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In 2015, Ghana launched the National Drinking Water Quality Management Framework (NDWQMF) to promote a risk-based approach to water quality through water safety plans (WSPs). This study uses a narrative review to synthesize WSP implementation progress in Ghana, identify gaps in practice, and provide recommendations for enhanced effectiveness and scale-up. Findings show limited uptake: only three of 88 urban water supply systems have adopted WSPs, while in the rural sector, the Community Water and Sanitation Agency has implemented WSPs in 177 of 1,022 small-town systems, and the safe water network in 46 systems. However, community-managed water systems overseen by local governments are yet to initiate WSPs. For those that have begun, significant documentation and implementation gaps are noted, including incomplete hazard listings, insufficient improvement plans, and absent standard operating procedures. To strengthen WSP implementation, this study emphasizes the need for robust regulatory mechanisms across urban and rural sectors, along with tailored guidelines and support structures to enable effective WSP adoption across diverse water systems., Competing Interests: The authors declare there is no conflict., (© 2024 The Authors This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (CC BY 4.0), which permits copying, adaptation and redistribution, provided the original work is properly cited (http://creativecommons.org/licenses/by/4.0/).)

Background: Water quality testing is critical for guiding water safety management and ensuring public health. In many settings, however, water suppliers and surveillance agencies do not meet regulatory requirements for testing frequencies. This study examines the conditions that promote successful water quality monitoring in Africa, with the goal of providing evidence for strengthening regulated water quality testing programs., Methods and Findings: We compared monitoring programs among 26 regulated water suppliers and surveillance agencies across six African countries. These institutions submitted monthly water quality testing results over 18 months. We also collected qualitative data on the conditions that influenced testing performance via approximately 821 h of semi-structured interviews and observations. Based on our qualitative data, we developed the Water Capacity Rating Diagnostic (WaterCaRD) to establish a scoring framework for evaluating the effects of the following conditions on testing performance: accountability, staffing, program structure, finances, and equipment & services. We summarized the qualitative data into case studies for each of the 26 institutions and then used the case studies to score the institutions against the conditions captured in WaterCaRD. Subsequently, we applied fuzzy-set Qualitative Comparative Analysis (fsQCA) to compare these scores against performance outcomes for water quality testing. We defined the performance outcomes as the proportion of testing Targets Achieved (outcome 1) and Testing Consistency (outcome 2) based on the monthly number of microbial water quality tests conducted by each institution. Our analysis identified motivation & leadership, knowledge, staff retention, and transport as institutional conditions that were necessary for achieving monitoring targets. In addition, equipment, procurement, infrastructure, and enforcement contributed to the pathways that resulted in strong monitoring performance., Conclusions: Our identification of institutional commitment, comprising motivation & leadership, knowledge, and staff retention, as a key driver of monitoring performance was not surprising: in weak regulatory environments, individuals and their motivations take-on greater importance in determining institutional and programmatic outcomes. Nevertheless, efforts to build data collection capacity in low-resource settings largely focus on supply-side interventions: the provision of infrastructure, equipment, and training sessions. Our results indicate that these interventions will continue to have limited long-term impacts and sustainability without complementary strategies for motivating or incentivizing water supply and surveillance agency managers to achieve testing goals. More broadly, our research demonstrates both an experimental approach for diagnosing the systems that underlie service provision and an analytical strategy for identifying appropriate interventions., (Copyright © 2018 The Authors. Published by Elsevier GmbH.. All rights reserved.)

This study investigated the effectiveness of Water Safety Plans (WSP) implemented in 99 water supply systems across 12 countries in the Asia-Pacific region. An impact assessment methodology including 36 indicators was developed based on a conceptual framework proposed by the Center for Disease Control (CDC) and before/after data were collected between November 2014 and June 2016. WSPs were associated with infrastructure improvements at the vast majority (82) of participating sites and to increased financial support at 37 sites. In addition, significant changes were observed in operations and management practices, number of water safety-related meetings, unaccounted-for water, water quality testing activities, and monitoring of consumer satisfaction. However, the study also revealed challenges in the implementation of WSPs, including financial constraints and insufficient capacity. Finally, this study provided an opportunity to test the impact assessment methodology itself, and a series of recommendations are made to improve the approach (indicators, study design, data collection methods) for evaluating WSPs.

