ThisseriesonInclusiveInnovationsexploresbusinessmodelsthatimprovethelivesofthoselivinginextremepoverty.EditorsareElaineTinsleyandNataliaAgapitova.ResearchedanddevelopedbyEndevaandAshleyInsightwithadditionalcontributionsbyBranislavKralik.

HIGHLIGHTS• Decentralizedwatertreatmentkioskscanbeconstructedinjustsixweeks,providingimmediateaccesstocleandrinkingwater.

• Thekioskscanreachthousandsofusersnotconnectedtopublicinfrastructure,atalowercostthanalternatives.

• Communitymembersaretrainedtorunandoperatekiosks,helpingensureprojectsustainabilityandaccountability.

INCLUSIVEINNOVATIONSBringingClean,AffordableWatertoPoorCommunitiesThroughDecentralizedWaterTreatmentKiosksWatertreatmentkiosksfortheunderservedprovideaquicker,sustainablesafedrinkingwatersolutiontoimprovehealthandeconomicoutcomes

SummaryAccesstocleanwaterindevelopingcountriesisconstrainedprimarilybythelimitedreachofpipedinfrastructure,whichmanycountries lack the resources toexpand.Decentralizedmodelsofwatertreatmentanddistributionpresentaninnovative,affordable,andsustainablesolutionforprovidingcleandrinkingwatertothepoor.DevelopmentChallengeAnestimated748millionpeopleintheworldlackaccesstoanimproveddrinkingwatersource,and73 million of them rely on untreated surface water (WHO/UNICEF 2014). The World HealthOrganization (WHO) estimates that inadequate drinking water, sanitation, and hygiene caused842,000diarrhealdiseasedeathsperyearin(2014).Inadditiontonegativeimpactsonhealth,lackof access to water stifles economic growth by keeping people out of work and school, withdisproportionate effects on women and girls. In some countries with large populations withoutaccess to drinking water, such as India, the health and other costs associated with consuminguntreatedwaterareestimatedatUSD600millionayear(WB,2015).Dischargeofuntreatedwateralsopollutesanddamagestheenvironment.Centralized filtration and expansion of existing piped water distribution systems are resourceintensive and time consuming, and they require government capacity that is often lacking. Incontrast, decentralizedwater treatmentmodels treat ground and surfacewater locally, providingsafe, healthy, and affordable drinking water to communities previously without access. Thesesolutionsusually require constructionof a treatmentplantand thedesignof a low-cost salesanddistributionsystems.

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Provide safe drinking water through decentralized water treatment unit

WATER TREATMENT UNITS

Set up sales point at treatment plant, ATM, or through hand delivery by micro-entrepreneurs

Get rights from government to use water from local source

Conduct awareness campaigns to promote safe drinking water and generate customers

hhh

Sell water at a sales point managed by the treatment plant or community members

Set prices well below cost of bottled or bagged water

Train operators from community in plant operations and maintenance, for sustainability

Use customer fees as revenue stream to cover operating and capital costs, along with grants

Set up decentralized community water treatment plant near where people live

$Target households without access to clean and low-cost drinkable water

Provide cost-effective drinking water source for rural, peri-urban or urban areas

Decentralizedwatertreatmentmodelswere initiallydevelopedtoaddressthewateraccessgap inruralareas.Manyofthenewunitsarebeingsetupinurbanandperi-urbanareas,tohelpcopewithincreasingurbanization.BusinessModelThisbusinessmodel is usedwhere localwater sources are contaminatedandapipeddistributionsystem that provides clean water is not in place. Contamination may include severe microbialpollution and high levels of arsenic, fluoride, iron, or nitrate, whichmay render simple, low-costsolutions (such as pumping,water harvesting, filtering through individual filters, or using chlorinetablets)ineffective.ComponentsoftheModelThestructureofthemodelvariesacrossenterprisesandorganizations.Somemodels(suchasthatdepicted in Figure 1) construct treatment plants near ground or surface water, which it thenextracts, purifies, packages, and distributes to local customers. The location of the plant (andacquisition of the land required) is determined in collaborationwith the local government.Otherenterprises(suchastheSafeWaterEnterpriseinKenya)usemembrane-basedtreatmentofwater.Differententerpriseshavedevelopedinnovativemethodsoftreatment,oftenrelyingonalternativeandrenewablesourcesofenergyinareaswhereelectricityisnotavailable.Watertreatmentfacilitycanberunonsolarpower,reverseosmosis,orthepowerofgravity.The nature ofwater contamination often determines the type of treatment technology required,whichmayhave cost implications.Microbial contamination, for example, requiresonly a low-costtank and chlorine treatment, whereas high levels of arsenic, fluoride, or nitrate require moresophisticatedtreatmentprocesses.Mostcustomersofdecentralizedwatertreatmentmodelsarehouseholds.Localschools,offices,andotherinstitutionsalsousethesystems.Somecompaniesprovidecustomerswithcontainers(thedesignofwhichplaysanimportantroleinproductmarketing),disinfectingthemateveryvisittothestoreorplantforwaterrefilling.Othersregularlydisinfectcustomers’owncontainers.Figure1.Providingsafedrinkingwaterthroughdecentralizedwatertreatmentunits

