Sustained effectiveness evaluation two years after two water systems were installed in Haitian communities

As a 2010 earthquake and cholera response project, in 2013–2014, an international non-governmental organization, working with local organizations, installed water systems in two Haitian communities. In 2016, 2 years after installation, we conducted a mixed-methods evaluation to assess sustained effectiveness, including 20 infrastructure assessments, 199 household surveys, water quality testing, 30 key informant interviews, and financial analysis of two water committee records. One of 14 (7.1%) installed kiosks were functional during the evaluation, with 42–60% of survey respondents near installed sources reporting using system water for drinking. No household water sample had detectable chlorine residual and non-detectable E. coli, except when household water treatment was reported. Informants expressed appreciation for the project, and discussed difficulties with operations, maintenance, and community engagement. Revenue was initially sufficient for operations and maintenance, although not sustainable because lack of trust led to poor quality service and then lack of payment. While the functional kiosks did provide water to some residents, overall project sustained effectiveness was not reached due to operational and maintenance issues, and lack of governance and community engagement. We recommend future implementers of small-scale water systems in complex contexts like Haiti plan for the technical and social components necessary for sustained effectiveness. HIGHLIGHTS Evaluating sustained effectiveness of water infrastructure interventions in rural Haiti.; Identifying factors that could improve small-scale water infrastructure/water system management in complex contexts.; Financial analyses of water infrastructure implementation.;