Department Sanitation, Water and Solid Waste for Development

Recent large randomized international trials observed only limited effects of basic WASH interventions among children. These findings indicated that more comprehensive strategies and interventions such as safely-managed levels of water and sanitation might be required to achieve the intended impacts.

The objective of this study therefore is to contribute to the evidence base on safely managed drinking and assess if a consistently better water quality at the point of consumption can be achieved by the installation of low-cost in-line chlorination to solar powered boreholes and establishing piped connections to household water taps. In addition, the study aims at assessing if improved water quality at the point of consumption reduces children’s health burden (diarrhoea, malnutrition, nutritional deficiency) in Gambia.

The study design is embracing a non-randomized longitudinal observational study with a comparator group. The cross-sectional baseline and endline data collections will assess situational factors, water quality at the point of collection and point of use, quantity of water used in the household, WASH infrastructure, knowledge, attitude and practice as well as health indicators using standardized tools.

The study objectives are:

To observe the change in child health and water quality after raising the service level from basic to safely managed drinking water:

• Analyse the change in water quality after treatment, at the water tap in the household and at the point of consumption.
• Determine child health (diarrhea, fever, cough, respiratory difficulties, malnutrition (including growth) & nutritional deficiencies) – in villages with safely managed drinking water and comparative areas
• Assess the consistency of consuming safe drinking water in the household (including acceptance of chlorinated water, frequency of use of various sources in the community including the drivers of potential source switching)
• Assess the reliability of operation, technical performance and maintenance of a water supply system consisting of solar operated boreholes including passive in-line chlorination and household connections.