Shallow groundwater containing toxic concentrations of arsenic is the primary source of drinking water for millions of households in rural West Bengal, India. Often, this water also contains unpleasant levels of iron and non-negligible fecal contamination. Alternatives to shallow groundwater are increasingly available, including government-built deep tubewells, water purchased from independent providers, municipal piped water, and household filters. We conducted a survey of 501 households in Murshidabad district in 2014 to explore what influenced the use of available alternatives. Socioeconomic status and the perceived likelihood of gastrointestinal (GI) illness (which was associated with dissatisfaction with iron in groundwater) were the primary determinants of the use of alternatives. Arsenic knowledge was limited. The choice amongst alternatives was influenced by economic, social, and aesthetic factors, but not by health risk perceptions. The use of purchased water was rarely exclusive and was strongly associated with socioeconomic status, suggesting that this form of market-based water provision does not ensure universal access. Demand for purchased water appeared to decrease significantly shortly after free piped water became available at public taps. Our results suggest that arsenic mitigation interventions that also address co-occurring water problems (iron, GI illness) could be more effective than a focus on arsenic alone.

Drinking water is of paramount importance for people's health. Many outbreaks due to poor water quality are being recorded even nowadays. Although the institutional framework exists at global (e.g., WHO guidelines) and national level, there are still many factors contributing to water contamination. Risk assessment tools, such as HACCP and Water Safety Plans, are being elaborated all over the world to act proactively referring to drinking water quality. The present paper aims at reviewing the implementation status of risk assessment tools around the world and presenting the benefits and the difficulties recorded during the implementation process. The benefits include improved water quality, improved operational efficiency, reduced consumers' complaints, reduced production cost, and reduced potential hazardous incidents. Studying the difficulties, the identification of critical success factors for the implementation of such tools is feasible. Some of the critical success factors include the financial and human resources, staff training, effective identification of critical control points, correct estimation of the occurrence and the severity of the hazards, effective coordination, and efficient monitoring.

Water is an indispensable resource crucial for sustaining life even though projections indicate that by 2025, over 3 billion people will inhabit water-stressed regions, with 14 countries transitioning from water stress to water scarcity. This study investigates the influence of financial planning based on financial control and decision-making on water availability for domestic use in the Pangani Basin, Tanzania. The research examines the interconnectedness between financial planning and water availability outcomes through a mixed-method approach, combining quantitative analysis and qualitative insights from key informants. Quantitative findings reveal a significant positive correlation between financial planning and domestic water availability (β = 0.377, p < 0.001), emphasising the importance of effective financial control particularly on budgeting and its proper use for improving infrastructure. Likewise, stakeholders' participation in the decision-making process is important for water resource management. The study highlights the importance of effective financial control and decision-making to ensure sustainable access to clean water for local communities. The study recommends that the Pangani Basin Water Institute emphasise proper use of financial resources for water infrastructure and prioritise stakeholder engagement in decision-making processes. [ABSTRACT FROM AUTHOR]

A water safety plan (WSP) is a tool proposed by the World Health Organization (WHO) for the mitigation of risks in water consumption, and little is known about the challenges of its implementation stage. The goal of this work was to identify the facilitating factors and challenges regarding WSP implementation from a case study in Brazil. Semi-structured interviews were conducted with water supply public service providers who already have implemented such policy and with supporting institutions that helped with the process implementation. As a result, it has been identified that the WSP implementation is strongly influenced by the quality of WSP preparation process, which means that this process is the foundation of the WSP implementation; through internal management of the organization, whose administrative discontinuities thwart the actions' implementation; and through the relationship of the service provider with the external actors, which can interfere be it in the data collection or the WSP implementation scope's entirety. Lastly, it was possible to conclude that the WSP preparation process, the organization's internal management, and its relationship with external actors are the specific factors that impact the WSP implementation. The conduction and deepening of studies aiming to improve the tools of support for WSP implementation are thus recommended. [ABSTRACT FROM AUTHOR]

Gender equity is an important element of health promotion and is vital to ensuring that the benefits and burdens of participation in health promotion activities are fairly distributed. Yet, the gendered consequences of participatory interventions are often overlooked. This is particularly relevant for water and sanitation initiatives, given that women are generally responsible for maintaining domestic hygiene and procuring water. This study uses a qualitative approach to assess the gender dynamics of participation in community-led total sanitation (CLTS) activities in Mpwapwa District, Tanzania. We used semi-structured interviews and focus-group discussions to investigate men's and women's involvement in health promotion initiatives and their key motivators for and challenges to participation. We interviewed 77 community members from four villages and analysed the responses using qualitative content analysis. The study supports the notion that participation reinforces gender inequity and reproduces gendered norms due to activity-specific participation, women's passive participation within activities, and their limited opportunities for decision-making. However, there were also indications that participation provided a platform to increase the status of women, prioritise women's needs and demand a stronger position in decision making within the household and the community. CLTS organisers should, therefore, harness the opportunity to address gender inequalities within the community. [ABSTRACT FROM AUTHOR]

