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Re-thinking progress:

Re-thinking progress:. Performance monitoring of drinking water quality in Cambodia. Andrew Shantz Consultant for WHO-Cambodia s hantz.andrew@gmail.com. Summary. Complexities of measuring access to water ‘ Improved ’ as an indicator for quality

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Re-thinking progress:

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  1. Re-thinking progress: Performance monitoring of drinking water quality in Cambodia Andrew Shantz Consultant for WHO-Cambodia shantz.andrew@gmail.com

  2. Summary Complexities of measuring access to water ‘Improved’ as an indicator for quality Historical performance monitoring data and future targets Comparison to point-of-consumption water quality Defining progress for the future

  3. Complexities • What components of water access do we actually want to assess? • Water quality? • Water quantity? • Water supply accessibility? • Water supply reliability? • What types of water usage are we interested in? • Drinking? • Domestic purposes? • Not always the same sources/supplies

  4. Complexities • What if >1 source/supply per household per year? • Wet season supplies • Dry season supplies • Primary / Secondary / Tertiary supplies • At what stage do we want to assess the water? • At the source (i.e. underground water, river, rainfall)? • Storage at the home (i.e. tank, jar, container)? • Point-of-consumption (i.e. post-treatment, drinking cup/glass)?

  5. Assessing water is complex! • Prioritize • Cannot assess and monitor everything • What is the focus of the decisions being made? • Public health? • Livelihoods/economics? • Infrastructure assessment? • What factors are most relevant to country context? • Think about what you truly want to understand • Define the question clearly • Work backwards to design the methodology to reach the answer

  6. JMP and ‘Improved’ Supplies • Improved supplies • Boreholes / tube wells • Improved dug wells • Piped water supplies • Rainwater harvesting • Unimproved supplies • Surface water • Unimproved dug wells • Vendor supplied water • Improved supplies ‘more likely’ to provide safe water • So…it is an indicator for quality

  7. 2014

  8. 2014

  9. What does the MDG indicator really mean? • Indicator for microbial water quality at the source • Not an indicator for… • Chemical water quality • Quantity • Reliability • Accessibility • Point-of-consumption  Public health?

  10. ‘Improved’ vs. Point-of-consumption • Progress on drinking water quality is apparent in rural Cambodia • 2015 MDG target already achieved • But what are the public health realities?

  11. POOR PROTECTION http://www.thehindu.com/news/national/karnataka/majority-of-rural-households-in-karnataka-use-unsafe-water-says-study/article2726480.ece

  12. UNHYGENIC STORAGE http://real-estate-malta.com/water-tanks-in-malta-how-to-clean/

  13. DIRTY HANDLING http://www.optimallyorganic.com/WaterDistiller.htm

  14. National assessment of microbial point-of-consumption water quality • 984 drinking water samples from the drinking glass • Representative of rural Cambodia • Representative of rainy season conditions

  15. National assessment of microbial point-of-consumption water quality • 84% of water samples came from Improved supplies • But only 23% met water quality standard for E. coli… • …and only 44% were considered lowrisk (<10 cfu) • Despite progress, public health issues remain

  16. Defining progress for the future • What do we really want to know? • How can performance monitoring shape decision-making? • What resources are available nationally? • But must think beyond JMP definitions to truly understand public health issues related to water

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