<p>Harding and Lindstrom 1 Protocol: Community Assessment</p><p>1. Brief Description</p><p>The Oregon State University student chapter of Engineers without Borders (EWB-OSU) </p><p> is constructing a rainwater catchment system in the communities of Las Mercedes, La </p><p>Cumbre, and El Naranjito, in the department of Achuapán, El Salvador. Included in this </p><p> project is a community health assessment that will serve as the foundation for ongoing </p><p> project evaluation. The community health assessment will include the development of a </p><p> community map and a household water, sanitation and health conditions survey, a “Use </p><p> and Satisfaction Survey” of the ongoing ceramic water filter distribution project, and </p><p> identification of existing community health resources. </p><p>2. Background and Significance</p><p>The communities of Las Mercedes/El Naranjito are located in the western portion of El </p><p>Salvador, in an area geographically isolated and subject to volcanic instability. The </p><p> residents of these communities obtain their drinking water from existing streams and </p><p> springs and from rainwater collection. Many community members must carry water from </p><p> sources as far as 45 minutes from their homes. Existing water sources often lie in the </p><p> valleys, and are subject to contamination from upstream sources. During the dry season, </p><p> when water sources have low volume and flow, there is an increased strain on water </p><p> resources, leaving the community at risk for water shortages.</p><p>The EWB-OSU chapter has made three previous site visits to establish and deepen </p><p> community relationships, determine community wants and identified needs, and to assess </p><p> project feasibility. In the spring of 2007, approximately 46 “Potters for Peace” ceramic </p><p> water filters (CWF) were installed in homes distributed among the communities. The Harding and Lindstrom 2 Protocol: Community Assessment</p><p>Community Water Board (CWB) has asked EWB-OSU to install rainwater catchment </p><p> systems at the household level. </p><p>The goal for the upcoming site visit is to assess feasibility of home based rain catchment </p><p> systems by installing one to three systems in households identified by the CWB. In </p><p> addition, a public health team will conduct a baseline health and resource assessment that </p><p> will serve as the foundation for ongoing evaluation of project impact on the community.</p><p>3. Methods and Procedures</p><p>The community health assessment will focus on assessing the current community water, </p><p> sanitation, and hygiene conditions affecting health in order to establish a base line of </p><p> conditions to determine impact of current and future project interventions in the three </p><p> communities. The assessment will include three activities: </p><p>1. Community Map and Water, Sanitation and Hygiene (WSH) Conditions Survey</p><p>2. Utilization and Satisfaction Monitoring of Ceramic Water Filters</p><p>3. Survey of Community Health Resources </p><p>Assessment Approach</p><p>The assessment will take place in three target communities that are separated </p><p> geographically in the Achuapán department of El Salvador. The communities and their </p><p> estimated total population based on previous Engineers Without Borders (EWB) and </p><p>Peace Corps volunteer assessments are indicated below. While the total number of </p><p> households is not confirmed, it is estimated that there are approximately 100 to 150 </p><p> households. Harding and Lindstrom 3 Protocol: Community Assessment</p><p>Total Number of</p><p>Community people El Naranjito 83 La Cumbre 86 Las Mercedes 277 Total 446</p><p>The assessment will be completed by the EWB project team in two segments. Segment I </p><p> includes Activities 1 (Community Map and WSH Conditions Survey) and 2 (Utilization </p><p> and Satisfaction Monitoring of Ceramic Water Filters), with Segment II focusing on </p><p>Activity 3 (Survey of Community Health Resources). A EWB team comprised of OSU </p><p> students and professional advisors will conduct these activities in the target communities </p><p> between December 9, 2007 and December 23, 2007.</p><p>Assessment Work Plan Narrative</p><p>Segment I</p><p>Segment I will consist of a Global Positioning Survey (GPS) of community physical </p><p> structures such as houses, schools, community meeting spaces, stores, and health clinics. </p><p>This information will be used to create a map of the targeted communities’ houses and </p><p> resources. During Segment I, the interviewers will complete a house-to-house or cluster </p><p> survey, (to be determined on site following an initial survey and scope feasibility </p><p> assessment), to obtain basic demographic information, data on access to drinking water </p><p> and location/type of sanitation facilities and some basic health indicators. In addition, </p><p> households that received a ceramic water filter (approximately 46) through previous EWB</p><p> project efforts will be asked to respond to questions related to their use of, condition of, </p><p> and satisfaction with the filters. The water from the filters will be tested for quality. The Harding and Lindstrom 4 Protocol: Community Assessment</p><p> primary caregiver or head of household will be asked to complete the survey. The </p><p> questions will be asked and recorded in Spanish, using an interpreter when necessary.