Department Sanitation, Water and Solid Waste for Development

REACH: Establishing a Drinking Water Security Strategy for Rural Nepal

In rural Nepal, 92% of households[i] have access to an improved drinking water source. Yet assessments of microbial contamination in Mid-Western Nepal shows that 70 - 80% of taps are not delivering water that is safe for drinking. Achieving Sustainable Development Goal Target 6.1 (SDG 6.1), to deliver “universal and equitable access to safe and affordable drinking water for all,” is especially challenging for remote rural settings facing multiple obstacles. These include unreliable supply chains for sampling materials, the high cost of laboratory equipment, and unreliable or non-existent access to electricity.

SANDEC’s Water Supply and Treatment (WS+T) Group is collaborating with the Safe Water Promotion and HELVETAS Swiss Intercooperation to improve access to safe drinking water in remote rural areas of Mid-Western Nepal.  Within HELVETAS’ Water Resource Management Program (WARM-P), this interdisciplinary research focuses on three general areas:

  • Understanding system vulnerabilities explaining microbial contamination
  • Developing solutions for effective water quality treatment and safe handling, and
  • Implementing a sustainable and robust monitoring system linked to a risk-based water safety strategy.

Eawag’s field studies have revealed inconsistent water quality across the piped schemes, high rates of recontamination of stored drinking water, and low perceived risk perception among water users. Spatial and temporal dynamics of water quality also revealed inadequate protection of spring sources supplying the system.

The project duration is 2017-2019, Its focus is to install solar-powered field laboratories across the WARM-P service region and to train local technicians to monitor and mitigate drinking water supplies. This project is supported by the Swiss Agency for Development and Cooperation (SDC) and a catalyst grant from the REACH: Water Security for the Poor programme.

 

[i] WHO/UNICEF JMP, Nepal: estimates on the use of water sources & sanitation facilities (1980 - 2015)

Project Timeline: 2017 - 2020

Project Status

An interdisciplinary group of researchers and practitioners is currently assessing the impact of the risk-based drinking water security intervention that was implemented in 2018-19 across five districts (Achham, Kalikot, Jajarkot, Dailekh and Surkhet), in terms of water quality, system functionality and user satisfaction.

Expected Outcomes and Impacts

This project will be among the first to investigate how a risk-based framework can be adapted to drinking water supplies in mountainous areas, providing much needed guidance and lessons learned for other countries dominated by alpine terrain seeking viable strategies for achieving SDG Target 6.1.

Publications

Can participation promote psychological ownership of a shared resource? An intervention study of community-based safe water infrastructure

Previous research suggests that community-based participation, a process through which beneficiaries can actively influence and define the direction and execution of development programs, can promote long-term uptake, use, and management of shared resources, such as community-based safe water infrastructure. However, results are heterogeneous. Psychological ownership theory and initial evidence suggests that participation promotes positive outcomes for shared resources by fostering sense of ownership through three routes: having control, intimate knowledge, and investing the self. This study used community-based safe water infrastructure as an example to investigate how various forms of participation affect acceptance, use, and functionality of a shared resource and whether this effect is mediated by psychological ownership. We conducted a nonrandomized cluster-based controlled trial with pre–post intervention assessment (N = 369) in 33 villages in rural Nepal, where safe water infrastructure is shared. Participatory intervention activities (e.g., influence in decision-making, contributing materials and labour) favourably affected self-reported outcomes and use of the water supply infrastructure but not observed functionality or drinking water quality. In conclusion, this study supports the assumption that participation can foster psychological ownership, which in turn can support successful management of a shared resource.
Ambuehl, B.; Kunwar, B. M.; Schertenleib, A.; Marks, S. J.; Inauen, J. (2022) Can participation promote psychological ownership of a shared resource? An intervention study of community-based safe water infrastructure, Journal of Environmental Psychology, 81, 101818 (11 pp.), doi:10.1016/j.jenvp.2022.101818, Institutional Repository

Assessing microbial water quality, users' perceptions and system functionality following a combined water safety intervention in rural Nepal

