influencing household water treatment behaviors · 2018. 2. 12. · significant predictors of water...
TRANSCRIPT
Influencing Household Water
Treatment Behaviors:
What We’ve Learned
Cecilia Kwak
Population Services International
• Programs use multiple communications channels to relay different aspects of messages & determinants
• Mass media: Broad-reaching communications
Radio, TV, print ads,
national campaigns
• Targeted communications
Community outreach,
peer educators,
street theater
influential leaders
Evolving communications is key to HWT
behavior change
PSI Behavior Change Model
Trends in Key Determinants of
Adopting HWT Behaviors
Significant Predictors of Water Treatment
Household surveys across 15 countries
Those who treat water with POU vs. those who do not treat water with POU
Range of behavioral determinants
Significant predictors of HWT practices across countries Social Support / Social Norms
Self-Efficacy
Perceived Availability
Perceived Threat / Perceived Susceptibility**
Perceived Availability of Products
PERCEIVED AVAILABILITY
“Where I live there are vendors that sell WaterGuard”
“I know where to obtain WaterGuard”
“I can find WaterGuard within 30 minutes of where I live”
(PSI Sudan 2010 TRaC Survey)
SELF-EFFICACY
Self-efficacy
I am confident to be able to
use all necessary materials to
treat water with WaterGuard”
I can take the required time to
treat water using WaterGuard
I think it is easy to use
WaterGuard
I can easily follow
WaterGuard instructions
POU Water
Treatment:
As Easy As
“1, 2, 3”
Social Norms and Social Support
• My neighbors take some
action to treat their water
to make it safer to drink
• The majority of people in
my village take some
action to treat their water
to make it safer to drink
Product Demonstration Teams:
Allow Trial and Error and Build Confidence
and Trust in POU
• Tanzania –
demonstration team
(nurses at health center)
PHOTO
• Malawi or Kenya – CBD
demonstration teams
(including handwashing
demo teams) PHOTO
The role of cholera control in initiating social
support of POU practices
“Caution! Cholera and
Typhoid kill. If you suffer
any of the symptoms visit
your doctor immediately.”
This message is brought to you
by the Ministry of Health
Perceived Risk / Susceptibility
2008 PSI Kenya Campaign:
Linda Kila Tone, “Guard Every Drop”
2007 Kenya: WaterGuard, the “caring
protector” that every mother needs
Zimbabwe: Introducing POU in the midst of
cholera
• PSI Zimbabwe’s Safe Water program was launched in 2008 before the cholera outbreak.
• First cholera outbreak in August 2008
– Spread to 56 of 62 districts
– >91,000 cumulative cases
• Program focus in cholera-reported areas; currently national scale
• Communications to promote hand washing, water treatment and IPC through xx partners
• Availability of water purification productsDemonstrate that water purification tablets are always easy to find and available within walking distance from their home
• Social supportEncourage assistance on use of water purification tablets as provided by partners, family members and friends
• BeliefsIncrease beliefs that water purification tablets kill all the germs in water and treating water makes the water safe to drink.
Safe Water System Program
Cholera outbreaks bring out immediate
support for water treatment
Demonstration of water treatment and correct withdrawal of water at a
community event, outskirts of Harare, Zimbabwe, 2009.
PSI/ Z in Action
Musicians take part in a cholera campaign in Harare
Social Support: My family, my neighbors treat their
drinking water
Social Support: My family, my neighbors treat their
drinking water
0.3%
26.2%
36.8%
14.5%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
2008 National Survey 2009 National Survey 2009 - Exposed to Communications
2009 - Not Exposed to Communications
Current Use of Water Treatment among HHs with children under 5, 2008 - 2009 by Exposure to Communications
2008 National Survey
2009 National Survey
2009 - Exposed to Communications
2009 - Not Exposed to Communications
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Availability*** Social Norms*** Self Efficacy to treat water***
Social Support***
Mean
Sco
res (
Ou
t o
f 5)
PSI Messages Addressed Key Determinants and Led to Increased Use of Water Treatment
2008 Baseline
2009 Non-Exposed
2009 Exposed
Note:
***p<.001
Lessons Learned
There are patterns among factors that drive POU
behaviors
Drivers of POU behaviors are often outside of the
individual sphere of influence
Need to contextualize behavioral determinants
Engagement around POU due to emergency
response is an important entry point
Measuring / evaluating is complex