June2017/3

Manyorganizations involve localcommunitiesandentrepreneurs increatingdistributionnetworksand sales forces, generating local employment and contributing to economic growth. Customerswholiveneartheplantsusuallypickuptheirwaterthemselves.Customersfartherawayoftenhavetheir water delivered, by bicycle or moped. Some customers purchase water through automatictellermachines (ATMs)—cloud-managed, solar-powered, cashless, vendingmachines that providecleanwater24hoursadaytocustomersusingprepaidcards.CostFactorsDecentralized water treatment solutions incur two main types of costs: the initial capitalexpenditure of building the plant and the operational cost associated with managing andmaintaining theplant, thedistributionnetwork,and sales.Theupfront capital cost canbe fundedthroughgovernment,adonorgrant,oraninvestor(suchasanimpactinvestor),basedonthecost-recovery aspect of themodel funded. In somemodels, governments fund the plant construction,recuperating their investment over time through the subsequent sales of water. In others theemphasis is on keeping thepriceofwater as lowaspossible inorder to reacha largenumberofbeneficiaries. In these models, revenues cover operational expenses only (labor, spare parts,consumables[suchaschemicalsubstancesrequiredinthetreatmentprocess],andenergy).RevenueStreamsThemainsourceofrevenue isthesaleofdrinkingwater.Additionalsourcescould includesalesofwatercontainers,chargesforhomedelivery,andsalesofretailproductsforsmall-scaletreatment,suchaschlorinetablets,orotherproductsfortreatmentatalargerscale.FinancialViabilityMost decentralizedwater treatmentmodels aspire to operate as financially sustainable for-profitbusinesses.Financialviabilitydependspartlyonthenatureofthecontaminationandtheprocessofpurificationrequired.Revenuesfromthesaleofwaterandotherservicesaredesignedtorecoveroperationalandinsomecasescapitalexpenditures.Recoveryofcapitalexpenditurescantakefromjustafewyearsto15–20years(SafeWaterNetwork2014).Many organizations face financial challenges. Low prices of water keep profit margins very low,especiallywheremaintenanceandoperationcostsarehigh.Toincreaserevenues,manyenterprisesofferservicestourbanandsemi-urbanareasathigherprices,tocross-subsidizetheirruralsales.PartnershipsWater treatment enterprises need to work very closely with the communities they serve. Strongcommunity involvement increases transparency and helps raise awareness and trust in thecompany’sproduct.Many enterprises recruit and train people from local communities to manage and maintain theplants as well as distribute and sell the final product. Some models put the water utility incommunityownershipandappoint localentrepreneurs tohandleday-to-daymanagement.Othersleasetheassettolocalentrepreneursthroughafranchisingschemeandsharerevenueswiththem.Stillotherscontrolwaterqualityandmanagecollectionofpaymentswhileputtingthecommunityinchargeofoperatingthetreatmentplant.Inthismodelthecommunityprovidestheland,energy,andwater.Anothercriticalpartnernationalandlocalgovernments,whichcanprovidegrantsandothersourcesof funding, including subsidized leasing of land. Every water provider must comply with nationalwatersafetyandhealthstandardsandhavealicensetoextractfromagivenwaterresource.

