Assessing sustainability of rural gravity-fed water schemes on Idjwi Island, D.R. Congo

How community engagement in water and sanitation interventions impacts human health, infrastructure and service longevity in low- and middle-income countries: a realist review

“…For example, penalties can be used to enforce standards for latrines (25), for not constructing a latrine, and for open defection (10). Trust is an essential contextual factor for such penalties -tensions arise when a community does not trust the person or committee collecting the fines and what they will do with the fines (18,25). Trust depends on the person or committee's record of financial management, and whether they have clear rules about the use of such penalties.…”

“…Sustainability of resources and services is facilitated by a committee's ability to make funds available for operational and maintenance costs, and by it having rules and procedures for funds management (e.g., having a well-educated treasurer who manages and collects funds within the community), or by having the community participate actively in monitoring committee finances (15,19,39,47). However, where there are known instances of abuse of funds or poor financial management, community members are less willing to contribute, leading to low sustainability of resources or services (18)(19)(20). Committee activity and social participation play key roles in managing maintenance and operation of water and sanitation systems and assist in management of funds ensuring continued service provision (16,43,51,52).…”

“…However, market failure of water kiosks occurs (and they become unviable in the long term) due to continued supply during the wet season in settings where there is increased availability of water due to cheaper options linked to rains then becomes unviable in the long term (51). Willingness to pay for a water system (17)(18)(19)21,51) and community-based water supply projects (52,53) often determines a systems reliability or sustainability, and this is linked to demand, affordability and financial capacity in a community. Ability to access resources and funding is important when communities lack knowledge and skills, and the ability to pay for such skills lacking (41).…”

“…Ownership is enabled by involving communities in the design, planning and implementation of a hardware, increasing the likelihood that the resource reflects community needs (15,72), the costs are appropriate and affordable (16,69), the community has the appropriate information for operations and maintenance (69,75), and the community is willing and able to commit to bear hardware costs and ongoing operational and maintenance costs (16,19,48,76), thus becoming self-sufficient (16,69,70). In the absence of this, a community may need to rely on external sources for sustainability of resources (18,52,75,76). Ownership is enabled when communities are allowed or granted decision-making authority in operations and have responsibility for maintenance of hardware (18).…”

“…Failure of interventions can occur for several reasons, such as lack of community involvement in design (15,16), lack of ownership (17,18), abuse of funds or poor financial management, lack of willingness of community members to contribute (18)(19)(20), lack of communication and connectedness (21) and no ongoing support and acknowledgement of change (22)(23)(24). In addition to an increased understanding of success and failures in WASH interventions, there is a growing trend to use community participation to drive health programmes, based on the expectation working with communities can help ensure interventions are more relevant to local priorities (25).…”