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M a g g i e M o n t g o m e r y , W H O H W T S S o u t h e r n A f r i c a
W o r k s h o p , M o z a m b i q u e 2 1 J u n e 2 0 1 1
WHO/UNICEF Toolkit on Monitoring and Evaluating Household Water Treatment and Safe
Storage
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Motivation
• Gap between needs and current HWTS coverage• Effective policies (and programs) require knowledge of
both "failures" and "successes"• Data on HWTS use and benefits is limited and often
biased• Existing monitoring indicators and guidance is narrow in
scope and fragmented
Thus, there is the need for globally relevant indicators, monitoring and reporting‐HWTS M&E Recommendations.
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Outline
Document overview and context
Proposed indicators
Monitoring in the field
Reporting, dissemination and feedback
Next steps with HWTS M&E efforts
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Why improved M&E for HWTS?
Understand what works and what does not
Technology
Use, behaviour
Implementation approaches
Translate understanding into improved delivery, ongoing support and follow-up
Compare and share
Justify further investments
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What's inside the document
Overview of purpose of HWTS and proven solutions
Developing a monitoring and evaluation framework
Proposed indicators
Conducting monitoring and evaluation
Annexes
Example surveys and sanitation safety plan forms
Links and resources
Overview of water quality monitoring field test options
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Assessing safe water solutions-water safety plans
Describe system
Accessibility and types of water sources
Reliability of sources
Users
Identify hazards
Source water quality
Contamination at collection, transport and in home
Assess risks
Develop and implement mitigation measuresHWTS!
WHO/ M Montgomery
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Identifying what to monitor and/or evaluate
Focus is NOT on health impact which requires careful selection of comparison group, rigorous data collection and review, complicated statistics.
Focus is on outputs and outcomes.
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Developing a M&E Framework
Understand the context
Engage stakeholders
Determine aims, select questions and indicators
Train M&E Team
Conduct M&E
Review and analyse data
Disseminate results (internal and external)
Use results to modify program, inform decision-makers
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What indicators do you use to measure HWTS?
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Do they know how to use?
Can you tell me how you use the product?
How much time you wait? Not leading!
Results:% of people who know correct
use
Tufts/ D Lantange
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Reported use
Have you ever used the product? Are you still using the product? NO - For how long did you use? NO - Why did you stop?
Are you using the product today? Do you have the product right now? When do you not use?
% of people with REPORTED use(note this is higher - survey/respondent bias)
Tufts/ D Lantange
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Reported Current Use
Can you give me a cup of water right now as you would give to your child?
Is this water treated in any way? If YES: With what?
% of people with REPORTED CURRENT USE
Tufts/ D Lantange
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Confirmed use and safe storage
Tufts/ D Lantange
Water quality testing Free chlorine residual (if chlorine) Microbiological testing
Observation Is it present? Is it assembled/correctly? Is it wet? Is the storage container covered,
clean and out of reach?% of people with CONFIRMED
USE
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Monitoring Water Quality
What water quality parameters can be used?• Bacterial indicators (i.e. E. coli)• Chlorine residual• Turbidity• Arsenic/flouride
What types of testing can be done?• Presence/Absence test (i.e. IDEXX)• Semi-Quantitative (i.e. Aquatest, H2S)• Quantitative (i.e. Oxfam Delaqua)
Tufts/ D Lantange
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Microbiological Testing -EFFECTIVE USE
Test stored household UNTREATED water
Test stored household TREATED water
% of households with contamination in UNTREATED and no contamination in TREATED
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Assessing Attitudes and Behaviour
Belief that others treat drinking-water at homeWho do you know that treats their water? How often doyou think they treat their water?
Confidence in improving quality of drinking-waterI feel confident that I can correctly treat water to make it safer to drink.
Community support in treating waterMy friends/community leaders /health care workers encourage me to treat water.
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Conducting M&E in the field is not easy!
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Analyzing Data
Descriptive statistics• i.e. % of households use HWT,
% households safely store water
Water quality results• What does a positive result mean?
Device is defective or not maintained properlyLack of correct usePossible re-contamination May still indicate improvement in water quality
Risk Assessment• i.e. % of households at "high risk" of diarrhoeal
disease
WHO/ M Montgomery
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Dissemination/ translating results in action
Gain initial feedback locally, then nationally, then internationally
Willingness to learn and "do better"
Agreement of stakeholders on interpretation of results
Coordination and implementation
Monitoring of gains
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Acknowledgements and Links
Daniele Lantagne (Tufts University)
WHO/UNICEF Toolkit on Monitoring and Evaluating Household Water Treatment-Coming soon online in 2012
WHO (2011). Water quality assurance tool. Online resource. http://www.who.int/water_sanitation_health/publications/wsp_qa_tool/en/index1.html.
UNICEF (2011). WaSH in Schools Monitoring Package. New York, USA. http://www.unicef.org/wash/schools/files/wash_in_schools_monitoringpackage_.pdf.
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Kila jambo ni wakati wake.(Each thing has an opportune moment.)
Obrigada. Questions?