Data collection and Ethics Procedures

The fieldwork was designed to be conducted to a total of 300 communities (4 per municipality). Baseline community level surveys were designed to be applied to each CAPS or existing informal committee if a CAPS was not formally established. Surveys

154 consisted of several questions from SIASAR as a means of ensuring data validation, as well as selected questions chosen by the Bank team, slightly more qualitative in nature, so as to better measure the impacts of the PROSASR intervention on the WSS service provision, including WSS system’s administration, the CAPS’ organization, water quality and the community´s sanitation and hygiene practices. The SIASAR questions were often tweaked to make the expression operationally clearer and accompanying survey manuals were put together to ensure that surveyors understood the motivation behind each question asked. These SIASAR surveys consisted of three component surveys – one community, one WSS infrastructure system and one service provider/CAPS, totalling 3-4 hours for surveying per community, excluding travel time.

Building on the SIASAR questions also allowed for the construction of the IAS Index for each community visited.

The surveys were designed to include the following elements, among others:

a. Number of residents

b. Characteristics of their source of drinking water c. Time to collect drinking water

d. Costs of drinking water

e. Perceptions of their drinking water

f. Are they connected to the community system g. Perceptions of the community system

h. Type of latrine/sanitation facility available to the household i. Interactions and impressions of community service providers j. Other households’ characteristics, including sanitation facilities

Finally, field work also included water quality tests collected for e-coli and chlorine.

These are elements of the SIASAR survey that until now have not been collected as part of SIASAR fieldwork. Resources were provided to the survey firm for 1,000 samples to be taken of e-coli across the 150 communities and 460 samples to be taken for chlorine using commercially available kits (see annex of this chapter). Since Water Quality testing is costly and complex to organise it was confined to a sub set of the study communities – samples were taken in a random selection of half of the entire

155 community selection⁴⁸. The purpose of the water quality sampling was both to examine the ultimate quality of water consumed at the household level but also to provide information about the most common or probably causes of water contamination as water is processed and delivered. The samples for e-coli were therefore taken at the following strategic points:

a. In the system: one prior to treatment (at the source) and another following treatment (if applicable). Where there was no treatment, the survey firm simply took one sample at the storage tank before it entered the network;

b. In the households: one sample in a storage facility from which the last glass of water was drunk by the respondent and one sample directly from the tap in the household.

In communities of 140 households or less, these samples were taken in two households. In communities of greater than 140 households, these samples were taken in 3 households;

c. In a subset of these communities there was one additional chlorine sample taken in the household furthest from the system and one additional e-coli sample taken in a household not connected to the system. Due to changes in FISE’s management team in early 2015, the activities linked to the Project suffered significant delays. These delays affected the timeline of the impact evaluation as the design was fully reviewed with the new FISE management team in order to ensure they agreed with the objectives and research questions. As such, baseline data collection started in November 2015 and was concluded in January 2016. As part of Project implementation, the Bank team and FISE just concluded the revision of the guiding documents for the AVAR process. The AVAR is scheduled to be launched at the end of February 2016. The next chapter summarizes the results of the baseline surveys.

The ethics procedures will follow first all University of Leeds Policy. The data collection followed the confidentiality and data registry of the university and the funders of the research (World Bank-SIEF). The procedures also involved consultations with the experts of SDDU (Dr Alice Temple) and because the IE surveys will not entail any intromission into human subjects (biomarkers, blood tests, stool tests), the compliance with the University policy is less complicated and straightforward. The only requisite is

48 Communities were randomly assigned to the intervention. The for the sampling of the survey at the household level, the households to be interviewed in the survey were randomly selected.

156 to proof the IRB clearance for basic household survey confidentiality (see appendix letter of the local IRB in Nicaragua CIRA-UNAN for baseline and endline). I conducted during the last year a series of certifications and survey registries required for the impact evaluation. This process followed World Bank’s Strategic Impact Evaluation Fund (SIEF). Finally, in the appendix there are the international registry of the IE survey and the NIH certificate obtained.

5.4. Conclusions

The evaluation and survey designs were closely collaborated with FISE and heavily based on SIASAR. We adapted question phrasing based on pilots to ensure clear expression and understanding on the part of surveyors, elaborating field manuals and providing training with support from a seasoned SIASAR’s expert. New household surveys were also closely debated with FISE so that only jointly agreed questions were taken to the field.

During implementation of the fieldwork, in addition to quality control checks by the survey firm’s own team, the research team hired with FISE an external Field Coordinator that carried out several field visits to the country to assess comprehension and quality of the evaluation design and data being collected and provide instructions for communications and protocols where necessary. The Field Coordinator required the Survey Firm to fill in a monitoring sheet, which reported the number of surveys and water samples being collected in each community visited.

157 5.5. Annex

158

159 5.5.1.Survey Instruments

The questionnaires of the baseline survey can be downloaded at:

https://catalog.ihsn.org/index.php/catalog/6520/related-materials The questionnaires of the endline survey are available at:

https://worldbankgroup-my.sharepoint.com/:f:/g/personal/cborjavega_worldbank_org/EhsDCmy3Vf1Cj0yVjI4 pEV0BoXVqmBy82EwJoYa1zwIjOQ

160 5.5.2.Water Quality Test and Protocols⁴⁹

The test utilized for measuring water quality Aquagenx® basic field kit that simultaneously detects and quantifies E. coli (EC) and Total Coliforms (TC) in a 100 mL sample. It uses a proprietary powder growth medium with a glucose substrate called X-Gluc. When E. coli metabolize this substrate in Aquagenx’s growth medium, the color of the water turns blue, indicating the presence of E. coli. The process of collecting samples of this test are shown below.

Figure 5-3 Procedure of Aguagenx test utilised in the water samples of the Impact Evaluation

The Aquagenx® thresholds of water pollution is based on the World Health Organization “Guidelines for Drinking Water Quality,” 4th Edition. MPN of E. coli per 100 mL is estimated from the combination of positive (blue color) and negative (no blue color) compartments in the Aquagenx® Compartment Bag. MPN of Total Coliforms per 100 mL is estimated from the combination of positive (blue fluorescence under UV light) and negative (no blue fluorescence under UV light) compartments in the Aquagenx® Compartment Bag. Based on these protocols from the kit, the test was piloted in Nicaragua at both baseline and endline survey with training to surveyors with specific protocols to identify potential sources of errors committed in the field for capturing and collecting tests. These pilot activities were then reflected in a protocol

49 The full procedure of test application is available at: https://www.aquagenx.com/wp-content/uploads/2019/06/MPN-CBT-ECTC-Instructions-DrinkingWater-June2019.pdf

161 process in Spanish to help surveyors understand what sort of issues can emerge if the test was not collected properly according to the protocol.

Figure 5-4 Testing Protocol for the Surveyors in Nicaragua

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