A Conceptual Framework to Evaluate the
Outcomes and Impacts of Water Safety Plans
Elizabeth Medlin, MPH
Global Water, Sanitation, and Hygiene Team
Environmental Health Services Branch
U.S. Centers for Disease Control and Prevention
Rick Gelting, Ph.D., P.E.; Kristin Delea, M.PH., REHS
National Center for Environmental Health
Division of Emergency and Environmental Health Services
WHO Framework for Safe Drinking Water
Public health context
and health outcomes
Health-based targets
Water Safety Plans
System
Assessment
Monitoring
Surveillance
Management &
Communication
WHO Framework for Safe Drinking Water
Public health context
and health outcomes
Health-based targets
Water Safety Plans
System
Assessment
Monitoring
Surveillance
Management &
Communication
Purposes of a WSP Conceptual Framework
• Varied outcomes and impacts of WSPs
• Common framework and terminology
• Basis for the development of indicators
• Common understanding of the time frames
• Various benefits of implementing WSPs
Logic Models
Logic Model Development Guide – WK Kellogg Foundation
Logic Models
Health-based targets
Public health context
and health outcomes
Water Safety Plans
System
Assessment
Monitoring
Surveillance
Management &
Communication
Logic
Model
WSP Conceptual Framework
Inputs
Water Safety Plan
• Stakeholders
Preparation
•Champion
• Staff /
Management
• Time
Commitment
•Facilities
• Materials /
Equipment
System
Assessment
Institutional
Changes
Operational
Changes
Feedback &
Improvement
Monitoring &
Evaluation
•Knowledge
•Political Will /
Motivation
Impacts
Feedback
Feedback
Feedback
• Water Supplier
Outcomes
Activities/Outputs
Management &
Communication
Water Supply
Improvements
Health
Improvements
Other
Financial
Changes
Environmental
Factors
(Sanitation,
Hygiene,
Food, etc.)
Policy
Changes
Socioeconomic
Improvements
•Funds
Months
Years
WSP Conceptual Framework
Inputs
Water Safety Plan
• Stakeholders
Preparation
•Champion
• Staff /
Management
• Time
Commitment
•Facilities
• Materials /
Equipment
System
Assessment
Institutional
Changes
Operational
Changes
Feedback &
Improvement
Monitoring &
Evaluation
•Knowledge
•Political Will /
Motivation
Impacts
Feedback
Feedback
Feedback
• Water Supplier
Outcomes
Activities/Outputs
Management &
Communication
Water Supply
Improvements
Health
Improvements
Other
Environmental
Factors
(Sanitation,
Hygiene,
Food, etc.)
Financial
Changes
Policy
Changes
Socioeconomic
Improvements
•Funds
Months
Years
WSP Conceptual Framework
Inputs

Stakeholders and partners
 Water supplier
 Institutional partners
 Less traditional partners

Champion

Time commitment, Facilities, Equipment

Funds

Motivation
WSP Conceptual Framework
Inputs
Water Safety Plan
• Stakeholders
Preparation
•Champion
• Staff /
Management
• Time
Commitment
•Facilities
• Materials /
Equipment
System
Assessment
Institutional
Changes
Operational
Changes
Feedback &
Improvement
Monitoring &
Evaluation
•Knowledge
•Political Will /
Motivation
Impacts
Feedback
Feedback
Feedback
• Water Supplier
Outcomes
Activities/Outputs
Management &
Communication
Water Supply
Improvements
Health
Improvements
Other
Financial
Changes
Environmental
Factors
(Sanitation,
Hygiene,
Food, etc.)
Policy
Changes
Socioeconomic
Improvements
•Funds
Months
Years
WSP Conceptual Framework
Activities / Outputs
Motivation
WSP
WSP Conceptual Framework
Inputs
Water Safety Plan
• Stakeholders
Preparation
•Champion
• Staff /
Management
• Time
Commitment
•Facilities
• Materials /
Equipment
System
Assessment
Institutional
Changes
Operational
Changes
Feedback &
Improvement
Monitoring &
Evaluation
•Knowledge
•Political Will /
Motivation
Impacts
Feedback
Feedback
Feedback
• Water Supplier
Outcomes
Activities/Outputs
Management &
Communication
Water Supply
Improvements
Health
Improvements
Other
Financial
Changes
Environmental
Factors
(Sanitation,
Hygiene,
Food, etc.)
Policy
Changes
Socioeconomic
Improvements
•Funds
Months
Years
WSP Conceptual Framework
Outcomes
Institutional
Changes

