When Are Mobile Phones Useful for Water Quality Data Collection? An Analysis of Data Flows and ICT Applications among Regulated Monitoring Institutions in Sub-Saharan Africa

Centralized or Onsite Testing? Examining the Costs of Water Quality Monitoring in Rural Africa

Rural water systems in Africa have room to improve water quality monitoring. However, the most cost-effective approach for microbial water testing remains uncertain. This study compared the cost per E. coli test (membrane filtration) of four approaches representing different levels of centralization: (i) one centralized laboratory serving all water systems, (ii) a mobile laboratory serving all systems, (iii) multiple semi-centralized laboratories serving clusters of systems, and (iv) decentralized analysis at each system. We employed Monte Carlo analyses to model the costs of these approaches in three real-world contexts in Ghana and Uganda and in hypothetical simulations capturing various conditions across rural Africa. Centralized testing was the lowest cost in two real-world settings and the widest variety of simulations, especially those with water systems close to a central laboratory (<36 km). Semi-centralized testing was the lowest cost in one real-world setting and in simulations with clustered water systems and intermediate sampling frequencies (1-2 monthly samples per system). The mobile lab was the lowest cost in the fewest simulations, requiring few systems and infrequent sampling. Decentralized testing was cost-effective for remote systems and frequent sampling, but only if sampling did not require a dedicated vehicle. Alternative low-cost testing methods could make decentralized testing more competitive.

Assessing Drinking Water Quality at the Point of Collection and within Household Storage Containers in the Hilly Rural Areas of Mid and Far-Western Nepal

Accurate assessments of drinking water quality, household hygenic practices, and the mindset of the consumers are critical for developing effective water intervention strategies. This paper presents a microbial quality assessment of 512 samples from household water storage containers and 167 samples from points of collection (POC) in remote rural communities in the hilly area of western Nepal. We found that 81% of the stored drinking water samples (mean log₁₀ of all samples = 1.16 colony-forming units (CFU)/100 mL, standard deviation (SD) = 0.84) and 68% of the POC samples (mean log₁₀ of all samples = 0.57 CFU/100 mL, SD = 0.86) had detectable E. coli. The quality of stored water was significantly correlated with the quality at the POC, with the majority (63%) of paired samples showing a deterioration in quality post-collection. Locally applied household water treatment (HWT) methods did not effectively improve microbial water quality. Among all household sanitary inspection questions, only the presence of livestock near the water storage container was significantly correlated with its microbial contamination. Households' perceptions of their drinking water quality were mostly influenced by the water's visual appearance, and these perceptions in general motivated their use of HWT. Improving water quality within the distribution network and promoting safer water handling practices are proposed to reduce the health risk due to consumption of contaminated water in this setting.

Monitoring river water and sediments within a changing Ethiopian catchment to support sustainable development

In many sub-Saharan states, despite governments' awareness campaigns highlighting potential impacts of aquatic pollution, there is a very limited action to protect the riverine systems. Managing the quality of water and sediments needs knowledge of pollutants, agreed standards, and relevant policy framework supporting monitoring and regulation. This study reports metal concentrations in rivers in industrializing Ethiopia. The study also highlights policy and capacity gaps in monitoring of river and sediments. For two sampling periods in 2013 and 2014, chromium (Cr), copper (Cu), zinc (Zn), and lead (Pb) were monitored in water and sediments of the Leyole and Worka rivers in the Kombolcha city, Ethiopia. The sampling results were compared with international guidelines and evaluated against the Ethiopian water protection policies. Chromium was high in the Leyole river water (median 2660 μg/L) and sediments (maximum 740 mg/kg), Cu concentrations in the river water was highest at the midstream part of the Leyole river (median 63 μg/L), but maximum sediment content of 417 mg/kg was found further upstream. Zinc was the highest in the upstream part of the Leyole river water (median 521 μg/L) and sediments (maximum 36,600 mg/kg). Pb concentrations were low in both rivers. For the sediments, relatively higher Pb concentrations (maximum 3640 mg/kg) were found in the upstream of the Leyole river. Except for Pb, the concentrations of all metals surpassed the guidelines for aquatic life, human, livestock, and irrigation water supplies. The median concentrations of all metals exceeded guidelines for sediment quality for aquatic organisms. In Ethiopia, poor technical and financial capabilities restrict monitoring of rivers and sediments and understanding on the effects of pollutants. The guidelines used to protect water quality is based on the World Health Organization standards for drinking water quality, but this is not designed for monitoring ecological health. Further development of water quality standards and locally relevant monitoring framework are needed. Development of monitoring protocols and institutional capacities are important to overcome the policy gaps and support the government's ambition in increasing industrialization and agricultural intensification. Failure to do so presents high risks for the public and the river ecosystem.

