Midstream Players Determine Population-Level Behavior Change: Social Marketing Research to Increase Demand for Lead-Free Components in Pitcher Pumps in Madagascar

Khaliq, Mahmooda; Sommariva, S; Buerck, Adaline M; Rakotondrazaka, Rinah; Rakotoarisoa, Lova; Barrett, Luke John Paul; Mihelcic, James R.

doi:10.3390/ijerph18147297

Cited by 5 publications

(12 citation statements)

References 38 publications

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“…In this study, the estimated US$8.7 million saved and a return on investment of ∼US$4000 for every dollar spent on the intervention demonstrates the importance of not only further identifying sources of exposure to lead and other chemical pollutants, but also potential mitigation strategies that engage with local agents in the informal economic sectors. Social/behavioral approaches can also be used to address needs, concerns, and current behaviors of these local agents to support them in innovating improved products that maintain their function but also result in improved well-being . The results presented in this study also demonstrate how the formation of partnerships between public, private, and civil society entities, as suggested by UN Sustainable Development Goal 17, can realize important local economic and health benefits.…”

Section: Resultsmentioning

confidence: 66%

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Health and Economic Consequences of Lead Exposure Associated with Products and Services Provided by the Informal Economy

Buerck

Usowicz

Cunningham

et al. 2021

Environ. Sci. Technol.

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In low- and middle-income countries (LMICs), the presence of an informal economy can lead to human exposure to toxic metals such as lead (Pb). This paper demonstrates the local health and economic benefits of modifying practices within the informal economic sector in Madagascar. Specifically, leaded components in 504 locally manufactured household water pumps were replaced with unleaded components. Prior to the intervention, 32% of the household systems exhibited lead concentrations above the World Health Organization (WHO) provisional drinking water guideline of 10 μg/L, but after the intervention, fewer than 3% of the systems were in exceedance. The reduction of lead concentration is modeled to reduce the fraction of children with elevated BLLs (>5 μg/dL) from 34 to 13%. The reduction in BLLs is estimated to provide an average economic benefit of US$11 800 per child based on predicted increases in lifetime productivity. This corresponds to a total benefit of US$8.7 million for the 730 children aged 1–5 associated with the pumps, representing a return on investment of greater than 1000-to-1. Results demonstrate how the formation of partnerships between public, private, and civil society entities, as suggested by UN Sustainable Development Goal 17, can realize important local economic and health benefits in LMICs.

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Section: Resultsmentioning

confidence: 66%

“…Social/ behavioral approaches can also be used to address needs, concerns, and current behaviors of these local agents to support them in innovating improved products that maintain their function but also result in improved well-being. 66 The…”

Section: ■ Results and Discussionmentioning

confidence: 99%

Health and Economic Consequences of Lead Exposure Associated with Products and Services Provided by the Informal Economy

Buerck

Usowicz

Cunningham

et al. 2021

Environ. Sci. Technol.

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“…In total, 18 interviews with technicians were conducted, of these 71% of technicians spoke Malagasy as their primary language, 82% of technicians transferred skills from another profession (i.e., welding), and 65% had another technician in their family. On average the technicians indicated installing or repairing approximately 6.5 pumps per month (Khaliq et al, 2021).…”

Section: Priority Audiencementioning

confidence: 99%

Convergence of Social Marketing and Engineering: A Lead Mitigation Study in Madagascar

