Unicef-Phw Flood 2007 M&e Final, 9-08

FLOOD EMERGENCY RELIEF PROJECT
IN NORTHERN GHANA, SEPTEMBER 2007
MONITORING & EVALUATION
REPORT
PROVISION OF CERAMIC FILTERS

FOR HOUSEHOLD WATER TREATMENT
AND SAFE STORAGE
September 2008
Prepared for
UNICEF
EUROPEAN COMMISSION
GOVERNMENT OF GHANA
Submitted by
TABLE OF CONTENTS
INTRODUCTION & PROJECT OBJECTIVES 4
INTRODUCTION 4
PURE HOME WATER 5
THE CERAMIC POT FILTER 5
THE FLOOD 2007 EMERGENCY RESPONSE PROJECT 6
MONITORING & EVALUATION PROCESS 8
DISTRICT ASSESSMENT 8
IN THE FIELD 8
IN THIS REPORT 8
COMMUNITY ASSESSMENT 9
IN THE FIELD 9
IN THIS REPORT 10
MONITORING & EVALUATION RESULTS
BONGO DISTRICT ASSESSMENT 11
BALUNGU COMMUNITY ASSESSMENT 12

ALIBA COMMUNITY ASSESSMENT 13
GOWRIE COMMUNITY ASSESSMENT 14
TALENSI NABDAM DISTRICT ASSESSMENT 15
PWALUGU COMMUNITY ASSESSMENT 16

BALUUGU COMMUNITY ASSESSMENT 17
ARIGU COMMUNITY ASSESSMENT 18
BOLGATANGA MUNICIPAL DISTRICT ASSESSMENT 19
SOE YIPALA COMMUNITY ASSESSMENT 20

DACHIO COMMUNITY ASSESSMENT 21
KUMBOSCO COMMUNITY ASSESSMENT 22
KUMBANGLI COMMUNITY ASSESSMENT 23
2
GARU TEMPANE DISTRICT ASSESSMENT 24
BUARBOKA COMMUNITY ASSESSMENT 25

NAMBOKO COMMUNITY ASSESSMENT 26
KASSENA NANKANA DISTRICT ASSESSMENT 27
GORUM COMMUNITY ASSESSMENT 28

NYAGANYA COMMUNITY ASSESSMENT 29
KANONIA COMMUNITY ASSESSMENT 30
AGRUMALOKO COMMUNITY ASSESSMENT 31
DUSIDOMA COMMUNITY ASSESSMENT 32
KAYORO COMMUNITY ASSESSMENT 33
KAYAVIO COMMUNITY ASSESSMENT 34
GONSA COMMUNITY ASSESSMENT 35
BUILSA DISTRICT ASSESSMENT 36
LOGVUUSA COMMUNITY ASSESSMENT 37

KAASA COMMUNITY ASSESSMENT 38
YAMKPANSA COMMUNITY ASSESSMENT 39
RECOMMENDATIONS 40
DISTRIBUTION 40
ISSUES 40
SOLUTIONS 40
TRAINING & HEALTH EDUCATION 40
ISSUES 40
SOLUTIONS 40
DISCONTINUED USE 41
ISSUES 41
SOLUTIONS 41
MONITORING & EVALUATION 43
ISSUES 43
SOLUTIONS 43
APPENDIX
3
INTRODUCTION & PROJECT OBJECTIVES
INTRODUCTION
In September 2007, Northern Ghana experienced severe weather conditions, resulting in

massive flooding in the Northern & Upper-East Regions of the country. An estimated 200,000
people were displaced from their homes and at least 30 people lost their lives during and in
the aftermath of this natural disaster. Water supplies were compromised or contaminated,
creating concerns about the risk for a widespread outbreak of waterborne disease such as
cholera, diarrhoea and Guinea Worm.
Districts most affected by the September 2007 floods
In a well-coordinated emergency response effort, UNICEF, sponsored by the European

Commission and in concert with the Regional Governments, contracted Pure Home Water
(PHW) for the distribution of Kosim Ceramic Water Filters to the households that were most
affected, and therefore most susceptible, to waterborne disease.
Five thousand filters were distributed to provide safe drinking water to households in the
flood-stricken rural communities of the East Mamprusi, Zabzugu-Tatali and East-Gonja
Districts of the Northern Region and throughout the flooded areas in the Bongo, Talensi-
Nabdam, Garu-Tempane, Builsa, KNDA and Bolgatanga Municipal Districts of the Upper-
East Region.
One year after the disaster, Pure Home Water is proud to present the initiators and sponsors
of this flood emergency response project an extensive monitoring and evaluation report.
4
PURE HOME WATER
Pure Home Water (PHW) is a legally registered Ghanaian non-profit social enterprise,
founded in 2005 by Susan Murcott, a Senior Lecturer at the Massachusetts Institute of
Technology. The goal of the organization is to disseminate small-scale, proven technologies
for the household treatment and safe storage of water as a complement to other efforts on
the part of the government and NGOs. Currently, PHW sells ceramic pot filters to both urban
and rural communities in Ghana. PHW has trained field personnel that are familiar with the
ceramic pot filters and how to successfully integrate this technology into the household.
THE CERAMIC POT FILTER
PHW’s primary product, the Kosim filter, is a version of the Potters for Peace ceramic pot
filter, developed by Fernando Mazariegos in Guatemala in 1981. PHW has distributed this
filter to over 11,000 households in Ghana to date. The Kosim filter is manufactured in Ghana
and consists of a ceramic pot, plastic safe-storage container, top ring, lid, tap, brush,
instruction sheet and one Aquatab. If correctly operated and maintained, the Kosim filter has
a proven life span of 3+ years.
The Kosim Ceramic Filter
Health impact studies performed by graduate students at the Massachusetts Institute of

Technology in 2006 and 2007 showed that traditional rural households relying on
unimproved water supplies using the ceramic pot filter, were 69% less likely to have
diarrhoea than people without the filter. Water quality test results show a 99.7% reduction of
E. coli, 99.4% reduction in Total Coliforms and a 92% reduction in turbidity from the source
water to the filtered water (Johnson, 2007) 1. The ceramic filter is also known to remove
Guinea Worm.
1
Johnson, S. Health and Water Quality Monitoring of Pure Home Water’s Ceramic Filter Dissemination in the Northern Region of Ghana.
Massachusetts Institute of Technology, Civil and Environmental Engineering Dept., Master of Engineering Thesis. June 2007.
http://web.mit.edu/watsan/project_ghana.htm.
5
THE FLOOD 2007 EMERGENCY RESPONSE PROJECT
PROCUREMENT AND TRANSPORTATION OF THE FILTERS
PHW procured 5,000 Kosim filters and transported them to Tamale for collection and
distribution by UNICEF.
DISTRIBUTION OF THE FILTERS TO THE AFFECTED COMMUNITIES
The Local Government and UNICEF determined which rural communities had been most
affected by the flooding and how many filter units would be reserved for each of these
communities. Then the Environmental Health staff of the local government distributed 3,000
Kosim filters from temporary depots to selected communities; after which UNICEF contracted
PHW to distribute the remaining 2,000 filters directly to other selected beneficiary
communities.
Distribution of Kosim Ceramic Filters in the Upper-East Region
DELIVERY OF A RELEVANT EDUCATION & TRAINING PROGRAM
In each community, PHW conducted a collective education & training program, aimed at
familiarizing the beneficiaries and the local Environmental Health staff with the basic
concepts of proper household water treatment and safe storage (HWTS). Participants
learned about the hazards of contaminated drinking water and how to properly assemble,
operate and maintain the Kosim ceramic filter unit for maximum effectiveness and longevity.
The Environmental Health staff was also taught how to effectively monitor and, if necessary,
re-educate the beneficiary households.
6
DISPERSION, ASSEMBLY AND COMMISSIONING OF THE FILTERS
After the training, PHW and the

local Environmental Health staff
registered and handed out one
filter unit to each selected
beneficiary. As it usually is the
woman who fetches and controls
the drinking water for the
household, it was decided that
every woman that represented a
household that was most affected
by the floods in her community,
would receive a filter unit. Grateful
beneficiaries eventually
transported their individual Kosim
ceramic filter unit to their
compound for assembly and
commissioning. Beneficiaries transporting their Kosim filter home
EXECUTION OF AN EXTENSIVE MONITORING & EVALUATION PROGRAM
PHW and the local Environmental Health staff performed a follow-up monitoring and
evaluation program to evaluate the community acceptance of the filter, to receive user
feedback in regard to the filter and to learn how the filter is used and maintained in order to
improve services to these and future users. To ascertain a maximum health benefit, PHW
and government staff re-educated the beneficiaries where deemed necessary, after each
interview. The data resulting from these interviews and the observations in the field have
been thoroughly analyzed and form the basis for this Monitoring & Evaluation Report.
7
MONITORING & EVALUATION PROCESS
DISTRICT ASSESSMENT
IN THE FIELD
In each of the six districts visited, PHW interviewed the Government Environmental Health
Staff that was responsible for the follow-up and monitoring of the beneficiaries.
Topics discussed during these interviews were typically:
• government staff appreciation for the ceramic filter;

