Water QualityNCT07317167
Evaluating a Water Safety Plan Intervention in Ghana
A study testing Water Safety Plans in people with Water Quality and Water Treatment, run by The Aquaya Institute at 1 site in Ghana.
Trial summary
The objective of this study is to evaluate the effects of water safety plans (WSPs) in rural Ghana. The investigators aim to evaluate the effects of WSPs on water supply system infrastructure, water availability and reliability, water quality, consumer perceptions, water service provider management and financial… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Water Quality, Water Treatment, Diarrhea
- What is being tested?
- Water Safety Plans
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 4,500 participants
- Where
- 1 siteGhana
- Study dates
- 13 Mar 2023to Feb 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Water systems must be operated by a partnering private, non-profit water supplier.
- Water systems must be functional during baseline data collection.
- To be eligible to participate in household surveys or focus group discussions, participants need to be at least 18 years of age and a customer of a eligible water system. To be eligible to participate in health care facility interviews, participants must be at least 18 years of age and work at a health care facility that serves community members using the included water system.
Who cannot join
- Water systems did not meet both of the above inclusion criteria.
- Water systems had already implemented a water safety plan.
- Water systems were involved in another ongoing research trial with similar expected outcomes.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
About this study
The objective of this study is to evaluate the effects of water safety plans (WSPs) in rural Ghana. The investigators aim to evaluate the effects of WSPs on water supply system infrastructure, water availability and reliability, water quality, consumer perceptions, water service provider management and financial sustainability, climate resilience, equity, and consumer health.
Read the detailed description
Much of the global population is exposed to contaminated drinking water. In piped systems, it is often easier to mitigate at the water supplier level where it can be centrally managed. A water safety plan (WSP) is a holistic tool for proactively ensuring the safety of drinking water supplies from source to tap, and the World Health Organization (WHO) recommends this systematic risk assessment and preventive management approach for water systems.
While application of WSPs has spread, systematic evidence for their implementation and effectiveness in improving water quality and health is limited, particularly in low-resource settings.
The objective of this study is to evaluate the impact of WSPs on water supply system infrastructure, water availability and reliability, water quality, consumer perceptions, water service provider management and financial sustainability, climate resilience, equity, and consumer health. The investigators will use a randomized controlled trial across 92 piped water supply systems serving small towns and rural areas in Ghana to test the effectiveness of WSPs. The investigators will collect data at baseline before the intervention is implemented, and at endline approximately 2 years after implementation begins. The investigators will also conduct a process evaluation of the WSP implementation quality.
- Conditions
- Water Quality, Water Treatment, Diarrhea
- Being tested
- Water Safety Plans
- Medical subject headings
- Diarrhea
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Water Safety PlansOther
Water safety plans will be implemented at the water system level as a holistic tool for ensuring the safety of drinking water supplies from source to tap. World Health Organization guidance will be followed for implementation and recommended water safety planning steps will be followed such as assembling a WSP Team, describing the water supply, hazard identification and risk assessment, developing and implementing an incremental improvement plan, monitoring control measures to verify the effectiveness of the WSP, and continuously documenting, reviewing, and improving WSP implementation.
| Study group | Role | What they receive |
|---|---|---|
| Water Safety Plan Intervention Arm | Experimental | Water Safety Plans Receives: Other: Water Safety Plans |
| Control Arm | No intervention | No Water Safety Plans: Water systems will continue to manage their water supplies without the introduction of water safety plans. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Free chlorine residue in water at point of collection (water quality impacts)
Free chlorine residue in water at point of collection (public standpipes and private taps) at or above target level of 0.2 mg/L, and at or above detectable level of 0.1 mg/L
Measured: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
E. coli in water at point of collection (water quality impacts)
- coli in water at point of collection (binary and categorical)
Measured: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Total coliform in water at point of collection (water quality impacts)
Total coliform in water at point of collection (binary)
Measured: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Turbidity of water at point of collection (water quality impacts)
Turbidity measured in NTU in water at point of collection
Measured: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Reliability/availability of water (water supply impacts)
Reliability/availability of water based on (1) service provider documented interruptions, and (2) consumer reported service interruptions
Measured: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Secondary outcomes (13)
Consumer satisfaction (consumer perception impacts)
Household respondent satisfaction with water supplier. They will be considered satisfied if they report they are either satisfied or very satisfied with the water supplier. They will be considered dissatisfied if they report they are either dissatisfied or very dissatisfied with the water supplier.
