Innovative distribution of point-of-use water treatment: A pilot project in Rwanda

Sur Eau, a point-of-use water disinfection product, has been available in Rwanda since 2002, and is currently sold through health centers and commercial outlets throughout the country. However, use of the product in poor rural communities is very low. In early 2008, Health Systems 20/20, a USAID-sponsored project, and Population Services International launched a pilot project in two districts in Rwanda to promote and distribute Sur Eau through the community based health organizations (mutuelles de sante). The mutuelles will promote and distribute Sur Eau through their community outreach agents, and in one of the two pilot districts will sell the product at a discounted price to mutuelle member households. The goal of the intervention is to increase household use of Sur Eau, decrease prevalence of diarrhea, and reduce expenditures on treatment of diarrheal disease (both payments by the mutuelles, and out-of-pocket payments by households).

A baseline evaluation was conduced in December 2007, to assess knowledge, attitude, and use of the product and diarrhea prevalence among mutuelle families with children under five. The baseline evaluation was conducted in the two intervention districts and one control district (where the pilot project will not be launched in 2008). A follow-up evaluation will be conducted in late 2008, to assess the impact of this pilot project on the use of Sur Eau and diarrhea prevalence among children under five.

This presentation will describe the details of the pilot project design and implementation, the methodology used to evaluate its impact, and the results from the baseline household survey. The audience will have an opportunity to assess the replicability of this intervention in other countries with widespread community-based health insurance schemes.