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Where
has the Safe Water System been used?
 Zambia
Project
Partners - CDC
- PSI
- USAID
- Ministry
of Health/Central Board of Health/District Health Management Team
- CARE
- Rotary
Club of Estes Park, Colorado
Target
population/location - Parents
with children under five years
- Primarily
low income urban areas
- Implementation
is on a national scale
Project
design - Field
trial in Kitwe, followed by pilot social marketing project in 3 compounds in Lusaka
and 3 compounds in Kitwe, and Ndola. Following successful pilot, the social marketing
campaign has expanded to all provinces of Zambia.
Intervention
elements -
Sodium
hypochlorite disinfectant produced locally by PSI, using appropriate technology.
The brand name is CLORIN.
- Locally
available plastic 2.5-liter, 5-liter, and 20-liter jerry cans for water storage
- Social
marketing of CLORIN at subsidized price
Project
implementation start date Results
of project evaluation - Field
trial: A water quality intervention that combines point-of-use water treatment,
safe water storage vessels, and community education was field tested in Zambia.
A total of 166 intervention households and 94 control households were randomly
selected. Baseline surveys were conducted and the intervention distributed. Active
diarrhea surveillance was conducted weekly, water was tested for chlorine residuals
biweekly, and a follow-up survey was conducted. Intervention households exhibited
high compliance: 97% reported using disinfectant and between 72% and 95% had measurable
total chlorine residuals in their water. The percentage of intervention households
storing water safely increased from 48% to 89%. Escherichia coli contamination
of stored water was detected in a lower percentage of intervention households
than control households (p<0.001). Residents of intervention households had
diarrhea rates that were 48% of the rates among controls (95% confidence interval=0.3,
0.9).
- Social
marketing trial: In late 1998, PSI began a social marketing campaign of CLORIN
the Safe Water System in several communities in Zambia. To evaluate the
campaign, we conducted cross-sectional studies. Systematic random samples of households
were selected in three periurban communities; households were interviewed about
demographics, water use and storage, water disinfection practices (CLORIN), diarrhea
prevalence, and knowledge about diarrhea. Stored household water was tested for
the presence of total and free chlorine residual. The percentage of households
using a narrow-mouth container to store drinking water ranged from 20% to 87%.
Over 90% of all study households had heard of CLORIN. Current use was highest
(78%) in households that had recently received motivational interviewing in addition
to social marketing; these households also had the lowest 2-week period prevalence
of diarrhea (7%). In one community, households with lower estimated wealth were
less likely to have ever used CLORIN (p=0.01) or to be using it on the day of
interview (p=0.01). Clorin is a seasonal product, used more often in the rainy
season when diarrhea and cholera outbreaks are more likely to occur. National
annual sales are 400,000-500,000 bottles. Since more households reported having
ever used Clorin than reported currently using it, we suspect that CLORIN may
be a seasonal product.
Remarks
- CDC safe water
vessel to be test-marketed in Zambia starting first quarter 2001
- PSI
is exploring the possibility of contracting with a private company to take over
production of Clorin in Zambia
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