• encountered monitoring issues;
• availability of resources to perform the monitoring in the field;
• breakage, leakage and product quality issues;
• availability of replacement parts and services;
• requests for distribution in other areas or communities;
• other suggestions & recommendations.
Upper-East districts & communities surveyed by Pure Home Water
IN THIS REPORT
To be concise, instead of transcribing the interviews literally, the main topics of conversation
have been abbreviated into two themes: compliments and concerns.
At the end of each district assessment, this report offers recommendations as to how Pure
Home Water and the Government Field Staff can most effectively follow up the current
situation in the field.
8
COMMUNITY ASSESSMENT
IN THE FIELD
In over 23 rural communities in the Upper-East

Region, PHW monitored over 1000 households and
inspected an equal number of ceramic filter units.
Monitoring visits were performed in the compound of

the beneficiary where the filter was set up, enabling
the surveyor to:
conduct the interview in the environment

where the filter is usually operated;
inspect the filter within its direct surroundings

and observe how the beneficiary operates
and maintains the filter;
re-educate the beneficiary by demonstrating

with his/her own filter.
Each script-based interview (see Appendix I) was a focused question/answer session

between the person who usually controls the use and maintenance of the filter and the PHW
surveyor, and was focused at the
situational assessment;
treatment or use of the filter unit;
maintenance of the filter unit;
storage of the filtered water;
appreciation for the filter unit;
physical inspection or observation;
re-education of the beneficiary.
PHW surveyors were trained to conduct interviews in such a way that2
he/she understood the objectives, subject matter and vocabulary of the survey;
the beneficiary could comfortably talk with a friendly local, at the same level and, if
possible, in their own local language;
the beneficiary was never interrupted, manipulated or prompted for a certain answer;
the beneficiary felt respected and never judged, embarrassed or forced.
At the end of each interview, the monitored filter unit was marked with an original
identification number and mapped by using GPS coordinates.
2
Adapted from: Whittington, Dale. 2002. “Improving the Performance of Contingent Valuation Studies in Developing Countries”
Environmental and Resource Economics 22:323-367, 2002. Kluwer Academic Publishers, Netherlands
9
IN THIS REPORT
This report summarizes the results of these monitoring visits in interview abbreviations and
graphics (see Appendix II), divided per district and community.
All data has been conveniently sorted and assessed in five main appraisal themes,
answering the most crucial questions to measure the success of each project phase.
Distribution
9 Did the project reach the targeted beneficiaries?

9 Were filters effectively dispersed over the community?
Training & Health Education
9 Did the health education create sufficient awareness about proper household water treatment
and safe water storage (HWTS)?
9 Were the ceramic filter operational & maintenance training concepts successfully adopted?
Treatment & Maintenance
9 Is the ceramic filter effectively operated and properly maintained?

9 Is the trained beneficiary the dedicated person to control the filter in the household?
9 What is filtered water used for?
9 Does the household apply other water treatment methods?
9 Is filtered water stored anywhere else in the household?
9 If a given household was not using its filter, what are the main reasons why that household
decided to stop using it?
Monitoring & Re-education
9 Is the Government Field staff effectively and regularly performing the monitoring rounds?
9 What are the typical re-education topics?
9 What are the most frequently asked questions by beneficiaries?
Appreciation
9 Does the community appreciate the ceramic filter?

9 According to beneficiaries, what are the benefits of using the ceramic filter?
Each theme has been evaluated and appropriately marked, using following scoring system:
: EXCELLENT – activity successful

: GOOD – regular follow-up advisable
: PASSABLE – improvement and follow-up advisable
: PROBLEMATIC – reappraisal for alternative solution

: UNSATISFACTORY – suspension of services
For each score below EXCELLENT (5/5), this report offers general recommendations (see
the Recommendations section at the end of this report) as to how concerns can be
overcome, processes can be improved or issues can be resolved.
10
MONITORING & EVALUATION RESULTS
BONGO DISTRICT ASSESSMENT
In the Bongo District, PHW interviewed a total of 102 beneficiaries in three monitored
communities: Balungu, Aliba and Gowrie.
Monitored Communities in Bongo District Ceramic Filter Use in Bongo District
Environmental Health Field Staff Interview Summary
Compliments
The government field staff of the Bongo district generally demonstrates a favourable attitude
towards the use of ceramic filters in their communities. Several of them live in these
communities and contentedly use the filter in their own home or in that of family members.
They flawlessly master the operational and maintenance instructions of the ceramic filter and
they fully understand the benefits of the system. They are highly active in the field, visiting
beneficiary households on a regular basis to monitor and convince effective use.
Concerns
Few issues disturb their activities, though they emphasize a need for vehicles and fuel to
improve their mobility in the field. Furthermore they suggest the need for ceramic filters in
each household, not only those that were directly affected by the floods. Finally they describe
product quality issues with certain filter units (gap between the ring lid and the ceramic pot;
low flow rates) and they mention the need for replacement parts and services.
Recommendations
A PHW team should revisit the Bongo communities to offer replacement services to the
households that have malfunctioning filter units and to distribute ceramic filters to each
household that has not yet received one.
Government field staff should continue regular surveillance and health education to support
the sustainable and effective use of the ceramic filter units in this district.
11
BALUNGU COMMUNITY ASSESSMENT
Population No: 544 Distribution Date: 8 February 2008

Household No: 102 Distribution No: 32
Compound No: 65 Monitoring Date: 18 June 2008

Water source(s): stream, borehole Monitored Household No: 24
Monitored Households in Balungu Ceramic Filter Use in Balungu
Distribution score:
Observation: The distribution was successful, although more filters should have been dispersed to cover every
flood-affected household in this community. Certain households received more than one filter to serve the
numerous family members, while other households could only observe in disappointment.
Training & Health Education score:
Observation: The health education and operational & maintenance training turned out highly successful.
Treatment & Maintenance score:
Observation: Filters are excellently handled and properly maintained on a regular basis. The trained beneficiary
is usually the person who is dedicated to controlling the filter unit. Due to scarcity, filtered water only serves for
drinking purposes. The households in this community do not apply methods other then the ceramic filter to treat
their drinking water. The storage container of the ceramic filter is the only safe water storage vessel in these
households. Malfunctioning filters are the single reason for discontinued use in this community.
Monitoring & Re-education score:
Observation: The government field staff is doing an outstanding job. Monitoring rounds are performed on a
regular basis and the little re-education that is necessary in this community is focused on the location and
hygienic use of the drinking vessel, the position of the ceramic filter unit in the compound, the cleaning and
frequency of cleaning of the ceramic pot and the overfilling of the safe storage container. Frequently asked
question: Where can I find replacement parts?
Appreciation score:
Observation: The households in this community are very grateful for receiving the filters and cheerful because
of our monitoring visit. Beneficiaries say they have now become inseparable from their filters because they are
no longer troubled by abdominal pains and diarrhoea; furthermore the quality and taste of their drinking water
has significantly improved. Those with malfunctioning filters are eagerly asking how they can repair their filter.
Households that did not receive a filter are trying to convince PHW to bring more filters soon.
12
ALIBA COMMUNITY ASSESSMENT


Water source(s): hand dug well, borehole, pond, stream Monitored Household No: 27
Monitored Households in Aliba Ceramic Filter Use in Aliba
Distribution score:
Observation: The distribution was successful, although more filters should have been dispersed to cover every
flood-affected household in this community. Certain households received more than one filter to serve the high
number of family members, while other households could only observe in disappointment.
Observation: The health education and operational & maintenance training turned out reasonably successful.
Some topics appear to be less obvious for certain beneficiaries, but these shall be observed and repeated
during household monitoring rounds.
Observation: Most filters are excellently handled and properly maintained on a regular basis. The trained
beneficiary is usually the person who is dedicated to controlling the filter unit. Due to scarcity, filtered water only
serves for drinking and cooking purposes. Due to the high turbidity of the water, households initially had to
sieve and boil their drinking water; now they are happy to use the ceramic filter as their main water treatment
method. In certain households, the storage container of the ceramic filter is not the only safe water storage
vessel in the compound. Malfunctioning filters are the main reason for discontinued use in this community.
Observation: The government field staff is doing an outstanding job. Monitoring rounds are performed at a
regular basis and the little re-education that is necessary in this community is focussed at the hygienic use of
the drinking vessel, the cleaning of the ceramic pot vs. the safe storage container and the overfilling of the
storage container. Frequently asked questions: Where can I find replacement parts? How do I properly clean
the ceramic pot? Should I boil the filtered water before drinking it? Can you make the container bigger?
Appreciation score:
Observation: It is a pleasure to see how beneficiaries cheer and praise the filter for improving their quality of life.
They say the filter protects their health because they no longer feel stomach pains or experience diarrhoea,
furthermore they can now enjoy the taste of clean drinking water. Numerous households that were unfortunate
enough not to receive a filter are pleading to bring more filters to this community.
13
GOWRIE COMMUNITY ASSESSMENT


