Existing strategies for improving global access to safe drinking water have met only limited success. We consider an unglamorous and often neglected dimension of drinking water infrastructure provision: cleaning. We randomly assigned caretakers of community wells to participate in a training workshop about how to clean wells. Thirteen to seventeen months later, wells with caretakers assigned to receive training have negligible rates of contamination with Escherichia coli (13 months: 2%; 17 months: 4%), while control wells have substantial rates of E. coli contamination (13 months: 14%; 17 months: 19%). Rates of contamination with any coliform bacteria are almost halved (13 months: control 55%, treated 30%; 17 months: control 77%, treated 46%). We estimate the cost of preventing exposure to coliform bacteria in drinking water to be US$0.89 per person and that, if scaled up, each US$2376 spent on the intervention could avoid the death of a child.

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.

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.

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.

Can transparency interventions improve WASH service provision? We use a randomized experiment to evaluate the impacts of a transparency intervention, a deliberative multi-stakeholder workshop initiated with a community scorecard exercise, in schools in rural Bangladesh. To measure impacts, we combine survey data, direct observations, and administrative data. The intervention leads to moderate but consistent improvements in knowledge of WASH standards and practices, and institutions for WASH service management, but does not improve school WASH service provision or change WASH facility use patterns. Drawing on rich descriptive data, we suggest several reasons why the intervention we evaluate did not improve WASH service outcomes and propose ways to improve the design of future interventions.

Development practitioners have long advocated for targeted beneficiary communities to participate in decision-making about how to provide local public goods and services. However, community participation in decision-making may have disadvantages as well as benefits, and the balance between the benefits and disadvantages may vary across different decision- making processes, interventions, and contexts. Previous studies of community participation in decision-making indeed report mixed results, but the underlying reasons for this remain uncertain. This study demonstrates that context matters. We investigate the heterogeneity of impacts in a field experiment conducted in two regions of rural Bangladesh. The experiment randomly assigns different decision-making processes to villages that receive otherwise identical interventions in the form of a program to increase access to safe drinking water. We show that a deliberative, consensus-based approach to community participation in decision- making has strongly heterogeneous effects compared to either a top-down approach or community decision-making without rules about how decisions are made. The consensus- based process doubles the program's impact in one region but barely increases it in the other. We  use  machine learning to  identify the  baseline  characteristics  and mechanisms that correlate most strongly with impact. The results suggest that the consensus-based process yields better outcomes when there is more at stake: specifically, when the community has fewer pre-existing safe sources of drinking water and thus more to gain from the intervention. The results are consistent with the view that inclusive participatory approaches to decision- making can increase program impacts but fully engaging in these processes is costly. When less  is  at  stake,  communities  may  not  fully  engage, and  the  advantages  of  inclusive participatory decision-making may not be realized.

Most development practitioners would list engaging communities in the provision of public services among best practices for improving access. However, whether community participation enhances provision and use of public services relative to a non-participatory approach is largely unknown because few studies compare impacts when the same public service intervention is implemented with and without community participation. This field experiment compares three approaches to providing safe water in rural Bangladesh. Delegating decisions to the community increases use of safe water by about 80% relative to a top-down provider making the same decisions but only when the approach to delegating decisions limits elite influence.

Growth and development depend on the sustainable provision of infrastructure. However, infrastructure is woefully underprovided in much of the developing world, and in many cases falls rapidly into disrepair. The problem is particularly acute in poor and  remote  rural  areas,  where  responsibility  for  maintenance  and  repair  of infrastructure largely lies with communities. A common policy response is to require beneficiaries  to  participate  in  the  design  or  financing  of  infrastructure.  Such participation requirements intend to create “buy-in” or a sense of ownership, thereby increasing the likelihood of maintenance and repair, but they also impose additional costs on poor communities. Are these costs justified? We assemble 15 years of data from more than 600 wells constructed in 259 villages in rural Bangladesh and exploit experimental variation in community participation in project implementation to show that participation can increase sustainability.

Development projects that set out to provide local public goods and services almost universally require communities to contribute collectively towards project costs. But despite the ubiquity of such requirements, we know little with certainty about their consequences, including whether consequences differ when communities contribute in cash or labour. Using a randomized experiment, we evaluate how requiring communities to contribute affects the impact of projects that aim to provide safe drinking water wells in rural Bangladesh. Cash contribution requirements strongly reduce take-up and impact relative to a contribution waiver. Labour contribution requirements with similar value if priced at the market wage do not, most likely because most households value their time below the market wage. These results suggest that in poor rural areas, where the monetary value of time is low, projects that require contributions may realize substantial welfare gains by replacing cash contribution requirements with labour contribution requirements. However, imposing any contribution requirement increases coordination and monitoring costs. After accounting for these costs,  requiring  communities to contribute decreases cost-effectiveness, undermining a central rationale for imposing such requirements.

Progress on improving access to safe drinking water is glacial, and existing strategies for improving access have met with only limited success. We consider an often neglected dimension of water infrastructure provision: cleaning. We randomly assigned caretakers of community wells to participate in a one-off training workshop about how to clean wells. Thirteen to seventeen months later, wells with caretakers assigned to receiving training have negligible rates of contamination with Escherichia coli and almost half the rates of contamination with any coliform bacteria, compared to control wells whose caretakers did not receive training. We estimate that the cost of preventing exposure to coliform bacteria in drinking water is US$0.88 per person and that if scaled up, each US$2034 spent on the intervention could avoid the death of a child. The results suggest that researchers and policy-makers who wish to increase access to safe drinking water should pay more attention to the unglamorous but important topic of cleaning.