A minimum of basic water supply service is pertinent to improving living standards and water-dependent quality of life indices. In Nigeria, 14% have access to safely managed drinking water services, though approximately 30% of water pumps and schemes are likely to fail within 12 months of construction. This study aims to determine household water security and its predictors in Osun State, Nigeria. The cross-sectional study recruited 548 households through a five-stage sampling technique and used a semi-structured questionnaire for data collection. Results were presented by descriptive and inferential statistics, while binary logistic regression identified water-security predictors at Pά 0.05. Hand-dug wells (27.7%) and motorized boreholes (21.2%) were the predominant household drinking water sources. A total of 43.7% of households were water-secured while 35.2% of water sources were within residential settlements. A total of 25.1% of households experienced water scarcity, and 27.2% of households treat drinking water mainly by chlorination (56.7%) and boiling (14.7%). A total of 21.2%, 64.2%, and 9% of households, respectively, have safely managed basic and limited water supply services. Drinking water sources were associated with house ownership (p = 0.001) and residence period (p = 0.025) while water treatment was associated with gender (p = 0.010) and wealth (p = 0.0001). Age (p = 0.002) and wealth (p = 0.0001) are predictors of household water security. Two-fifths of households were water-secured, highlighting the dearth of potable water supply services and the need to incorporate strategic predictors of household water security in the existing national and state-level water resources regulations. [ABSTRACT FROM AUTHOR]

The current study investigates the water quality parameters of drinking water resources in District Neelam (DNLM), Azad Jammu & Kashmir (AJK), Northwestern Pakistan. The studied area has been recently reported with many waterborne diseases, which probed this analytical study. The samples were aseptically collected from springs, taps, and surface water bodies. The water quality parameters, such as physical, microbiological, anions, and heavy metals, were tested. Results showed that the electrical conductance (EC) and total dissolved solids (TDS), were 974.60 µS/cm and 912.10 mg/L, respectively, exacerbating the quality of drinking water in DNLM. For microbial water testing, we used 3M-Petrifilms as a detection source, which could separate coliform bacteria from E. coli by creating unique surface chromophores. Out of sixty collected samples, 76% had bacterial contamination. Nitrite, nitrate, and phosphate (9.8, 15.0, and 15.1 mg/L), were also surpassing the safe limits of the World Health Organization (WHO) standards for water quality measurement. The heavy metals, i.e., As, Cr, Cu, and Pb were also tested in current analysis. Pb and Cr (0.04 mg/L and 0.06 mg/L) exceeded from safe drinking water guidelines of the WHO and more than 50% of the collected samples had Pb as a major water pollutant in DNLM. Poor waste management, open sludge discharge, lack of municipality measures, and mineral leaching into the freshwaters of DNLM due to mining and metal extraction processes were the main sources of water pollution in the region. The inorganic pollutants were responsible for the sudden rise of different malignancies and other fatal diseases (vital organ failures and reproductive disorders) in the region, which has not been reported in the past. The current investigation yielded useful baseline data of the drinking water reserves of NW Pakistan that could help to develop techniques for the mitigation of water pollutants present in the region. [ABSTRACT FROM AUTHOR]

Coliforms (FB) posing population health risks in groundwater (GW) have been identified for decades, with recent studies assessing how hydrogeological and non-hydrogeological parameters correlate with their presence. This study focused on explaining the physicochemical and hydrological factors influencing the presence of fecal contamination in the GW system of Ad-Dawadmi, KSA, a hyperarid area facing a prolonged drought. It was designed and implemented by sampling 47 working wells and their laboratory analysis. The data analyses indicated that the salinity exhibited a purification effect such that at levels higher than 3500 and 6000 mg/L, no E. coli and total coliform (TC) were detected. Heavy metals, especially copper, showed strong, hygienic effects at 195 and 300 µg/L thresholds for E. coli and TC, respectively, while those of Fe were at 1200 and 2000 µg/L. Nitrates, dissolved organic carbon (DOC), and dissolved oxygen (DO) showed a quasi-random interrelationship with FB. The occurrence of FB in boreholes up to 52 m below ground level (BGL) challenges the single water resource in the region. Integrating various analyses help constrain and provide multiple lines of evidence for the inferred remarks. This work presented some methodological aspects for understanding the effects of the physicochemical and hydrogeological factors on FB that may better protect water quality and improve human health outcomes. [ABSTRACT FROM AUTHOR]

