Abstract
Most countries maintain regulatory requirements for testing of drinking water supplies to guide treatment procedures and ensure safe water delivery to consumers. It is unclear, however, if water quality data are always used effectively, particularly in low-resource settings. Efforts to improve the use of water quality data will benefit from a comprehensive understanding of existing systems for managing and sharing information. This study evaluates the methods used to organize, analyze, and transmit drinking water quality data among 26 water supplier or surveillance institutions and two regulatory agencies in six countries of sub-Saharan Africa. Following extensive qualitative and quantitative data collection, we developed data flow diagrams to map formal and informal water quality networks. We found high levels of similarities between the information systems established by different institutions operating under different regulatory structures. We determined that the key barriers to information flows were the limited aggregation and analysis of data and the poor enforcement of data sharing requirements. Our results suggest that broad reforms are necessary to improve the use of these water quality data to manage water safety. These measures could include strengthening enforcement of testing and reporting, building staff capacity for managing and using data, and integrating collection of water quality data with other information systems.
Highlights
Diarrheal diseases resulting from unsafe drinking water are responsible for an estimated 230,000 deaths every year in subSaharan Africa[1]
Previous research on drinking water quality monitoring in lowresource settings has mostly focused on the structural elements of administering and operating testing programs, including: (i) evaluating the extent of testing practices[6,7], (ii) developing, evaluating, or inventorying tools available for low-cost fecal indicator organism testing[8,9,10,11,12], (iii) guidance on sampling frequencies, locations, or logistics[13,14,15,16], and (iv) mobile phonebased collection of data[17,18,19,20]
This study describes and assesses the formal and informal systems used by institutions with regulatory requirements for testing drinking water quality in sub-Saharan Africa to organize, analyze, and transmit information
Summary
Diarrheal diseases resulting from unsafe drinking water are responsible for an estimated 230,000 deaths every year in subSaharan Africa[1]. A recent survey of 72 water suppliers and public health agencies in 10 sub-Saharan African countries found that 85% had performed some level of microbiological water testing within the last year6 It is unclear, if the water quality data generated by these regulatory monitoring programs is always used effectively. Our previous research found that many institutions in sub-Saharan Africa do respond to test results that indicate contamination, undertaking remedial or preventative actions to mitigate water quality risks[7] In most of these cases, the information producers and users were the same entity: for example, a community health worker at a local health office would test a drinking water sample, and, subsequently, communicate the results and recommend improvements to water source owners[20].
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