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WHO & UNICEF Toolkit for Monitoring & Evaluating Household Water Treatment and Safe Storage Workshop on HWTS and Water Safety Plans November 1416, 2013 Nagpur, India Ryan Rowe Water Institute at UNC

WHO UNICEF for Household Water Treatment and Safe Storagehwts.web.unc.edu/files/2014/07/2013Nagpur_Day2_05_Rowe.pdf · Tufts/ D Lantan ge Tufts/ D Lantang e. 13 Deciding which indicators

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Page 1: WHO UNICEF for Household Water Treatment and Safe Storagehwts.web.unc.edu/files/2014/07/2013Nagpur_Day2_05_Rowe.pdf · Tufts/ D Lantan ge Tufts/ D Lantang e. 13 Deciding which indicators

WHO & UNICEFToolkit for Monitoring & Evaluating

Household Water Treatmentand Safe Storage

Workshop on HWTS and Water Safety PlansNovember 14‐16, 2013

Nagpur, India

Ryan RoweWater Institute at UNC

Page 2: WHO UNICEF for Household Water Treatment and Safe Storagehwts.web.unc.edu/files/2014/07/2013Nagpur_Day2_05_Rowe.pdf · Tufts/ D Lantan ge Tufts/ D Lantang e. 13 Deciding which indicators

Who really needs HWTS?

• Water safety plans – example?

Starting points

• Target those at high risk (cholera)

• People living with HIV (crypto)

• The malnourished

• Children in schools

• Emergency response

Page 3: WHO UNICEF for Household Water Treatment and Safe Storagehwts.web.unc.edu/files/2014/07/2013Nagpur_Day2_05_Rowe.pdf · Tufts/ D Lantan ge Tufts/ D Lantang e. 13 Deciding which indicators

• Huge unmet need

• Need knowledge of  failures & successes 

• Harmonise activities by governments, donors, researchers, practitioners

• Improve quality and comparability of data

Motivation for toolkit

Page 4: WHO UNICEF for Household Water Treatment and Safe Storagehwts.web.unc.edu/files/2014/07/2013Nagpur_Day2_05_Rowe.pdf · Tufts/ D Lantan ge Tufts/ D Lantang e. 13 Deciding which indicators

Correct and consistent use / Effective useneeded for health impact

Challenges in achieving full benefit

Chart source:Brown & Clasen, 2012.

Page 5: WHO UNICEF for Household Water Treatment and Safe Storagehwts.web.unc.edu/files/2014/07/2013Nagpur_Day2_05_Rowe.pdf · Tufts/ D Lantan ge Tufts/ D Lantang e. 13 Deciding which indicators

• Purpose of HWTS and proven methods

• Designing and conducting M&E activities

• Choosing and using 20 harmonised indicators

• Case studies from the field

• Annexes

– Example surveys and sanitation survey forms

– Links and resources for program design, implementation

– Water quality monitoring field test options

Uses for the toolkit

Page 6: WHO UNICEF for Household Water Treatment and Safe Storagehwts.web.unc.edu/files/2014/07/2013Nagpur_Day2_05_Rowe.pdf · Tufts/ D Lantan ge Tufts/ D Lantang e. 13 Deciding which indicators

• On‐site visual inspection of water sources to identify hazards to water safety

• Checklist of questions, provides a measure of risk

• Address visible risks before sampling water quality!

Know the area around your water

Page 7: WHO UNICEF for Household Water Treatment and Safe Storagehwts.web.unc.edu/files/2014/07/2013Nagpur_Day2_05_Rowe.pdf · Tufts/ D Lantan ge Tufts/ D Lantang e. 13 Deciding which indicators

So, if a bird is shitting in it …

Page 8: WHO UNICEF for Household Water Treatment and Safe Storagehwts.web.unc.edu/files/2014/07/2013Nagpur_Day2_05_Rowe.pdf · Tufts/ D Lantan ge Tufts/ D Lantang e. 13 Deciding which indicators

Uncovered water storage is a risk

Area around water point is

unclean

Photo credit: Ryan Rowe, July 2012, Lilongwe, Malawi.

