A community-based approach to promote household water treatment in Rwanda

Chankova, Slavea; Hatt, Laurel; Musange, Sabine

doi:10.2166/wh.2012.071

Cited by 9 publications

(14 citation statements)

References 12 publications

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“…Evaluation of the pilot, drawing on a difference-in-differences design and data from pre- and post-pilot household surveys of 4,780 households, showed that after 18 months of pilot implementation, knowledge and the use of the product increased significantly in the two pilot districts, but remained unchanged in a control district. The pilot was associated with a 40–42 percentage point increase in overall use [22]. …”

Section: Discussionmentioning

confidence: 99%

Lessons learned from a community based intervention to improve injection safety in Pakistan

et al. 2013

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BackgroundA national study in 2007 revealed that in Pakistan the prevalence of hepatitis B is 2.5% and for hepatitis C it is 5%. Unsafe injections have been identified as one of the reasons for the spread of these infections. Trained and untrained providers routinely perform unsafe practices primarily for economic reasons i.e. they reuse injection equipment on several patients. The patients, do not question the provider about the need for an injection because of social barriers or whether the syringe is coming from a new sterile packet due to lack of knowledge. The present paper represents an intervention that was developed to empower the community to improve unsafe injection practices in rural Pakistan.MethodsIn a rural district of Pakistan (Tando Allahyar, Sindh) with a population of approximately 630,000 a multipronged approach was used in 2010 (June to December) to improve injection safety. The focus of the intervention was the community, however providers were not precluded. The organization of interventions was also carefully planned. A baseline assessment (n=300) was conducted prior to the intervention. The interventions comprised large scale gatherings of the community (males and females) across the district. Smaller gatherings included teachers, imams of mosques and the training of trained and untrained healthcare providers. The Pakistan Television Network was used to broadcast messages recorded by prominent figures in the local language. The local FM channel and Sunday newspaper were also used to disseminate messages on injection safety. An end of project assessment was carried out in January 2012. The study was ethically reviewed and approved.ResultsThe interventions resulted in improving misconceptions about transmission of hepatitis B and C. In the baseline assessment (only 9%) of the respondents associated hepatitis B and C with unsafe injections which increased to 78% at the end of project study. In the baseline study 15% of the study participants reported that a new syringe was used for their most recent injection. The post-intervention findings showed an increase to 29% (n=87).ConclusionIt is difficult to assess the long-term impact of the intervention but there were several positive indicators. The duration of intervention is the key to achieving a meaningful impact. It has to be at least 18–24 months long.

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Section: Discussionmentioning

confidence: 99%

Lessons learned from a community based intervention to improve injection safety in Pakistan

et al. 2013

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“…Access to resources such as latrines (8,11,31,46,56,61,62), water (33,50,60,63,64) and handwashing facilities (62) can be driven by diffusion. When these facilities or the idea of them are new (i.e.…”

Section: Accessmentioning

confidence: 99%

“…Women communicate with the committees about system breakdowns and without whom, such information sharing that lead to repair may not occur (50). Such active communication reflects ownership and indicate a willingness to work together and build connections within the community which promotes continuous access by facilitating ongoing response to maintenance issues (32,47,59,63).…”

Section: Accessmentioning

confidence: 99%

“…Diffusion can occur through communication among peers, which leads to shared understanding, therefore reinforcing the adoption of new behaviour at an individual or community level(30,31,46,63). Examples of diffusion influencing behaviour change include reduction of open defecation(10,34,45,48,55,65), water purification(63), disposable of rubbish and care of animals(45), and sanitation and hygiene behaviours(60), which may lead to improved health outcomes such as reduction in diarrhoea rates and waterborne diseases(42,60). Behaviour change is also further enabled by diffusion in communities with high levels of social cohesion and connectedness -by enabling communication among peers, to build and share knowledge(46,62), and as highly regarded leaders influence the spread of new behaviour and create new social norms through their endorsement(11,20,34,55).…”

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confidence: 99%

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How community engagement in water and sanitation interventions impacts human health, infrastructure and service longevity in low- and middle-income countries: a realist review

Nelson

Drabarek

Jenkins

et al. 2020

Preprint

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Background Access to safe water and sanitation is considered a basic human right and a focus of the Sustainable Development Goals. However, many water and sanitation interventions do not have long lasting impacts in communities and are generally associated with high levels of failure. Limited information is available to understand what types of interventions work for whom and under what circumstances. Methods A realist review to understand how, and under what circumstances community engagement in water and sanitation interventions impacts access (to safe water and sanitation), change (in health status or behaviour), and sustainability (of resources and services). We systematically searched PubMed, Web of Science and Scopus databases to identify studies from low- and middle-income countries.Results We reviewed 56 studies conducted in 25 countries. We identified five mechanisms that explain access, change and sustainability outcomes: 1) accountability (policies and procedures to hold communities and committees responsible for their actions and outcomes of an initiative), 2) diffusion (spread of an idea or behaviour by innovators over time through communication amongst members of a community), 3) market (the interplay between demand and supply of a service or resource), 4) ownership (sense of possession and control of the service or resource), and 5) shame (a feeling of disgust in one’s behaviour or actions). Contextual elements identified include: community location, communities with similar characteristics, communication, leadership, fines/penalties, seasonality, resource dependency, access to resources and funding, community financial and technical skills and knowledge, leadership, ongoing support and acknowledgement of change, community connectedness and social cohesion, community willingness to pay, committees that followed and understood responsibilities, rules and management plans, active committees with women and community/committee involvement in the design, planning or implementation of the intervention. Conclusion The findings highlight five key mechanisms, impacted by 19 contextual factors that explain outcomes of community-based water and sanitation interventions. Policy makers, program implementers and institutions need to consider community dynamics, location, resources, committees and level of community involvement, prior to the introduction of community-based water and sanitation interventions.

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“…If the cause of a specific disease is understood or at least well-characterized, then the spread of that disease within a community can be reduced to a minimum or completely eradicated. Supplying human communities with safe drinking water has been established as a necessity, thus warrants monitoring and scrutiny [1][2][3][4], to mitigate against waterborne diseases.…”

Section: Introductionmentioning

confidence: 99%

Avoiding the Use of Exhausted Drinking Water Filters: A Filter-Clock Based on Rusting Iron

Ndé-Tchoupé

Lufingo

et al. 2018

Water

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Efficient but affordable water treatment technologies are currently sought to solve the prevalent shortage of safe drinking water. Adsorption-based technologies are in the front-line of these efforts. Upon proper design, universally applied materials (e.g., activated carbons, bone chars, metal oxides) are able to quantitatively remove inorganic and organic pollutants as well as pathogens from water. Each water filter has a defined removal capacity and must be replaced when this capacity is exhausted. Operational experience has shown that it may be difficult to convince some low-skilled users to buy new filters after a predicted service life. This communication describes the quest to develop a filter-clock to encourage all users to change their filters after the designed service life. A brief discussion on such a filter-clock based on rusting of metallic iron (Fe 0 ) is presented. Integrating such filter-clocks in the design of water filters is regarded as essential for safeguarding public health.

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A community-based approach to promote household water treatment in Rwanda

Cited by 9 publications

References 12 publications

Lessons learned from a community based intervention to improve injection safety in Pakistan

Lessons learned from a community based intervention to improve injection safety in Pakistan

How community engagement in water and sanitation interventions impacts human health, infrastructure and service longevity in low- and middle-income countries: a realist review

Avoiding the Use of Exhausted Drinking Water Filters: A Filter-Clock Based on Rusting Iron

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