June2017/4

Some organizations partnerwithNGOs, hospitals, schools, and colleges to raise awareness abouthealthbenefitsofdrinkingsafewatertohelpcreatedemand.Implementation:DeliveringValuetothePoorAwarenessManyenterprisescreateandraiseawarenessaboutthehealthandotherbenefitsofdrinkingcleanand safe water, sometimes in partnerships with local institutions. Activities include informationcampaignsincollaborationwithlocalauthoritiesandNGOsandlecturesatlocalschools.Awareness-building is particularly important in regions where the harmful consequences of consumingcontaminated water are not immediate. Where NGOs once provided water for free, the newrequirementtopaymayneedtobeexplained.AcceptanceWater providerswin acceptance among customers by engaging local leaders, partneringwith thecommunity,employinglocalpeople,andkeepingpricesaffordable.Asinmanyotherareas,peopleatthebottomofthepyramidoftenspurngoodsandservicesdesigned,branded,andmarketed“forthe poor.” In rural communities expensive national and international brands of bottledwater areoften considered signs of high social and economic status. Accordingly, decentralized watertreatmententerprises strive tobeperceivedasprovidersofabetterandhealthier lifeandhighersocial status, sometimes selling water in attractive, clean, and reusable containers in order tocompetewithproductssoldbythebottledwaterindustry.AccessibilityDecentralizedwatertreatmentcentersarelocatedclosetothecommunitiestheyserve.Customerspickuptheirwaterattheplant,atanATM,oratalocalretailstore,ortheycanhaveitdeliveredittotheirhome.Watersalespointsmustbe located inareaswithasufficiently largecustomerbaseand/or traffic. By generating employment within poor communities, water treatment enterprisescanprovideaccesstoothergoodsandservicesthatmaynotpreviouslyhavebeenavailabletosomecommunitymembers.AffordabilityDecentralizedwater treatmentsolutionsaremuchmoreaffordable thanextensionofpipedwaterinfrastructure. Theyare therefore a good solution inmanydeveloping countries. Treatedwater ispricedbasedonmanyfactors.Thepricehastobe lowerthanthatofexpensivebottledwaterandlow enough to be affordable to a critical mass of poor customers so that revenues earned aresufficienttocoveroperationalandothercostsResultsandCost-EffectivenessScaleandReachCommunity-manageddecentralizedwatertreatmentsystemsareservingmillionsofpeoplearoundtheworld. India alone has an estimated 7,000–12,000water treatment systems in 2014. In 2012WaterHealth,asocialenterprise(SE)withoperationsinSouthAsiaandSub-SaharanAfrica,had500sites reaching more than 5 million customers. In India the company’s customer base rose from15,000in2009tomorethan1.4millionin2011(WaterhealthInternational,IFCCaseStudy).TheSENaandiFoundationwillsoonbeprovidingmorethanhalfamillionpeoplewithsafewaterthroughits400operationalplantsacross14statesinIndia.Themodelishighlyeffectiveinreachingpeoplewithnooptionsotherthandrinkingcontaminatedorexpensive bottled water. Some challenges remain in terms of reaching the very bottom of the

