Message on behalf of Susan Murcott who is traveling
Orlando Hernandez - Monday 22 January 2007
Hi Orlando and Rochelle
I picked up Patricia's email on the EConf just yesterday and read it and Orlando's paper today. Excellent paper Orlando - a very fine job of summarizing a very difficult subject.
One immediate comment about the 2 indicators short-listed at the end...
The "use" and "sustained use" indicators I proposed in my Quito and Bangkok Network presentations came out of discussions with Network members, so I attribute them to the "Implementation Working Group members" and the Network as much as to me. The use and sustained use indicators are percentages (number divided by number is a %), in common with Rochelle's indicator: "% of HH practicing effective household water management. The idea lacking from both of my indicators - "rate of adoption" and "rate of sustained use" -- is the idea, which I like very much, of "practicing effective HH water management" and which I assume that Rochelle or folks at HIP/USAID or Maria Elena or someone else is ready to define for us.
There are three elements missing from Rochelle's indicator, which include:
1) My presentation of the indicator shows both the numerator and the denominator (but Rochelle's is conflated),
2) The term "targeted HHs." Targeted HH's can be all the HHs in a given country, it can be all the HHs in a targeted intervention group or some other set.
3) Time (I suggest "adoption" = 1 month; "sustained use" = 1 year, but these periods are rather arbitrary and certainly open for discussion.)
Now, I have been thinking of a new way to represent the individual components and variables more clearly, so I have made a Table and attached that to this document. Have a look.
I am providing all these thoughts now because I think it is an important clarification, and next week, the week of the E-conf is going to be a blur for me, travelling with students from Tamale to Accra to Nairobi.. with lots of lose ends to tie up with various activities in Ghana. Meanwhile, I have forwarded the invitation to the E-Conf to my Ghana teammates, and hopefully they can also make a contribution to the effort.
So....I will keep thinking about this, and discussing it among my teammates and colleagues here. Meanwhile, please critique what I have offered and interject this discussion and Table for me into the E-Conf if I don't get a chance early next week when the conference begins.
Thanks to Orlando for his paper and to Rochelle for her indicator. I am looking forward to the E.Conf opportunity for gaining the wisdom of the HWTS community's experience from this and sharing ideas at the Kenya meeting.
Susan Murcott's document can be found in the list of documents associated with this conference.
New topic
Rochelle Rainey - Saturday 27 January 2007
Hi everyone! I just keep getting behinder and behinder so here goes...
Susan, thanks very much for your detailed response to Orlando’s discussion paper that launched this e-conference.
First I want to provide more detail on USAID's proposed indicator “% of households without continuous access to piped water under pressure in the house that are practicing effective household water management”.
The current definition we are using for this indicator is:
Continuous piped water under pressure in the household is defined as:
1. Presence of a tap within the house; and
2. Respondent reports that water comes out of the tap 24 hours a day, 7 days per week
This was added to the indicator to make sure that our denominator is not inflated by people who do not need to treat their water in the household.
Effective household water management is defined as:
1. Presence of chlorine residual in household drinking water storage container; and/or
2. Presence of a covered ceramic water filter in an accessible spot in the kitchen, with filter in place and water in the lower container; and/or
3. Presence of multiple SODIS bottles exposed to full sunlight
This definition has then been used to develop a Lot Quality Assurance Sample survey module that will be incorporated into a larger child survival survey to be carried out annually to provide data for USAID reporting. We (the environmental health team at USAID and our contractors promoting hygiene improvement including point of use water treatment and safe storage) are not involved in this study directly, so we don’t know what the sampling frame or sample size will be. I believe the first LQAS studies will be carried out this year in a few countries and these questions will be on the table as we pilot test the instrument and process. So, Susan, the numerator/denominator question and the “targeted households” issues you point out are missing are very valid but answers are unknown at this point. I look forward to discussing this more with you in person next week!
For Susan’s issue of timing, I agree that it provides very useful information at the program level, but I wonder if the variability in consistent use is so great even in households that adopt a practice, if this would make sense for a global indicator.
Which brings me to the question of scale, and what level of detail is appropriate for indicators at project level, program level, organizational level (like PSI data from all countries) and global for all organizations promoting all technologies and behaviors.
Many of the ones in Susan’s table are very useful and appropriate for program level (also, Arinita, I like your suggestion of an indicator like “contact agent or individual” for this level), but from a donor’s perspective USAID is looking for one or two very simple things we can count and report on. I also have the feeling that organizations have their own internal momentum, like USAID with the LQAS and PSI with its excellent research tools (like WAWI, Chris! and thanks, Navendu, for your information on PSI) and wonder about our ability as individuals to change those larger processes.
I think in general, Orlando’s proposed indicators of behavioral determinants could be seen more as project-type indicators for use at a level closer to the actual implementation, while the behavioral indicators of # liters water treated and % households practicing effective household water management are more useful for advocacy and reporting to the broader community.
Mark, CDC also suggested that USAID include a water quality marker in our LQAS. I have passed that suggestion on along with the draft LQAS, and will continue to lobby for this as the process unfolds. Stay tuned and meanwhile good luck in your work on fast, cheap, reliable indicators of water quality.
To address another issue of the conference, as you see, currently safe storage is not included in USAID’s definition of “effective household water management” although there is a section in the draft LQAS instrument to collect this data based on the characteristics of covered with a solid lid and having a narrow mouth and/or a tap for removing water without introducing anything into the container. While I think behaviors around water transport, storage and handling are important in maintaining water quality, as Orlando said there is no consensus around how often does the vessel need to be emptied, cleaned, where it is stored, how to measure it so it is not included in the definition at this time.
Ok, I am stopping now, but will continue to follow the interesting discussion. Orlando, thanks for the summaries! Cheers, Rochelle