Background: There is increasing recognition of the complexity underlying WASH conditions in developing countries. This article explores the complexity by assessing the vulnerability of a specific area to poor WASH conditions using a qualitative approach.Methods: We present our findings for the district of East Sumba in Indonesia. This area is known as one of the poorest regions in Indonesia with inadequate WASH services, indigenous belief that hinder the practice of WASH-related behaviours, and has a high rate of children malnutrition. All the factors that contribute to poor WASH conditions were discussed through the lens of the Financial, Institutional, Environmental, Technological, and Social (FIETS) framework. We then summarised the factors and visualized the "system" using a mind map which shows how factors are interconnected and helps to find the root causes of poor WASH conditions.Results: There are three main challenges that inhibit the improvement of WASH conditions in this area: inadequate institutional capacity, water scarcity, and poor socio-economic conditions. We found that a village leader is the most important actor who influences the sustainability of WASH services in this area and healthcare workers are influential WASH promoters. This study also shows how culture shapes people's daily lives and institution performance, and influences the current WASH conditions in East Sumba. The mind map shows there is an overlap and interconnection between FIEST aspects and WASH conditions in the study area.Conclusion: WASH conditions are influenced by many factors and are often interconnected with each other. Understanding this complexity is necessary to improve WASH conditions and sustain adequate WASH services in developing countries. Finally, WASH interventions have to be considerate of the prevailing cultural practices and should involve multidisciplinary stakeholders. [ABSTRACT FROM AUTHOR]

The goal of this research was to investigate the feasibility of using electrocoagulation (EC) as a primary surface water treatment process that could be used with solar panels in decentralised locations. In this study, the removal of turbidity, ultraviolet light at 254 nm (UV 254) and dissolved organic carbon (DOC) was studied. Operating parameters such as current density (0·91–10 mA/cm2) and charge loading (0·083–1·250 A h/l) in bipolar and monopolar configuration were studied using a direct current (DC) power supply. Experimental results showed that a current density of 4·55 mA/cm2 and a treatment time of 60 min in the bipolar configuration allowed the best removal of turbidity, UV 254 and DOC (97·0, 93·0 and 95·2%, respectively). For the second part of the study, the DC power supply was replaced by two photovoltaic panels without the use of a set of batteries and a charge controller. According to the results, the turbidity removal is directly proportional to the solar radiation intensity. This suggests that it is possible to control the charge loading by adjusting the treatment time as a function of solar intensity. Such outcomes suggest that solar-powered EC would be a suitable technology for areas not connected to centralised water treatment networks. [ABSTRACT FROM AUTHOR]

Aims: The World Health Organization (WHO) has recommended Water Safety Plans (WSPs) since 2004 as a means to reduce drinking water contamination and risks to human health. These risk management programs have shown promise across several potential areas of evaluation, such as economic benefits and regulatory compliance. Since WSPs are largely carried out by people who interact with water treatment equipment and processes, operational performance indicators may be key to understanding the mechanisms behind desirable WSP impacts such as water quality and public health improvement.Method: This study reports performance measures collected at a WSP implementation location in southwestern France over several years.Results: Quantitative assessment of performance measures supported qualitative reports from utility managers. Results indicate significantly reduced duration of low-chlorine events at one production facility and a significant decrease in customer complaints related to water quality, manifesting reported improvements in operational performance and the customer service culture.Conclusion: The findings demonstrate some success stories and potential areas of future performance tracking. Cyclical iteration of the WSP can help to achieve continuous quality improvement. Successfully applied evaluation criteria such as the number of water quality complaints or alarm resolution time might be useful across other locations. [ABSTRACT FROM AUTHOR]

Water Safety Plan (WSP) implementation has the potential to greatly improve, commonly very challenging and resource limited, small drinking water supplies. Although slower than in urban or high-income settings, the uptake of WSPs in low- and middle-income countries (LMICs) is accelerating. Understanding the factors which will make a WSP successful will further improve efficient uptake and assist with its long-term sustainability. Based on an extensive literature search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISM-A) methodology, 48 publications, including case studies and guidance documentation, formed the basis of this review. These were analysed using inductive and deductive coding methods to (i) identify the success factors applicable to WSP implementation in small drinking water supplies in LMICs and (ii) to investigate which factors are more or less critical depending on the geography and level of development of the implementing country. Key challenges identified during the review process were also noted. A comparison of these success factors was made with those identified from high-income and urban settings. The three most important success factors identified are the development of technical capacity, community engagement, and monitoring and verification. Factors specific to small drinking water supplies in LMICs include support from non-government organisations, integration into existing water sanitation and hygiene (WASH) programs, simplicity, and community engagement. Certain factors, such as adaptability, the use of guidance documentation, international collaboration, the role of pilot studies, knowledge sharing, and stakeholder involvement are applicable to all WSP settings. Due to the specific challenges faced by small drinking water systems and the limited number of original research publications on this topic, this study highlights the need for further data collection and research focused on success factors in these settings. It is anticipated that the consideration of the success factors identified in this study will assist implementers in improving the uptake and long-term sustainability of WSPs in small drinking water supplies in low- and middle-income settings. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]