June2017/5

pyramid,however. IntheNaandiFoundation’scatchmentareainIndia,forexample,10percentofhouseholdsstillcannotafforditsproducts(KumarandMuckerjee2014).ImprovingOutcomesVirtuallyallofWaterlife’s customers in ruralareashaveseen improvement in theiroverallhealth,leadingtolowerexpenditureonmedicineandhealthcare(WBG/DMCaseStudyofWaterlifeIndia).DatafromapublichealthcenterinMadavganfarata,Maharashtraindicatea65percentdecreaseindiarrhea,a57percentdeclineinurinarystones,anda57percentdropinskindiseasesinthedistrictwhereWaterlifeoperates.AveragemonthlysavingsasaresultofdecentralizedtreatedwaterwasUSD28 for rural households andUSD15 for urbanhouseholds (IFC 2013). The provision of cleanwateralsocutsdownontheneedtoboilwater,reducingindoorpollutionandfuelcosts.Justprovidingcleanwater isnotsufficientto improvehealthoutcomes,however.Cleanwatercanget easily decontaminated once purchased. It is therefore necessary to periodically sanitizecontainers used for water transfer and to raise awareness regarding hygienic practices, such ashand-washingandsafewaterstorage(Cherunyaandothers2015).Accesstosafewatermakespeoplehealthierandbetterabletoworkandattendschool.Itreducestheneedtofetchwater fromresources locatedfaraway,a functionusuallyperformedbywomenandgirls.Throughemphasisoncommunityownershipandmanagement, themodelssupport localentrepreneursandretailersandgenerateemployment.Cost-EffectivenessThe cost of providing water through conventional pipes in India is USD 0.25 per month perhouseholdforunlimitedvolumeplusUSD8millionforinfrastructureexpansion(WBG/DMWaterlifeCaseStudy.UndertheWaterlifemodel,thecostisUSD0.0004perliter(tothecustomer)andUSD60,000–USD 65,000 (the more expensive option runs on solar power) for construction of thetreatmentplant(IFC2015).In many countries it may take years to expand water pipelines to remote areas. In contrast, adecentralizedwatertreatmentsystemcantakeaslittleas45daystosetup.ScalingUpChallengesDecentralizedwatertreatmentplantsfaceseveralchallenges—andopportunities—inreachingscale.In many areas with access to free but polluted water, it may take considerable effort to buildawareness about the long-term negative effects of drinking unclean water, especially where theconsequences are not immediately apparent, as is the casewithwater polluted by arsenic. LocalcommunitiesmaybeusedtoreceivingfreewaterfromNGOsorotherdevelopmentactors,amodelthat is not financially sustainable. To address these issues, SEs often formpartnershipswith localauthorities, schools, and other institutions respected by the communities to launch informationcampaigns.Tokeepdistributioncost low, it is importantthat treatmentplantsbe located indenseareaswitheasyaccess tocustomers.To reachmore remoteareas, servicescaneitherbecross-subsidizedbyoperations indenseorurbanareas(wherehigherpricesarecharged)orsubsidizeddirectlybythegovernment.Theavailabilityof skilledpersonnel tomanage,operate,andmaintain theplant isoftena limitingfactor.Someorganizationshavebuiltrecruitmentandtrainingoflocalpeopleintothecoreoftheirmodels,generatingemploymentinadditiontoprovidingsafedrinkingwater.

June2017/6

RoleofGovernmentandPublicPolicyGovernmentcansupportthescalingupofdecentralizedwatertreatmentsolutionsinseveralways.It can address public perceptions regarding water quality and health hazards, ensuring thepopulation that it is safe to drink and use the locally treated water. It can adjust governancestructuresaccordingto financingstrategiesandestablishclearrelations (rolesandresponsibilities)among stakeholders, including municipalities, property owners, and SEs. If necessary, thegovernment can reform existing (or create new) institutions to maintain relations amongstakeholdersandmonitorwaterqualityanduses.Itcanadjusttheregulatoryframeworkatvariouslevels. In Kenya, for example, theWater Act of 2002 created a “delegatedmanagementmodel,”which provided criteria for small-scale private water providers to be formally recognized andthereforesubjecttoregulation.Most decentralized water treatment models depend on public funding. Governments can accessnew sources of financing for water development projects in various ways. They can capture thevalueofthelandthroughalandvaluetaxinwhichaproportionoftheincreasedvaluethataccruesto landowners benefiting from new or improved infrastructure is captured and used to fund theinfrastructureprovided. They can capture the valueaddedby thedecentralizedwater systemsbyissuing land-based bonds (with the land as collateral). They can attract private financing fromengineeringfirmsthatbuildandservicewatersystemsorfromlandowners,ownersofhouses,andland and housing developers (in Mexico housing developers are the second-largest investors inwater supplyand sanitationafter the federal government). Theycanalso leverageprivate financethroughpublic-privatepartnerships.Table1.ExamplesofSEsprovidingdecentralizedwatertreatmentCompany Country DescriptionGrameenVeoliaWaterLtd.

Bangladesh Built filtration plants in five low-income communities and connectedthemtonetworkofwatertaps.Plantsarerunasbusinesses,aimingtocoveralloperatingexpenses.

NaandiFoundation

India Operatesmorethan400mini-waterpurificationplantsinmainlyruralcommunities, financed through public-private partnerships.Model isbasedonDesign-Build-Operate-Transferconcept,wherebycommunityendsupoperatingplantsandNaandiisresponsibleonlyformonitoringandqualitycontrol.

SafeWaterEnterprise

Kenya Equips small kiosks with mobile SkyHydrant water filters, whichremovesuspendedsolids,bacteria,andviruses fromwaterwithhair-thinmembrane fibers. Filtrationprocessoperateswithoutelectricity,requiringnogridconnectivity.

