Delivering drinking water by truck in humanitarian contexts: results from mixed-methods evaluations in Democratic Republic of Congo and Bangladesh.

Water trucking is a commonly implemented, but severely under-researched, drinking water supply intervention in humanitarian response. To fill this research gap, we conducted three mixed-methods water trucking program evaluations in Democratic Republic of the Congo and Bangladesh, including interviews, water point observations, household surveys, focus groups, and water quality testing. Results indicated the programs had complex implementation structures involving multiple agencies and limited infrastructure to properly collect, treat, and deliver water. All programs met water access indicators, did not meet water quantity indicators, and inconsistently met water quality indicators. FCR declined through the water chain; and household water E. coli concentrations were associated with household FCR, receiving behavior change messages, storage container type, and distance from distribution point. Users appreciated water trucking, especially compared to previous water sources, and expressed desires for increased quantity, improved quality, and consistent delivery. If water trucking programs are implemented, it is recommended to: have the financial resources to install sanitary collection and distribution infrastructure, establish a management team of all implementation partners, ensure sufficient water quantity is delivered, ensure recommended FCR levels at distribution points, monitor FCR throughout distribution, and complete behavior change communication activities about the program and safe water storage with users.