Including water quality monitoring in rural water services: why safe water requires challenging the quantity versus quality dichotomy

The study addresses how and whether rural water service providers (RWSPs) in sub-Saharan Africa can include water quality monitoring in their activities without undermining cooperation among market (service providers), bureaucracy (government and regulators), and communities. Motivated by SDG targets and national mandates (e.g., Kenya’s 2016 Water Act), the paper highlights major rural–urban disparities in access to safe water and the paucity of rural water quality monitoring. Given pluralistic institutional arrangements and the importance of stakeholder cooperation, the research examines the dilemmas and conflicts of interest that arise when integrating water quality monitoring into rural services, aiming to understand barriers and enablers to achieving sustained drinking water safety.

The paper situates the research within literature documenting: (a) global SDG baseline inequalities in safe drinking water, especially rural deficits in sub-Saharan Africa; (b) limited routine monitoring in rural SSA; (c) the shift toward pluralist institutional arrangements and cooperation among stakeholders; and (d) evidence on empowerment, ability to pay, action knowledge, and self-efficacy as determinants of sustainable service delivery and household water safety behaviors. It reviews WHO/IWA guidance on risk-based water safety planning (WSP), noting global uptake but lower implementation in SSA and challenges including inadequate financing, technical capacity, buy-in, and fragmented institutions. Studies emphasize the need to contextualize quality results within overall service considerations (quantity, reliability, acceptability) and to adopt comprehensive communication and behavior-change support, especially for hazards at consumers’ premises.

Design: A qualitative, multi-stakeholder institutional experiment centered on a Kenyan RWSP, using dilemma analysis to capture and organize conflicting viewpoints as parallel rationalities. A water quality monitoring program was co-designed and implemented with the RWSP to ground stakeholder engagement in real activities and results. Monitoring program: Began December 2018 with monthly testing at 88 sites across 56 locales, covering microbial and chemical parameters and identifying both microbial and geogenic issues. Site selection included the most improved source in each locale plus additional community-important sources. Approximately two-thirds of communities were registered with the RWSP; one-third were not, to include diverse LWM perspectives. Participants and data collection: Perspectives were gathered from community lay water managers (LWMs), county/local government, national government and regulators, formal water service providers (FWSPs), and additional RWSPs operating in five SSA countries. Data sources included semi-structured interviews, informal meetings, questionnaires, monthly surveys, and document review. Interview counts included LWMs (n=38, July–August), RWSPs (n=6, September), national bureaucracy (n=4, April), and county/local bureaucracy (n=4, July–August). LWMs (n=56) completed questionnaires (November, January) and monthly surveys (December–November). Some interviews were conducted in Kiswahili or a local language with translators; most were recorded and transcribed (two by notes). Ethics approvals were obtained from the Kenyan National Council of Science and Technology and the University of Oxford CUREC; all participation was informed and uncompensated. Analytic approach: Data were organized in NVivo and coded using versus coding to identify contradictions. Dilemmas were categorized by stage (generate, share, engage, respond), then by topic, and typed as ambiguity, judgement, or problem. The final framework comprised 19 topics (e.g., access priority, responsibility to use, empowerment, communication mode). Associations between topics were classified as barriers, enablers, or neutral and visualized in an axial hive network using R (ggraph), disaggregated by stakeholder group (market, bureaucracy, community).

- Identified 111 dilemmas across stakeholders, reflecting tensions between minimizing risks and adhering to moral principles. - Dilemmas grouped into 19 topics spanning generating, sharing, engaging with, and responding to information; 69 substantive links mapped between topics. - Only 9 links were enablers: 8 tied to adopting a comprehensive, educative communication mode with LWMs/users; 1 tied to RWSPs’ motivation via sharing results with sector partners to attract investment. - Over half of links (36) were barriers: 23 within-group and 13 between-group. Key barrier topics included: access priority (G1), responsibility to use results (E3), empowerment (R5), and entitlement to results (S6). - Access priority (G1) was most influential: 14 dilemmas and 22 inter-topic links. It encapsulates the false dichotomy between quantity and quality and fears that monitoring threatens supply (e.g., resource diversion, controversy, required shutdowns for geogenic issues, or disruptive treatment). - Contradictory assumptions were widespread: users purportedly do not care about quality, yet disclosure of problems is assumed to cause distress and political backlash. These assumptions obscure disempowerment and lack of resources/knowledge among LWMs. - LWMs expressed willingness to adopt multibarrier safety measures (source protection, cleaning, disinfection, small-volume treatment for drinking) but lacked funds, fundraising know-how, and technical confidence (empowerment dilemma). Knowledge was viewed as enabling, yet without response capacity, disclosure can cause distress (“knowledge is power” versus “ignorance is bliss”). - Monitoring raised confidentiality and sharing dilemmas: RWSPs faced difficulty deciding how to share with users/LWMs amid government confidentiality concerns; communities feared politicization and project destabilization if results were public. - Unclear, operationalized responsibility for acting on results led to abnegation across groups; introducing monitoring risked defaulting expectations onto RWSPs, creating identity and role conflicts and threatening cooperation.

Findings show that treating water quantity and quality as a dichotomy delays progress toward safe water by deterring monitoring and action. Fears that monitoring threatens basic supply, contradictory assumptions about public concern, and unclear roles collectively shift responsibility and undermine cooperation. To mitigate these barriers, results should be contextualized within overall service and health risks; external support is needed to build financing, capacity, and empowerment (especially for LWMs); and water safety planning (WSP) offers a structured, risk-based framework aligning technical and institutional responses. However, WSP implementation struggles in rural contexts due to financing/capacity constraints, buy-in challenges, fragmented institutions, and path dependencies. A comprehensive, educative communication approach fosters cooperation but raises scalability concerns. Early adoption of WSP can clarify responsibilities and broaden feasible technical options, reducing later trade-offs and resistance.

The study demonstrates that the entrenched quantity-versus-quality dichotomy impedes rural water safety by fostering fears, contradictory assumptions, and responsibility gaps that deter monitoring and cooperative action. Incorporating supported water safety planning from project inception—technically and institutionally—can contextualize monitoring, clarify responsibilities, and expand feasible risk management options. Funders and implementers should avoid “quantity first, quality later” approaches and design systems with preventive risk management from the outset, coupled with comprehensive stakeholder communication. Future work should examine the financial and logistical feasibility of scaling full-programme educative communication within RWSP models and further investigate how ability to pay and self-efficacy shape sustainable community-scale water safety management.

- Scope centered on one Kenyan RWSP and its stakeholder network; generalizability may be context-limited. - Perspectives of general water users were not directly included; community inputs reflect lay water managers as primary contacts. - Not all LWM primary contacts were available for interviews; two interviews were not recorded; some were translated, potentially affecting nuance. - The researcher’s association with the RWSP’s monitoring program may have influenced perceptions despite efforts to present independently. - Analytical focus prioritized contradictions relevant to the RWSP context; some contradictions (e.g., within/between bureaucratic divisions, FWSP–government engagement) were intentionally excluded. - The full perspective document was not shared back due to sensitivity and confidentiality; only partial examples are provided.