SafeWaterNetwork

GhanaandIndia

Has providedmore than a quarter of amillion people in Ghana andIndia with access to safe water, by working with communities.Provides training, tools, and support to ensure that system is locallymanagedandoperated.

Sarvajal India For-profit SE (partofPiramalEnterprises)operatescommunitywaterfiltration plants through local franchisees in Indian villages of about5,000 inhabitants. Is experimenting with water distribution throughATMs.

WaterHealth

Bangladesh,Ghana,India,thePhilippines

Uses new technologies (including UV light disinfection) to purify anyavailable local water source. Centers employ local workers tomaintain,test,anddispensewaterataffordableprices.Investmentofjust USD 25,000 (less than USD 10 a person) provides a typicalcommunity in Indiawith its ownWaterHealthCenter and service for10years.

Waterlife India Providescleanwatertohouseholds,apartmentcomplexes,andofficesin underserved and challenging areas, operating in partnership with

June2017/7

the government, NGOs, panchayats, self-help groups,commercialinstitutions,andinternationalagencies.Hallmarkofmodelisfocusonqualitybyprovidingreliableserviceandmaintenance.

ReferencesCherunya,PaulineChepchirchir,ChristineJanezic,andMichaelLeuchner.2015.“SustainableSupply

ofSafeDrinkingWaterforUnderservedHouseholdsinKenya:InvestigatingtheViabilityofDecentralizedSolutions.”Water7(10):5437–57.

G20.2012.WaterlifeIndiaPrivateLimited.http://www.g20challenge.com/wp-content/uploads/2012/06/Waterlife.pdf.

IFC(InternationalFinanceCorporation)2013.WaterHealthCaseStudy.Washington,DC.http://www.ifc.org/wps/wcm/connect/16b69e804e9a9864bf8bff1dc0e8434d/WHI.pdf?MOD=AJPERES

Kumar,Manoj,andRohiniMuckerjee.2014.“SafeDrinkingWaterforRuralPopulationsinIndia:AnEffectiveServiceDeliveryModelbyNaandiFoundation.”JournalofFieldActions2.https://factsreports.revues.org/3655.

OECD(OrganisationforEconomicCo-operationandDevelopment)2009.AlternativeWaysofProvidingWaterEmergingOptionsandTheirPolicyImplications.Paris:OECD.

SafeWaterNetwork.2014.CommunitySafeWaterSolutions:IndiaSectorReview.http://www.safewaternetwork.org/sites/default/files/SWN_Indiapercent20Sectorpercent20Review_Septpercent202014_Full_Report.pdf.

WHO(WorldHealthOrganization)andUNICEF.2014.ProgressonDrinkingWaterandSanitation.http://apps.who.int/iris/bitstream/10665/112727/1/9789241507240_eng.pdf?ua=1.

WorldHealthOrganization:Water-relateddiseaseshttp://www.who.int/water_sanitation_health/diseases/en/

WorldBank.2015.WaterlifeIndiaCaseStudy,Washington,DC

June2017/8

Profile:SafeWaterNetworkIndiaProvidingpotablewatertocommunitiesthatlackaccesstodrinkingwater

ChallengeSome 97 million people in India lackaccess to safe water, according to theWorld Health Organization. Three-quarters of India’s surface water iscontaminated by waste, andgroundwater often contains high levelsof fluoride, nitrate, and other mineralcontaminants. Water- and sanitation-related illnesses account for 70–80percent of the country’s diseaseburden.Thechallengeistoprovidesafedrinkingwater at an affordable rate tolow-incomecommunities.InnovationSafe Water Network was co-founded in 2006 by the actor and philanthropist Paul Newman.Although it is a nonprofit organization, it is based onmarket principles and a customer-orientedapproach.In2008,theorganizationlauncheditsfirsteffort,arooftoprainwaterharvestingprogramthatbuiltor refurbished more than 1,000 community and household cisterns. Soon after, it set up watertreatmentandsalespoints.TheseSafeWaterStations(locallycallediJalStations)areequippedwithwatertreatmenttechnologytotreatgroundwatercontaminationinaffectedareas.SitesforSafeWaterStationsareidentifiedbasedonthefollowingcriteria:

• Waterqualityisverypoor.• Householdsdemandandarewillingtopayforsafedrinkingwater.• Thecommunityhasatleast400households,andatleast75percentofhouseholdsarelikely

to participate. (If half of the population buyswater regularly, the program needs at least2,000peoplein500householdstobefinanciallyviable.)

