Clinical trial NCT06570005: Evaluating a Water Quality Assurance Fund Intervention in Ghana and Kenya
Official title: Evaluating a Water Quality Assurance Fund Intervention in Ghana and Kenya
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Water Quality
Water Treatment
Knowledge
Satisfaction
Lead sponsor: The Aquaya Institute
Sponsor class: OTHER
Collaborators: name: United States Agency for International Development (USAID)
name: Conrad N. Hilton Foundation
name: The Leona M. and Harry B. Helmsley Charitable Trust
name: Kwame Nkrumah University of Science and Technology (KNUST)
name: Water Mission
First posted: 2024-08-26
Enrollment: 4800
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: SEQUENTIAL
Intervention model description: Stepped-wedge Randomized Controlled Trial
Primary purpose: OTHER

Brief summary: The objective of this study is to evaluate the effects of a novel financial and capacity strengthening intervention (the 'Water Quality Assurance Fund' program) on water safety management in rural Ghana and Kenya. The investigators hypothesize the intervention will improve water system operator knowledge, chlorination practices, and water quality at the point of collection, as well as improve consumer satisfaction, awareness, and willingness-to-pay for water that is tested and treated.

Detailed description: Regular water quality monitoring by water suppliers is essential for maintaining adequate treatment processes and verifying safe water quality to protect public health. Yet, many small water suppliers are unable to conduct regular water quality tests due to financial, logistical, and capacity constraints. The goals of the Water Quality Assurance Fund program are to address these constraints by incentivizing established laboratories to extend their services to these smaller water systems and, in parallel, promote the use of water quality data for better water safety management.

The objective of this study is to evaluate the effects of a novel financial and capacity strengthening intervention (the 'Water Quality Assurance Fund' program) on water safety management in rural Ghana and Kenya. As part of the intervention, written legal agreements between water systems, centralized laboratories, and the organization facilitating the Assurance Fund will provide water systems with regular water quality testing and provide laboratories a guarantee of payments if water systems fail to pay for testing services on time. The Assurance Fund program will also deliver capacity strengthening, technical guidance, and community sensitization activities.

The investigators hypothesize the intervention will improve water system operator knowledge, chlorination practices, and water quality at the point of collection, as well as improve consumer satisfaction, awareness, and willingness-to-pay for water that is tested and treated. A secondary aim is to assess implementation challenges and enabling factors associated with the expansion of water testing services by existing professional water quality laboratories to rural water suppliers.

Eligibility criteria: Eligibility to receive the intervention was determined by water system criteria:

Inclusion Criteria:

* The district or county government was interested in participating in the Assurance Fund program and water systems within the district/county were accessible to a partner central laboratory that was able to provide water sample collection and testing services for a fee.
* Water systems were functional.
* Water systems were piped water systems (Kenya, Ghana) or mechanized boreholes with a single tapstand (Ghana).
* Water systems could afford regular water quality testing from the selected laboratory.

Exclusion Criteria:

* Water systems did not meet above inclusion criteria.

To be eligible to participate in household surveys, participants need to be at least 18 years of age and a customer of a eligible water system.

Primary outcomes:
measure: Adequate free chlorine residual in water at the point of collection
timeFrame: Baseline, 6-months, 12-months, 18-months, 24-months
Secondary outcomes:
measure: Detectable free chlorine residual in water at the point of collection
timeFrame: Baseline, 6-months, 12-months, 18-months, 24-months
measure: E. coli in water at the point of collection
timeFrame: Baseline, 6-months, 12-months, 18-months, 24-months
measure: Water system operator knowledge
timeFrame: Baseline, 12-months, 24-months
measure: Consumer awareness
timeFrame: Baseline, 12-months, 24-months
measure: Consumer satisfaction
timeFrame: Baseline, 12-months, 24-months
measure: Willingness-to-pay
timeFrame: Baseline, 12-months, 24-months
measure: Adequate free chlorine residual in household stored water
timeFrame: Baseline, 12-months, 24-months
measure: Detectable free chlorine residual in household stored water
timeFrame: Baseline, 12-months, 24-months
measure: E. coli in household stored water
timeFrame: Baseline, 12-months, 24-months
Other outcomes:
measure: Water system chlorination frequency
timeFrame: Baseline, 6-months, 12-months, 18-months, 24-months
measure: Water system revenue
timeFrame: Baseline, 6-months, 12-months, 18-months, 24-months
measure: Households use of enrolled water for drinking
timeFrame: Baseline, 12-months, 24-months
Locations:
city: Accra
country: Ghana
facility: The Aquaya Institute
city: Nairobi
country: Kenya
facility: The Aquaya Institute
Study officials:
affiliation: The Aquaya Institute
name: Valerie Bauza, PhD
role: PRINCIPAL_INVESTIGATOR
References: