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Evaluating Population Services International's Household Point-of-Use WaterTreatment Program in Rwanda, 2006-2010

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The Point-of-Use-Zinc (POUZN) project is a USAID-funded project implemented by Abt Associates in partnership with Population Services International (PSI). The project is a diarrhea prevention program that engages the private sector (commercial and non-governmental organization) in health product marketing and communications to promote behavior change. While the five-year program was implemented in five countries, this paper will focus on program performance in two countries, Rwanda and Benin.

Rwanda, a small country with a population of more than 10 million, has one of the highest under-five mortality rates in the world: one in 10 children dies before reaching his/her fifth birthday. In October 2007, PSI conducted a baseline household survey with caregivers of children under the age of five, which showed that 32 percent of urban and 42 percent of rural Rwandans treat their drinking water with a chemical product. In the cases where a household treated with a product other than Sûr' Eau (the PSI-marketed chlorine product in Rwanda), options included oxidizing agents such as bleach and permanganate. A follow-up study was conducted in March 2010 to evaluate the success of PSI's marketing campaign to address household water treatment with Sûr' Eau We found that households exposed to at least one communication message were significantly more likely to say they had ever heard of Sûr'Eau, know where to purchase Sûr'Eau, ever use and currently use Sûr'Eau, and know that the main cause of diarrhea is dirty drinking water. We found that households not exposed to the messaging in 2010 were more likely to know where to buy Sûr'Eau ever use Sûr'Eau compared to the 2007 baseline (p<.05) but the increases were even more dramatic for those exposed.

Benin is one of the poorest and least developed countries of the world, ranking 161/182 in the UN's Human Development Index for 2009. Sixty-six percent of the population resides in rural areas. Overall health indicators are poor, with a low life expectancy of 56 years and high infant (78/1000 live births) and child mortality (123/1000 live births) (UNICEF 2008). In October 2009, PSI conducted a baseline household survey of caregivers of children under 5, and using the 2006 DHS as a comparison point, shows that ever treatment of water with any chlorine product increased from 4% to 12%. Caregivers who self-reported currently using Aquatabs (the PSI-marketed chlorine product in Benin) increased from virtually nothing to 6%. However, the increases are starker when comparing caregivers who were exposed to PSI communications versus those who were not. While 10% of caregivers who were not exposed to any communications had ever treated their water in 2009, 21% of those who were exposed had ever treated their water. Just under 5% of caregivers who were not exposed werecurrently using Aquatabs but 13% of those who were exposed were current using.

Rwanda and Benin are case studies that show the effectiveness of the POUZN project. While household water treatment levels are still low in each country, they have vastly improved in targeted areas in the last 2-3 years. Scaling up the program is essential to success in water treatment and reducing diarrheal disease in each country.

Keywords: Benin; Rwanda; household water treatment; point-of-use; safe water system; social marketing

Document Type: Research Article


Publication date: 2011-01-01

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