• AlocalelectedbodyhastheauthorityandiswillingtosignatripartiteagreementwithSafeWaterNetworkandthelocaloperatorgivingSafeWaterNetworktherighttooperate.Theagreement includes amechanism for setting an affordable but viable price forwater andensuringequitableaccesstoallcommunitymembers.

In consultation with the community, a local entrepreneur or community-based organization isselected to operate the water station. Safe Water Network selects the most appropriate watertreatmenttechnology,providesthefundsforcapital investment,buildsthestation,andsubsidizesthemarketingcosts.All stationsareequippedwitha remotemonitoring system thatenables24/7monitoringofplantperformanceandwaterquality.Monitoringenablestechnicalissuestobeaddressedbytheprojectteam immediately,keepingdowntime to less than2percent.Eachstation isexpected tocover itsoperational costs from the start. The local entrepreneur, while setting aside some percentagetowardplantmaintenance,earnsfixedfeesfromthewatersales,andthebalanceisreturnedtoSafeWater SafeWater Network uses its revenues toward plant repayment and is used as a revolving

iJalstationslikethisoneinthevillageofPeddapur,inTelangana,provideresidentswithrelativelyinexpensivecleanwater.

June2017/9

grant to invest inothercommunities. It takesabout7-8years to recover thecostsof settingupastation.Ifastationprovesnonviable,eitheroperationallyorfinancially,SafeWaterNetworkhastherighttoterminateoperationsandrelocatethetreatmentplant.ImpactSafe Water Network India has brought access to safe, affordable drinking water to more than672,000peoplethrough180iJalStationsinthestatesofTelangana,UttarPradesh,andMaharashtra(2017),havingdoubledthenumberofitsstationsinjustthepastcoupleofyears.Waterispricedtomakeitasaffordableaspossiblewhilecoveringoperatingcosts.In90percentofcommunitiesserved,itsellsforUSD0.06–0.08per20liters—afractionoftheUSD1.20chargedforthecheapestbrandedbulk-packagedtreatedwater.iJalwaterisalsolessexpensivethanuntreatedwaterfromtankersorboreholes.Educationabout thehealthbenefitsofproperly treatedwater ispartof themodel,particularly inareaswheredissolvedmineralshavecontaminatedthewater.Educationisalsonecessarytocounterthebeliefthatboilingwatercanmakeitsafetodrink.SafeWaterStationsgenerateslivelihoodsforlocalstationentrepreneurs,operators,anddriverswhotransportthewater.Theyalsoprovidetrainingonhowtomanageasmallbusiness.ScalingUpThemainexternaldriverofthismodelisthevastunmetdemandforsafedrinkingwater.SafeWaterNetwork in India andGhanahave reachednearly amillionpeople (2017). Five variablesdrive thefinancialviabilityofindividualstations:thepopulationofthecommunity,householdsize,householdparticipation,distribution,percapitaconsumption,andmostcritically,willingnesstopay.Internally, twodriversunderpindesignandscale-up: cost reductionandacommitment to sharingknowledge.Thenetworkkeepscostslowbyusingtechnologyandlimitingitsstafftoasmallteam–half of which are for awareness raising and knowledge dissemination, an important part of thecompany’ssocialmissionandalsoimproveswillingnesstopay.While the Indian government has becomemore involved in procurement of decentralized watertreatment plants, its focus on the lowest price, without incorporating quality and social impacts,limitsthenetwork’sabilitytowinpublicsectorcontracts.