Water source(s): hand dug well, borehole, pond, dam, stream Monitored Household No: 51
Monitored Households in Gowrie Ceramic Filter Use in Gowrie
Distribution score:
Observation: The distribution was successful. Most flood-affected households have received a ceramic filter
and filters have been well-dispersed over the community.
Observation: Most filters are well handled and properly maintained on a regular basis. The trained beneficiary is
usually the person who is dedicated to controlling the filter unit. Due to scarcity, filtered water only serves for
drinking and cooking purposes. Because of the high turbidity of the water, households combined sieving, boiling
and AquaTabs to treat their drinking water; now they are happy to use the ceramic filter as their main water
treatment method. The storage container of the ceramic filter is the only safe water storage vessel in these
households. Malfunctioning filters are the main reason for discontinued use in this community.
Observation: The government field staff is doing an outstanding job. Monitoring rounds are performed at a
regular basis and the little re-education that is necessary in this community is focussed on the hygienic use of
the drinking vessel, the cleaning of the ceramic pot, overfilling and cleaning of the storage container, the stable
positioning of the filter unit. Frequently asked questions: Where can I find replacement parts? Can you give me
a proper drinking cup? Can you make the container bigger?
Appreciation score:
Observation: Households are very thankful for receiving the ceramic filter. Some have become remarkably
attached to their filter unit because, they say, it protects them from waterborne disease such as diarrhoea and
abdominal pains. They feel more comfortable in their body and have more strength and energy. Many are very
pleased with the taste and quality improvement of their water. They say it seems they are now enjoying Voltic.
14
TALENSI NABDAM DISTRICT ASSESSMENT
In the Talensi Nabdam District, PHW interviewed a total of 267 beneficiaries in three
monitored communities: Pwalugu, Baluugu and Arigu.
Monitored Communities in Talensi Nabdam District Ceramic Filter Use in Talensi Nabdam District
Compliments
The government field staff of the Talensi Nabdam district appears to have a favourable
attitude towards the use of ceramic filters. Based on the information acquired during PHW
household interviews, we can conclude that most of the field staff sufficiently master the
operational and maintenance instructions of the ceramic filter, enabling them to properly
monitor the communities in their district. A great support to their field activities comes
definitely from the selfless efforts of certain energetic community members, who regularly
ensure that their surrounding neighbours effectively use their ceramic filter.
Concerns
As the Talensi Nabdam government field staff, like other districts, endures a lack of human
and material resources that are essential for field activities, they appear to struggle to
continue to integrate regular monitoring visits in their field agenda, although they realize that
a decreased health staff presence in the field negatively influences the number of effective
users in these communities. Furthermore, as suggested by the government field staff and
confirmed by PHW during the monitoring rounds, a large number of flood-affected
households did not receive a filter, while others less impacted by the floods have. Those
unfortunate enough not to have received a filter are disgruntled because they do not grasp
why a direct neighbour can enjoy filtered water, but they did not receive a filter; “didn’t we all
suffer from the floods?” Finally, a considerable number of filters need replacement parts.
Recommendations
A PHW team should revisit the Talensi Nabdam communities to offer replacement services
to the households that have malfunctioning filter units and to distribute ceramic filter units to
each household that has not yet received one. The government field staff should further
strengthen its presence in the field in order to stabilize and eventually augment the
population of effective users.
15
PWALUGU COMMUNITY ASSESSMENT
Population No: 7120 Distribution Date: 22 January 2008

Compound No: - Monitoring Date: 1 & 2 July 2008

Water source(s): hand dug well, borehole, pond, dam, Monitored Household No: 213
stream, river
Monitored Households in Pwalugu Ceramic Filter Use in Pwalugu
Distribution score:
Observation: The distribution was successful. Although a large number of filters were dispersed, even more
were needed to cover every flood-affected household in this community. Certain households received more
than one filter to serve the high number of family members, while other households observed in disappointment.
Observation: A large majority of filters are well handled and properly maintained on a regular basis. The trained
beneficiary is the person who is dedicated to controlling the filter unit. Due to scarcity, filtered water only serves
for drinking and cooking purposes. Some households combine boiling and the ceramic filter as the main water
treatment methods. For most households, the storage container of the ceramic filter is the only safe water
storage vessel. Malfunctioning filters (15% need replacement parts) are the main reason for discontinued use in
this community. Other reasons are: beneficiary prefers to consume untreated rain water, beneficiary is travelling
or has relocated or beneficiary sees no benefit in filtered drinking water.
Observation: Considering the size of this community and the number of filters that need monitoring, the
government field staff seems to be doing a reasonably good monitoring job, although it must be said that a
substantial part of their field work is performed by devoted community members. Re-education is focused on
the hygienic use and location of the drinking vessel, the cleaning of the ceramic pot, overfilling and cleaning of
the storage container, the stable positioning of the filter unit in the compound. Frequently asked questions:
Where can I find replacement parts? Can you make the container bigger?
Appreciation score:
Observation: Most households are very grateful to have received the ceramic filter because they say it protects
their health (no more diarrhoea, no more stomach or abdominal pains), they feel stronger and have more
energy. Furthermore the taste and appearance of their drinking water has considerably improved.
16
BALUUGU COMMUNITY ASSESSMENT

Household No: - Distribution No: 63
Compound No: - Monitoring Date: 3 July 2008

Water source(s): borehole, stream Monitored Household No: 24
Monitored Households in Baluugu Ceramic Filter Use in Baluugu
Distribution score:
Observation: The distribution was quite successful, although the community counts several more flood-affected
households than the number of filters that were dispersed.
Observation: The operational & maintenance training was reasonably successful, although some topics appear
to be less evident for a number of beneficiaries; these topics shall be observed and repeated during household
monitoring rounds. The health education seems less effective as close to half of the beneficiaries decided to
stop using their ceramic filter unit.
Observation: Over half of the filters are adequately handled and properly maintained on a regular basis. The
trained beneficiary is the person who is dedicated to controlling the filter unit. Due to scarcity, filtered water only
serves for drinking purposes. Because of the turbidity, some households first sieve their water before filtering it.
The storage container of the ceramic filter is the only safe water storage vessel for these households.
Malfunctioning filters (17% need replacement parts) are the most important reason for discontinued use in this
community; in most other cases the beneficiary prefers consuming untreated rain water.
Observation: During the PHW monitoring round in this community, it quickly became evident that the
government field staff had not set foot in this community for ceramic filter monitoring. Typical re-education
topics were the location and hygienic use of the drinking vessel, cleaning and frequency of cleaning of the
ceramic pot vs. the storage container and the stable position of the ceramic filter in the compound. Frequently
asked questions: Where can I find replacement parts? Where can I acquire (buy) a filter?
Appreciation score:
Observation: Most beneficiaries are pleased with the ceramic filter and are most convivial towards the PHW
monitoring team. Many love the filter because, so they say, it gives them better health and it provides them with
clean and better tasting drinking water. Those with malfunctioning filters are keen to know how they can repair
and re-commission their filter.
17
ARIGU COMMUNITY ASSESSMENT
Population No: - Distribution Date: 22 January 2008


Water source(s): borehole, pipe Monitored Household No: 30
Monitored Households in Arigu Ceramic Filter Use in Arigu
Distribution score:
Observation: The distribution was a success although more filters should have been dispersed to cover the
entire flood-affected community. Certain households received several filters to serve a high number of
household members, while others received nothing.
Observation: The filter operations training and the health education were successful, but the maintenance
training needed more emphasis in this community. If deemed necessary, then maintenance topics shall be
reiterated during the monitoring rounds.
Observation: Most filters are properly handled and reasonably maintained on a regular basis. The trained
beneficiary is the person who is dedicated to controlling the filter unit. Due to scarcity, filtered water only serves
for drinking purposes. Ceramic filters are the only water treatment method and the filter unit safe storage
container is the only safe water storage for households in this community. Malfunctioning filters (13% need
replacement parts) are the most important reason for discontinued use in this community; in most other cases
the beneficiary prefers consuming untreated (rain) water.
Observation: PHW could not confirm previous monitoring activities in this community. Fortunately the
beneficiaries had convinced themselves of the benefits of the ceramic filter, without the support of regular
monitoring visits. Typical re-education topics were the location and hygienic use of the drinking vessel, cleaning
and frequency of cleaning of the ceramic pot vs. the storage container and the stable position of the ceramic
filter in the compound. Frequently asked questions: Where can I find replacement parts?
Appreciation score:
Observation: The beneficiaries in this community are very grateful to have received the filter. They encourage
PHW to bring more filters for the households that have not yet received one because, so they say, the filter
protects the community members from stomach pains and diarrhoea. Filtered water makes their body stronger,
gives them more energy and improves the drinking water quality and taste. Some beneficiaries with
malfunctioning filters say that if their filter is repaired, they will use it again.
18
BOLGATANGA MUNICIPAL DISTRICT ASSESSMENT
In the Bolgatanga Municipal District, PHW interviewed a total of 158 beneficiaries in four
monitored communities: Soe Yipala, Dachio, Kumbosco and Kumbangli.
Monitored Communities in Bolgatanga Municipal District Ceramic Filter Use in Bolgatanga Municipal District
Compliments
The government field staff of the Bolgatanga Municipal district appears rather indifferent
towards the use of ceramic filters. Most probably that is due to the fact that this district did
not specifically dedicate field staff to the follow-up of the communities where ceramic filters
have been distributed.
Concerns
Likewise to its counterparts, the Bolgatanga district endures a serious lack of material
resources and motivated human resources, resulting in disrupted and ineffective field
activities. Based on the information acquired during PHW household interviews, we can
conclude that virtually no monitoring visits have been performed in this district; the local staff
even turns out to be unfamiliar with the geographical location of the communities where
filters have been distributed. Therefore no reports, suggestions or concerns were recorded
from district staff. Households do report replacement needs and put forward mixed feelings
amongst community members because some did and others did not receive a ceramic filter.
Recommendations
A PHW team should revisit the Bolgatanga Municipal communities to offer replacement
services to the households that have malfunctioning filter units and to distribute ceramic filter
units to each household that has not yet receive one.
Furthermore a number of dedicated local government field staff who are familiar with the
communities that received ceramic filters, should be selected and trained to perform
monitoring visits and health education and to convince the beneficiaries to continue to use
the filter effectively.
19
SOE YIPALA COMMUNITY ASSESSMENT


