Systematic Review of Global Water & Sanitation Social Marketing

Social marketing can be effective in preventing diarrheal diseases by promoting household behaviors related to water management, sanitation and hygiene. We systematically reviewed the published literature since 1990. We excluded articles that were (a) not original research and (b) related to the diarrheal diseases but not water or sanitation. We identified 90 potentially relevant articles and determined that 29 met our criteria. Papers were included only if they discussed interventions that used social marketing, targeted behaviors related to water and sanitation, and focused on controlling diarrhea. Of the 29 papers, the majority (15) focused on household water treatment; others on handwashing, hygiene, sanitation.

We summarize the social marketing strategies – 4 Ps, or place, product, price, and promotion – segmented by behavior and health condition outcomes and present case studies. During the 1990s, CDC and PAHO designed the “Safe Water System,” to improve water safety in developing countries. The behavior change component employs media campaigns, community mobilization, and interpersonal communication.

Additionally, we describe social marketing for handwashing promotion, which can be a cost-effective and prevent 50 percent of both diarrheal diseases and ARIs (PPPHW 2008 & Luby et al 2005). We also describe campaigns for hygiene and sanitation.

We conclude by identifying knowledge gaps in water and sanitation social marketing. We describe an intervention research agenda, which includes the use of new technologies (handheld devices) and social networking strategies based on the 4 Ps, to promote and evaluate behavior change. We argue that these powerful tools should be used to reach underrepresented audiences with campaigns and collect evaluation data.