title: To What Extent is Drinking Water Tested in Sub-Saharan Africa? A Comparative Analysis of Regulated Water Quality Monitoring.
abstract: Water quality information is important for guiding water safety management and preventing water-related diseases. To assess the current status of regulated water quality monitoring in sub-Saharan Africa, we evaluated testing programs for fecal contamination in 72 institutions (water suppliers and public health agencies) across 10 countries. Data were collected through written surveys, in-person interviews, and analysis of microbial water quality testing levels. Though most institutions did not achieve the testing levels specified by applicable standards or World Health Organization (WHO) Guidelines, 85% of institutions had conducted some microbial water testing in the previous year. Institutions were more likely to meet testing targets if they were suppliers (as compared to surveillance agencies), served larger populations, operated in urban settings, and had higher water quality budgets (all p < 0.05). Our results indicate that smaller water providers and rural public health offices will require greater attention and additional resources to achieve regulatory compliance for water quality monitoring in sub-Saharan Africa. The cost-effectiveness of water quality monitoring should be improved by the application of risk-based water management approaches. Efforts to strengthen monitoring capacity should pay greater attention to program sustainability and institutional commitment to water safety.
authors.affiliation: The Aquaya Institute, Nairobi 00505, Kenya. rachel@aquaya.org.
authors.forename: Rachel
authors.initials: R
authors.lastname: Peletz
authors.affiliation: The Aquaya Institute, Nairobi 00505, Kenya. emily@aquaya.org.
authors.forename: Emily
authors.initials: E
authors.lastname: Kumpel
authors.affiliation: The Aquaya Institute, Nairobi 00505, Kenya. mateyobonham@gmail.com.
authors.forename: Mateyo
authors.initials: M
authors.lastname: Bonham
authors.affiliation: The Aquaya Institute, Larkspur, CA 94939, USA. zarah.rahman@gmail.com.
authors.forename: Zarah
authors.initials: Z
authors.lastname: Rahman
authors.affiliation: The Aquaya Institute, Larkspur, CA 94939, USA. ranjiv@aquaya.org.
authors.forename: Ranjiv
authors.initials: R
authors.lastname: Khush
mesh_terms: D017954:Africa South of the Sahara / Q000453:epidemiology; D060766:Drinking Water / Q000382:microbiology / Q000592:standards*; D004784:Environmental Monitoring / Q000379:methods*; D005243:Feces / Q000382:microbiology; D006801:Humans; D011634:Public Health; D062486:Public Health Surveillance; D014871:Water Microbiology; D014876:Water Pollution / Q000706:statistics & numerical data*; D060753:Water Quality / Q000592:standards*
chemical_list: D060766:Drinking Water
keywords: drinking water; fecal contamination; health agencies; institutional performance; regulated testing; sub-Saharan Africa; water monitoring; water quality; water utilities