DelAgua - Rwanda

In Rwanda, DelAgua Health is partnered with the Ministry of Health to deploy household water filters and improved cookstoves to 25% of the poorest families in the country.

Continued financing of the Project and the anticipated expansion thereof through all of Rwanda is conditional upon the demonstrated coverage and use of the intervention hardware. As part of this effort, Portland State University is responsible for evaluating the adoption rates and health impacts of the technologies. This will be conducted through two primary activities:

  • A controlled research trial to evaluate health impacts and adoption.
  • Instrumented monitoring of a sample of the installed technologies to evaluate adoption.

Controlled Research Trial to Evaluate Public Health Impacts and Adoption

The London School of Hygiene and Tropical Medicine, with Emory University, the Oregon Health and Science University, and the University of Rwanda, are conducting a large scale randomized controlled trial across the western province of Rwanda in 2015 to evaluate the effectiveness of the DelAgua intervention.

This evaluation focuses on “outcomes” (e.g., fewer cases of disease) and “impact” (lower healthcare costs, increased school attendance and productivity) rather than “inputs” (e.g. number of units delivered or people covered). At the same time, since reducing exposure is a necessary condition to the effectiveness of environmental health interventions, the research team is monitoring the impact of the intervention on critical intermediate outcomes such as microbiological water quality and indoor air quality.

The study employs a randomized controlled design to evaluate the impact of the intervention on environmental exposure indicators for water quality and indoor air quality in a sample of the target population and a control group.

Instrumented Monitoring of a Sample of the Installed Technologies to Evaluate Adoption

Within the randomized controlled trial, a sample of the households will receive water filters and cookstoves equipped with cellular network based remotely reporting sensors that record the performance and use of the interventions.

Remotely reporting instrumentation can provide solutions to many of the issues around sustainability of water treatment, energy and poor infrastructure in developing communities such as unreliable survey data and relying on spot checks to assess performance.

Once the technology interventions are instrumented with the Portland State University sensor package, surveys of families and communities who have monitoring devices will be conducted to determine differences between survey data and the monitoring system. Specifically, usage and performance data will be recorded to gain insight into the operational effectiveness of the interventions.

In parallel, a blinded reactivity study is being conducted within the randomized controlled trial, to evaluate if knowledge of sensors impact household behavior.

Monitoring

DelAgua utilizes mobile data collection and a central database for program implementation, analysis, and record keeping. All distributions, education, and evaluation activities are conducted through smart-phone based database tools. During distribution, the community health workers log the names, phone numbers, and national identification numbers of the recipients, and scan barcodes of the distributed technologies. During household visits, the team re-scan barcodes and take household identification information, as well as GPS coordinates. All survey questions are conducted through the phone, allowing for consistency between surveyors as well as automated quantitative evaluation of program performance. Through the implementation of mobile data collection DelAgua is able to effectively administer and manage large-scale development programs with expedited technology rollouts, detailed household level education campaigns, and comprehensive technology product tracking.

Partners

DelAgua Health