Measured: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Household use of enrolled piped water system for drinking (consumer perception impacts)
Household use of enrolled piped water system for drinking (binary).
Measured: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Households perceive water quality issues with piped water system (consumer perception impacts)
Household respondents report water quality issues with the taste, odor, or appearance of supplied water.
Measured: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Number of complaints (consumer perception impacts)
Number of complaints regarding the service or quality of water. This will be measured based on (1) household self-reporting, and (2) water system reports or records.
Measured: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Prevalence of diarrhea (health impacts)
Prevalence of reported diarrhea in the past two weeks. Diarrhea is defined as 3 or more loose or watery stools within 24 hours. Measured for a household's youngest child <5 years old, and any household member showing symptoms.
Measured: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Blood in stool (health impacts)
Prevalence of reported blood in stool in the past two weeks. Measured for a household's youngest child <5 years old, and any household member showing symptoms.
Measured: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Prevalence of severe diarrhea (health impacts)
Prevalence of reported severe diarrhea in the past two weeks. Defined as having a fever and either diarrhea or blood in stool. Measured for a household's youngest child <5 years old.
Measured: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Prevalence of acute respiratory infection (health impacts)
Prevalence of reported severe or non-severe acute respiratory infection (ARI) in the past two weeks. A severe ARI is defined as having a fever and either a cough or difficulty breathing. A non-severe ARI is defined as having a cough or difficulty breathing. Measured for a household's youngest child <5 years old.
Measured: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Number of clinic visits for water-related illness (health impacts)
Clinical visits will be assessed based on (1) the number of clinic visits reported by households for diarrhea-related illness, and (2) records for the number of cases of water-related illness in patients who visited healthcare facilities serving the included communities.
Measured: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
E. coli in stored water at point of consumption (water quality impacts)
- coli in stored household water at point of consumption (binary and categorical)
Measured: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Total coliform in stored water at point of consumption (water quality impacts)
Total coliform in stored household water at point of consumption (binary)
Measured: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Free chlorine residue in stored water at point of consumption (water quality impacts)
Free chlorine residue in stored household water at point of consumption at or above target level of 0.2 mg/L, and at or above detectable level of 0.1 mg/L
Measured: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Total chlorine residue in stored water at point of consumption (water quality impacts)
Total chlorine residue in stored household water at point of consumption at or above target level of 0.2 mg/L, and at or above detectable level of 0.1 mg/L
Measured: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted5 Jan 2026
- Study start13 Mar 2023
- Primary completionFeb 2026 (estimated)
- Study completionFeb 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Water QualityStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Randomized Controlled Trial
- Masking
- None (open label)
- Enrolment
- 4,500 participants (estimated)
Sponsor and investigators
- Lead sponsor
- The Aquaya Institute
- Sponsor type
- University, hospital or other
- Collaborators
- Kwame Nkrumah University of Science and Technology, Conrad N. Hilton Foundation
- Responsible party
- Sponsor
- Investigators
- Valerie Bauza, Principal investigator, The Aquaya Institute
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07317167
- Sponsor's protocol ID
- WSP Evaluation
- Status last verified
- Nov 2025
- First submitted
- 20 Nov 2025
- Last updated
- 5 Jan 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: De-identified individual participant data will be made available.
Study at a glance
From the registry record, last updated by the sponsor on 5 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Evaluating a Water Safety Plan Intervention in Ghana
- ClinicalTrials.gov ID
- NCT07317167
- Acronym / sponsor ID
- WSP Evaluation
- Conditions
- Water Quality, Water Treatment, Diarrhea
- Study type
- Interventional
- Recruitment status
- Enrolling by invitation
- Enrolment
- 4,500 participants (estimated)
- Lead sponsor
- The Aquaya InstituteUniversity, hospital or other
- Collaborators
- Kwame Nkrumah University of Science and Technology, Conrad N. Hilton Foundation
- Study start
- 13 Mar 2023 (actual)
- Primary completion
- Feb 2026 (estimated)
- Study completion
- Feb 2026 (estimated)
- First posted
- 5 Jan 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The objective of this study is to evaluate the effects of water safety plans (WSPs) in rural Ghana. The investigators aim to evaluate the effects of WSPs on water supply system infrastructure, water availability and reliability, water quality, consumer perceptions, water service provider management and financial sustainability, climate resilience, equity, and consumer health.
