Pragmatic water and health research in a complex emergency: Learnings and way forward

Climate change is straining water and sanitation services (WSS), leading to disruptions that threaten public health. In low-income and fragile contexts, there is an urgent need to increase investments in WSS, as well as to enhance efficiency in the utilisation of available financial resources. Operational research can help optimise future investments in WSS. In this perspective, we share our experience carrying out research embedded within a large-scale water supply infrastructure improvement programme in an urban, cholera-endemic area in South Kivu (Democratic Republic of the Congo). Through the lens of this concrete example, we highlight the need for rigorous research on higher quality drinking water services in low-income and fragile countries, discuss how multi-stakeholder research partnerships and pragmatic methods can contribute to the generation of rigorous evidence where it is most needed, and illustrate the role of research in strengthening capacities for both science and practice.