Water system chlorination frequency | Water system operator reports weekly chlorinating frequency. | Baseline, 6-months, 12-months, 18-months, 24-months |
| Water system revenue | Revenue reported by water systems. |
Eligibility to receive the intervention was determined by water system criteria:
Inclusion Criteria:
Exclusion 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.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Valerie Bauza, PhD | Contact | 4148011025 | valerie@aquaya.org | |
| Caroline Delaire, PhD | Contact | caroline@aquaya.org |
| Name | Affiliation | Role |
|---|---|---|
| Valerie Bauza, PhD | The Aquaya Institute | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Aquaya Institute | Recruiting | Accra | Ghana |
De-identified individual participant data will be made available.
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| ID | Term |
|---|---|
| D010549 | Personal Satisfaction |
| ID | Term |
|---|---|
| D001519 | Behavior |
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| Kwame Nkrumah University of Science and Technology |
| OTHER |
| Water Mission | UNKNOWN |
Stepped-wedge Randomized Controlled Trial
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E. coli in water at point of collection (binary and categorical). |
| 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). | Baseline, 12-months, 24-months |
| Consumer awareness | Household respondent is aware enrolled water is tested or treated | 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. | 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). | 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. | 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. | Baseline, 12-months, 24-months |
| E. coli in household stored water | E. coli in household stored water (binary and categorical). | Baseline, 12-months, 24-months |
| Baseline, 6-months, 12-months, 18-months, 24-months |
| Households use of enrolled water for drinking | Households use of enrolled water for drinking (binary). | Baseline, 12-months, 24-months |
| The Aquaya Institute | Recruiting | Nairobi | Kenya |
|