Oral

Providing safe, reliable, piped in water to every household is an essential goal, yielding optimal health gains while contributing to the Millennium Development Goal targets for poverty reduction, nutrition, childhood survival, school attendance, gender equity and environmental sustainability. While committed strongly to this goal, and to incremental improvements in water supplies wherever possible, the World Health Organization and others have called for interim approaches that will accelerate the heath gains associated with safe drinking water for those whose water supplies are unsafe. Interventions to treat and maintain the microbial quality of water at the household level are among the most promising of these approaches. In many settings, both rural and urban, people have access to sufficient quantities of water, but that water is unsafe. Effective point-of-use interventions—if used correctly and consistently—can significantly improve the microbiological integrity of the water at the point of ingestion, and thus deliver some of the health benefits of improved water supplies. This session will combine presentations on research concerning the effectiveness and cost effectiveness of the intervention with the practical experience of implementers following different strategies to achieve uptake at scale. Field trials have shown household based-interventions (boiling, chlorination, filtration, solar disinfection and flocculation/disinfection) to be highly effective in improving microbiological water quality and reducing disease. There is also evidence that the intervention is cost-effective and that beneficiaries will bear part or all of the cost. Despite this evidence, however, the promising results from efficacy studies have not yet been widely translated to the field. The experience to date of commercial, social marketing and public sector/donor strategies for scaling up will be presented and discussed. By offering vulnerable populations with the tools to treat their own drinking water, household water treatment has the potential for empowering the unserved to take charge of their own water security as they continue to take steps toward improved access. Nevertheless, the intervention has important limitations compared to household connections. The session will close with a discussion of the policy implications of promoting household water treatment.

Session Objectives: 1.Explain the evidence on the effectiveness and cost-effectiveness of household water treatment for preventing waterborne disease in low-income settings. 2. Describe and assess experiences in implementing household water treatment interventions using novel social-marketing and commercial delivery strategies. 3.Discuss the economic and policy implications of endeavoring to scale up the intervention as a key component of water supply, sanitation and hygiene initiatives.

CE Credits: Medical (CME), Health Education (CHES), Nursing (CNE), Public Health (CPH)