</p><p>Segment II</p><p>To determine what health and education resources are available to the community, focus </p><p> groups with area health and community workers (e.g. health outreach workers, midwives, </p><p> schoolteachers, Peace Corps volunteer, etc.) will be conducted. We anticipate completing </p><p> two focus groups during the project period. </p><p>4. Risks/Benefits Assessment</p><p>Risk: There is potential discomfort from being interviewed about personal sanitation </p><p> habits, as well as discomfort related to concern about the possible personal identification </p><p> of responses. These potential issues will be addressed in the following manner:</p><p>1. Participants will be assured that no names or personal identifiers will be used in </p><p> the collecting, analyzing, or reporting of data.</p><p>2. All interviews will be conducted in Spanish, using interpreters as necessary.</p><p>3. The interviews will be conducted in a private area at the participant’s home.</p><p>4. The participants have the option of withdrawing from the study at any time.</p><p>Benefit: There are no foreseeable direct benefits to each individual participant in this </p><p> survey. However, there may be indirect benefits to the participants in that the information </p><p> gained from the community health assessment will likely lead to improved water and </p><p> sanitation services in the communities.</p><p>Conclusion: There are minimal foreseeable risks and no direct benefits to participation in</p><p> this study. Harding and Lindstrom 5 Protocol: Community Assessment</p><p>5. Participant Population</p><p>Participants will be community members living in Las Mercedes, La Cumbre, and El </p><p>Naranjito. Population demographics will be adult males and females between the ages of </p><p>18 and 65 years. This will include heads of households and primary caregivers. In </p><p> addition, we will be interviewing local health promoters and key informants within the </p><p> community.</p><p>6. Subject Identification and Recruitment </p><p>We will be using a survey approach that will include households that have received EWB </p><p> ceramic water filters and households that have not. The total number of households will </p><p> not exceed 60. We will communicate our survey plans at the initial community meeting. </p><p>Our initial plan is to conduct thirty interviews with recipients of CWFs and 30 with those </p><p> that have not received filters using a cluster sampling technique to insure that we get a </p><p> good representative sample from the three communities. The total number of CWF versus</p><p> non-CFW surveys may be adjusted in El Salvador following the initial meeting with </p><p> community leaders. </p><p>7. Compensation</p><p>There is no compensation or incentives (monetary or otherwise) for participating in this </p><p> study.</p><p>8. Informed Consent Process</p><p>Before beginning the interview, the EWB team will verbally give information about the </p><p> survey to the respondent . This will be done in Spanish by an interpreter. This </p><p> explanation will include the reason for the interview, what the team plans to do with the Harding and Lindstrom 6 Protocol: Community Assessment</p><p> information recorded, the safeguards the team will follow to ensure anonymity of the </p><p> participant, and that the participant has the right to refuse the interview, as well as the </p><p> right to withdraw from participation at any time. All questions will be answered to the </p><p> satisfaction of the participant. Each participant will be given the opportunity to decline to </p><p> be interviewed. We will ask for verbal consent to proceed with the interview. We are not</p><p> asking the participants to sign a formal consent document for the following reasons:</p><p>1. The culture of El Salvador is primarily an oral society that relies on the spoken </p><p> word.</p><p>2. There is a cultural and social reluctance to put a signature on a formal document.</p><p>3. The study poses minimal risk to the participant.</p><p>9. Anonymity or Confidentiality</p><p>All surveys and observations will be identified by number only; no names or other </p><p> personal identifiers will be used. All existing community data will be reported in the </p><p> aggregate; no individual names or personal identifiers will be used. All written material </p><p> will be stored in a locked file folder. </p>