Water source(s): borehole, pond, dam, stream, river Monitored Household No: 40
Monitored Households in Soe Yipala Ceramic Filter Use in Soe Yipala
Distribution score:
Observation: The distribution in this community could have been better executed. First of all the number of
households affected by the floods greatly exceeds the number of ceramic filters distributed in this community.
Furthermore, the attentive chief of this community pleads ‘africanism’, most likely referring to favouritism by
those that have selected the beneficiary households. In the limited community area that was lucky enough to
receive them, filters were effectively dispersed to the households.
Observation: Both the health education and the operational & maintenance training were generally successful.
Observation: Most of the filters are effectively handled and properly maintained on a regular basis. The trained
serves for drinking purposes. Except for the ceramic filter, no other water treatment methods are applied in this
community. The storage container of the ceramic filter is the only safe water storage vessel in these
households. The main reason for discontinued use is a considerable amount of malfunctioning filters (10% need
replacement parts due to breakage or leakage).
Observation: The government field staff is not executing the monitoring rounds. In fact, the first monitoring visits
were performed by the PHW team and focused at re-educating the households about the location and hygienic
use of the drinking vessel, cleaning of the ceramic pot vs. the storage container, overfilling of the storage
container, etc. Frequently asked questions: Where can I find replacement parts? Can you make the container
bigger?
Appreciation score:
Observation: Most beneficiary households in this community are in high spirits about their ceramic filter. They
say it protects them from stomach pains and diarrhoea; they generally feel better and stronger in their body.
Furthermore they say the taste of the drinking water is significantly improved by the filter.
20
DACHIO COMMUNITY ASSESSMENT


Water source(s): borehole, stream, river Monitored Household No: 60
Monitored Households in Dachio Ceramic Filter Use in Dachio
Distribution score:
Observation: The distribution was successful, though many more filters should have been delivered to cover the
entire flood-affected community.
Observation: Both the health education and the operational & maintenance training were generally successful.
serves for drinking purposes. Except for the ceramic filter, no other water treatment methods are applied in this
community. The storage container of the ceramic filter is the only safe water storage vessel in these
households. The main reason for discontinued use seems to be a considerable number of malfunctioning filters
(19% need replacement parts due to breakage or leakage). However, due to the multiple players involved in the
initial distribution process, it is unclear whether filters started malfunctioning at the time of distribution or
because households were not correctly handling it.
were performed by the PHW team and focused at re-educating the households about the location and hygienic
use of the drinking vessel, cleaning of the ceramic pot vs. the storage container, overfilling of the storage
container, etc. Frequently asked question: Where can I find replacement parts?
Appreciation score:
Observation: Even without regular monitoring, most of the households in this community are happy to continue
using the filter because they say it protects their health (no more stomach pains or diarrhoea), they feel stronger
and more comfortable than before. Furthermore the taste and quality of the drinking water is significantly
improved after filtering. If replacement parts were available, most other households say they would re-
commission their currently malfunctioning filter.
21
KUMBOSCO COMMUNITY ASSESSMENT


Water source(s): borehole, river, stream, hand dug well Monitored Household No: 26
Monitored Households in Kumbosco Ceramic Filter Use in Kumbosco
Distribution score:
Observation: The distribution was not a success as most filters ended up clustered in households that were
least affected by the floods. To effectively cover this flood stricken community many more filters were needed
than were actually distributed.
Observation: The filter operations & maintenance training were successfully presented to the beneficiaries.
Some topics appear to be less obvious for certain beneficiaries, but these shall be observed and reiterated
during household monitoring rounds. Whether the health education was effective, remains doubtful considering
the number of households that have given up using the ceramic filter.
Observation: Most of the filters that are still in use, are effectively handled and properly maintained on a regular
basis. The trained beneficiary is usually the person who is dedicated to controlling the filter unit. Due to scarcity,
filtered water only serves for drinking and cooking purposes. Households in this community do not apply
methods to treat water other then the ceramic filter. The storage container of the ceramic filter is the only safe
water storage vessel in these households. Half of the households in this community stopped using the filter
because of breakage/leakage (15%) or because they see no benefit in filtering borehole or rain water.
were performed by the PHW team and focused at re-educating the households about general health topics,
location and hygienic use of the drinking vessel, cleaning of the ceramic pot vs. the storage container, etc.
Frequently asked question: Where can I find replacement parts?
Appreciation score:
Observation: Numerous households are happy to use the ceramic filter because it protects their health and it
improves the quality and taste of their drinking water. Several others will use the filter again once the rains stop
falling.
22
KUMBANGLI COMMUNITY ASSESSMENT

Compound No: - Monitoring Date: 22 August 2008

Water source(s): borehole, stream, river Monitored Household No: 32
Monitored Households in Kumbangli Ceramic Filter Use in Kumbangli
Distribution score:
Observation: For a privileged minority of households in this community, the distribution was successful.
Unfortunately most of the households did not receive a filter because fewer filters were distributed then there
were flood-affected households. Some households received more than one filter to serve the high number of
family members.
Observation: Based on interviews with households that decided to continue using the ceramic filter, the
operational & maintenance training appears a success. The great number of households that decided to stop
using the filter makes the effectiveness of the health education rather doubtful.
Observation: Most of the filters that are still in use, are effectively handled and properly maintained on a regular
basis. The trained beneficiary is usually the person who is dedicated to controlling the filter unit. Due to scarcity,
filtered water only serves for drinking purposes. Except for boiling, households in this community do not apply
other methods to treat water; for most households drinking water passes through the ceramic filter. The storage
container of the ceramic filter is the only safe water storage vessel in these households. Half of the households
stopped using the filter because they see no benefit in filtering borehole water or they prefer to consume
untreated rain water. No breakage was recorded in this community.
were performed by the PHW team and focused at re-educating the households about general health topics,
hygienic use of the drinking vessel, cleaning of the ceramic pot, overfilling of the safe storage container, etc.
Frequently asked question: Where can I find replacement parts?
Appreciation score:
Observation: Most of the households in this community are thankful for receiving the ceramic filter because they
say it improves the quality and taste of their drinking water and it protects them from disease. Some of the
households that harvest rain water during rainy season say that they will re-commission the filter once the rainy
season ends.
23
GARU TEMPANE DISTRICT ASSESSMENT
In the Garu Tempane District, PHW interviewed a total of 40 beneficiaries in two monitored
communities: Buarboka and Namboko.
Monitored Communities in Garu Tempane District Ceramic Filter Use in Garu Tempane District
Compliments
The government field staff of the Garu Tempane district demonstrates a rather impassive
attitude towards the use of ceramic filters in the area.
Concerns
Like other districts, Garu Tempane has limited resources, especially human resources. That
is most probably why no dedicated field staff has been appointed to follow-up the
communities where ceramic filters have been distributed. Based on the information acquired
during PHW monitoring rounds, it can be concluded that virtually no monitoring visits have
been performed by the local field staff in this district. Therefore no reports, suggestions or
concerns were recorded until a government staff that joined PHW during monitoring rounds
did eventually, and correctly, observe the need for replacement parts. Later, government
staff mentioned that the distribution of the filters could have been better organised for
Buarboka and that an increased presence in the field would improve the sustainable use
figures for Namboko.
Recommendations
A PHW team should revisit the Garu Tempane communities to offer replacement services to
the households that have malfunctioning filter units and to distribute ceramic filter units to
households in Namboko that have not yet receive one.
Furthermore, a number of dedicated local government field staff who are familiar with the
monitoring visits, provide health education and convince the beneficiaries to continue to use
the filter effectively.
24
BUARBOKA COMMUNITY ASSESSMENT
Population No: 2138 Distribution Date: 3 March 2008


Water source(s): hand dug well, borehole, pipe Monitored Household No: 6
Monitored households in Buarboka Ceramic Filter Use in Buarboka
Distribution score:
Observation: The distribution in this community turned out to be disastrous as most of the filters missed their
target beneficiaries because they were distributed on a market day and so ended up in the homes of visitors
from nearby communities that were unaffected by the floods. Out of sixty-four filters distributed, only a fraction
were found here; it is not clear where the other filters are.
Observation: Similar to the distribution, both the training and health education are deemed highly unsuccessful.
Observation: The few filters found in this community were poorly handled and maintained. Due to scarcity,
filtered water is only used for drinking purposes. Households in this community generally do not treat drinking
water; furthermore they see no reason why they should use the ceramic filter. For those that do use the filter,
the storage container of the ceramic filter is the only safe water storage vessel. Reasons for discontinued use
are breakage, leakage and a general disinterest for the system.
Observation: The government field staff is not executing the monitoring rounds. Unfortunately, the first
monitoring visits were performed by the PHW team. Not surprisingly the government field staff was unaware of
the unfortunate situation in the field. Re-education during the PHW monitoring round was focused on all training
and health education topics.
Appreciation score:
Observation: The households in this community have no interest nor display any curiosity for the ceramic filters.
25
NAMBOKO COMMUNITY ASSESSMENT

