The Sustainable WASH Systems Learning Partnership led by 欧美口爆视频 Boulder 

Over the last five years, the learning partnership coordinated the efforts of seven organizations in sub-Saharan Africa and southeast Asia seeking to develop, test and document sustainable approaches to local water, sanitation and hygiene (WASH) to support initial infrastructure investments.

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Caleb Cord is the first author on a new paper in Science of The Total Environment that looks at water, sanitation, and hygiene (WASH) services in developing countries from the systems level.

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In 2017 The Millennium Challenge Corporation issued a Notice of Funding Opportunity (NOFO) Annual Program Statement (APS) to request partnership applications related to several technical areas. MCC received a concept note from a the University of 欧美口爆视频 Boulder鈥檚 Mortenson Center in Global Engineering & Resilience in response to the high frequency monitoring (HFM) data technical area with a focus on Sierra Leone, and has since undertaken a collaborative process to determine the nature of its engagement on a potential partnership. As a result of this, MCC and the University of 欧美口爆视频 has recently signed a partnership agreement. The following is an overview of this effort.

The Sierra Leone Threshold Program is implementing the Water Sector Reform Project which includes an infrastructure component as part of the District Metering Area (DMA) and Kiosk Demonstration Activity. MCC has a strong interest in maximizing its learning from the DMA Activity. MCC intends to use the APS to work with a consortium of the University of 欧美口爆视频 (欧美口爆视频) and SweetSense Inc to use and collect high frequency monitoring (HFM) data using emerging and cost-effective technologies to understand a range of indicators related to the service levels of these kiosks and how they improve access to water in the project DMAs. M&E may also be interested in monitoring these indicators after the Threshold Program ends. Some examples of the indicators of interest include:

• Water levels in the tanks
• Time required to fill each tank
• Times of supply availability from the network
• Night time versus daytime availability of water
• Times of highest and lowest demand from customers
• Effects of seasonality on water availability

MCC aims to work with 欧美口爆视频 to install remote sensors on the storage tanks at the kiosks that will be built by the project in the DMAs and operated under new management models. Data from the sensors can be made available to a range of stakeholders through an accompanying web-based dashboard that will enable consumers of the data to understand trends in water availability, demand and consumption at the kiosks. Data collected through this partnership will not only contribute to the independent evaluation, improve reporting on the Indicator Tracking Table (ITT), but also may be used by MC欧美口爆视频 and Guma Valley Water Company (GVWC) to improve implementation of the kiosk pilot. In addition, the DMA Activity was designed with the expectation that practices piloted that prove to be effective in the DMAs would be replicated by GVWC across Freetown. GVWC is already starting to plan for replication of the kiosks and these HFM data may help to inform potential future scale up of the DMA kiosk models.

By focusing on the DMA kiosk tanks, this monitoring initiative will have a targeted monitoring scope, which MCC and MC欧美口爆视频 believe is feasible given the Threshold timeline, priorities and resources available. This initiative will be co-funded and co-managed by MCC M&E along with

the Office of Strategic Partnerships. The University of 欧美口爆视频 will also cost share in the agreed upon effort in line with the requirements of the NOFO. In the selection and management of this initiative, MCC understands the importance of collaborating with the 欧美口爆视频, MC欧美口爆视频 and other relevant stakeholders to mitigate any risks that may arise during implementation and explore opportunities for sustainability after the Threshold Program.

Using technology such as remote sensing meters or mobile phones to monitor outcomes related to water and electricity projects at a high frequency is still a relatively novel approach within MCC. M&E often relies on periodic surveys and administrative data that are difficult and costly to collect. The successful piloting of this initiative will present a model for other MCC water projects of how M&E can capitalize on the use of these and similar technology tools to collect more reliable data more frequently. The APS also provides significant flexibility in terms of the potential to collaboratively shape how the technology available can suit MCC鈥檚 monitoring needs. This partnership will validate the APS as another tool that should be considered when looking for solutions to conduct monitoring activities in other data challenged environments where MCC invests.

