Upgrading a Piped Water Supply from Intermittent to Continuous Delivery and Association with Waterborne Illness: A Matched Cohort Study in Urban India

Ercümen, Ayşe; Arnold, Benjamin F.; Kumpel, Emily; Burt, Zachary; Ray, Isha; Nelson, Kara L.; Colford, John M.

doi:10.1371/journal.pmed.1001892

Cited by 89 publications

(101 citation statements)

References 37 publications

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“…The water policy literature has shown that intermittent water supply imposes significant costs on households, especially with respect to water quality and human health (Kumpel & Nelson, 2013;Ercumen et al, 2015). Unpredictable supplies impose particularly large costs, especially upon household members tasked with managing the water (Pattanayak et al, 2005;Subbaraman et al, 2015;Zérah, 2000).…”

Section: Household Welfare Effectsmentioning

confidence: 99%

Flows, leaks and blockages in informational interventions: A field experimental study of Bangalore's water sector

2018

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a b s t r a c tMany policies and programs based on informational interventions hinge upon the assumption that providing citizens with information can help improve the quality of public services, or help citizens cope with poor services. We present a causal framework that can be used to identify leaks and blockages in the information production and dissemination process in such programs. We conceptualize the ''information pipeline" as a series of connected nodes, each of which constitutes a possible point of blockage. We apply the framework to a field-experimental evaluation of a program that provided households in Bangalore, India, with advance notification of intermittently provided piped water. Our study detected no impacts on household wait times for water or on how citizens viewed the state, but found that notifications reduced stress. Our framework reveals that, in our case, noncompliance among human intermediaries and asymmetric gender relations contributed in large part to these null-to-modest results. Diagnostic frameworks like this should be used more extensively in development research to better understand the mechanisms responsible for program success and failure, to identify subgroups that actually received the intended treatment, and to identify potential leaks and blockages when replicating existing programs in new settings.

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Section: Household Welfare Effectsmentioning

confidence: 99%

Flows, leaks and blockages in informational interventions: A field experimental study of Bangalore's water sector

2018

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“…The matched cohort design seeks to minimise the risk of unmeasured confounders by matching on characteristics likely to impact outcomes of interest (Austin, 2011;Stuart, 2010). This design has been used in other studies of pre-existing interventions where randomization is not possible (Arnold et al, 2009(Arnold et al, , 2010Ercumen et al, 2015a).…”

Section: Introductionmentioning

confidence: 99%

Use, microbiological effectiveness and health impact of a household water filter intervention in rural Rwanda—A matched cohort study

Kirby

Nagel

Rosa

et al. 2017

International Journal of Hygiene and Environmental Health

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Kirby, M.A.; Nagel, C.L.; Rosa, G.; Umupfasoni, M.M.; Iyakaremye, L.; Clasen, T.F. (2017) This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Graphical abstract ABSTRACTUnsafe drinking water is a substantial health risk contributing to child diarrhoea. We investigated impacts of a program that provided a water filter to households in rural Rwandan villages. We assessed drinking water quality and reported diarrhoea 12-24 months after intervention delivery among 269 households in the poorest tertile with a child under 5 from 9 intervention villages and 9 matched control villages. We also documented filter coverage and use. In Round 1 (12-18 months after delivery), 97.4% of intervention households reported receiving the filter, 84.5%were working, and 86.0% of working filters contained water. Sensors confirmed half of households with working filters filled them at least once every other day on average. Coverage and usage was similar in Round 2 (19-24 months after delivery). The odds of detecting faecal indicator bacteria in drinking water were 78% lower in the intervention arm than the control arm (odds ratio (OR) 0.22, 95% credible interval (CrI) 0.10-0.39, p<0.001). The intervention arm also had 50% lower odds of reported diarrhoea among children <5 than the control arm (OR=0.50, 95% CrI 0.23-0.90, p=0.03). The protective effect of the filter is also suggested by reduced odds of reported diarrhoea-related visits to community health workers or clinics, although these did not reach statistical significance.

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“…However, service reliability can affect potential health gains from on-plot water access. Households with more reliable water service have been shown to experience less diarrhea (Majuru et al, 2011) and bloody diarrhea (Ercumen et al, 2015) than households with intermittent service.…”

Section: Introductionmentioning

confidence: 99%

On-plot drinking water supplies and health: A systematic review

Overbo

Williams

Evans

et al. 2016

International Journal of Hygiene and Environmental Health

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Many studies have found that household access to water supplies near or within the household plot can reduce the probability of diarrhea, trachoma, and other water-related diseases, and it is generally accepted that on-plot water supplies produce health benefits for households. However, the body of research literature has not been analyzed to weigh the evidence supporting this. A systematic review was conducted to investigate the impacts of on-plot water supplies on diarrhea, trachoma, child growth, and water-related diseases, to further examine the relationship between household health and distance to water source and to assess whether on-plot water supplies generate health gains for households. Studies provide evidence that households with on-plot water supplies experience fewer diarrheal and helminth infections and greater child height. Findings suggest that water-washed (hygiene associated) diseases are more strongly impacted by on-plot water access than waterborne diseases. Few studies analyzed the effects of on-plot water access on quantity of domestic water used, hygiene behavior, and use of multiple water sources, and the lack of evidence for these relationships reveals an important gap in current literature. The review findings indicate that on-plot water access is a useful health indicator and benchmark for the progressive realization of the Sustainable Development Goal target of universal safe water access as well as the human right to safe water.

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Upgrading a Piped Water Supply from Intermittent to Continuous Delivery and Association with Waterborne Illness: A Matched Cohort Study in Urban India

Cited by 89 publications

References 37 publications

Flows, leaks and blockages in informational interventions: A field experimental study of Bangalore's water sector

Flows, leaks and blockages in informational interventions: A field experimental study of Bangalore's water sector

Use, microbiological effectiveness and health impact of a household water filter intervention in rural Rwanda—A matched cohort study

On-plot drinking water supplies and health: A systematic review

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