Harding and Lindstrom

Harding and Lindstrom 1 Protocol: Community Assessment

1. Brief Description

The Oregon State University student chapter of Engineers without Borders (EWB-OSU)

is constructing a rainwater catchment system in the communities of Las Mercedes, La

Cumbre, and El Naranjito, in the department of Achuapán, El Salvador. Included in this

project is a community health assessment that will serve as the foundation for ongoing

project evaluation. The community health assessment will include the development of a

community map and a household water, sanitation and health conditions survey, a “Use

and Satisfaction Survey” of the ongoing ceramic water filter distribution project, and

identification of existing community health resources.

2. Background and Significance

The communities of Las Mercedes/El Naranjito are located in the western portion of El

Salvador, in an area geographically isolated and subject to volcanic instability. The

residents of these communities obtain their drinking water from existing streams and

springs and from rainwater collection. Many community members must carry water from

sources as far as 45 minutes from their homes. Existing water sources often lie in the

valleys, and are subject to contamination from upstream sources. During the dry season,

when water sources have low volume and flow, there is an increased strain on water

resources, leaving the community at risk for water shortages.

The EWB-OSU chapter has made three previous site visits to establish and deepen

community relationships, determine community wants and identified needs, and to assess

project feasibility. In the spring of 2007, approximately 46 “Potters for Peace” ceramic

water filters (CWF) were installed in homes distributed among the communities. The Harding and Lindstrom 2 Protocol: Community Assessment

Community Water Board (CWB) has asked EWB-OSU to install rainwater catchment

systems at the household level.

The goal for the upcoming site visit is to assess feasibility of home based rain catchment

systems by installing one to three systems in households identified by the CWB. In

addition, a public health team will conduct a baseline health and resource assessment that

will serve as the foundation for ongoing evaluation of project impact on the community.

3. Methods and Procedures

The community health assessment will focus on assessing the current community water,

sanitation, and hygiene conditions affecting health in order to establish a base line of

conditions to determine impact of current and future project interventions in the three

communities. The assessment will include three activities:

1. Community Map and Water, Sanitation and Hygiene (WSH) Conditions Survey

2. Utilization and Satisfaction Monitoring of Ceramic Water Filters

3. Survey of Community Health Resources

Assessment Approach

The assessment will take place in three target communities that are separated

geographically in the Achuapán department of El Salvador. The communities and their

estimated total population based on previous Engineers Without Borders (EWB) and

Peace Corps volunteer assessments are indicated below. While the total number of

households is not confirmed, it is estimated that there are approximately 100 to 150

households. Harding and Lindstrom 3 Protocol: Community Assessment

Total Number of

Community people El Naranjito 83 La Cumbre 86 Las Mercedes 277 Total 446

The assessment will be completed by the EWB project team in two segments. Segment I

includes Activities 1 (Community Map and WSH Conditions Survey) and 2 (Utilization

and Satisfaction Monitoring of Ceramic Water Filters), with Segment II focusing on

Activity 3 (Survey of Community Health Resources). A EWB team comprised of OSU

students and professional advisors will conduct these activities in the target communities

between December 9, 2007 and December 23, 2007.

Assessment Work Plan Narrative

Segment I

Segment I will consist of a Global Positioning Survey (GPS) of community physical

structures such as houses, schools, community meeting spaces, stores, and health clinics.

This information will be used to create a map of the targeted communities’ houses and

resources. During Segment I, the interviewers will complete a house-to-house or cluster

survey, (to be determined on site following an initial survey and scope feasibility

assessment), to obtain basic demographic information, data on access to drinking water

and location/type of sanitation facilities and some basic health indicators. In addition,

households that received a ceramic water filter (approximately 46) through previous EWB

project efforts will be asked to respond to questions related to their use of, condition of,

and satisfaction with the filters. The water from the filters will be tested for quality. The Harding and Lindstrom 4 Protocol: Community Assessment

primary caregiver or head of household will be asked to complete the survey. The

questions will be asked and recorded in Spanish, using an interpreter when necessary.

Segment II

To determine what health and education resources are available to the community, focus

groups with area health and community workers (e.g. health outreach workers, midwives,

schoolteachers, Peace Corps volunteer, etc.) will be conducted. We anticipate completing

two focus groups during the project period.

4. Risks/Benefits Assessment

Risk: There is potential discomfort from being interviewed about personal sanitation

habits, as well as discomfort related to concern about the possible personal identification

of responses. These potential issues will be addressed in the following manner:

1. Participants will be assured that no names or personal identifiers will be used in

the collecting, analyzing, or reporting of data.

2. All interviews will be conducted in Spanish, using interpreters as necessary.

3. The interviews will be conducted in a private area at the participant’s home.

4. The participants have the option of withdrawing from the study at any time.

Benefit: There are no foreseeable direct benefits to each individual participant in this

survey. However, there may be indirect benefits to the participants in that the information

gained from the community health assessment will likely lead to improved water and

sanitation services in the communities.

Conclusion: There are minimal foreseeable risks and no direct benefits to participation in

this study. Harding and Lindstrom 5 Protocol: Community Assessment

5. Participant Population

Participants will be community members living in Las Mercedes, La Cumbre, and El

Naranjito. Population demographics will be adult males and females between the ages of

18 and 65 years. This will include heads of households and primary caregivers. In

addition, we will be interviewing local health promoters and key informants within the

community.

6. Subject Identification and Recruitment

We will be using a survey approach that will include households that have received EWB

ceramic water filters and households that have not. The total number of households will

not exceed 60. We will communicate our survey plans at the initial community meeting.

Our initial plan is to conduct thirty interviews with recipients of CWFs and 30 with those

that have not received filters using a cluster sampling technique to insure that we get a

good representative sample from the three communities. The total number of CWF versus

non-CFW surveys may be adjusted in El Salvador following the initial meeting with

community leaders.

7. Compensation

There is no compensation or incentives (monetary or otherwise) for participating in this

study.

8. Informed Consent Process

Before beginning the interview, the EWB team will verbally give information about the

survey to the respondent . This will be done in Spanish by an interpreter. This

explanation will include the reason for the interview, what the team plans to do with the Harding and Lindstrom 6 Protocol: Community Assessment

information recorded, the safeguards the team will follow to ensure anonymity of the

participant, and that the participant has the right to refuse the interview, as well as the

right to withdraw from participation at any time. All questions will be answered to the

satisfaction of the participant. Each participant will be given the opportunity to decline to

be interviewed. We will ask for verbal consent to proceed with the interview. We are not

asking the participants to sign a formal consent document for the following reasons:

1. The culture of El Salvador is primarily an oral society that relies on the spoken

2. There is a cultural and social reluctance to put a signature on a formal document.

3. The study poses minimal risk to the participant.

9. Anonymity or Confidentiality

All surveys and observations will be identified by number only; no names or other

personal identifiers will be used. All existing community data will be reported in the

aggregate; no individual names or personal identifiers will be used. All written material

will be stored in a locked file folder.