Risk-based water safety interventions are one approach to improve drinking water quality and consequently reduce the number of people consuming faecally contaminated water. Despite broad acceptance of water safety planning approaches globally, there is a lack of evidence of their effectiveness for community-managed piped water supplies in rural areas of developing countries. Our research, in the form of a cluster-based controlled pre-post intervention analysis, investigated the impact of a combined water safety intervention on outcomes of microbial water quality, users' perceptions and piped system functionality in rural Nepal. The study enrolled 21 treatment systems and 12 control systems across five districts of the Karnali and Sudurpaschim provinces. Treatment group interventions included field laboratories for microbial analysis, regular monitoring of water quality including sanitary inspections, targeted treatment and infrastructure improvements, household hygiene and water filter promotion, and community training. In certain systems, regular system-level chlorination was implemented. Before and after the interventions, the microbial water quality was measured at multiple points within the water system. This information was complemented by household interviews and sanitary inspections. The main result to emerge from this study is that chlorination is the only identified intervention that led to a significant reduction in E. coli concentration at the point of consumption. Secondly, the effectiveness of other interventions was presumably reduced due to higher contamination at endline in general, brought about by the monsoon. All the interventions had a positive impact on users' perceptions about their water system, as measured by expectations for future functionality, satisfaction with the services received, and awareness of the potential health risks of drinking contaminated water. For future applications we would recommend the more broadly applied use of chlorination methods at system level as a key component of the package of risk-based water safety interventions.
Bänziger, C.; Schertenleib, A.; Kunwar, B. M.; Bhatta, M. R.; Marks, S. J. (2022) Assessing microbial water quality, users' perceptions and system functionality following a combined water safety intervention in rural Nepal, Frontiers in Water, 3, 750802 (14 pp.), doi:10.3389/frwa.2021.750802, Institutional Repository

Evaluation of system-level, passive chlorination in gravity-fed piped water systems in rural Nepal

Over 2 billion people globally lack access to safely managed drinking water. In contrast to the household-level, manually implemented treatment products that have been the dominant strategy for gaining low-cost access to safe drinking water, passive chlorination technologies have the potential to treat water and reduce reliance on individual behavior change. However, few studies exist that evaluate the performance and costs of these technologies over time, especially in small, rural systems. We conducted a nonrandomized evaluation of two passive chlorination technologies for system-level water treatment in six gravity-fed, piped water systems in small communities in the hilly region of western Nepal. We monitored water quality indicators upstream of the treatment, at shared taps, and at households, as well as user acceptability and maintenance costs, over 1 year. At baseline, over 80% of tap samples were contaminated with Escherichia coli. After 1 year of system-level chlorination, only 7% of those same taps had E. coli. However, 29% of household stored water was positive for E. coli. Per cubic meter of treated water, the cost of chlorine was 0.06-0.09 USD, similar to the cost of monitoring technology installations. Safe storage, service delivery models, and reliable supply chains are required, but passive chlorination technologies have the potential to radically improve how rural households gain access to safely managed water.
Crider, Y. S.; Sainju, S.; Shrestha, R.; Clair-Caliot, G.; Schertenleib, A.; Kunwar, B. M.; Bhatta, M. R.; Marks, S. J.; Ray, I. (2022) Evaluation of system-level, passive chlorination in gravity-fed piped water systems in rural Nepal, Environmental Science and Technology, 56(19), 13985-13995, doi:10.1021/acs.est.2c03133, Institutional Repository

The role of psychological ownership in safe water management: a mixed-methods study in Nepal

Long-term management and use of community-based safe water systems are essential to reduce water-related health risks in rural areas. Water sector professionals frequently cite water users' sense of ownership for the water system as essential for its continuity. This study aims to provide the first insight into users' understanding of psychological ownership, as well as generalizable data, regarding safe water management in rural Nepal. In this convergent mixed-methods study, we conducted 22 qualitative and 493 quantitative interviews with community members in five districts of Nepal, where spring-fed piped water supplies were previously implemented through a demand-led, participatory planning approach. We analyzed the qualitative data by thematic analysis and modeled quantitative routes to and consequences of psychological ownership in generalized estimating equations. Findings from qualitative and quantitative analyses converged to show that community members' decision-making, investment of labor and money, and knowledge about the water system were associated with greater psychological ownership. Psychological ownership was related to greater acceptance and responsibility for maintenance and use, as well as greater confidence in functionality of the water system, but not to its actual functionality. The results highlight the potential of psychological ownership and community participation for the longevity of community-based safe water infrastructure.
Ambuehl, B.; Tomberge, V. M. J.; Kunwar, B. M.; Schertenleib, A.; Marks, S. J.; Inauen, J. (2021) The role of psychological ownership in safe water management: a mixed-methods study in Nepal, Water, 13(5), 589 (18 pp.), doi:10.3390/w13050589, Institutional Repository

