Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #109935

Matthew C. Freeman¹, Daniel P. Abbott¹, Richard Rheingans, MA, PhD¹, and Robert Quick, MD, MPH². (1) Center for Global Safe Water, Global Environmental Health, Emory University, Grace Crum Rollins Building, 1518 Clifton Rd, Atlanta, GA 30322, 404-831-5109, mcfreem@sph.emory.edu, (2) Foodborne and Diarrheal Diseases Branch, Centers for Disease Control and Prevention, 1600 North Clifton Road, MS-38, Atlanta, GA 30333

Background: The Safe Water System (SWS), which consists of point of use water treatment, safe water storage, and behavior change techniques, is a low cost, simple and effective point-of-use water quality intervention. Field trials on 3 continents have shown that use of the SWS reduces the diarrheal disease risk by >40%. Social marketing programs have increased access to SWS products in 14 countries. However, challenges remain with regards to equitable access and product distribution. In Western Kenya, where SWS products are socially marketed through commercial channels, CDC has partnered with the Society for Women and AIDS in Kenya (SWAK) and developed a novel approach to product dissemination - local women's groups work within their communities to educate neighbors, sell health products, and generate income.

Methods: We conducted a cross-sectional survey in a random sample of households in 8 communities served by active SWAK groups in Nyanza Province, Kenya. The survey included demographic and socioeconomic characteristics, and water handling, sanitary, and hygienic practices. Stored water was tested for residual chlorine to determine use of Klorin, the local SWS water treatment solution. We grouped households into 5 quintiles of relative wealth using a World Bank principal component analysis. Additionally, multivariate models were constructed to assess the association between Klorin use and diarrhea knowledge and attitude; literacy and education levels; water source and handling practices; and socio-economic indicators.

Results: We interviewed persons from 485 households in 8 villages, 437 (90%) were women. Klorin adoption, as determined by detectable chlorine residuals in stored water, ranged from 5% to 39% (median 20%) in the 8 communities. There were no significant differences in measurable Klorin use between the poorest (46%) and wealthiest (47% [p=0.948]) socioeconomic quintiles; no differences existed between any two quintiles.

Conclusions: Purchase and use of Klorin was relatively high in this population and did not appear to be influenced by socioeconomic status. These results suggest that the SWAK social entrepreneurship model may be an effective approach to lowering barriers to use of socially marketed products.

Learning Objectives:

• 1 – Understand what is meant by social entrepreneurship and recognize the potential that this type of intervention has for access equity in low income country programs.
• 2 –Identify opportunities to use social entrepreneurship
• 3 – Understand programmatic inequity, its significance, and how to assess and ameliorate it in low income settings.

Keywords: Water Quality, Equal Access

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation