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

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.

Outline

Document overview and context

Proposed indicators

Monitoring in the field

Reporting, dissemination and feedback

Next steps with HWTS M&E efforts

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

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

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

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.

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

What indicators do you use to measure HWTS?

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

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

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

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

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

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

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.

Conducting M&E in the field is not easy!

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

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

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.

Kila jambo ni wakati wake.(Each thing has an opportune moment.)

Obrigada. Questions?