Compound No: - Monitoring Date: 20 June 2008

Water source(s): hand dug well, dam, borehole, stream Monitored Household No: 34
Monitored Households in Namboko Ceramic Filter Use in Namboko
Distribution score:
Observation: The distribution was successful, although a considerable number of households did not receive a
filter because fewer filters were distributed then there were flood affected households. In addition some
households received more than one filter to serve the high number of family members.
Observation: Unfortunately the health education and operational & maintenance training turned out to be rather
unsuccessful, resulting in untimely discontinued use, mistreatment and damaging filter maintenance practices.
Observation: As a result of the unsuccessful training and education, most of the filters are poorly handled and
maintained. The trained beneficiary is not always the person who is dedicated to controlling the filter unit. Due
to scarcity, filtered water only serves for drinking purposes. Except for sieving or boiling, households in this
community do not apply other methods to treat water; most drinking water passes through the ceramic filter.
The storage container of the ceramic filter is the only safe water storage vessel in these households. Reasons
for discontinued use are: breakage/leakage (35% of these filters need replacement parts) or beneficiary sees
no benefit in filtered drinking water.
monitoring visits were performed by the PHW team. Not surprisingly, the government field staff was unaware of
the unfortunate situation in the field. Re-education during the PHW monitoring round was focused on all training
and health education topics.
Appreciation score:
Observation: In spite of everything, a considerable number of households in this community are happy to use
the filter because they say it improves the quality of their water significantly: after filtering there are no more
worms in the water and it tastes sweeter than ever. Furthermore family members are feeling more comfortable
in their body and they get less often sick (diarrhoea, stomach pains). Several beneficiaries are asking how they
can acquire filters for their family and friends in other communities.
26
KASSENA NANKANA DISTRICT ASSESSMENT
In the Kassena Nankana District, PHW interviewed a total of 304 beneficiaries in eight
monitored communities: Gorum, Nyaganya, Kanonia, Agrumaloko, Dusidoma, Kayoro,
Kayavio and Gonsa.
Monitored Communities in Kassena Nankana District Ceramic Filter Use in Kassena Nankana District
Compliments
The government field staff of this district displayed a limited awareness about the ceramic
filters that is unfortunately comparable to the attitude observed in several other districts in the
region. Although no previous government monitoring activities were perceived in this district,
when receiving mobility support from the PHW monitoring team, the district field staff did
show sufficient readiness to perform the crucial follow-up actions in the field.
Concerns
However inclined one is to hope for similar laborious field efforts as demonstrated by its
neighbouring counterparts in the North and South of the region, one cannot deny that the
Kassena Nankana district’s field activities are also distorted due to a serious lack of
resources. No dedicated field staff has been appointed to monitor the communities where
ceramic filters have been distributed, unfortunately resulting in far lower average sustainable
use figures than anywhere else in the region. When government staff joined the PHW
monitoring team in the field, they did conclude that a more frequent government monitoring
presence could have positively convinced the beneficiaries to make better use of their
ceramic filters.
Recommendations
A PHW team should revisit the Kassena Nankana communities to offer replacement services
to the households that have malfunctioning filter units. PHW should also repossess ceramic
filter units from households that have determined them obsolete and subsequently
redistribute them to households that have not yet received a filter.
Furthermore a number of dedicated local government field staff who are familiar with the
monitoring visits, provide health education and convince the beneficiaries to sustainable use.
27
GORUM COMMUNITY ASSESSMENT


Water source(s): hand dug well, borehole, stream Monitored Household No: 66
Monitored Households in Gorum Ceramic Filter Use in Gorum
Distribution score:
Observation: The distribution was successful, although a considerable number of households did not receive a
filter (fewer filters were distributed then there were flood-affected households in this community). Some
households received more than one filter to serve the high number of household members.
Observation: Beneficiaries that decided to continue to use the ceramic filter, prove that the operational &
maintenance education was mostly a success. Since close to half of them have given up the filter, the
effectiveness of the health education is questionable.
Observation: The filters that are still in use generally are effectively handled and properly maintained on a
regular basis. The trained beneficiary is the person who is dedicated to controlling the filter unit. Due to scarcity,
filtered water only serves for drinking purposes. Households in this community do not apply methods other then
the ceramic filter to treat water. The storage container of the ceramic filter is the only safe water storage vessel
in these households. Many beneficiaries decided to stop using the filter because they do not see benefit in
filtering borehole water, while others have malfunctioning filters (product quality issues, breakage or leakage) or
have removed the ceramic pot from the storage container to use the latter for safe water storage. Astonishingly,
at least three households said that they had packed and hidden the ceramic filter because they feared that
sooner or later a child would break the filter because they had no suitable place to position it in the compound.
monitoring visits were performed by the PHW team. Re-education topics: location and hygienic use of the
drinking vessel, cleaning of the ceramic pot vs. the plastic storage container, unstable position of the filter unit.
Frequently asked questions: Where can I find replacement parts? Can you make the storage container bigger?
Appreciation score:
Observation: Those that are still using the ceramic filter are very excited to continue filtering, because they say
the filtered water not only protects their health (no more stomach pains, nor diarrhoea). They also find the water
sweeter and cleaner. Unfortunately close to half of the beneficiaries here do not share that opinion.
28
NYAGANYA COMMUNITY ASSESSMENT
Population No: - Distribution Date: 1 February 2008

Household No: - Distribution No: -

Water source(s): hand dug well Monitored Household No: 20
Monitored Households in Nyaganya Ceramic Filter Use in Nyaganya
Distribution score:
Observation: The distribution was successful. All households that were affected during the floods have received
one or more ceramic filter units; amounts depending on the number of household members.
Observation: The collective health education and filter operations & maintenance training were successfully
presented to the beneficiaries. Some topics could be less obvious for certain beneficiaries, but these shall be
observed and reiterated during household monitoring rounds.
beneficiary is the person who is dedicated to controlling the filter unit. Due to extreme scarcity, filtered water
only serves for drinking purposes. The only method for treating drinking water in this community is the ceramic
filter. The storage container of the ceramic filter is the only safe water storage vessel in these households. Only
one household decided to stop using the filter because it prefers consuming untreated rain water. No breakage
or leakage was recorded in this community. Even with flow rates perceived as too low (product quality issue),
one beneficiary is determined to continue using the filter.
drinking vessel, cleaning of the ceramic pot vs. the plastic storage container, unstable position of the filter unit,
overfilling of the safe storage container. Frequently asked questions: Where can I find replacement parts? Can
you make the storage container bigger?
Appreciation score:
Observation: Most households are very thankful, even jubilant to have received the ceramic filter. The water
source for this geographically lower side of the community only yields turbid water, which is made potable once
it has passed through the filter. Community members say that not only have the taste and appearance of their
water improved, but that they also feel stronger and healthier in their body.
29
KANONIA COMMUNITY ASSESSMENT


Water source(s): hand dug well Monitored Household No: 44
Monitored Households in Kanonia Ceramic Filter Use in Kanonia
Distribution score:
Observation: The distribution was successful, although a small number of households did not receive a filter
because fewer filters were distributed then there were households at the time of the floods.
Observation: Beneficiaries that have decided to continue to use the ceramic filter, prove that the operational &
maintenance education was mostly a success. Since all except few have given up the filter, the effectiveness of
the health education is doubtful.
Observation: The few filters that are still in use, are generally effectively handled and properly maintained on a
regular basis. The trained beneficiary is the person who is dedicated to controlling the filter unit. Due to scarcity,
filtered water only serves for drinking purposes. Households in this community don’t usually treat their water,
except the few that have adapted to using the ceramic filter. The storage container of the ceramic filter is the
only safe water storage vessel in these households. In this community, many beneficiaries decided to stop
using the ceramic filter because they prefer consuming untreated rain water, others are travelling or have a
malfunctioning filter (breakage/leakage/low flow rate). A more sensible conclusion for discontinued use in this
community appears to be negative peer influence.
Observation: Unfortunately the government field staff is not executing the monitoring rounds, resulting in
extremely low sustained use figures. In fact, the first monitoring visits were performed by the PHW team. Re-
education topics: location and hygienic use of the drinking vessel, cleaning of the ceramic pot, unsuitable
position of the filter unit.
Appreciation score:
Observation: It cannot be denied that for most households in this community, the ceramic filter is not a desired
object. During the monitoring visit, some beneficiaries appear rather ashamed of the fact that the PHW team
discovered ceramic filters catching dust in the darkest corner of their compounds; some even rushed to clean,
assemble and commission the filter, while the PHW team was moving towards their compound. Most filters in
this community are in a good condition and could be better put to use in another community that values them.
30
AGRUMALOKO COMMUNITY ASSESSMENT