This initiative may also offer learning for MCC's Waster, Sanitation and Irrigation (WSI) practice group. For example, the dashboard that will be used for sharing data with stakeholders could be built in to MCC鈥檚 water projects and customized to present specific types of data in real time based on the project context and budget. This could offer different stakeholders (including MCAs, and implementing entities) data which they can use to improve project implementation.

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Project Lead: Bernard Amadei

According to the Systems Dynamics Society*, system dynamics is a computer-aided approach to policy analysis and design. It applies to dynamic problems arising in complex social, managerial, economic, or ecological systems 鈥� literally any dynamic systems characterized by interdependence, mutual interaction, information feedback, and circular causality.

Distinguished Professor Bernard Amadei鈥檚 current interests reside in the application of systems science and complexity science in small-scale community development projects and geological engineering projects. More specifically, he is interested in how to use system dynamics tools combined with other decision making tools to: (i) model the complex interactions taking place across social, natural, economic, and infrastructure systems; and (ii) understand how such interactions may contribute to sustainable development.

More specifically, Dr. Amadei is working on the application of system dynamics to the Water-Energy-Land-Food nexus. He is in the process of completing a new book on the Peace-Sustanability-Climate Security nexus to be published by Routledge in 2023. 

Recent books by B. Amadei:
(1) "" ISBN 9781947083523 and 9781947083547, Momentum Press (2019);
(2) "" Momentum Press (2015);
(3) "" ASCE Press (2014)

Research by Dr. Bernard Amadei and PhD student David Zelinka

 courtesy of Bernard Amadei from his book, ", Momentum Press (2019)

*Definition courtesy of  

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The Sustainable WASH Systems Learning Partnership led by 欧美口爆视频 Boulder was organized and manged the the Mortenson Center beginning in 2016. The learning partnership coordinated the efforts of seven organizations in sub-Saharan Africa and southeast Asia seeking to develop, test and document sustainable approaches to local water, sanitation and hygiene (WASH) to support initial infrastructure investments.

The project was unique in that it partnered with local organizations to implement and compare activities across multiple countries and contexts 鈥� offering a more holistic picture of what works and what doesn鈥檛 from a systems level. The final report summarizes the work and shows how a systems-level understanding and engagement approach can help providers navigate challenges to service sustainability. It also shows how incentivizing preventive maintenance and fast repair times can improve rural water services and describes how collective action platforms can bring about policy change.

Amy Javernick-Will and Karl Linden, both associate directors of the Mortenson Center in Global Engineering and co-principal investigators for the project, said this final report serves as a cap to an incredibly productive and valuable research project. 

The Partnership's main website is available at .

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June 3, 2019

A large-scale program to deliver water filters and portable biomass-burning cookstoves to Rwandan homes reduced the prevalence of reported diarrhea and acute respiratory infection in children under 5 years old by 29% and 25%, respectively, according to  in the journal PLOS Medicine.

The results suggest that programmatic delivery of household water filters and improved cookstoves can provide a scalable interim solution for rural populations that lack access to safe drinking water and rely on traditional fires for cooking.

鈥淯ntil now, there has been limited evidence of the effects when these products are delivered at scale,鈥� said Evan Thomas, director of 欧美口爆视频 Boulder鈥檚 Mortenson Center for Global Engineering. 鈥淭he study demonstrates the viability of bringing water filters and cookstoves to vulnerable households and will help inform future national initiatives.鈥�

Unsafe drinking water and household air pollution are major causes of mortality around the world. An estimated 1.1 billion people lack access to safe drinking water, more than a third of whom rely primarily on open wells and untreated surface water that can be contaminated with human and animal feces.

Cooking indoors on traditional open-fire stoves with solid biomass fuels such as wood and charcoal has been linked with pneumonia, low birth weight and impaired development in children. Household air pollution is also associated with pulmonary and cardiovascular disease in adults. More than 80% of Rwandans rely on firewood as their primary fuel source.

鈥淎fter neonatal disorders, pneumonia and diarrheal disease are the two leading killers of children under 5 years of age in Rwanda and much of sub-Saharan Africa,鈥� said Professor Thomas Clasen of Emory University and the London School of Hygiene and Tropical Medicine, who led the health impact study.

