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Elizabeth Medlin, MPH Global Water, Sanitation, and Hygiene Team Environmental Health Services Branch U.S. Centers for Disease Control and Prevention Rick Gelting, Ph.D., P.E.; Kristin Delea, M.PH., REHS A Conceptual Framework to Evaluate the Outcomes and Impacts of Water Safety Plans National Center for Environmental Health Division of Emergency and Environmental Health Services

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Page 1: Elizabeth Medlin, MPH Global Water, Sanitation, and Hygiene Team Environmental Health Services Branch U.S. Centers for Disease Control and Prevention Rick

Elizabeth Medlin, MPHGlobal Water, Sanitation, and Hygiene Team

Environmental Health Services BranchU.S. Centers for Disease Control and Prevention

Rick Gelting, Ph.D., P.E.; Kristin Delea, M.PH., REHS

A Conceptual Framework to Evaluate the Outcomes and Impacts of Water

Safety Plans

National Center for Environmental Health

Division of Emergency and Environmental Health Services

Page 2: Elizabeth Medlin, MPH Global Water, Sanitation, and Hygiene Team Environmental Health Services Branch U.S. Centers for Disease Control and Prevention Rick

System Assessme

nt

Monitoring Management &

Communication

Water Safety Plans

Health-based targets

Surveillance

Public health context and health outcomes

WHO Framework for Safe Drinking Water

Page 3: Elizabeth Medlin, MPH Global Water, Sanitation, and Hygiene Team Environmental Health Services Branch U.S. Centers for Disease Control and Prevention Rick

WHO Framework for Safe Drinking Water

System Assessme

nt

Monitoring Management &

Communication

Water Safety Plans

Health-based targets

Surveillance

Public health context and health outcomes

Page 4: Elizabeth Medlin, MPH Global Water, Sanitation, and Hygiene Team Environmental Health Services Branch U.S. Centers for Disease Control and Prevention Rick

Purposes of a WSP Conceptual Framework

• Varied outcomes and impacts of WSPs

• Common framework and terminology

• Basis for the development of indicators

• Common understanding of the time frames

• Various benefits of implementing WSPs

Page 5: Elizabeth Medlin, MPH Global Water, Sanitation, and Hygiene Team Environmental Health Services Branch U.S. Centers for Disease Control and Prevention Rick

Logic Models

Logic Model Development Guide – WK Kellogg Foundation

Page 6: Elizabeth Medlin, MPH Global Water, Sanitation, and Hygiene Team Environmental Health Services Branch U.S. Centers for Disease Control and Prevention Rick

Logic Models

System Assessment

MonitoringManagement

& Communicatio

n

Water Safety Plans

Health-based targets

Surveillance

Public health context and health outcomes

Logic Model

Page 7: Elizabeth Medlin, MPH Global Water, Sanitation, and Hygiene Team Environmental Health Services Branch U.S. Centers for Disease Control and Prevention Rick

WSP Conceptual Framework

Inputs

• Water Supplier

• Stakeholders

•Champion

• Staff / Management

• Time Commitment

•Facilities

• Materials / Equipment

•Knowledge

•Political Will / Motivation

•Funds

Water Supply Improvements

Health Improvements

Water Safety Plan

Impacts

Socioeconomic Improvements

Other Environmental Factors

(Sanitation, Hygiene,

Food, etc.)

Institutional Changes

Operational Changes

Financial Changes

Policy Changes

FeedbackFeedbackFeedback

Activities/Outputs Outcomes

Months Years

Preparation

System Assessment

Monitoring & Evaluation

Management & Communication

Feedback & Improvement

Page 8: Elizabeth Medlin, MPH Global Water, Sanitation, and Hygiene Team Environmental Health Services Branch U.S. Centers for Disease Control and Prevention Rick

WSP Conceptual Framework

Inputs

• Water Supplier

• Stakeholders

•Champion

• Staff / Management

• Time Commitment

•Facilities

• Materials / Equipment

•Knowledge

•Political Will / Motivation

•Funds

Water Supply Improvements

Health Improvements

Water Safety Plan

Impacts

Socioeconomic Improvements

Other Environmental Factors

(Sanitation, Hygiene,

Food, etc.)

Institutional Changes

Operational Changes

Financial Changes

Policy Changes

FeedbackFeedbackFeedback

Activities/Outputs Outcomes

Months Years

Preparation

System Assessment

Monitoring & Evaluation

Management & Communication

Feedback & Improvement

Page 9: Elizabeth Medlin, MPH Global Water, Sanitation, and Hygiene Team Environmental Health Services Branch U.S. Centers for Disease Control and Prevention Rick

WSP Conceptual FrameworkInputs

Stakeholders and partners Water supplier Institutional partners Less traditional partners

Champion

Time commitment, Facilities, Equipment

Funds

Motivation

Page 10: Elizabeth Medlin, MPH Global Water, Sanitation, and Hygiene Team Environmental Health Services Branch U.S. Centers for Disease Control and Prevention Rick

WSP Conceptual Framework

Inputs

• Water Supplier

• Stakeholders

•Champion

• Staff / Management

• Time Commitment

•Facilities

• Materials / Equipment

•Knowledge

•Political Will / Motivation

•Funds

Water Supply Improvements

Health Improvements

Water Safety Plan

Impacts

Socioeconomic Improvements

Other Environmental Factors

(Sanitation, Hygiene,

Food, etc.)