June2017/10

Profile:WaterHealthInternationalTreatingandsellingtreated,affordabledrinkingwatertourbanandper-urbancommunitiesinGhana

ChallengeMore than 3 million people in Ghana lackaccess to an improved water source. Thecountry’s large chemical, mining, andagriculture industries have led to severearsenic,mercury,andcyanidepollution,aswellasmicrobial contamination.Expensivewater treatment solutions are needed tofilterthewatertomakeitsafefordrinking.Inaddition,manypartsof thecountry lackbasicwater infrastructure.Thechallenge isto provide safe drinking water at anaffordableratetolow-incomecommunities.InnovationWaterHealthInternational(www.waterhealth.org)hasbeenoperatinginGhanasince2008,usingabuild-operate-transfermodel based onmanagement contracts of 20–25 years.OnceWaterHealthbuilds a center, it contracts it out to a local community or agency to operate andmaintain for aperiod of time. Its unique UV treatment technology and innovative business model make high-quality,potablewateraffordabletohouseholdsearningjustUSD2dollarsaday.The plant sells both “utilitywater” (used forwashing and cleaning) and potablewater. Their "DrWater"brandedproductisconsumerfriendlytoencouragewidespreadadoption.UtilitywatercostsUSD0.05–0.08per20liters.Thiswaterisfilteredtosafedrinkingwaterstandardsbutdoesnotgothroughthefinalreverseosmosisprocess.Drinkingwatercanbecollectedfromtheplant(atacostofUSD0.20per20liters)ordeliveredtohomes(atacostofaboutUSD0.50per20liters).WaterHealth reaches areas where it is not profitable or feasible for traditional water utilities tooperate.Itssystemisflexible,asunitsofvarioussizescanbeinstalled.SmallertreatmentunitscostUSD50,000toequipandinstall;alargeunitcancostuptoUSD90,000.Theplantsaremanufacturedaskitsthatcanbeeasilyassembledandmaintainedbylocalworkers.Waterlifeownsandoperatesthecenter,thentransfersittothecommunityafter20-25years.The local authority (a village chief or district council) provides the land, access to electricity, andrightsofaccesstothewatersource.WaterHealthemploysandtrainsstaffwhorunthecenterandhelpsthe localcommunitysetupawaterboardto liaisebetweenthecommunity/usersandthosethatrunthewatercentertoensureasmoothoperationandtransitiontocommunityownershipattheendofthecontract.Severalcentersaredevelopedatthesametimeinvillagesthatareclosetooneanother,inordertoeasereplicationandallowefficienciesinmanagementservicesacrossthecenters.WaterHealthteststhewaterregularlyandmaintainstheunit,usingrevenuefromthewatercentertodoso.Itachievesbreak-even on operational costs in four to sixmonths. To be fully sustainable, the unit needs toserveapopulationofatleast5,000people.

WatertreatmentplantslikethisoneintheGreaterAccraregionaremanufacturedaskitsthatcanbeeasilyassembledandmaintainedbylocalworkers.

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ImpactWaterHealthprovides250,000–300,000peopleinGhanawithaccesstocleandrinkingwatertreatedat 35 plants. Eachplant typically serves about 10,000people—significantlymore thanborewells,whichprovide just300–500peoplewithaccess tounfilteredwater.AlthoughWaterHealth initiallyworked in rural areas, 50–70percent of its new facilities are in peri-urbanor urban areas,wheredemandfrompeoplelivingininformalorunplannedsettlementsisgrowing.An independent review of the cleanliness of a sample ofwater fromWaterHealth plants showedthat at the treatment center, WaterHealth water had 93 percent lessE. colicontamination thansurfacewater (Opryszkoandothers2015).However, aswaterqualitydegrades after it leaves theplant (due to contact with unclean hands, the mixing of surface water with clean water, andcontaminatedstoragevessels)--WaterHealthalsochlorinatessomeofitswaterinat-riskareas.ScalingUpGrants ofUSD 4.5million from the Coca-Cola Africa Foundation and theDiageo Foundation haveallowed WaterHealth to expand its activities. Access to finance for capital investment andpartnership support from local government will determine future growth. Support from localgovernment is alsoneededas the systemcomplementspublicprovision.Constraints to scalingupinclude lack of access to land, aswater centers need to be in a central place to ensure sufficientcustomers,andlackofrelevantskillsintheworkforceinGhanaforemployeestomaintainthewaterfiltrationsystems.ReferenceOpryszko,MelissaC.,YayiGuo,LukeMacDonald,LauraMacDonald,SamaraKiihl,andKelloggJ.

Schwab.2015.“ImpactofWater-VendingKiosksandHygieneEducationonHouseholdDrinkingWaterQualityinRuralGhana.”AmericanJournalofTropicalMedicineandHygiene88(4):651–60.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3617848/