WaSH CQI: Applying continuous quality improvement methods to water service delivery in four districts of rural northern Ghana.

Autor: Fisher MB; Department of Environmental Sciences and Engineering, The Water Institute at UNC, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America., Danquah L; School of Geosciences, University of Energy and Natural Resources, Sunyani, Ghana., Seidu Z; West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana., Fechter AN; The Water Project, Concord, NH, United States of America., Saga B; Solidarites International, Clichy, France., Bartram JK; Department of Environmental Sciences and Engineering, The Water Institute at UNC, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America., Liang KM; Department of Environmental Sciences and Engineering, The Water Institute at UNC, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America., Ramaswamy R; Public Health Leadership Program, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States of America.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2020 Jul 15; Vol. 15 (7), pp. e0233679. Date of Electronic Publication: 2020 Jul 15 (Print Publication: 2020).
DOI: 10.1371/journal.pone.0233679
Abstrakt: Continuous, safely managed water is critical to health and development, but rural service delivery faces complex challenges in low- and middle-income countries (LMICs). We report the first application of continuous quality improvement (CQI) methods to improve the microbial quality of household water for consumption (HWC) and the functionality of water sources in four rural districts of northern Ghana. We further report on the impacts of interventions developed through these methods. A local CQI team was formed and trained in CQI methods. Baseline data were collected and analyzed to identify determinants of service delivery problems and microbial safety. The CQI team randomized communities, developed an improvement package, iteratively piloted it in intervention communities, and used uptake survey data to refine the package. The final improvement package comprised safe water storage containers, refresher training for community WaSH committees and replacement of missing maintenance tools. This package significantly reduced contamination of HWC (p<0.01), and significant reduction in contamination persisted two years after implementation. Repair times in both intervention and control arms decreased relative to baseline (p<0.05), but differences between intervention and control arms were not significant at endline. Further work is needed to build on the gains in household water quality observed in this work, sustain and scale these improvements, and explore applications of CQI to other aspects of water supply and sanitation.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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