Water source(s): borehole, river Monitored Household No: 30
Monitored Households in Agrumaloko Ceramic Filter Use in Agrumaloko
Distribution score:
Observation: The distribution was successful. A small number of targeted beneficiaries did not receive a filter
because they were not present during the distribution phase; their filters were handed out to other households
in this community. Some households received more than one filter because of the high number of family
members.
Observation: The majority of the filters are effectively handled and properly maintained on a regular basis. The
trained beneficiary is the person who is dedicated to controlling the filter unit. Due to scarcity, filtered water only
serves for drinking purposes. Households in this community treat their drinking water with the ceramic filter
and/or boiling. The storage container of the ceramic filter is not the only safe water storage vessel in these
households; some use similar plastic containers to store more drinking water in their compound. In this
community beneficiaries decided to stop using the ceramic filter because they are travelling or they prefer
consuming untreated rain or borehole water. No malfunctioning filters have been found in this community.
were performed by the PHW team. Re-education topics: location and hygienic use of the drinking vessel,
cleaning of the ceramic pot vs. the plastic storage container, unstable position of the filter unit, overfilling of the
safe storage container. Frequently asked questions: Where can I find replacement parts? Can you make the
storage container bigger?
Appreciation score:
Observation: Many households in this community are excited to use the ceramic filter because the filtered water
protects or improves their health, they feel stronger and more energetic, and their drinking water looks cleaner
and tastes better. Others decided that borehole and rainwater do not need filtering, but would consider re-
commissioning the filter before the dry season.
31
DUSIDOMA COMMUNITY ASSESSMENT

Compound No: 26 Monitoring Date: 19 August 2008

Water source(s): hand dug well, borehole, dam Monitored Household No: 68
Monitored Households in Dusidoma Ceramic Filter Use in Dusidoma
Distribution score:
Observation: This community received a sufficient amount of ceramic filters, most of which were effectively
dispersed over the community. Numerous households received more than one filter to serve the high number of
household members.
Observation: The limited amount of beneficiaries that have decided to continue to use the ceramic filter, prove
that the operational & maintenance education was mostly a success. Since many have given up the filter, one
can have more doubts about the effectiveness of the health education.
Observation: The few filters that are still in use, are excellently handled and properly maintained on a regular
basis. The trained beneficiary is usually the person who is dedicated to controlling these filter units. Due to
scarcity, filtered water only serves for drinking purposes. The community members that choose to treat their
drinking water, use the ceramic filter and/or boiling as treatment method; no other methods were recorded. The
storage container of the ceramic filter is the only safe water storage vessel in these households. It appears that
an important reason for discontinued use, is a considerable amount of malfunctioning filters (15% need
replacement parts). It is unclear whether beneficiaries stopped using filters because of malfunction or that filters
got damaged of ill-treatment after the beneficiary decided to stop using them. Most beneficiaries that stopped
using the filter prefer consuming untreated rainwater; others are travelling, have relocated or consider the
untreated borehole water safe enough.
drinking vessel, cleaning of the ceramic pot vs. the plastic storage container, unstable position of the filter unit.
Frequently asked questions: Where can I find replacement parts? Can you make the storage container bigger?
Appreciation score:
Observation: A minority of beneficiaries chose to continue to use the ceramic filter mainly because they say it
protects their health and it improves the taste and quality of their drinking water. Unfortunately many others
decided the filter was obsolete. As rainy season ends, the number of filter users could potentially increase.
32
KAYORO COMMUNITY ASSESSMENT


Water source(s): borehole Monitored Household No: 27
Monitored Households in Kayoro Ceramic Filter Use in Kayoro
Distribution score:
Observation: A significant number of flood affected households did not receive a ceramic filter because not
enough filters were distributed. All distributed filters were effectively dispersed throughout the community.
Observation: Beneficiaries that have decided to continue to use the ceramic filter, prove that the operational &
maintenance education was a success. Since so many have stopped using the filter, one has more doubts
about the effectiveness of the health education.
scarcity, filtered water only serves for drinking purposes. The community members that choose to treat their
drinking water, only use the ceramic filter as treatment method; no other methods were recorded. The storage
container of the ceramic filter is the only safe water storage vessel in these households. It appears that an
important reason for discontinued use, is the number of malfunctioning filters (17% need replacement parts); it
is not clear whether beneficiaries stopped using filters because of malfunction or filters were damaged after the
beneficiary decided to stop using them. Most beneficiaries who stopped using the filter prefer consuming
untreated rainwater; others are travelling or consider the borehole water safe enough.
monitoring visits were performed by the PHW team. Re-education topics: hygienic use of the drinking vessel,
frequency of filter cleaning, overfilling of the storage container, unstable position of the filter unit, etc. Frequently
asked user questions: Where can I find replacement parts? Can you make the storage container bigger?
Appreciation score:
Observation: A minority of beneficiaries chose to continue to use the ceramic filter mainly because they say it
protects their health and it improves the taste and quality of their drinking water. All others decided the filter was
obsolete, especially during rainy season and with a borehole close to their compound; the approaching dry
season could potentially increase the number of ceramic filter users.
33
KAYAVIO COMMUNITY ASSESSMENT
Population No: - Distribution Date: 1 February 2008


Water source(s): dam, borehole, stream Monitored Household No: 12
Monitored households in Kayavio Ceramic Filter Use in Kayavio
Distribution score:
Observation: A number of flood affected households did not receive a filter because not enough filters were
distributed. It seems that the filters that were distributed, were well dispersed over the community. Several
community members that did not receive a ceramic filter are convinced of favouritism.
Observation: Those that have decided to continue to use the ceramic filter, prove that the operational &
maintenance education was a success. As many beneficiaries have given up the filter, there are more doubts
scarcity, filtered water is only used for drinking purposes. The community members that choose to treat their
drinking water, use the ceramic filter as the single treatment method. The storage container of the ceramic filter
is the only safe water storage vessel in these households. It appears that an important reason for discontinued
use, is the number of malfunctioning filters (17% breakage). It is not clear whether beneficiaries stopped using
filters because of breakage or that filters were damaged after the beneficiary decided to stop using them. Most
beneficiaries that stopped using the filter prefer consuming untreated rainwater.
monitoring visits were performed by the PHW team. Re-education topics: hygienic use and location of the
drinking vessel, frequency of filter maintenance, unstable position of the filter unit, etc. Frequently asked user
questions: Where can I find replacement parts? Can you make the storage container bigger?
Appreciation score:
Observation: The beneficiaries that chose to continue to use the ceramic filter, did so mainly because they say
it protects their health and it improves the taste and appearance of their drinking water. All others decided the
filter was obsolete during rainy season; therefore the number of ceramic filter users can potentially increase
with the approaching dry season.
34
GONSA COMMUNITY ASSESSMENT

Compound No: 12 Monitoring Date: 20 August 2008

Water source(s): dam, hand dug well, stream Monitored Household No: 37
Monitored Households in Gonsa Ceramic Filter Use in Gonsa
Distribution score:
Observation: At a ratio of more than five ceramic filters per household or less than three users per filter unit, this
community received many more filters than were required. Half the distributed amount of filters would have
been adequate to protect the whole community population from waterborne disease.
Observation: The few beneficiaries that decided to continue to use the ceramic filter, prove that the operational
& maintenance education was a success. As most beneficiaries have given up the filter, one has more doubts
scarcity, filtered water is used for drinking purposes. The community members that choose to treat their drinking
water, use the ceramic filter and/or boiling as treatment methods. The storage container of the ceramic filter is
the only safe water storage vessel in these households. It appears that an important reason for discontinued
use, is the number of malfunctioning filters (16% breakage/leakage), though it is not clear whether beneficiaries
stopped using filters because of malfunction or filters were damaged after the beneficiary decided to stop using
it. Most beneficiaries that stopped using the filter prefer consuming untreated rainwater or are travelling.
Observation: The government field staff is not executing the monitoring rounds. Sadly, the first monitoring visits
were performed by the PHW team. Re-education topics: hygienic use and location of the drinking vessel,
overfilling of the storage container, unstable position of the filter unit, etc. Frequently asked user questions:
Where can I find replacement parts? Can you make the storage container bigger?
Appreciation score:
Observation: A small number of beneficiaries chose to continue to use the ceramic filter mainly because they
say it protects their health and it improves the taste and appearance of their drinking water. A number of the
large majority that have given up the filter because of the abundance of surface water during rainy season,
could potentially use their filter once again with the approaching dry season.
35
BUILSA DISTRICT ASSESSMENT
In the Builsa District, PHW interviewed a total of 130 beneficiaries in three monitored
communities: Logvuusa, Kaasa and Yamkpansa.
Monitored Communities in Builsa District Ceramic Filter Use in Builsa District
Compliments
The Builsa government field staff actively supports the use of ceramic filters in their district
communities. Equal to their colleagues in the Bongo district, the Builsa government staff is
an exemplary role model regarding how the communities that received the ceramic filters
should be effectively monitored. Not only do they show the highest field activity levels that
PHW has witnessed in the Upper-East region, they confidently master the operational and
maintenance instructions of the ceramic filter and they fully understand the benefits of the
system.
Concerns
Nevertheless the Builsa district suffers from similar deficiencies as its neighbouring districts
in the Upper-East. Next to a lack of human resources, there is a serious need for financial
resources to support the mobility of the local staff. All the same it should be inspiring for
colleagues in other districts to witness the creativity that the Builsa government staff apply to
enable themselves to actively continue their community services in the field. Finally, during
monitoring rounds they found a need for replacement parts and they advise that filters should
be distributed to each household in every community, not only those that were directly
affected by the floods.
Recommendations
A PHW team should revisit the Builsa communities to offer replacement services to the
households that have malfunctioning filter units and to distribute Kosim ceramic filter units to
each household that has not yet received one.
The local government health staff should continue regular surveillance and health education
to support the beneficiaries towards effective use of the system.
36
LOGVUUSA COMMUNITY ASSESSMENT

