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How to clean a tubewell: the effectiveness of three approaches in reducing coliform bacteria
KTH, School of Architecture and the Built Environment (ABE), Sustainable development, Environmental science and Engineering, Water and Environmental Engineering. NGO Forum for Public Health, Dhaka, Bangladesh. (KTH-International Groundwater Arsenic Research Group)ORCID iD: 0000-0001-8844-5001
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2023 (English)In: Science of the Total Environment, ISSN 0048-9697, E-ISSN 1879-1026, Vol. 872, p. 161932-161932, article id 161932Article in journal (Refereed) Published
Abstract [en]

Access to safe drinking water in rural Bangladesh remains a perpetual challenge. Most households are exposed to either arsenic or faecal bacteria in their primary source of drinking water, usually a tubewell. Improving tubewell cleaning and maintenance practices might reduce exposure to faecal contamination at a potentially low cost, but whether current cleaning and maintenance practices are effective remains uncertain, as does the extent to which best practice approaches might improve water quality. We used a randomized experiment to evaluate how effectively three approaches to cleaning a tubewell improved water quality, measured by total coliforms and E. coli. The three approaches comprise the caretaker's usual standard of care and two best-practice approaches. One best-practice approach, disinfecting the well with a weak chlorine solution, consistently improved water quality. However, when caretakers cleaned the wells themselves, they followed few of the steps involved in the best-practice approaches, and water quality declined rather than improved, although the estimated declines are not consistently statistically significant. The results suggest that, while improvements to cleaning and maintenance practices might help reduce exposure to faecal contamination in drinking water in rural Bangladesh, achieving widespread adoption of more effective practices would require significant behavioural change.

Place, publisher, year, edition, pages
Elsevier BV , 2023. Vol. 872, p. 161932-161932, article id 161932
Keywords [en]
Drinking water, Coliform bacteria, Deep tubewells, Cleaning/maintenance, Disinfection
National Category
Medical and Health Sciences Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:kth:diva-324514DOI: 10.1016/j.scitotenv.2023.161932ISI: 000944995500001PubMedID: 36796696Scopus ID: 2-s2.0-85148543994OAI: oai:DiVA.org:kth-324514DiVA, id: diva2:1741444
Funder
Swedish Research Council FormasSwedish Research Council Formas
Note

QC 20230404

Available from: 2023-03-06 Created: 2023-03-06 Last updated: 2023-12-08Bibliographically approved
In thesis
1. Increasing the impact and sustainability of safe drinking water supply systems in rural Bangladesh: Randomized experiments with interventions in project life cycle
Open this publication in new window or tab >>Increasing the impact and sustainability of safe drinking water supply systems in rural Bangladesh: Randomized experiments with interventions in project life cycle
2023 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [sv]

Tillgång till rent dricksvatten är en global utmaning, vilket återspeglas i hållbar utvecklingsmål 6. I Bangladesh är det en brådskande fråga att överbrygga klyftan mellan de som har säkert hanterat dricksvatten och de med förbättrade källor. Denna studie uppskattar orsakssamband mellan ingrepp i projektets livscykel och deras inverkan på hållbar tillgång till rent dricksvatten på landsbygden.  En  serie  randomiserade  kontrollförsök  (RCT)  genomfördes  i  olika  regioner  i Bangladesh  under  15  år  av  rörbrunnskonstruktionsprogram  för  att  tillhandahålla  arsenikfritt dricksvatten.  RCT:erna  utvärderade  förändringar  av  beslutsprocesser,  bidragskrav  och underhållspraxis. Gemenskapens deltagande i beslutsprocesser kan öka effekten och hållbarheten hos program för säkert dricksvatten. Att kräva att samhällen bidrar ekonomiskt eller genom arbetskraft ökar inte nödvändigtvis programmets genomslagskraft, och det kan leda till minskat utnyttjande och minskad kostnadseffektivitet, även om det kan öka hållbarheten. Gemenskapens vattenkällor är mindre effektiva än förväntat på grund av föroreningar som införts under kollektiv användning och problem som rör transport och lagring: de bidrar till att minska exponeringen för arsenik men tar inte upp avföringskontamination effektivt. Desinficering av brunnar med en svag klorlösning  minskade  fekal  kontaminering.  Vaktmästares  standardrengöringsmetoder  följer  i allmänhet inte bästa praxis och kan försämra vattenkvaliteten. Utbildning av vaktmästare i bästa praxis visade sig dock vara mycket effektiv för att minska. Escherichia coli-kontamination, vilket avsevärt  förbättrar vattenkvaliteten.  Trots  vissa  brister  i  vaktmästarens  återkallande  och efterlevnad,  belyser  dessa  resultat  den  avgörande  roll  som  korrekta  rengörings- och underhållsmetoder spelar för att minska exponeringen för fekal kontaminering på landsbygden i Bangladesh, för att säkerställa tillgång till rent dricksvatten. Studien belyser kraften hos RCT:er för att ta itu med komplexa orsaksfrågor relaterade till säker tillgång till dricksvatten. Även om värdefulla insikter har uppnåtts, understryker studien att många obesvarade frågor kvarstår, vilket understryker det pågående behovet av forskning inom detta kritiska område. Sammanfattningsvis ger denna studie viktiga bevis om hur man kan förbättra projektdesign och därmed öka tillgången till säkert dricksvatten på landsbygden i Bangladesh.