Institutional Changes

Operational Changes

Financial Changes

Policy Changes

FeedbackFeedbackFeedback

Activities/Outputs Outcomes

Months Years

Preparation

System Assessment

Monitoring & Evaluation

Management & Communication

Feedback & Improvement

Page 11: Elizabeth Medlin, MPH Global Water, Sanitation, and Hygiene Team Environmental Health Services Branch U.S. Centers for Disease Control and Prevention Rick

WSP Conceptual FrameworkActivities / OutputsMotivation

WSP

Page 12: Elizabeth Medlin, MPH Global Water, Sanitation, and Hygiene Team Environmental Health Services Branch U.S. Centers for Disease Control and Prevention Rick

WSP Conceptual Framework

Inputs

• Water Supplier

• Stakeholders

•Champion

• Staff / Management

• Time Commitment

•Facilities

• Materials / Equipment

•Knowledge

•Political Will / Motivation

•Funds

Water Supply Improvements

Health Improvements

Water Safety Plan

Impacts

Socioeconomic Improvements

Other Environmental Factors

(Sanitation, Hygiene,

Food, etc.)

Institutional Changes

Operational Changes

Financial Changes

Policy Changes

FeedbackFeedbackFeedback

Activities/Outputs Outcomes

Months Years

Preparation

System Assessment

Monitoring & Evaluation

Management & Communication

Feedback & Improvement

Page 13: Elizabeth Medlin, MPH Global Water, Sanitation, and Hygiene Team Environmental Health Services Branch U.S. Centers for Disease Control and Prevention Rick

WSP Conceptual Framework Outcomes

Four Categories: Institutional Change Operational Change Financial Change Policy Change

Different time scales

Institutional Changes

Operational Changes

Financial Changes

Policy Changes

Page 14: Elizabeth Medlin, MPH Global Water, Sanitation, and Hygiene Team Environmental Health Services Branch U.S. Centers for Disease Control and Prevention Rick

Increased communication

Increased knowledge

Improved perceptions and attitudes

Increased training

Institutional Changes

Operational Changes

Financial Changes

Policy Changes

OutcomesInstitutional Change

Gelting, 2008, unpublished

WSP in Guyana brought together the water supplier and the drinking water regulator:

Relations

Communications

Coordination of efforts

Page 15: Elizabeth Medlin, MPH Global Water, Sanitation, and Hygiene Team Environmental Health Services Branch U.S. Centers for Disease Control and Prevention Rick

Improved system infrastructure

Implementation of improvedprocedures

Institutional Changes

Operational Changes

Financial Changes

Policy Changes

OutcomesOperational Change

Mahmud et al, 2007

WSP in Bangladesh identified a need for direct ACTION by operators to:

-repair damaged water source infrastructure

-move sources of contamination

-clean the surroundings of the water supplies

Page 16: Elizabeth Medlin, MPH Global Water, Sanitation, and Hygiene Team Environmental Health Services Branch U.S. Centers for Disease Control and Prevention Rick

Cost savings

Cost recovery

Increased donor support and investment

Institutional Changes

Operational Changes

Financial Changes

Policy Changes

OutcomesFinancial Change

Environmental & Engineering Managers, Ltd, 2007

WSP in Jamaica:

”…Utility and government are well-prepared to implement and sustain donor-financed improvements.”

“WSPs provide a new stage for funding assistance.”

Page 17: Elizabeth Medlin, MPH Global Water, Sanitation, and Hygiene Team Environmental Health Services Branch U.S. Centers for Disease Control and Prevention Rick

Informal WSP knowledge-sharing and promotion

WSP model sharing as norms of practice

WSP formal regulatory requirements

Institutional Changes

Operational Changes

Financial Changes

Policy Changes

OutcomesPolicy Change

Environmental & Engineering Managers, Ltd, 2007

WSP in Jamaica:

WSPSuccess

WSPs as requirement

in regulations

8 to 10 years

Page 18: Elizabeth Medlin, MPH Global Water, Sanitation, and Hygiene Team Environmental Health Services Branch U.S. Centers for Disease Control and Prevention Rick

WSP Conceptual Framework

Inputs

• Water Supplier

• Stakeholders

•Champion

• Staff / Management

• Time Commitment

•Facilities

• Materials / Equipment

•Knowledge

•Political Will / Motivation

•Funds

Water Supply Improvements

Health Improvements

Water Safety Plan

Impacts

Socioeconomic Improvements

Other Environmental Factors (Sanitation,

Hygiene, Food, etc.)

Institutional Changes

Operational Changes

Financial Changes

Policy Changes

FeedbackFeedbackFeedback

Activities/Outputs Outcomes

Months Years

Preparation

System Assessment

Monitoring & Evaluation

Management & Communication

Feedback & Improvement

Other Environmental Factors

(Sanitation, Hygiene,

Food, etc.)

Page 19: Elizabeth Medlin, MPH Global Water, Sanitation, and Hygiene Team Environmental Health Services Branch U.S. Centers for Disease Control and Prevention Rick

WSP Conceptual Framework

Inputs

• Water Supplier

• Stakeholders

•Champion

• Staff / Management

• Time Commitment

•Facilities

• Materials / Equipment

•Knowledge

•Political Will / Motivation

•Funds

Water Supply Improvements

Health Improvements

Water Safety Plan

Impacts

Socioeconomic Improvements

Other Environmental Factors

(Sanitation, Hygiene,

Food, etc.)

Institutional Changes

Operational Changes

Financial Changes

Policy Changes

FeedbackFeedbackFeedback

Activities/Outputs Outcomes

Months Years

Preparation

System Assessment

Monitoring & Evaluation

Management & Communication

Feedback & Improvement

Page 20: Elizabeth Medlin, MPH Global Water, Sanitation, and Hygiene Team Environmental Health Services Branch U.S. Centers for Disease Control and Prevention Rick

For more information please contact Centers for Disease Control and Prevention1600 Clifton Road NE, Atlanta, GA 30333Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: [email protected] Web: www.cdc.gov

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

National Center for Environmental Health

Division of Emergency and Environmental Health Services

THANK YOU FOR YOUR ATTENTION!