This study investigates the relationship between sanitary inspection and microbial water quality analysis in handpumps across 12 sub-Saharan African countries. Using data from 1028 boreholes, the researchers compared sanitary inspection scores with E. coli occurrence using established and alternative statistical models. The findings reveal no significant association between sanitary risk score and E. coli occurrence using either model, highlighting that these tools provide distinct information. An alternative model, incorporating contamination sources, carriers, and barrier breakdowns, showed a slightly better fit, particularly when rainfall was included as a carrier. The study recommends training water system operators in sanitary inspection and further research to improve the understanding of individual risk factors and incorporate contextual data.

Emma Kelly, Ryan Cronk, Michael Fisher, Jamie Bartram