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.
Daniel, D.; Diener, A.; van de Vossenberg, J.; Bhatta, M.; Marks, S. J. (2020) 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, International Journal of Environmental Research and Public Health, 17(7), 2172 (14 pp.), doi:10.3390/ijerph17072172, Institutional Repository

Improving drinking water quality in rural communities in Mid-Western Nepal

Achieving universal access to safe drinking water is a global challenge, especially in rural areas of low-income countries. In Nepal, most rural households have access to a protected drinking water source. However, for 75% of the rural population, these sources are impacted by fecal and chemical contaminants. This chapter describes 4 years of applied research on drinking water quality in Mid-Western Nepal, in collaboration with Helvetas Swiss Intercooperation and the REACH: Improving Water Security for the Poor program. The aim of this project was to improve access to safe drinking water for rural households served by the Helvetas Water Resources Management Programme. The field activities were organized into three phases: a baseline characterization of microbial quality at water collection points and household water storage containers for 505 households; an investigation of households' perceptions and practices regarding household water treatment; and controlled evaluation of a combined water safety intervention's impact on E. coli concentrations for five piped schemes. The interventions examined included solar-powered field laboratories, centralized data management, targeted infrastructure improvements, household filter promotion, a sanitation and hygiene behavior change campaign, and community-level orientation and training. By the end of the study period the share of taps and storage containers meeting the WHO guideline for microbial safety increased from 7% to 50% and from 17% to 53%, respectively. These findings indicate that a combination of tailored interventions can effectively reduce fecal contamination at the points of collection and consumption for piped supplies in remote rural communities.
Marks, S.; Shrestha, R. (2020) Improving drinking water quality in rural communities in Mid-Western Nepal, In: O’Bannon, D. J. (Eds.), Women in water quality. Investigations by prominent female engineers, 47-59, doi:10.1007/978-3-030-17819-2_3, Institutional Repository

Understanding the effect of socio-economic characteristics and psychosocial factors on household water treatment practices in rural Nepal using Bayesian belief networks

About 20 Million (73%) people in Nepal still do not have access to safely managed drinking water service and 22 million (79%) do not treat their drinking water before consumption. Few studies have addressed the combination of socio-economic characteristics and psychosocial factors that explain such behaviour in a probabilistic manner. In this paper we present a novel approach to assess the usage of household water treatment (HWT), using data from 451 households in mid and far-western rural Nepal. We developed a Bayesian belief network model that integrates socio-economic characteristics and five psychosocial factors. The socio-economic characteristics of households included presence of young children, having been exposed to HWT promotion in the past, level of education, type of water source used, access to technology and wealth level. The five psychosocial factors capture households' perceptions of incidence and severity of water-borne infections, attitudes towards the impact of poor water quality on health, water treatment norms and the knowledge level for performing HWT. We found that the adoption of technology was influenced by the psychosocial factors norms, followed by the knowledge level for operating the technology. Education, wealth level, and being exposed to the promotion of HWT were the most influential socio-economic characteristics. Interestingly, households who were connected to a piped water scheme have a higher probability of HWT adoption compared to other types of water sources. The scenario analysis revealed that interventions that only target single socio-economic characteristics do not effectively boost the probability of HWT practice. However, interventions addressing several socio-economic characteristics increase the probability of HWT adoption among the target groups.
Daniel, D.; Diener, A.; Pande, S.; Jansen, S.; Marks, S.; Meierhofer, R.; Bhatta, M.; Rietveld, L. (2019) Understanding the effect of socio-economic characteristics and psychosocial factors on household water treatment practices in rural Nepal using Bayesian belief networks, International Journal of Hygiene and Environmental Health, 222(5), 847-855, doi:10.1016/j.ijheh.2019.04.005, Institutional Repository