Ghana's water safety journey: A review of efforts toward a risked-based water quality management

In 2015, Ghana launched the National Drinking Water Quality Management Framework (NDWQMF) to promote a risk-based approach to water quality through water safety plans (WSPs). This study uses a narrative review to synthesize WSP implementation progress in Ghana, identify gaps in practice, and provide recommendations for enhanced effectiveness and scale-up. Findings show limited uptake: only three of 88 urban water supply systems have adopted WSPs, while in the rural sector, the Community Water and Sanitation Agency has implemented WSPs in 177 of 1,022 small-town systems, and the safe water network in 46 systems. However, community-managed water systems overseen by local governments are yet to initiate WSPs. For those that have begun, significant documentation and implementation gaps are noted, including incomplete hazard listings, insufficient improvement plans, and absent standard operating procedures. To strengthen WSP implementation, this study emphasizes the need for robust regulatory mechanisms across urban and rural sectors, along with tailored guidelines and support structures to enable effective WSP adoption across diverse water systems.