Monitoring and Evaluation of Comunidad Connect’s Nica Agua Program Open Access

McBride, Macklin (Fall 2021)

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Background: In Nicaragua, diarrheal illness is the fourth leading cause of communicable disease-related DALYs. A key component of diarrhea prevention is the use of safe drinking water, but rural Nicaragua has particularly low rates of access to safe water. Comunidad Connect is a non-governmental organization with multiple programs throughout Nicaragua, including one that seeks to improve access to safe drinking water by providing BioSand water filters to participants. This program, known as Nica Agua, lacks a robust monitoring and evaluation (M&E) system. This special studies project develops three M&E options for Comunidad Connect to consider in the evaluation of the Nica Agua program in Los Robles, Nicaragua.


Methods and Results: The development of the M&E plans first involved the creation of a logic model grounded in a behavioral change theoretical framework. Next, a logistical framework was developed to detail the activities of Nica Agua, the required monitoring of each step, and possible obstacles to the program. From this framework, three evaluation designs for the Nica Agua program were developed: a probability design with a stepped wedge implementation, a plausibility design with a neighboring community control, and an adequacy design. The procedures, advantages, disadvantages, and resource requirements of each option were discussed.


Discussion: The probability evaluation results are attributable to Nica Agua and the design preserves equality in terms of the distribution of filters. However, it is logistically complex and resource-intensive. By contrast, the plausibility design is less complex and requires fewer resources, but results cannot be definitively attributed to the program. Furthermore, the plausibility design lacks equality in that filters are not provided to controls. The adequacy design is simple, requires few resources, and provides filters to all participants, but evaluation results cannot be attributed to the program. Given these strengths and limitations, along with the goals and resources of Comunidad Connect, the plausibility design with a neighboring community control is recommended for Nica Agua. Once implemented, this evaluation project will guide Comunidad Connect’s future efforts to address diarrheal illness in northern Nicaragua, as well as contribute to evidence-based practice for combating diarrheal illness in other settings.

Table of Contents

Introduction 1

Literature review 5

Methods and Results 16

Discussion 41

Appendices 52

References 62

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