Experiences in running a complex electronic data capture system using mobile phones in a large-scale population trial in southern Nepal

The increasing availability and capabilities of mobile phones make them a feasible means of data collection. Electronic Data Capture (EDC) systems have been used widely for public health monitoring and surveillance activities, but documentation of their use in complicated research studies requiring multiple systems is limited. This paper shares our experiences of designing and implementing a complex multi-component EDC system for a community-based four-armed cluster-Randomised Controlled Trial in the rural plains of Nepal, to help other researchers planning to use EDC for complex studies in low-income settings. We designed and implemented three interrelated mobile phone data collection systems to enrol and follow-up pregnant women (trial participants), and to support the implementation of trial interventions (women's groups, food and cash transfers). 720 field staff used basic phones to send simple coded text messages, 539 women's group facilitators used Android smartphones with Open Data Kit Collect, and 112 Interviewers, Coordinators and Supervisors used smartphones with CommCare. Barcoded photo ID cards encoded with participant information were generated for each enrolled woman. Automated systems were developed to download, recode and merge data for nearly real-time access by researchers. The systems were successfully rolled out and used by 1371 staff. A total of 25,089 pregnant women were enrolled, and 17,839 follow-up forms completed. Women's group facilitators recorded 5717 women's groups and the distribution of 14,647 food and 13,482 cash transfers. Using EDC sped up data collection and processing, although time needed for programming and set-up delayed the study inception. EDC using three interlinked mobile data management systems (FrontlineSMS, ODK and CommCare) was a feasible and effective method of data capture in a complex large-scale trial in the plains of Nepal. Despite challenges including prolonged set-up times, the systems met multiple data collection needs for users with varying levels of literacy and experience.

Assessing Drinking Water Quality and Water Safety Management in Sub-Saharan Africa Using Regulated Monitoring Data

Universal access to safe drinking water is prioritized in the post-2015 Sustainable Development Goals. Collecting reliable and actionable water quality information in low-resource settings, however, is challenging, and little is known about the correspondence between water quality data collected by local monitoring agencies and global frameworks for water safety. Using 42 926 microbial water quality test results from 32 surveillance agencies and water suppliers in seven sub-Saharan African countries, we determined the degree to which water sources were monitored, how water quality varied by source type, and institutional responses to results. Sixty-four percent of the water samples were collected from piped supplies, although the majority of Africans rely on nonpiped sources. Piped supplies had the lowest levels of fecal indicator bacteria (FIB) compared to any other source type: only 4% of samples of water piped to plots and 2% of samples from water piped to public taps/standpipes were positive for FIB (n = 14 948 and n = 12 278, respectively). Among other types of improved sources, samples from harvested rainwater and boreholes were less often positive for FIB (22%, n = 167 and 31%, n = 3329, respectively) than protected springs or protected dug wells (39%, n = 472 and 65%, n = 505). When data from different settings were aggregated, the FIB levels in different source types broadly reflected the source-type water safety framework used by the Joint Monitoring Programme. However, the insufficient testing of nonpiped sources relative to their use indicates important gaps in current assessments. Our results emphasize the importance of local data collection for water safety management and measurement of progress toward universal safe drinking water access.