Or, if water is handled unsafely …

Page 9: WHO UNICEF for Household Water Treatment and Safe Storagehwts.web.unc.edu/files/2014/07/2013Nagpur_Day2_05_Rowe.pdf · Tufts/ D Lantan ge Tufts/ D Lantang e. 13 Deciding which indicators

20 recommended indicators

• Research‐tested, common sense, stakeholder reviewed

• Sample survey available in the toolkit

• Mix and match according to your needs and constraints

Page 10: WHO UNICEF for Household Water Treatment and Safe Storagehwts.web.unc.edu/files/2014/07/2013Nagpur_Day2_05_Rowe.pdf · Tufts/ D Lantan ge Tufts/ D Lantang e. 13 Deciding which indicators

• Self‐reported data not as reliable– Better to ask: Did you do anything to make the water safer to drink? How?

• Confirm through direct observation – Ask to see the treatment method, stored water; Is the device wet?

• % households with REPORTED andOBSERVED use provides a more reliable indicator of level of uptake

Tufts/ D Lantange

Reported and observed use

Page 11: WHO UNICEF for Household Water Treatment and Safe Storagehwts.web.unc.edu/files/2014/07/2013Nagpur_Day2_05_Rowe.pdf · Tufts/ D Lantan ge Tufts/ D Lantang e. 13 Deciding which indicators

• Knowledge is just the first step!– Do they know how to treat? Where do they draw their water? What about vulnerable members of household?

• Then confirm through demonstrated use and alsomonitor regularly

• % households with CORRECT, CONSISTENT suggests knowledge and behaviour change

• Multi‐step products require additional training and support* but may be more microbiologically effective

Correct and consistent use

Lantagne & Clasen, 2012

Page 12: WHO UNICEF for Household Water Treatment and Safe Storagehwts.web.unc.edu/files/2014/07/2013Nagpur_Day2_05_Rowe.pdf · Tufts/ D Lantan ge Tufts/ D Lantang e. 13 Deciding which indicators

• Added element of objectivity and measure of risk

• Common parameters– Turbidity, chlorine residual, bacterial indicators (e.g. presence/absence of E.coli or TTC), arsenic, fluoride

• Use field‐proven and performance tested methods!

• % of households with EFFECTIVE use derived from measuring water quality before and after

Assessing water quality

Tufts/ D Lantange

Tufts/ D Lantange

Page 13: WHO UNICEF for Household Water Treatment and Safe Storagehwts.web.unc.edu/files/2014/07/2013Nagpur_Day2_05_Rowe.pdf · Tufts/ D Lantan ge Tufts/ D Lantang e. 13 Deciding which indicators

13

Deciding which indicators to use

Page 14: WHO UNICEF for Household Water Treatment and Safe Storagehwts.web.unc.edu/files/2014/07/2013Nagpur_Day2_05_Rowe.pdf · Tufts/ D Lantan ge Tufts/ D Lantang e. 13 Deciding which indicators

Interpreting data, share lessons

What works, what does not?

Share results for feedback and improvement

Correct, consistent and effective use can reasonably be linked to health impact

WHO/ M Montgomery

WHO & UNICEF International Network onHousehold Water Treatment and Safe Storage

Join 150 organisations and 1500 people – free membership!Learn more: http://www.who.int/household_water/en

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Page 15: WHO UNICEF for Household Water Treatment and Safe Storagehwts.web.unc.edu/files/2014/07/2013Nagpur_Day2_05_Rowe.pdf · Tufts/ D Lantan ge Tufts/ D Lantang e. 13 Deciding which indicators

Thank you. Shukriya. Questions?

Download the toolkit: http://www.who.int/household_water/en

Join the [email protected]

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