Abstract [en]

Access to safe drinking water is a global challenge, as reflected in Sustainable Development Goal 6. In Bangladesh, bridging the gap between those with safely managed drinking water and those with improved sources is a pressing issue. This study estimates causal relationships between interventions in the project life cycle and their impact on sustainable access to safe drinking water in rural areas. A series of Randomized Control Trials (RCTs) were conducted across different regions of Bangladesh over 15 years of tubewell construction programs to provide  arsenic  free  safe  drinking  water.  The  RCTs  evaluated  changes  to decision-making  processes,  contribution  requirements,  and  maintenance practices. Community participation in decision-making processes can enhance the  impact  and  sustainability  of  safe  drinking  water  programs.  Requiring communities to contribute financially or through labour does not necessarily increase program impact, and it can lead to reduced take-up, and decreased cost- effectiveness though it may increase sustainability. Community water sources are less effective than expected due to contamination introduced during collective use and issues related to transport and storage: they help to mitigate arsenic exposure  but do not effectively  address faecal  contamination. Disinfecting tubewells  with  a  weak  chlorine  solution  reduced  faecal  contamination. Caretakers standard cleaning practices do not generally adhere to best practices and may worsen water quality. However, training caretakers in best practices proved highly effective in reducing Escherichia coli contamination, significantly improving water quality. Despite some imperfections in caretakers' recall and compliance, these results highlight the crucial role of proper cleaning and maintenance practices in reducing exposure to faecal contamination in rural Bangladesh, ensuring access to safe drinking water. The study highlights the power of RCTs in addressing complex causal questions related to safe drinking water access. While valuable insights have been gained, the study emphasizes that numerous unanswered questions remain, underscoring the ongoing need for research in this critical field. In summary, this study provides important evidence about how to improve project design and thereby increase access to safe drinking water in rural Bangladesh.

Place, publisher, year, edition, pages
Stockholm, Sweden: KTH Royal Institute of Technology, 2023. p. 63
Series
TRITA-ABE-DLT ; 2353
Keywords
Randomized Experiment, Safe Drinking Water, Participation, Decision-Making, Contribution Requirements, Cost-effectiveness, Faecal Coliform, Arsenic, Tubewell, Cleaning, Maintenance, Impact, Sustainability, Bangladesh, Randomiserat Experiment, Säkert Dricksvatten, Deltagande, Beslutsfattande, Bidragskrav, Kostnadseffektivitet, Fekal Koliform, Arsenik, Tubewell, Rengöring, Underhåll, Påverkan, Hållbarhet, Bangladesh
National Category
Environmental Engineering Economics
Research subject
Land and Water Resources Engineering
Identifiers
urn:nbn:se:kth:diva-340635 (URN)978-91-8040-784-7 (ISBN)
Public defence
2024-01-19, Sahara, Teknikringen 10B, KTH Campus, video conference link https://kth-se.zoom.us/j/65300584434, Stockholm, 13:00 (English)
Opponent
Supervisors
Funder
Swedish Research Council Formas, 2018-01107
Note

QC 20231211

Available from: 2023-12-11 Created: 2023-12-08 Last updated: 2023-12-18Bibliographically approved

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Habib, Md. AhasanBhattacharya, Prosun

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