Abstract
Access to safe drinking-water has increased in recent decades, yet many people still lack access
and rates of water-related ill-health and death remain alarmingly high. Those reliant upon small
drinking-water supplies (SDWS), which are often rural and community-managed, are particularly at
risk of consuming contaminated drinking-water. SDWS are often geographically remote and have
limited access to technical and financial resources. Drinking-water management should be
underpinned by the principles of risk assessment and risk management (RARM). Although RARM
have huge potential to drive improvements to the water quality of SDWS, uptake is lower than for
larger water supplies, with associated research also more sparce. Furthermore, data can be
produced by numerous stakeholders and stored in several locations creating challenges for data use
to assess risk. In recent years, concerns have been raised that data collected are not consistently
used for decision-making and therefore unleashing the potential of data to assess risk could also
address this concern.
The aim of this research was to identify techniques and provide tools to support effective
implementation and increase the use of RARM at a global level. This aim was achieved through: (i)
identifying enabling environments and approaches which support implementation and uptake of
RARM, (ii) proposing methods to leverage data for greater use in RARM, (iii) developing a field- and
desk- based tool to support RARM, and (iv) disseminating recommendations through journal
publications. The research used mixed methods of literature reviews, semi-structured interviews,
surveys and expert feedback, and quantitative data collection and modelling. Data were collected
via online methods through discussions with individuals who have worked in England, Wales,
Rwanda, Portugal, Canada, Palestine, Nepal and United States of America. Additional data were
collected during fieldwork in Malawi and Brazil. Modelling was conducted using an open access set
of data collected from water supplies in Ethiopia.
Findings highlight that RARM has the potential to provide benefits to SDWS especially during periods of uncertainty. Key enabling environments were identified which are applicable regardless of a country’s income level or governance approach. These include the need for sustainable financial and technical support, a suitable regulatory framework and effective community engagement. SDWS, regardless of a country’s development, suffer from challenges of data fragmentation, technical and financial limitations. Data could be leveraged through improved data harmonization, but any data system must consider the capacities of the context within which it is being used. The two tools developed (a sanitary inspection form for household water treatment and an interaction matrix model) are the first of their kind for this application and are key, practical outputs of this work.