Safe Water Network And The University Of Iowa Conclude Need For More Evidence On Post-2015 Drinking Water Approaches

Safe Water Network presented our findings at the 2015 Water & Health Conference at the University of North Carolina, hosted by the Water Institute. In collaboration with the University of Iowa, School of Public Health we conducted a systematic literature review and key informant interviews on the health impact of intervention strategies in water service delivery in low and middle income countries. This work is important in documenting what the sector already knows about effective strategies so we can optimize our operations, target resources for maximum impact, and identify gaps in sector knowledge. 

Our poster highlighted that, though many drinking water interventions have been conducted and evaluated over recent decades, most have provided free, household level water treatment and storage. Since published studies are a result of these interventions, there are few studies testing economically sustainable approaches. While these studies have generally reported positive impact on diarrhea, benefits are often short-lived as participants revert to former practices once study resources have left. 

The studies we found have limited application to our market-based model for several reasons. Most studies evaluated the effectiveness of delivering intervention resources or promotion messages for free directly to households on disease reduction. These types of intervention designs create unique convenience, financial, and social incentives for participants to adopt intervention concepts, and may influence self-reported health benefits. Interventions that hand-deliver free water supply, treatment, or storage resources for free on a house by house basis are not logistically and financially scalable or sustainable, yet there is otherwise insufficient evidence to understand how these intervention design elements influence intervention success. Few community-level interventions qualified for inclusion, and of those most did not include software (e.g. behavior change, social marketing) elements designed to increase people’s acceptance, adoption and use. Even fewer studies evaluated interventions that required participants to support some or all financial costs independently. Most studies use self-reported data and are un-blinded, making them prone to bias. 

With the Sustainable Development Goals come a commitment to sustainable solutions. The market-based community model is part of the response to the global water crisis, whether as the primary source of clean water in communities or as complementary to government supply. Research needs to catch up to these post-2015 approaches. As part of our ongoing efforts to assess and improve the model, we will next conduct an independent assessment of our Stations in Ghana and India to validate the viability of the model along operational, financial, and consumers parameters.