Difficulties in Bringing Point-of-Use Water Treatment to Scale in Rural Guatemala

Abstract

In an earlier study in rural Guatemala, 257 households that received flocculant-disinfectant to treat their drinking water had 39% less diarrhea than 257 control households. Three weeks after completion of the study, national marketing of the flocculant-disinfectant was extended into the study communities. Six months later, we assessed frequency of and characteristics associated with purchase and use of the flocculant-disinfectant by revisiting the original study households and administering a questionnaire. Four hundred sixty-two households (90%) completed the follow-up survey; 22 households (5%) purchased the flocculant-disinfectant within the preceding 2 weeks and used it within the last week. Neither being randomized to the intervention group during the efficacy study nor combined spending on laundry soap, toothpaste, and hand soap in the preceding week was associated with active repeat use. Even after efficacy was demonstrated within their community and an aggressive sophisticated marketing approach, few households purchased flocculant-disinfectant for point-of-use water treatment.

Integrating Water Treatment into Antenatal Care: Impact on Use of Maternal Health Services and Household Water Treatment by Mothers—Rural Uganda, 2013

“…Low demand for and use of sachets has been observed in other studies. [16][17][18][19] ANC and maternity registry data corroborated survey findings by showing that approximately equal numbers of water treatment kits and sachet refills were distributed instead of the programmed four sachet refills per water treatment kit.…”

“…A total of 19,586 water treatment kits were distributed at the 37 HF from January to December 2013. Of these, 16 There are several possible explanations for why this intervention did not impact maternal health service use. First, survey data suggested there was discordant demand for the water treatment kits and sachet refills.…”

“…To determine the cross-sectional survey sample size, we assumed that the comparison group would have a 5% usage of sachets, which were available in shops in Uganda before the study began, and that the intervention group would report an increase in sachet use to 15%. To assure an adequate sample size, the estimated baseline use of sachets was higher than typically seen 16 and the expected increase in use of free product was modest. A sample of 150 women in each group would provide 90% power to detect the difference in sachet use at an α = 0.05.…”

User preferences and willingness to pay for safe drinking water: Experimental evidence from rural Tanzania

“…Low rates of consistent use have been observed for several types of HWTS systems, (Luby et al, 2008;Brown et al, 2009) and finding the best method to promote adoption and consistent use is an active area of research (Parker Fiebelkorn et al, 2012). In particular, social marketing research has found that consumer preferences and viable price points strongly influence effective demand and the likelihood of consistent use (Evans et al, 2014).…”

Performance evaluation of household water treatment systems used in Kerman for removal of cations and anions from drinking water

“…Studies done on the efficacy of POU systems to remove pollutants in laboratory scale have shown that the removal rates of pollutants by these systems are desirable (Coulliette et al 2013). Based on the World Health Organization's opinion, water treatment at the point of use is cost effective compared to other methods (Luby et al 2008).…”