Evaluation of the Indian Health Service Sanitation Facilities Construction Program. Impact and performance of providing drinking water and sanitation projects for American Indian communities

An evaluation of the IHS Sanitation Facilities Construction (SFC) Program’s performance and impact from 2003 to 2013 on California American Indians through the provision of drinking water and sanitation projects is presented. The research examined project delivery, interventions, deficiency monitoring, health impact, and tribal capacity using information from the IHS and EPA databases and a tribal organization capacity questionnaire. The project duration goal was met; however, the rate of completed projects is declining. The majority of interventions addressed high-level water transmission and treatment deficiencies. The percentage of homes with adequate facilities increased from 78% to 84%. However, remaining deficiencies have increased by 300%. There was an 18.7% decrease in selected water-related diseases; although, not statistically significant. Seven communities with high initial disease rates had a statistically significant reduction of 44%. The majority of tribal utility organizations had acceptable capacity. The SFC Program is performing at a moderate to high level.