Household No: 145 Distribution No: -
Compound No: 37 Monitoring Date: 23 July 2008

Water source(s): hand dug well, borehole, dam Monitored Household No: 43
Monitored households in Logvuusa Ceramic Filter Use in Logvuusa
Distribution score:
Observation: A small number of targeted beneficiaries did not receive a filter because they were not present
during the distribution phase; their filters were handed out to other households in this community. Several
households received more than one filter because of the high number of family members.
Observation: The collective health education and filter operations & maintenance training were highly
successful. Some health education topics appear to be less obvious for certain beneficiaries, but these shall be
Observation: Most of the filters are effectively handled and excellently maintained on a regular basis. The
trained beneficiary is usually the person who is dedicated to controlling the filter unit. Due to scarcity, filtered
water only serves for drinking purposes. Except for boiling, households in this community do not apply other
methods to treat water; all drinking water passes through the ceramic filter. The storage container of the
ceramic filter is the only safe water storage vessel in these households. Reasons for discontinued use are:
breakage/leakage; beneficiary is travelling, sees no benefit in filtered drinking water or chooses to consume
untreated rainwater.
Observation: The government field staff is effectively and at regular intervals performing the monitoring rounds.
Re-education topics: correct assembly of the filter unit, location of the drinking vessel, overfilling of the storage
container, unstable position of the filter unit, health education (benefit of filtered water), etc. Frequently asked
user questions: Where can I find replacement parts? Can you make the storage container bigger?
Appreciation score:
Observation: For many households in this community, the filter has become the single most important device in
their compound. In some households the filter is found on a pedestal, dressed and shining as if a shrine.
Beneficiaries say the filtered water protects their family from stomach pains, diarrhoea and other waterborne
disease. They feel healthier, stronger and have considerably more energy. Furthermore their water tastes and
looks better than before.
37
KAASA COMMUNITY ASSESSMENT


Water source(s): hand dug well, borehole Monitored Household No: 19
Monitored Households in Kaasa Ceramic Filter Use in Kaasa
Distribution score:
Observation: Though a substantial part of this community was hit by the floods, only a small number of the
population was lucky enough to receive a filter. Those that did not receive a filter passionately expressed their
disappointment and also pointed out nepotism during the distribution process.
observed during household monitoring rounds and will then be reiterated to the individual.
serves for drinking purposes. Except for boiling, households in this community do not apply other methods to
treat water; all drinking water passes through the ceramic filter. The storage container of the ceramic filter is the
only safe water storage vessel in these households. Reasons for discontinued use are: breakage/leakage and
beneficiary is travelling.
Re-education topics: correct use of the filter unit, hygienic use and location of the drinking vessel, overfilling of
the storage container, cleaning of the ceramic pot versus the storage container, unstable position of the filter
unit, correct (re-)assembly of the filter unit, etc. Frequently asked user questions: Where can I find replacement
parts? Can you make the storage container bigger?
Appreciation score:
Observation: The minority that can enjoy filtered water in this community is elated with the ceramic filter: they
say it protects them from stomach pains, diarrhoea and other waterborne diseases. They feel stronger and
have more energy; furthermore the water looks cleaner and tastes better than ever before.
38
YAMKPANSA COMMUNITY ASSESSMENT

Household No: 129 Distribution No: -

Water source(s): hand dug well, borehole, river Monitored Household No: 68
Monitored Households in Yamkpansa Ceramic Filter Use in Yamkpansa
Distribution score:
Observation: A small number of targeted beneficiaries did not receive a filter because they were not present
during the distribution phase; their filters were handed out to other households in this community. Some
households received more than one filter because of the high number of family members.
observed during household monitoring rounds and will then be reiterated to the individual.
serves for drinking purposes. Except for boiling, households in this community do not apply other methods to
treat water; all drinking water passes through the ceramic filter. The storage container of the ceramic filter is the
only safe water storage vessel in these households. Reasons for discontinued use are: breakage/leakage;
beneficiary is travelling, is physically challenged or is consuming untreated rainwater.
Re-education topics: correct use of the filter unit, hygienic use and location of the drinking vessel, overfilling of
the storage container, cleaning of the ceramic pot versus the storage container, unstable position of the filter
unit, etc. Frequently asked user questions: Where can I find replacement parts? Can you make the storage
container bigger?
Appreciation score:
Observation: Households in this community are excited to use the ceramic filter, they say the filtered water
protects/improves their health (they no longer experience stomach pains or diarrhoea), they feel stronger and
more energetic; their drinking water looks clean and tastes better. Those that have not received a filter are
pleading to receive one as soon as possible.
39
RECOMMENDATIONS
DISTRIBUTION
Issue: The local Government Environmental Health officers were responsible for the selection of the
target beneficiaries. They assessed the situation in the field and investigated which communities and
specifically which households in those communities had been worst hit by the floods. Subsequently
they advised UNICEF on the number of filters needed and where exactly these should be delivered.
UNICEF then contracted PHW to join the government staff in the field for the health education, training
and finally the distribution. Unfortunately the government field staff never prepared a list of
beneficiaries before the actual distribution phase. In many communities this resulted in a rather ‘ad
hoc’ selection of beneficiaries at the moment of the distribution itself: those that were fast enough to
register their name as ‘beneficiary’, entitled them to receiving a ceramic filter. Additionally, in most
communities the number of flood-affected households greatly exceeded the number of available
ceramic filters. This limited number of filters often ended up poorly dispersed, sometimes clustered in
less flood-affected community areas, leaving those that were hit the worst, without this much-needed
intervention.
Solution: During the assessment phase, before the filters actually arrive in the community, the
Government Field staff should carefully identify and map the most affected community area(s) and list
the households that live there as ‘targeted beneficiaries’. The number of listed households then
determines the exact amount of ceramic filters required for that community. Subsequently, in the
distribution phase, this list will guide the team to accurately disperse the filters to the right people.
Another approach would be to completely blanket target communities, insuring that every household
received one or more filters.
TRAINING & HEALTH EDUCATION
Issue: In each community, beneficiaries were assembled in a large group to attend a standard, one-
way health education and filter training; ‘standard’ because every community received the same
training and ‘one-way’ because this training generally instructed the beneficiaries without allowing
much space for interaction or exercise, resulting in less-effective trainings.
Solution: Trainings should be conducted to small groups of beneficiaries, enabling the trainees to
actively interact during the training process and allowing them an opportunity to perform easily
understood and practical exercises that will familiarise them with the basic concepts of proper
household water treatment and safe storage (HWTS), the hazards of contaminated drinking water and
how to properly assemble, operate and maintain the ceramic filter for maximum effectiveness. Training
programs should vary based on community specific situations, e.g. many beneficiaries that are
fortunate enough to have access to improved water sources in their community, will shortly after the
flood-affected water source has been decontaminated, stop using the ceramic filter because drinking
water taken from that source is then considered clean. For such communities, the training should
educate the beneficiaries on the benefits of filtering borehole and rain water and/or on how to use the
Kosim filter safe storage container for safe drinking water storage. Additionally, the concept and use of
AquaTabs could be introduced and distributed in the community.
40
DISCONTINUED USE
Issue: 3 to 6 months after the distribution, some ceramic filters are no longer in use.
13% because of a malfunctioning filter

