Evaluating a Water Quality Assurance Fund Intervention in Ghana and Kenya

The Aquaya Institute

Status: Enrolling

Conditions: Water Treatment; Satisfaction; Knowledge; Water Quality

Treatments: Other: Water Quality Assurance Fund

Study type: Interventional

Funder types: Other; Other U.S. Federal agency

Identifiers

NCT06570005

REAL-Water Assurance Fund

Details and patient eligibility

About

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.

Full 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.

Enrollment: 4,800 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Eligibility to receive the intervention was determined by water system 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.

Exclusion Criteria:

• Water systems did not meet above inclusion 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.

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Sequential Assignment

Masking: None (Open label)

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4,800 participants in 4 patient groups

Assurance Fund Intervention Arm 1

Experimental group

Description:

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

Treatment:

Other: Water Quality Assurance Fund

Assurance Fund Intervention Arm 2

Experimental group

Description:

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.

Treatment:

Other: Water Quality Assurance Fund

Assurance Fund Intervention Arm 3

Experimental group

Description:

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.

Treatment:

Other: Water Quality Assurance Fund

Non-randomized Arm

Experimental group

Description:

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.

Treatment:

Other: Water Quality Assurance Fund