Evaluating a Water Safety Plan Intervention in Ghana

Evaluating a Water Safety Plan Intervention in Ghana

The objective of this study is to evaluate the effects of water safety plans (WSPs) in rural Ghana. The investigators aim to evaluate the effects of WSPs on water supply system infrastructure, water availability and reliability, water quality, consumer perceptions, water service provider management and financial sustainability, climate resilience, equity, and consumer health.

Much of the global population is exposed to contaminated drinking water. In piped systems, it is often easier to mitigate at the water supplier level where it can be centrally managed. A water safety plan (WSP) is a holistic tool for proactively ensuring the safety of drinking water supplies from source to tap, and the World Health Organization (WHO) recommends this systematic risk assessment and preventive management approach for water systems.

While application of WSPs has spread, systematic evidence for their implementation and effectiveness in improving water quality and health is limited, particularly in low-resource settings.

The objective of this study is to evaluate the impact of WSPs on water supply system infrastructure, water availability and reliability, water quality, consumer perceptions, water service provider management and financial sustainability, climate resilience, equity, and consumer health. The investigators will use a randomized controlled trial across 92 piped water supply systems serving small towns and rural areas in Ghana to test the effectiveness of WSPs. The investigators will collect data at baseline before the intervention is implemented, and at endline approximately 2 years after implementation begins. The investigators will also conduct a process evaluation of the WSP implementation quality.

Eligibility to receive the intervention was determined by water system criteria:

Inclusion Criteria:

• Water systems must be operated by a partnering private, non-profit water supplier.
• Water systems must be functional during baseline data collection.

To be eligible to participate in household surveys or focus group discussions, participants need to be at least 18 years of age and a customer of a eligible water system. To be eligible to participate in health care facility interviews, participants must be at least 18 years of age and work at a health care facility that serves community members using the included water system.

Exclusion Criteria:

• Water systems did not meet both of the above inclusion criteria.
• Water systems had already implemented a water safety plan.
• Water systems were involved in another ongoing research trial with similar expected outcomes.