Buerck

Khaliq

Rakotondrazaka³

et al. 2023

Social Marketing Quarterly

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Background and Situation Analysis The importance of Water Sanitation and Hygiene (WASH) projects for the protection of health is embedded in the sustainable development goals. However, within the development and humanitarian fields sustainability of WASH projects is still a challenge with 30–50% of projects failing within two to five years of implementation. Though failure is not linked to any one source, a common theme speaks to a greater need for community engagement and integration of the wants and needs of the end-user in the design process. Social marketing, with its focus on the consumer and use of commercial marketing strategies to achieve behavior change is a promising approach that can be integrated into ongoing WASH initiatives to meet program outcomes and to achieve long-term sustainability. Priority audience Primary audience includes technicians who manufacture and repair pitcher pumps. Secondary audience includes community members in Toamasina, Madagascar, who will experience a decrease in exposure to lead through their water supply. Behavioral objectives Decrease exposure to lead (Pb) introduced through the use of a decentralized, self-supply water system, the pitcher pump. Specifically, decrease use of leaded components in the manufacturing and repair of pitcher-pumps Strategy/Intervention Development of the intervention followed the social marketing process including conducting a situational analysis, identification and selection of a behavioral focus and priority population, formative research, development of an integrated marketing strategy, pretesting the strategy, followed by campaign implementation, and monitoring and evaluation. An intervention focused on building a sense of community and introducing the element of professionalism for the pump manufacturers was developed, consisting of personalized one-on-one outreach to raise awareness of the health topic, followed by skill building trainings on how to make the switch to non-leaded components. This was coupled with tangible products that created a new professional network, documentation of work, and backing of work by trusted government entities. Evaluation Methods and Results Using the theory of planned behavior, a pre/post-test summative evaluation was developed. Preliminary results indicate that pump technicians no longer use lead in pumps unless specifically requested by the pump owners. These results indicate a positive shift towards the use of lead-free components with project follow-up and analysis ongoing. Recommendations for Social Marketing Practice Use of social marketing within the WASH sector is lacking. This paper demonstrates the integration of social marketing in an ongoing WASH project. Through a description of each step of the process, our experiences in implementing it and the lessons learned, we hope to guide future integration. Additionally, this paper demonstrates the convergence of engineers and social marketers working collaboratively on an interdisciplinary team and how this served to enhance project understanding, aid in building local partnerships and help with long-term sustainability.

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“…Interventions may include encouraging a change in ongoing manufacturing practices that result in an improved product, and developing mechanisms to provide alternative, improved, or enhanced livelihood options, both with the intent to reduce lead exposures. 133 Ultimately, high-income countries that are now demanding metals and materials to transform to a less fossil-fueldependent society need to require responsible recycling of precious metals (including at low concentrations), both at home and abroad. This will be especially challenging because it is estimated that 49% of global lead reserves occur within what are defined as fragile states.…”

Section: ■ Future Perspectivesmentioning

confidence: 99%

“…These stakeholders include informal recyclers and artisans. Interventions may include encouraging a change in ongoing manufacturing practices that result in an improved product, and developing mechanisms to provide alternative, improved, or enhanced livelihood options, both with the intent to reduce lead exposures …”

Section: Future Perspectivesmentioning

confidence: 99%

Advancing Knowledge to Reduce Lead Exposure of Children in Data-Poor Low- and Middle-Income Countries

Champion

Khaliq

Mihelcic

2022

Environ. Sci. Technol. Lett.

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Though age-standardized disability-adjusted lifeyears rates due to lead exposure are declining globally, lead continues to harm global populations and, in particular, young people in low-and middle-income countries (LMICs). Legacy pollution and unregulated informal activities here contribute to markedly high exposures. Malnutrition amplifies lead's deleterious effects, as does a lack of access to healthcare and education/ awareness. Children are the most vulnerable subpopulation, owing to their relatively high lead intake and rapidly developing organ systems. As such, a majority of the 800 million children estimated with blood lead levels (BLLs) of >5 μg/dL reside in LMICs, and recent data suggest both higher and more variable BLLs in lowerversus high-income economies. Interestingly, urbanization (and development itself) can drive increased lead exposures as these countries progress toward a high-income classification, wherein regulatory efforts then reduce exposures. To help address this continuing health concern and to provide insight for researchers and practitioners, this Global Perspective aims to explore recent trends in global childhood BLL data and to elucidate potential and established contributors to lead exposures unique to LMICs. This work highlights the need for opportunities to advance knowledge in data-poor locations that address the unique, local, and complex aspects of a global environmental health concern.

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Midstream Players Determine Population-Level Behavior Change: Social Marketing Research to Increase Demand for Lead-Free Components in Pitcher Pumps in Madagascar

Cited by 5 publications

References 38 publications

Health and Economic Consequences of Lead Exposure Associated with Products and Services Provided by the Informal Economy

Health and Economic Consequences of Lead Exposure Associated with Products and Services Provided by the Informal Economy

Convergence of Social Marketing and Engineering: A Lead Mitigation Study in Madagascar

Advancing Knowledge to Reduce Lead Exposure of Children in Data-Poor Low- and Middle-Income Countries

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