Health impact evaluation of Surakarta water project; USAID consultation report

Report is based on review of project documentation and results of a questionnaire administered onsite. In designing the planned evaluation, the following are recommended: (1) include a longitudinal study in addition to the planned baseline and follow-up surveys since currently available surveillance data are of little use; (2) hire two epidemiologists, a sanitary engineer, and field workers; (3) identify cohorts of 200 families with at least one child aged 0-4 for weekly evaluation of illness and quarterly evaluation of water and sanitation facility usage; (4) develop a definition of diarrhea; (5) conduct an on-going analysis of the data collected; (6) measure the heights and weights of children aged 0-4 twice yearly; (7) develop and test reporting forms on enteric diseases; (8) work with the city to standardize reporting of water-related diseases; (9) identify or develop a local laboratory capability; and (10) develop techniques to monitor the water/sanitation behavior of young children. To improve the project, it is recommended that: (1) community leaders and personnel from other local water/sanitation activities be involved; (2) a health education component be added; (3) avaliable data on population and incidence of disease be used to determine which areas of the city of Surakarta are to be included; (4) a mechanism for collecting routine water quality data be developed; and (5) capabilities to operate and maintain as well as to evaluate new and existing to operate and maintain as well as to evaluate new and existing water systems be created.