24% because of access to improved water sources or other reasons
(i) Malfunctioning Filters
Breakage
95% of all breakage occurs with the ceramic pot (a fired clay pot), the most fragile element of the
Kosim ceramic filter unit. If not handled with care, one can easily break or crack the pot rendering it
useless: a cracked or broken pot will no longer effectively filter the water. Although the whole pot is
fragile and will break if dropped to the floor, the weakest spot is definitely the lip (the part that allows
the pot to rest on top of the ring lid). Lip breakage usually happens when the ceramic pot is not gently
handled or can occur when it is lifted out of the safe storage container while it is filled with water, then
the weight can be enough to break off the lip. Breaking the lip does not always destroy the pot, but it
does create a gap between the ring lid and the ceramic filter, allowing unfiltered water to contaminate
the filtered water inside the safe storage container; lip breakage can also create cracks in the sides of
the ceramic pot, making it useless as it will no longer effectively filter the water.
5% of all breakage occurs with the plastic safe storage container. To allow the tap to fit in, the plastic
container has been perforated. It is this perforation that forms the weakest spot of the safe storage
container. If during the installation, the tap is tightened too hard in the perforation of the storage
container, there is a chance that the plastic of the container cracks and as a result starts leaking water.
Leakage
Leakage usually occurs when the tap is incorrectly inserted in the perforation of the safe storage
container. As described above, some filters may start leaking when a heavy-handed tap installation
results in a cracked container; although most filters start leaking because of incorrectly or incompletely
installed tap ‘washers’. Washers are two rubber rings that closely secure the tap in the plastic safe
storage container; they are specifically made to prevent leakage, but if incorrectly installed, they may
be the cause of leakage.
(ii) Access to improved water sources
Clearly the main reason why households stop using the ceramic filter, is the access to an improved
water source such as a borehole, a protected hand dug well or pipe water; or the availability of rain
water during the wet season. Improved water sources may be temporarily inaccessible due to
contamination as a result of a natural disaster or malfunction; once they are restored to their useful
condition, households will revisit them as their most preferred source of drinking water. Some
households have installed primitive rainwater harvesting systems in their compound. Typically with an
approaching wet season, many of these households decide to at least temporarily and unfortunately
some permanently, separate from their ceramic filter, preferring to consume the untreated rain water.
Naturally, water that originates from such water sources usually appears clean to the eye, easily
convincing the beneficiary that further treatment is pointless.
(iii) Other reasons
Solution:
(i) Malfunctioning Filters
Pure Home Water and their partners at Massachusetts Institution of Technology and the World Health
Organization-hosted International Network to Promote Household Drinking Water Treatment and Safe
41
Storage, should further research to find ways to reduce or eliminate breakage in use and to implement
their findings as quickly as possible in order to provide beneficiaries with a product that is less fragile.
Most ceramic filter units malfunction because they are not properly handled; marginally few because of
fatigue failure. Just like many other devices, the ceramic filter unit contains elements that are fragile
and will break if not handled with care. Prevention is therefore crucial in order to minimize the potential
for malfunction. The best approach for prevention is definitely to deliver a relevant and comprehensible
education and practical training to the person that will control the ceramic filter unit. In addition to
protecting the beneficiary household by teaching them how to use the ceramic filter to properly treat
and store household drinking water, the enhanced utilization practices resulting from a successful
training, will also maximize the longevity of the ceramic filter unit.
No matter how successful the training or how careful the beneficiary, accidents happen and filters get
broken or start leaking. Ideally, these malfunctioning filters can be quickly repaired so that households
can continue to enjoy safe drinking water. Unfortunately, households with malfunctioning filters
currently have no access to replacement parts or services. As the Government Field staff are
expected to monitor the beneficiary households on a regular basis, they are in the ideal position to list
the required replacement parts for each household and each community. One approach could be for a
certain percentage (e.g. 15%) of extra filters to be provided at the time of delivery to each District
Environmental Health Directorate. Alternatively, after reaching a certain quota of malfunctioning filters,
the Government Field staff can notify PHW to deliver the required replacement parts to the District
Environmental Health Directorate, from where they can then be further allocated in the field by the
Government Field staff.
In order to further improve the effectiveness and durability of the Kosim ceramic filter, PHW
communicates regularly with counterparts and experts around the world. The most important issues
are currently the fragile lip of the ceramic pot and the weak area around the perforation in the plastic
safe storage container. Obviously, PHW would like to make the whole ceramic pot less fragile, but it is
the nature and purpose of its components (clay and sawdust) that makes this part so brittle, yet highly
effective. Further improving on the fragility of the whole ceramic pot will therefore be highly unlikely,
though following a recommendation by an international expert, PHW will soon advise its ceramic pot
manufacturer to make the lip of the ceramic filter considerably stronger by increasing the thickness
from ½” to ¾”. In cooperation with the manufacturer of the plastic container, PHW is also investigating
how to make the safe storage container more durable.
As the different elements of the Kosim ceramic filter are supplied by various manufacturers,
sporadically it happens that one or more elements do not meet the prescribed quality standards,
sometimes resulting in incompatible product elements and therefore a malfunctioning ceramic filter
unit. PHW has no hands-on control in the fabrication process; although it does advise its
manufacturers how to improve on each product component. In order to guarantee end-users a quality
product, PHW strives to effectively integrate these different elements with the help of a dedicated
Quality Control Officer. This person is committed to investigate and resolve each product anomaly in
concert with the manufacturer of the part.
(ii) Access to Improved Water Sources and other reasons for discontinued use
Evidence from studies around the world have shown that access to an improved water supply does
not necessarily guarantee a safe drinking water – that water can become contaminated in transit and
through unhygienic household water management and storage practices. It is therefore important that
hygienic household water management and treatment processes become the norm for ALL
households, regardless of whether they are drinking from improved or unimproved water supplies. If
households are discontinuing the use of ceramic filters seasonally, because of the availability of
improved sources, they should be encouraged to continue their practices of treating and safe storage
of water with their Kosim ceramic pot filter. If households are discontinuing the use of ceramic filters
permanently, these filters should be redistributed to others who can benefit.
In most cases the interviewed beneficiaries decided to stop using the ceramic filter because they did
not sufficiently realize the benefits of providing their households with treated drinking water.
Convincing them to continue to use the ceramic filter, starts with an effective health education training,
followed by monitoring and re-education visits at regular intervals, allowing Government field staff to
42
reiterate these benefits where deemed necessary. If trainings are successful and monitoring rounds
are properly executed, then the number of ceramic filter users is likely to be significantly higher and
more stable, then what it is now, even in communities with access to improved water sources.
MONITORING & EVALUATION
Issue: In several districts, the monitoring & evaluation is not regularly (or not at all) executed by the
Government Field staff. As a result of this important lack of support in the field, a large number of
beneficiaries stopped using or were over time no longer correctly using the ceramic filter unit.
Solution: It appears that the main reason why most government staff minimized its efforts in the field is
a serious lack of financial, material and human resources. For future projects at least a part of the
government expenditure for ceramic filter monitoring should be budgeted and reimbursed. Monitoring,
evaluation and re-education are extremely important to the overall success of ceramic filter distribution
projects and should therefore be properly and regularly executed.
43

Unicef-Phw Flood 2007 M&e Final, 9-08

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Unicef-Phw Flood 2007 M&e Final, 9-08

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FLOOD EMERGENCY RELIEF PROJECT

IN NORTHERN GHANA, SEPTEMBER 2007

MONITORING & EVALUATION

PROVISION OF CERAMIC FILTERS

INTRODUCTION & PROJECT OBJECTIVES 4

PURE HOME WATER 5

THE CERAMIC POT FILTER 5

THE FLOOD 2007 EMERGENCY RESPONSE PROJECT 6

MONITORING & EVALUATION PROCESS 8

MONITORING & EVALUATION RESULTS

BONGO DISTRICT ASSESSMENT 11

BALUNGU COMMUNITY ASSESSMENT 12

TALENSI NABDAM DISTRICT ASSESSMENT 15

PWALUGU COMMUNITY ASSESSMENT 16

BOLGATANGA MUNICIPAL DISTRICT ASSESSMENT 19

SOE YIPALA COMMUNITY ASSESSMENT 20

BUARBOKA COMMUNITY ASSESSMENT 25

KASSENA NANKANA DISTRICT ASSESSMENT 27

GORUM COMMUNITY ASSESSMENT 28

BUILSA DISTRICT ASSESSMENT 36

LOGVUUSA COMMUNITY ASSESSMENT 37

TRAINING & HEALTH EDUCATION 40

MONITORING & EVALUATION 43

In September 2007, Northern Ghana experienced severe weather conditions, resulting in

Districts most affected by the September 2007 floods

In a well-coordinated emergency response effort, UNICEF, sponsored by the European

THE CERAMIC POT FILTER

The Kosim Ceramic Filter

Health impact studies performed by graduate students at the Massachusetts Institute of

PROCUREMENT AND TRANSPORTATION OF THE FILTERS

DISTRIBUTION OF THE FILTERS TO THE AFFECTED COMMUNITIES

Distribution of Kosim Ceramic Filters in the Upper-East Region

DELIVERY OF A RELEVANT EDUCATION & TRAINING PROGRAM

After the training, PHW and the

EXECUTION OF AN EXTENSIVE MONITORING & EVALUATION PROGRAM

Topics discussed during these interviews were typically:

• government staff appreciation for the ceramic filter;

Upper-East districts & communities surveyed by Pure Home Water

In over 23 rural communities in the Upper-East

Monitoring visits were performed in the compound of

 conduct the interview in the environment

 inspect the filter within its direct surroundings

 re-educate the beneficiary by demonstrating

Each script-based interview (see Appendix I) was a focused question/answer session

PHW surveyors were trained to conduct interviews in such a way that2

9 Did the project reach the targeted beneficiaries?

Training & Health Education

Treatment & Maintenance

9 Is the ceramic filter effectively operated and properly maintained?

Monitoring & Re-education

9 Does the community appreciate the ceramic filter?

: EXCELLENT – activity successful

: PROBLEMATIC – reappraisal for alternative solution

BONGO DISTRICT ASSESSMENT

Monitored Communities in Bongo District Ceramic Filter Use in Bongo District

Environmental Health Field Staff Interview Summary

Population No: 544 Distribution Date: 8 February 2008

Compound No: 65 Monitoring Date: 18 June 2008

Monitored Households in Balungu Ceramic Filter Use in Balungu

Training & Health Education score:

Treatment & Maintenance score:

Monitoring & Re-education score:

Population No: 418 Distribution Date: 8 February 2008

conduct the interview in the environment

inspect the filter within its direct surroundings

re-educate the beneficiary by demonstrating