197774 Impact of community-based distribution of point-of-use water treatment product: Results from a pilot project in Rwanda

Wednesday, November 11, 2009

Slavea Chankova, MPA , International Health Division, Abt Associates, Bethesda, MD
Jean Damascene Butera, MPH , International Health Division, Abt Associates, Bethesda, MD
Sur Eau, a point-of-use chlorine-based water disinfection product, has been available in Rwanda since 2002, sold through health centers and commercial outlets throughout the country. However, use of the product in poor rural communities has remained 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 (known as "mutuelles de sante" or mutuelles).

The mutuelles promoted and distributed Sur Eau through their community outreach agents. In one of the two pilot districts they sold the product at a discounted price to mutuelle member households, while in the other pilot district the product was sold at the market price. The goal of the intervention was 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).

An impact evaluation of the pilot was conducted, using a difference-in-differences study methodology, with a baseline and follow-up household surveys in the two pilot districts and a comparison district (where the program was not implemented at that time). In each of the three study districts, 800 households who were mutuelle members and had at least one child under five years were surveyed using a structured questionnaire. The study assessed the impact of the pilot on knowledge, attitude, and use of Sur Eau; diarrhea prevalence; and reduction of expenditures on diarrhea treatment in the target population.

The presentation will share the results from the impact evaluation, and discuss the implications for scale up of this innovative pilot project in Rwanda and in other countries with established community-based health insurance schemes.

Learning Objectives:
To learn about the design, implementation, and evaluation results of a pilot project that engaged community-based health insurance schemes in the distribution of a point-of-use water treatment product to member households. The audience will have an opportunity to assess the replicability of this intervention in other countries with established community-based health insurance schemes.

Keywords: Water, Evaluation

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Slavea Chankova has five years of experience in monitoring and evaluation of health programs in developing countries, conducting evaluation work for a number of public and private organizations including USAID, GAVI, UNICEF, and PATH. She holds a Masters of Public Affairs degree from Princeton University.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.