Detailed description
Much of the global population is exposed to contaminated drinking water. In piped systems, it is often easier to mitigate at the water supplier level where it can be centrally managed. A water safety plan (WSP) is a holistic tool for proactively ensuring the safety of drinking water supplies from source to tap, and the World Health Organization (WHO) recommends this systematic risk assessment and preventive management approach for water systems.
While application of WSPs has spread, systematic evidence for their implementation and effectiveness in improving water quality and health is limited, particularly in low-resource settings.
The objective of this study is to evaluate the impact of WSPs on water supply system infrastructure, water availability and reliability, water quality, consumer perceptions, water service provider management and financial sustainability, climate resilience, equity, and consumer health. The investigators will use a randomized controlled trial across 92 piped water supply systems serving small towns and rural areas in Ghana to test the effectiveness of WSPs. The investigators will collect data at baseline before the intervention is implemented, and at endline approximately 2 years after implementation begins. The investigators will also conduct a process evaluation of the WSP implementation quality.
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- Randomized Controlled Trial
| Arm | Type | Receives |
|---|---|---|
| Water Safety Plan Intervention Arm | Experimental | Other: Water Safety PlansWater Safety Plans |
| Control Arm | No intervention | –No Water Safety Plans: Water systems will continue to manage their water supplies without the introduction of water safety plans. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Water systems must be operated by a partnering private, non-profit water supplier.
- Water systems must be functional during baseline data collection.
- To be eligible to participate in household surveys or focus group discussions, participants need to be at least 18 years of age and a customer of a eligible water system. To be eligible to participate in health care facility interviews, participants must be at least 18 years of age and work at a health care facility that serves community members using the included water system.
Key exclusion criteria (3 listed)
- Water systems did not meet both of the above inclusion criteria.
- Water systems had already implemented a water safety plan.
- Water systems were involved in another ongoing research trial with similar expected outcomes.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Water Safety PlansWater safety plans will be implemented at the water system level as a holistic tool for ensuring the safety of drinking water supplies from source to tap. World Health Organization guidance will be followed for implementation and recommended water safety planning steps will be followed such as assembling a WSP Team, describing the water supply, hazard identification and risk assessment, developing and implementing an incremental improvement plan, monitoring control measures to verify the effectiveness of the WSP, and continuously documenting, reviewing, and improving WSP implementation. | Other | Water Safety Plan Intervention Arm |
Primary outcome
Free chlorine residue in water at point of collection (water quality impacts)
Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Free chlorine residue in water at point of collection (public standpipes and private taps) at or above target level of 0.2 mg/L, and at or above detectable level of 0.1 mg/L
E. coli in water at point of collection (water quality impacts)
Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
E. coli in water at point of collection (binary and categorical)
Total coliform in water at point of collection (water quality impacts)
Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Total coliform in water at point of collection (binary)
Turbidity of water at point of collection (water quality impacts)
Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Turbidity measured in NTU in water at point of collection
Reliability/availability of water (water supply impacts)
Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Reliability/availability of water based on (1) service provider documented interruptions, and (2) consumer reported service interruptions
13 secondary outcomes
Consumer satisfaction (consumer perception impacts)
Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Household use of enrolled piped water system for drinking (consumer perception impacts)
Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Households perceive water quality issues with piped water system (consumer perception impacts)
Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Number of complaints (consumer perception impacts)
Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Prevalence of diarrhea (health impacts)
Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Blood in stool (health impacts)
Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Prevalence of severe diarrhea (health impacts)
Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Prevalence of acute respiratory infection (health impacts)
Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Number of clinic visits for water-related illness (health impacts)
Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
E. coli in stored water at point of consumption (water quality impacts)
Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Total coliform in stored water at point of consumption (water quality impacts)
Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Free chlorine residue in stored water at point of consumption (water quality impacts)
Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Total chlorine residue in stored water at point of consumption (water quality impacts)
Time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 Jan 2026.
- Individual participant dataSharing planned: Yes. De-identified individual participant data will be made available.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Valerie Bauza principal investigator
The Aquaya Institute
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Water Safety Plans in people with Water Quality and Water Treatment, run by The Aquaya Institute at 1 site in Ghana.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: enrolling by invitation, as of the sponsor's last update on 5 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Ghana. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Free chlorine residue in water at point of collection (water quality impacts) (time frame: Baseline (before intervention), Endline (approximately 24-months after the start of the intervention)). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Jan 2026.