207152 Implementing Solar Water Disinfection (SODIS) technology: Factors influencing household adoption of SODIS in a community randomised trial in Bolivia

Monday, November 9, 2009: 11:15 AM

Andri Christen, MSc , Department of Public Health & Epidemiology, Swiss Tropical Institute, University of Basel, Basel, Switzerland
Gonzalo Duran Pacheco, MSc , Department of Public Health & Epidemiology, Swiss Tropical Institute, University of Basel, Basel, Switzerland
Jan Hattendorf, PhD , Department of Public Health & Epidemiology, Swiss Tropical Institute, University of Basel, Basel, Switzerland
Myriam Cevallos , Department of Public Health & Epidemiology, Swiss Tropical Institute, University of Basel, Basel, Switzerland
Carlos Morante, Ing , Project Concern International, Cochabamba, Bolivia
Benjamin Arnold, MPH , Division of Epidemiology, University of California, Berkeley, Berkeley, CA
John Colford, MD PhD , Division of Epidemiology, University of California, Berkeley, Berkeley, CA
Daniel Mäusezahl, PhD MPH , Department of Public Health & Epidemiology, Swiss Tropical Institute, University of Basel, Basel, Switzerland
  
Background: Solar Water Disinfection (SODIS) is one of the most efficacious and affordable home-based water treatment methods to reduce child diarrhoea. Despite large-scale dissemination of SODIS, only few reports describe implementation effectiveness and characteristics leading to the adoption and regular use of SODIS. A SODIS-campaign at community- and household level in rural Bolivia among 11 communities in a community-randomized trial resulted in a median 33% SODIS-use over one year. This analysis was undertaken to identify user groups and characteristics associated with SODIS-use.

Methods: We characterized SODIS-user groups employing cluster analysis (CA) on several indicators to generate a valid estimate of SODIS-use. Effects of the SODIS-campaign factors (e.g. frequency of attending events) and community- and household level characteristics were assessed through a multinomial random-effects regression. The model accounted for between-community variation.

Results: The best-performing user group participated at 70% of all possible events, the weakest at < 50%. Household characteristics associated with higher SODIS-use were latrine ownership (OR=7.8, 95%CI: 1.2-50)and presence of wasted children (OR=4.7, 95%CI: 1.4-15.6).

Conclusions: The determinants for SODIS-adoption are related to consciousness about health matters. Pre-existing health knowledge, motivation and knowledge about drinking water disinfection acquired through previous exposure to water and sanitation programmes are associated with successful SODIS-uptake. This emphasizes the importance of understanding recipients' characteristics and attitudes towards new technologies prior to implementation. Current SODIS-implementation campaigns in over 30 countries offer an under-utilized opportunity to evaluate and improve implementation effectiveness.

Learning Objectives:
Identify population characteristics that may determine early, late or non-adoption of a household water treatment method. Describe factors and characteristics that determine SODIS user group membership. Discuss reasons why socioeconomic characteristics may not determine membership of a household water treatment user group.

Keywords: Public Health Education and Health Promotion, Developing Countries

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Masters research on water quality and identification of Norwalk-like viruses. Scientific field director for a NIH-funded community randomized trial household water treatment in Bolivia. Consultant for an evaluation trial of an environmental health programme on water and indoor air quality in Peru.
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.

See more of: Water, Public Health, & Health Promotion
See more of: Public Health Education and Health Promotion