The world is not
on track to meet Sustainable Development Goal
6.1 to provide universal access to safely managed drinking water by
2030. Removal of priority microbial contaminants by disinfection is
one aspect of ensuring water is safely managed. Passive chlorination
(also called in-line chlorination) represents one approach to disinfecting
drinking water before or at the point of collection (POC), without
requiring daily user input or electricity. In contrast to manual household
chlorination methods typically implemented at the point of use (POU),
passive chlorinators can reduce the user burden for chlorine dosing
and enable treatment at scales ranging from communities to small municipalities.
In this review, we synthesized evidence from 27 evaluations of passive
chlorinators (in 19 articles, 3 NGO reports, and 5 theses) conducted
across 16 countries in communities, schools, health care facilities,
and refugee camps. Of the 27 passive chlorinators we identified, the
majority (22/27) were solid tablet or granular chlorine dosers, and
the remaining devices were liquid chlorine dosers. We identified the
following research priorities to address existing barriers to scaled
deployment of passive chlorinators: (i) strengthening local chlorine
supply chains through decentralized liquid chlorine production, (ii)
validating context-specific business models and financial sustainability,
(iii) leveraging remote monitoring and sensing tools to monitor real-time
chlorine levels and potential system failures, and (iv) designing
handpump-compatible passive chlorinators to serve the many communities
reliant on handpumps as a primary drinking water source. We also propose
a set of reporting indicators for future studies to facilitate standardized
evaluations of the technical performance and financial sustainability
of passive chlorinators. In addition, we discuss the limitations of
chlorine-based disinfection and recognize the importance of addressing
chemical contamination in drinking water supplies. Passive chlorinators
deployed and managed at-scale have the potential to elevate the quality
of existing accessible and available water services to meet “safely
managed” requirements.