Does a Free-Trial Approach Increase Purchase and Use of a Household Water Treatment and Safe Storage Product in Rural Haiti?

Tsai, Feng Jen; Wu, Michael; Lin, Chia Ping

doi:10.4269/ajtmh.19-0606

Cited by 3 publications

(2 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The studies in the graph are restricted to studies reporting one or more single time point measures of adoption and provided chlorine products entirely for free for the study duration. The latter restriction excludes Tsai et al, 63 Blanton et al, 58 Mellor et al, 53 and Luby et al 37 (which provided the final time point follow-up to Chiller et al 38 ). Among the studies included here, only Opryszko et al 48 had self-reported adoption.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Adoption of Point-of-Use Chlorination for Household Drinking Water Treatment: A Systematic Review

Crider

Tsuchiya

Mukundwa

et al. 2023

Environ Health Perspect

View full text Add to dashboard Cite

Background: Centralized chlorination of urban piped water supplies has historically contributed to major reductions in waterborne illness. In locations without effective centralized water treatment, point-of-use (POU) chlorination for households is widely promoted to improve drinking water quality and health. Realizing these health benefits requires correct, consistent, and sustained product use, but real-world evaluations have often observed low levels of use. To our knowledge, no prior reviews exist on adoption of chlorine POU products. Objectives: Our objectives were to identify which indicators of adoption are most often used in chlorine POU studies, summarize levels of adoption observed, understand how adoption changes over time, and determine how adoption is affected by frequency of contact between participants and study staff. Methods: We conducted a systematic review of household POU chlorination interventions or programs from 1990 through 2021 that reported a quantitative measure of adoption, were conducted in low- and middle-income countries, included data collection at households, and reported the intervention start date. Results: We identified 36 studies of household drinking water chlorination products that met prespecified eligibility criteria and extracted data from 46 chlorine intervention groups with a variety of chlorine POU products and locations. There was no consensus definition of adoption of household water treatment; the most common indicator was the proportion of household stored water samples with free chlorine residual . Among studies that reported either free or total chlorine–confirmed adoption of chlorine POU products, use was highly variable (across all chlorine intervention groups at the last time point measured in each study; range: 1.5%–100%; sample size-weighted ; unweighted ). The median follow-up duration among intervention groups was 3 months. On average, adoption declined over time and was positively associated with frequency of contact between respondents and study staff. Discussion: Although prior research has shown that POU chlorine products improve health when correctly and consistently used, a reliance on individual adoption for effective treatment is unlikely to lead to the widespread public health benefits historically associated with pressurized, centralized treatment of piped water supplies. https://doi.org/10.1289/EHP10839

show abstract

Section: Resultsmentioning

confidence: 99%

“…In rural Haiti, Tsai et al. 63 provided half of respondents with a free trial of Klorfasil, a granular chlorine POU product, followed by the opportunity to purchase at a subsidized price. The other half received no free trial.…”

Section: Resultsmentioning

confidence: 99%

Adoption of Point-of-Use Chlorination for Household Drinking Water Treatment: A Systematic Review

Crider

Tsuchiya

Mukundwa

et al. 2023

Environ Health Perspect

View full text Add to dashboard Cite

show abstract

Why do low-cost point-of-use water treatment technologies succeed or fail in combating waterborne diseases in the field? A systematic review

Chaúque,

Issufo,

Benitez

et al. 2023

Journal of Environmental Chemical Engineering

View full text Add to dashboard Cite

Determinants of adoption of household water treatment in Haiti using two analysis methods: logistic regression and machine learning

Heylen,

Antoine,

Ritter

et al. 2024

Journal of Water and Health

View full text Add to dashboard Cite

Household water treatment (HWT) is recommended when safe drinking water is limited. To understand determinants of HWT adoption, we conducted a cross-sectional survey with 650 households across different regions in Haiti. Data were collected on 71 demographic and psychosocial factors and 2 outcomes (self-reported and confirmed HWT use). Data were transformed into 169 possible determinants of adoption across nine categories. We assessed determinants using logistic regression and, as machine learning methods are increasingly used, random forest analyses. Overall, 376 (58%) respondents self-reported treating or purchasing water, and 123 (19%) respondents had residual chlorine in stored household water. Both logistic regression and machine learning analyses had high accuracy (area under the receiver operating characteristic curve (AUC): 0.77–0.82), and the strongest determinants in models were in the demographics and socioeconomics, risk belief, and WASH practice categories (although determinant relative strength varied by analysis). Determinants that can be influenced inform HWT promotion in Haiti. It is recommended to increase access to HWT products, provide cash and education on water treatment to emergency-impacted populations, and focus future surveys on known determinants of adoption. We found both regression and machine learning methods need informed, thoughtful, and trained analysts to ensure meaningful results and discuss the benefits/drawbacks of analysis methods herein.

show abstract

Does a Free-Trial Approach Increase Purchase and Use of a Household Water Treatment and Safe Storage Product in Rural Haiti?

Cited by 3 publications

References 21 publications

Adoption of Point-of-Use Chlorination for Household Drinking Water Treatment: A Systematic Review

Adoption of Point-of-Use Chlorination for Household Drinking Water Treatment: A Systematic Review

Why do low-cost point-of-use water treatment technologies succeed or fail in combating waterborne diseases in the field? A systematic review

Determinants of adoption of household water treatment in Haiti using two analysis methods: logistic regression and machine learning

Contact Info

Product

Resources

About