From data to decisions: understanding information flows within regulatory water quality monitoring programs

<jats:title>Abstract</jats:title><jats:p>Most countries maintain regulatory requirements for testing of drinking water supplies to guide treatment procedures and ensure safe water delivery to consumers. It is unclear, however, if water quality data are always used effectively, particularly in low-resource settings. Efforts to improve the use of water quality data will benefit from a comprehensive understanding of existing systems for managing and sharing information. This study evaluates the methods used to organize, analyze, and transmit drinking water quality data among 26 water supplier or surveillance institutions and two regulatory agencies in six countries of sub-Saharan Africa. Following extensive qualitative and quantitative data collection, we developed data flow diagrams to map formal and informal water quality networks. We found high levels of similarities between the information systems established by different institutions operating under different regulatory structures. We determined that the key barriers to information flows were the limited aggregation and analysis of data and the poor enforcement of data sharing requirements. Our results suggest that broad reforms are necessary to improve the use of these water quality data to manage water safety. These measures could include strengthening enforcement of testing and reporting, building staff capacity for managing and using data, and integrating collection of water quality data with other information systems.</jats:p>