Towards an advanced water service level: Microbial drinking water quality management at government schools and healthcare facilities in resource-constrained rural settings, Kabarole Uganda

Acquiring advanced water service levels as per the SDG6 remains a challenge, more so in Low- and Middle- Income settings; thus, this study seeks to improve drinking water quality management at schools and healthcare facilities through gaining knowledge on locally affordable solutions to keep drinking water safe in rural resource-constrained settings of Kabarole District in Uganda, Eastern Africa. A mixed methods approach helps to generate relevant data to answer research questions. Longitudinal monitoring water quality data for seventy-three institutions obtained between April 2022 – July 2023 from The Aquaya Institute with Conrad N. Hilton Foundation (CNHF) funding, and observations and Key Informant Interviews (KII) at 26 institutions formed the methods and data for this research. On analysis, 93.6% of the institutions used improved water points, but 8 in 10 tested positive for E. coli. Institutions rely mostly on piped water and rainwater collection. These sources experience seasonal water quality fluctuations. In both seasons, boreholes with handpumps had low-risk water. Water service levels fluctuated seasonally at schools, and 8 in 10 (n=26) water sources had a low sanitary risk. Cleaning and covering storage and drinking water containers emerged as the most prevalent drinking water quality practice. Water treatment topped the remedial actions suggested by the institutions. In conclusion, schools and healthcare facilities should maintain the hygiene of utensils and containers, invest in safe and reliable water sources like boreholes with hand pumps and pursue affordable treatment options to improve water quality.Please note that missing pages in the document are where signatures have been redacted.