鈥淭he results of this randomized controlled trial provide strong evidence that effective interventions can be successfully delivered and embraced by a population at risk, even in remote rural settings.鈥�

In the fall of 2014, over 101,000 households with nearly half a million people from the poorest economic quartile of Rwanda鈥檚 Western Province were selected to receive a Vestergaard Frandsen LifeStraw Family 2.0 table-top household water filter and an EcoZoom Dura high efficiency portable wood-burning cookstove together with community and household education and behavior change messaging. Each household was visited approximately every 4 months for a year following the distribution.

The program was financed and led by the social enterprise  (in partnership with the Rwanda Ministry of Health) and branded 鈥�Tubeho Neza,鈥� which translates to 鈥渓ive well鈥� in Kinyarwanda.

鈥淒elAgua is delighted that the study has confirmed some of the health benefits of a well-designed large scale intervention as well as the acknowledged reduction in carbon emissions,鈥� said DelAgua Chairman Neil McDougall. 鈥淜ey to this success has been the ongoing education and support of Rwandan Community Health Workers (CHWs). Without CHW involvement, the intervention would not have demonstrated the same health and other benefits and as such their involvement is integral to the success of this and similar future projects,鈥�

Among children under 5 years of age, the intervention reduced seven-day prevalence of diarrhea by 29% and acute respiratory infection by 25%, although intervention use decreased throughout the study period. Drinking water quality also improved in the intervention arm, but adult and child personal exposures to fine particulate matter remained unchanged despite increased outdoor cooking.

The reported respiratory-related health impacts were surprising, however. Other biomass-burning stove intervention studies found no effect on self-reported respiratory symptoms among cooks and/or children, leading to efforts to shift to cleaner fuels such as LPG.

Moreover, investigators in the Rwanda study reported no reduction in personal level exposure to fine particulate matter (PM2.5) from the stoves among adult cooks or children. They suggested that the impact on respiratory infection could be attributable in part to an immunological boost from experiencing fewer enteric infections.

Overall, the results suggest that the program was effective in improving drinking water quality, and reducing risk of diarrhea and respiratory illness among children under 5, pointing the way toward an interim solution for healthier living while cleaner cooking solutions are developed and scaled to reach the poorest.

"The intent was to address the leading causes of illness and death in Rwanda, respiratory disease and diarrhea, especially among the lowest income households," said co-author Dr. Jean de Dieu Ngirabega, who was the director general of Clinical and Health Services in Rwanda Ministry of Health and later the head of the Institute of HIV/AIDS, Disease Prevention and Control in Rwanda Biomedical Center during the course of the program.

"The program's success speaks in part to the hard work of our Community Health Workers, who trained households on the use of these technologies over several years. I am pleased that these results show these positive health benefits can be achieved at scale. It is an opportunity for low-income countries to meet the targets set out in Sustainable Development Goal 3 (SDG3) for health."

鈥淭hese results should have important policy implications in Rwanda and beyond. We see strong evidence that the intervention provides significant benefits that might continue to accrue if the program continues to be supported,鈥� said Thomas, an associate professor in the College of Engineering and Applied Scienc who designed and managed this program for DelAgua from 2012 through 2016. Thomas first started working in Rwanda in 2003 with  while studying at 欧美口爆视频 Boulder.

欧美口爆视频 Boulder鈥檚 Mortenson Center supports 70 graduate students working in 24 countries globally on water, sanitation, energy and infrastructure. More than a dozen new international engineering programs have been added to the center鈥檚 portfolio in recent years, including partnerships in France, England, Australia, Ecuador and China, offering all interested students the opportunity of a global experience.

The new paper was co-authored by Corey Nagel from the University of Arkansas, Miles Kirby and Laura Zambrano of Emory University Rollins School of Public Health, Ghislaine Rosa of the London School of Hygiene and Tropical Medicine, Sanctus Musafri of the University of Rwanda and Dr. Jean de Dieu Ngirabega of the Rwanda Biomedical Center and East African Health Research Commission. 欧美口爆视频 Boulder Professor Karl Linden and alumna Christina Barstow contributed to the program鈥檚 design and research.

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