Four Categories:
 Institutional Change
 Operational Change
 Financial Change
 Policy Change
Operational
Changes
Financial Changes
Policy Changes

Different time scales
Outcomes
Institutional Change




Institutional
Changes
Increased communication
WSP in Guyana brought together the
water supplier and the drinking water
Operational
regulator:
Changes
Increased knowledge
Relations
Financial Changes
Improved perceptions and attitudes
Communications
Policy Changes
Increased training
Coordination of efforts
Gelting, 2008, unpublished
Outcomes
Operational Change
Institutional
Changes

WSP in Bangladesh identified a need for
ACTION by operators to:
Improved system direct
infrastructure
Operational
Changes

-repair damaged water source
Implementation of improved
infrastructure
Financial Changes
procedures
-move sources of contamination
Policy Changes
-clean the surroundings of the water
supplies
Mahmud et al, 2007
Outcomes
Financial Change



Cost savings
Institutional
Changes
WSP in Jamaica:
Operational
Changes
”…Utility and government are wellprepared to implement and sustain
donor-financed improvements.”
Financial Changes
Increased donor support and
investment
“WSPs provide a new stage for funding
Policy Changes
assistance.”
Cost recovery
Environmental & Engineering Managers, Ltd, 2007
Outcomes
Policy Change



WSP in Jamaica:
Informal WSP knowledge-sharing
and promotion
WSP
Success
WSP model sharing as norms of
practice
Institutional
Changes
WSPs as
requirement in
regulations
Operational
Changes
Financial Changes
8 to 10 years
Policy Changes
WSP formal regulatory requirements
Environmental & Engineering Managers, Ltd, 2007
WSP Conceptual Framework
Inputs
Water Safety Plan
• Stakeholders
Preparation
•Champion
• Staff /
Management
• Time
Commitment
•Facilities
• Materials /
Equipment
System
Assessment
Institutional
Changes
Operational
Changes
Feedback &
Improvement
Monitoring &
Evaluation
•Knowledge
•Political Will /
Motivation
Impacts
Feedback
Feedback
Feedback
• Water Supplier
Outcomes
Activities/Outputs
Management &
Communication
Water Supply
Improvements
Health
Improvements
Other
Environmental
Environmenta
lFactors
Factors
(Sanitation,
Hygiene,
Food, etc.)
Financial
Changes
Policy
Changes
Socioeconomic
Improvements
•Funds
Months
Years
WSP Conceptual Framework
Inputs
Water Safety Plan
• Stakeholders
Preparation
•Champion
• Staff /
Management
• Time
Commitment
•Facilities
• Materials /
Equipment
System
Assessment
Institutional
Changes
Operational
Changes
Feedback &
Improvement
Monitoring &
Evaluation
•Knowledge
•Political Will /
Motivation
Impacts
Feedback
Feedback
Feedback
• Water Supplier
Outcomes
Activities/Outputs
Management &
Communication
Water Supply
Improvements
Health
Improvements
Other
Financial
Changes
Environmental
Factors
(Sanitation,
Hygiene,
Food, etc.)
Policy
Changes
Socioeconomic
Improvements
•Funds
Months
Years
THANK YOU FOR YOUR ATTENTION!
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
E-mail: cdcinfo@cdc.gov
Web: www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official
position of the Centers for Disease Control and Prevention.
National Center for Environmental Health
Division of Emergency and Environmental Health Services