To address technical constraints to microbial water quality testing in remote and low-income settings, the Aquatest research program, led by the University of Bristol in the UK and funded by the Bill & Melinda Gates Foundation, has developed Aquatest: a simple, entirely self-contained diagnostic test for quantifying fecal contamination levels in water.

To develop a comprehensive understanding of microbial water testing and technical requirements among a global range of potential end-users, Aquaya is currently managing field pilots of Aquatest with water providers, public health surveillance agencies, research institutions and NGOs organizations in 14 developing countries across South America, Asia and Africa.  We are also working in Alberta, Canada to determine whether Aquatest is suitable for remote water testing in developed countries.

Among water providers, our partners range from the Nairobi City Water and Sewerage Company, which supplies drinking water to approximately five million residents, to the Ecuadorian municipality of Pindal, which serves approximately seven thousand consumers but has no existing facilities for microbial water quality testing. In Sri Lanka and Morocco, we are working with local community water supply managers in order to evaluate Aquatest’s use by non-professionals. These community managers operate piped systems serving settlements ranging from approximately 100 to 700 households. Prior to the Aquatest pilot, these community managers had no experience with on-site water quality testing and only infrequently sent samples to external laboratories for analysis.

Aquaya is also piloting the Aquatest system with health agencies who are responsible for monitoring all drinking water sources in their jurisdiction, from urban piped supplies to point sources in rural areas. While most health agencies do have laboratories and trained technicians for analyzing water samples at their provincial offices, they struggle to monitor remote sources due to the logistical challenges of transporting samples back to the central laboratory for analysis. Field staff from these agencies are often based in small towns throughout the province and are responsible for regularly visiting remote communities for a range of activities including health education programs, sanitary inspections, and vaccination campaigns. During the pilot, these field staff are using Aquatest to expand monitoring by reducing their reliance on testing at central laboratories. Surveillance agencies piloting Aquatest include the Chris Hani Municipal Health Services department in South Africa, the Pichincha Provincial Department of Health in Ecuador, the Cochabamba Department of Health in Bolivia and six district health departments in Mozambique.

Rural Health techicians prepare the Aquatest incubator in Tiraque, Bolivia

In addition to these local government actors, Aquaya has partnered with the National Environmental Engineering Research Institute (NEERI) in Nagpur, India, and the Center for Global Safe Water at Emory University. These partnerships with international research institutions provide the opportunity to evaluate Aquatest’s applicability in large scale research projects. Finally, we are also piloting Aquatest with Oxfam in the Democratic Republic of Congo (DRC), Kenya, Somaliland and Bangladesh in order to evaluate Aquatest as a tool for use by International NGOs and their local partners in humanitarian relief and recovery programs.

Aquaya’s field research will help determine Aquatest’s potential for increasing microbial water quality testing in remote settings and will help inform the the optimum strategies for reaching relevant end-users with a commercial product.  In addition, we will analyze the current uses of water quality data in order to identify possible opportunities for increasing the management impact of this data.

Check out more photos of the Aquatest pilot in our photo library.

Earlier this year, the World Health Organization (WHO) and UNICEF announced that, on a global level, we have met the United Nations’ 2015 Millennium Development Goal for increasing access to safe water.  A sigh of relief, however, may be somewhat premature.  The fact remains that there are still significant levels of disparity in water access and water quality within the developing world.

To guide the development of inclusive water sector policies, Aquaya, together with the Water Institute at the University of North Carolina, has published a comparative analysis of policy approaches for improving water quality monitoring across nine countries: Bolivia, Brazil, Cambodia, Ecuador, Lao PDR, Malawi, Peru, Sri Lanka and Vietnam. The paper, titled A Comparative Assessment of Institutional Frameworks for Managing Drinking Water Quality, was published in the Journal of Water, Sanitation and Hygiene for Development. *

Morocco's National Water Agency hires independent entrepreneurs to analyze water samples in remote areas.

Our study examined institutional roles for water quality monitoring.  WHO guidelines stipulate two complementary types of monitoring: water providers (for example municipal water utilities) should conduct their own regular operational water quality assessments, while an independent agency (usually responsible for public health) should conduct surveillance monitoring.  We created institutional framework diagrams to visualize responsibilities in each country and found that in most of the study countries, regulations do specify responsibilities for both operational and surveillance monitoring of both urban and rural drinking water supplies.  In reality, however, the actual capacity and resources available for operational and surveillance monitoring outside of major urban centers are generally insufficient.

Rural operational monitoring is likely to remain challenging in many developing countries due to the large numbers and diversity of small water providers.  However, we suggest that an increasing reliance on ‘audit-based’ surveillance  (auditing of operational monitoring data rather than independent parallel surveillance monitoring) of larger municipal water utilities in some countries offers a strategy for shifting direct surveillance resources to rural areas.  More broadly, innovations such as audit-based surveillance provide compelling examples of policy approaches for improving the cost-effectiveness of water quality management.

* The abstract from our publication is available here.  For a reprint of the full publication, please contact Zarah Rahman: Zarah@aquaya.org