Evaluating a Water Quality Assurance Fund Intervention in Ghana and Kenya

NCT ID: NCT06570005

Last Updated: 2024-08-26

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 4800 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2022-12-06
• Study Completion Date: 2025-09-30

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.

Conditions

Water Quality; Water Treatment; Knowledge; Satisfaction

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: SEQUENTIAL
• Primary Study Purpose: OTHER
• Blinding Strategy: NONE

Study Groups

Assurance Fund Intervention Arm 1

In this study arm, intervention activities will start after initial baseline data collection.

Group Type: EXPERIMENTAL

Water Quality Assurance Fund

Intervention Type: OTHER

• At the water system level: 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 (for up to three concurrent unpaid invoices). Regular debrief meetings will be held with water operators and local government authorities to discuss test results and water treatment options, and to encourage water systems to share water quality information with their consumers. Technical guidance to improve water treatment will be provided, if requested by water system operators or local government authorities.
• At the community level: Community engagement, primarily at the onset, to inform the community about the water quality testing program and answer questions.

Assurance Fund Intervention Arm 2

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.

Group Type: EXPERIMENTAL

Water Quality Assurance Fund

Intervention Type: OTHER

• At the water system level: 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 (for up to three concurrent unpaid invoices). Regular debrief meetings will be held with water operators and local government authorities to discuss test results and water treatment options, and to encourage water systems to share water quality information with their consumers. Technical guidance to improve water treatment will be provided, if requested by water system operators or local government authorities.
• At the community level: Community engagement, primarily at the onset, to inform the community about the water quality testing program and answer questions.

Assurance Fund Intervention Arm 3

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.

Group Type: EXPERIMENTAL

Water Quality Assurance Fund

Intervention Type: OTHER

• At the water system level: 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 (for up to three concurrent unpaid invoices). Regular debrief meetings will be held with water operators and local government authorities to discuss test results and water treatment options, and to encourage water systems to share water quality information with their consumers. Technical guidance to improve water treatment will be provided, if requested by water system operators or local government authorities.
• At the community level: Community engagement, primarily at the onset, to inform the community about the water quality testing program and answer questions.

Non-randomized Arm

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.

Group Type: EXPERIMENTAL

Water Quality Assurance Fund

Intervention Type: OTHER

• At the water system level: 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 (for up to three concurrent unpaid invoices). Regular debrief meetings will be held with water operators and local government authorities to discuss test results and water treatment options, and to encourage water systems to share water quality information with their consumers. Technical guidance to improve water treatment will be provided, if requested by water system operators or local government authorities.
• At the community level: Community engagement, primarily at the onset, to inform the community about the water quality testing program and answer questions.

Interventions

Water Quality Assurance Fund

• At the water system level: 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 (for up to three concurrent unpaid invoices). Regular debrief meetings will be held with water operators and local government authorities to discuss test results and water treatment options, and to encourage water systems to share water quality information with their consumers. Technical guidance to improve water treatment will be provided, if requested by water system operators or local government authorities.
• At the community level: Community engagement, primarily at the onset, to inform the community about the water quality testing program and answer questions.

Intervention Type: OTHER

Eligibility Criteria

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.

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.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

United States Agency for International Development (USAID)

FED

Sponsor Role: collaborator

Conrad N. Hilton Foundation

OTHER

Sponsor Role: collaborator

The Leona M. and Harry B. Helmsley Charitable Trust

OTHER

Sponsor Role: collaborator

Kwame Nkrumah University of Science and Technology (KNUST)

UNKNOWN

Sponsor Role: collaborator

Water Mission

UNKNOWN

Sponsor Role: collaborator

The Aquaya Institute

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Valerie Bauza, PhD

Role: PRINCIPAL_INVESTIGATOR

The Aquaya Institute

Locations

The Aquaya Institute

Accra, , Ghana

Site Status: RECRUITING

The Aquaya Institute

Nairobi, , Kenya

Site Status: RECRUITING

Countries

Ghana; Kenya

Central Contacts

Valerie Bauza, PhD

Role: CONTACT

valerie@aquaya.org

4148011025

Caroline Delaire, PhD

Role: CONTACT

caroline@aquaya.org

Facility Contacts

Bashiru Yachori

Role: primary

bashiru@aquaya.org

233246884576

Peace Musonge

Role: primary

peace@aquaya.org

32489116884

Other Identifiers

REAL-Water Assurance Fund

Identifier Type: -

Identifier Source: org_study_id