Water Safety Plans | November 2010 Household and small community water safety Kuching 2 November...

Water Safety Plans | November 2010

Household and small community water safety

Household and small community water safety

Kuching2 November 2010

Bruce GordonWater, Sanitation, Hygiene and Health


Guidelines for Drinking-water Quality (GDWQ)

Guidelines for Drinking-water Quality (GDWQ)

Flagship normative publications of WHO.

– Demand for the document is among the highest and most sustained of all WHO publications.


WHO Guidelines for Drinking Water Quality, Framework for Safe Drinking Water:

WHO Guidelines for Drinking Water Quality, Framework for Safe Drinking Water:

Health-based targets(National regulatory body)

Independent surveillance(Surveillance agency)

Water Safety Plan(Water utility)

External audit of WSP

Verification monitoring

Risk management plan

Implementation of step-wise improvements

Continuous monitoring

Documentation and supporting programmes

Considers overall public health context and contribution of drinking-water to disease burden

Eventually need to be expressed as Water Quality, Performance, or Technology Targets


Water Safety Plan (simplified) Water Safety Plan (simplified)

Continuous cycle

What are the risks?

How do I control the risks?Monitoring

Source: Netti et al. 2005


Implementing a WSP?Implementing a WSP?


Water Safety Plans Water Safety Plans

System mapping Risk Assessment Control measures

Monitoring + verification

Improvements (e.g. investment planning)

WSP stepsWSP steps


WSPs: Sanitary survey reborn?WSPs: Sanitary survey reborn?


• Paradigm shift (from reactive to preventive)• But common sense ("sanitary survey +")


Benefits of WSP approachBenefits of WSP approach

Reduce disease

Risk-based approach

Enhance good practice

Evidence-based investments

Save money in the long-term


Small Community Water Supplies – the need for a WSP approach

Small Community Water Supplies – the need for a WSP approach

Undertrained operators

Varying and inconsistent perception of risks

Unclear roles and responsibilities;

Limited resources

More frequently associated with waterborne disease in both developed & developing countries


The case for HWTSThe case for HWTS

Dramatically improves microbial water quality

Significantly reduces diarrhoea

Among the most effective of water, sanitation, and hygiene interventions

Can be rapidly deployed and taken up by vulnerable populations


WHO Guidelines for Drinking-water Quality WHO Guidelines for Drinking-water Quality

"HWTS has been shown to significantly improve water quality and reduce waterborne infectious disease risks"


Effectiveness ranges of HWTS technologies for the reduction of microbes in water

Effectiveness ranges of HWTS technologies for the reduction of microbes in water

Disinfection/coagulation

Household slow sand filtration

Fiber and fabric filters

Diatomaceous earth filters

Thermal treatment

UV irradiation

Solar disinfection

Free chlorine disinfection

Settling/sedimentation

Porous ceramic filtration

0 1 2 3 4 5 6 7 8 9

Log(10) reduction of microbes

Bacteria

Viruses

Protozoa

Courtesy of Mark Sobsey, University of North Carolina


The Need for a NetworkThe Need for a Network

Looking Back: the situation in 2003

• lack of awareness of effectiveness, and cost effectiveness

• lack of supportive policies

• limited cooperation: fragmented advocacy, research and implementation efforts

• limited tools available to support implementation

• major gaps in implementation research

Response: Establishment of an International Network


Limitations of HWTS Limitations of HWTS

Does not improve access to water (quantity)

Does not provide the health and economic benefits associated with a regular, piped-into home, water supply

Places the burden of water quality management on consumers

Demands a lot from householders, requiring: – Consistent and sustained behaviour change– Time investments to manage water – Financial investments


Current Evidence (simplified) Current Evidence (simplified)

Intervention Effect size on diarrhoea

morbidity

Reduction (percent)

Reference

Water quality, under 12 months 0.56 44% Waddington et al. 20091

Water quality, after 12 months or more 0.81 19% Waddington et al. 20091

Sustainable impact


Challenges Challenges

Has not achieved sustained pubic health impact

Government have not developed comprehensive policies or regulations addressing (non-boiling) HWTS options as part of their overall water safety efforts

Largely a small-scale intervention undertaken by NGOs in isolation from central government-formulated drinking-water supply programmes


Give up?Give up?


NO!NO!

For many vulnerable populations, HWTS remains the only viable approach to rapidly improving water safety

Immense potential health and other benefits associated with ultimately succeeding in scaling-up HWTS

Challenges are significant, but are not dissimilar to those that had been faced previously by successful current interventions

– (e.g. bednets to protect against malaria).


UNICEF and WHO: 7 point plan to control diarrhoea: UNICEF and WHO: 7 point plan to control diarrhoea:

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