203057 Annual maintenance fees and the key to sustainable improved drinking sources: An evaluation of the faith-based Shallow Well Program Northern Region, Malawi

Tuesday, November 10, 2009

Natasha Prudent, MPH , Rollins School of Public Health: Emory University, Atlanta, GA
The study evaluates an annual fee-based water maintenance system in rural Malawi using logistics regression and qualitative interviews. Regression analyses show that unadjusted 2006/2007-year maintenance fee payment is a statistically significant predictor of a present functioning shallow-well (OR = 6.88; 95% CI= 5.32, 8.90). Despite this strong association only 38% of the communities paid the maintenance fees in 2006 or 2007. Yet, 78% of the shallow wells constructed from 1997 to 2005 are presently functional. When interviewed, some communities felt no need to pay the annual maintenance fees because their wells were working properly, never or rarely needing repairs. In such communities, local water committees expressed a sense of distrust towards the higher-level management structure which collected the fees. These communities could not connect fee payments with tangible results. However, when the water point would eventually fail, these same communities could not organize to use the existing maintenance structure which they historically distrusted. As a result, these communities turned to other, often unimproved water sources. Increased dialogue within the management system and the community through the inclusion of health education within the maintenance structure, further training of local water committees on transparent budgeting practices, as well as the use of participatory geographic information systems in decision and resource planning will increase interaction between the maintenance structure and the community, build trust, and assist in community acceptance of a sustainable fee-based water maintenance system.

Learning Objectives:
1.)Describe a hierarchical fee-based maintenance system for water points 2.)Evaluate community perceptions of fees associated with drinking water

Keywords: Water, Access

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Received my Masters of Public Health in Global Environmental Health at Emory University. Conducted research on the abstract subject for my masters thesis in Malawi with a faith-based organization.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.