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PSI Diarrhea Prevention and Safe Water Approaches


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PSI Diarrhea Prevention and Safe Water Approaches

  1. 2. Why Worry About Water, Sanitation, and Hygiene? Unsafe Water: More than 884 million people worldwide lack access to improved water sources No Sanitation: 2.5 billion don’t have access to a latrine or toilet So What? : Every 15 seconds child dies from dehydration due to diarrhea.
  2. 3. Goal: Reduce Global Burden of Diarrhea <ul><li>Every Year: 1.5 M children die from diarrheal diseases; 4,000 every day </li></ul><ul><li>90% children under 5 </li></ul><ul><li>80% transmission from consumption of unsafe drinking water </li></ul>Graphic Citation: Proportion of Worldwide Cases of Diarrhea (0 – 4 years of age)*
  3. 4. Ensuring the Water is Clean… When You Drink it <ul><li>Even when water is delivered by wells to a community, water often becomes contaminated while being transported from the well to the home or while it is being stored in the household. </li></ul>
  4. 5. <ul><li>Low additional cost and widespread applicability make them a viable complement to infrastructure development </li></ul><ul><li>Enables households to manage their water quality </li></ul>Household Water Treatment (HWT): One Family at a Time
  5. 8. <ul><li>CDC ’ s Safe Water Solution (Sodium hypochlorite solution) </li></ul><ul><li>Low Cost: Less than a penny a day for a family of 6; </li></ul><ul><li>Builds Local Capacity: Produced locally ; thereby reducing production costs and improving sustainability. </li></ul><ul><li>NaDCC Aquatabs (NaDCC tabs) </li></ul><ul><li>Facilitates distribution : Light and easy to transport </li></ul><ul><li>Long Product Life: Five year expiration date </li></ul><ul><li>Individual sale possible: Facilitating purchase by consumers with little disposable cash </li></ul><ul><li>Flocculant – Disinfectant (PUR Purifier of Water®) </li></ul><ul><li>Facilitates distribution : Light and easy to transport </li></ul><ul><li>Long Product Life: Three year expiration date </li></ul><ul><li>Added Effectiveness: Also removes turbidity, other micro-organisms (i.e. giardia) and arsenic </li></ul><ul><li>Visual Cue: Enhances demand, especially rural audiences </li></ul>PSI’s current HWT Options: Ensuring household drinking water quality
  6. 9. Social • marketing (so shel • mar kit ing) n. 1. The application of marketing concepts and techniques to influence behavior among a target audi-ence in order to benefit themselves and society.
  7. 10. Communications + Product = Healthy Behavior
  8. 11. <ul><li>PSI’s Child Survival programs are in over 30 countries </li></ul>
  9. 12. Liters of water treated since PSI Safe Water programs began: over 60 billion
  10. 13. A Case Study: Enabling People in Madagascar to treat their drinking water
  11. 14. Applying Evidence to Improve HWT Uptake: Madagascar Sur’Eau use: 2004 and 2006
  12. 15. Challenges Encountered <ul><ul><li>Lack of developed commercial sector – limited reach of wholesalers </li></ul></ul><ul><ul><li>Lack of rural coverage </li></ul></ul><ul><ul><li>Low profit margins compared to other FMCG </li></ul></ul><ul><ul><li>Increased costs </li></ul></ul><ul><ul><li>Limited funding leading to modest A&P Budgets </li></ul></ul><ul><ul><li>“ Water treatment culture” is harder to create than thought </li></ul></ul>
  13. 16. Hotely Sûr’e Sekoly Sûr’e Community-Based Distribution Agents
  14. 17. Using key determinants to drive behavior change: <ul><li>Self efficacy : </li></ul><ul><ul><li>Simply Instructions </li></ul></ul><ul><ul><li>More product demonstrations via CHWs and other </li></ul></ul><ul><li>Social norms: </li></ul><ul><ul><li>Develop a “Women Network” and revise packaging to promote Sûr’Eau use </li></ul></ul><ul><li>Risk of diarrhea: </li></ul><ul><ul><li>Implement concentrated IPC/ mass media campaign on negative effects of diarrhea </li></ul></ul><ul><ul><li>used radio spots, mobile video units, and interpersonal communication activities to educate about the dangers of diarrhea; implemented intensive IPC in high prevalence zones </li></ul></ul>
  15. 18. Madagascar Sur’Eau use: 2004, 2006, 2008
  16. 19. Primary CS Indicators <ul><li>Water treatment: </li></ul><ul><ul><li>% of households with children under five ever using a PSI point of use treatment product to treat drinking water </li></ul></ul><ul><ul><li>% of households with children under five consistently treating drinking water using promoted method </li></ul></ul><ul><ul><li>% of households with children under five treating drinking water using promoted methods in the last 24 hours </li></ul></ul><ul><ul><ul><li>Verified with chlorine residual testing </li></ul></ul></ul><ul><ul><li>% of households with children under five correctly treating drinking water using promoted method </li></ul></ul><ul><li>Water storage </li></ul><ul><ul><li>% of households with children under five correctly storing treated drinking water </li></ul></ul>
  17. 20. Primary CS Indicators <ul><li>Handwashing </li></ul><ul><ul><li>% of caregivers with children under five who wash their hands at critical times: </li></ul></ul><ul><ul><ul><li>before preparing food </li></ul></ul></ul><ul><ul><ul><li>before feeding a child </li></ul></ul></ul><ul><ul><ul><li>before eating </li></ul></ul></ul><ul><ul><ul><li>after defecation </li></ul></ul></ul><ul><ul><ul><li>after changing a child </li></ul></ul></ul><ul><ul><li>% of households with children under five who have soap present in the home </li></ul></ul><ul><li>Hygiene </li></ul><ul><ul><li>% of caregivers who used a toilet or latrine the last time they defecated </li></ul></ul><ul><ul><li>% of caregivers who always use a toilet or latrine for disposing of children’s feces </li></ul></ul>
  18. 21. Taking HWT to Scale: Lesson Learned <ul><li>Focus on key determinants </li></ul><ul><li>Constant communication of culturally-relevant aspirational messages </li></ul><ul><li>Partnerships are critical to success </li></ul><ul><li>Work through multiple channels to enable behavior change and increase product update </li></ul><ul><li>Monitoring and Evaluation of standard indicators is essential </li></ul><ul><li>Emergency Relief can serve as a launching pad and be leveraged for behavior change </li></ul>
  19. 22. Conclusion: These interventions are… Effective: Offer measurable reduction in diarrheal disease prevalence Offer measurable increase in good hygiene practices and beliefs Affordable From a penny a day to $0.20 a day for a family of 6 Scalable: Allow PSI to ensure that millions of people can drink a glass of clean, safe water every day.