week 4 implementation strategies for hwts

8/11/2019 Week 4 Implementation Strategies for HWTS

1/75

Implementation models

Introduction to Household Water Treatment and Safe Storage, Mo

Dr. Richard Johnston


2/75

How to get products inhouseholds, into use?

Implementation strateg

Different objectives

Business concepts Supply, Demand, Financing

Introduction


3/75

Business models

Financial Profit Maximization

Social Profit Maximization

No recovery ofinvested capital

Rinv

N/A

Profit-maximizingbusiness

Social businessNot-for-profitorganization

S


4/75

Base of the pyramid

Base of the Pyramid (BO

1.2 Billion( $ 2000 annum)

1.6 Billion

( $ 725 annum)


< $2,000

$2,000-$20,000

> $20,000 Industrialized

markets

Emergingmass markets

PPP Po

Source: (Gebauer, 2012) after (Prahalad


5/75

Base of the pyramid

Base of the Pyramid (BO


1.6 Billion

( $ 725 annum)


< $2,000

$2,000-$20,000

> $20,000 Industrialized

markets

Emergingmass markets

PPP Po

Source: (Gebauer, 2012) after (PrahaladSource: (WRI, 2007: The Next 4 Billion)


6/75

Conventional Business Models

Market

penetration

1 - Existence

2 - Survival

3 - Success

4 - Scale-up

5 - Maturity

Time (or cumulative investments)

Sou


7/75

BOP Business models

BOP market

penetration

1 - Existence

2 - Survival

3 - Success

4 - Scale-up

5 - Maturity

BOP market

creation

Business modelinnovation

Creating needswheremarketsexist

Creating marketswhere needsexist

Time (or cumulative investments)

Sou


8/75

Demand

Financing

Su

Elements for any business plan


9/75

Product

Price Promotion

Place (markets)

Population

Programme monitoringevaluation

The 6 Ps

http://www.unicef.org/cholera/Annexes/Supporting_Resources/Annex_9/UNICEF-HWTS_Training_Partici
http://www.unicef.org/cholera/Annexes/Supporting_Resources/Annex_9/UNICEF-HWTS_Training_Participants_Notes_2009.pdfhttp://www.unicef.org/cholera/Annexes/Supporting_Resources/Annex_9/UNICEF-HWTS_Training_Participants_Notes_2009.pdfhttp://www.unicef.org/cholera/Annexes/Supporting_Resources/Annex_9/UNICEF-HWTS_Training_Participants_Notes_2009.pdfhttp://www.unicef.org/cholera/Annexes/Supporting_Resources/Annex_9/UNICEF-HWTS_Training_Participants_Notes_2009.pdfhttp://www.unicef.org/cholera/Annexes/Supporting_Resources/Annex_9/UNICEF-HWTS_Training_Participants_Notes_2009.pdf


10/75

High-end p

AspirationaAdvertising

SupermarkAppliance

Retail Razors an

Financial profit maximization

Demand

Supply

Financing


11/75

Hindustan Unilevel Pu

Tata Swach Forbes Aquasure Mineral pot filters Katadyn Sawyer

CSR innovations

Profit-maximizing businesses


12/75

Development for a dec

2008: Launch Classic 2009: Auto-fill ($70)

2010: Compact ($22) . Tat

2010: Marvella ($150)

Aspirational marketing

Safe as boiled water Direct To Home netwo

10,000 demonstrators

Sold 3.7 million units b

Example: Hindustan Unilever Pureit

2000 1000 6800Autofill Classic 23L Compact 14L Marvella

3200Source: www.pureitwater.com


13/75

Example: Hindustan Unilever Pureit

Ultima RO+UV Marvella RO Marvella RO Slim Marvella UV Marvella OGT

3800 3100 2600 1550 1200Classic Autofill 23L Advanced 23L Classic 23L Classic 14L Intella 12L

20990 16000 10990 7990 7990

2000 1000 6800Autofill Classic 23L Compact 14L Marvella

3200

Development for a dec

2008: Launch Classic 2009: Auto-fill ($70)

2010: Compact ($22) . Tat

2010: Marvella ($150)

Aspirational marketing

Safe as boiled water Direct To Home netwo

10,000 demonstrators

Sold 3.7 million units bSource: www.pureitwater.com


14/75

Unsafe wa

Social mar Communithousehold

NGOs

Health wor Entreprene

Cost recov Micro-cred

Social profit maximization

Demand

Supply

Financing

Unsafewater

Consistent

Use

Effective

Option


15/75

Cambodian ceramic fil RDIC

IDE

Population Services In(PSI)

Safe Water System Medentech Aquatabs P&G Purifier of water

Social businesses

http://www.ehproject.org/PDF/ehkm/LessonsLearnedFinal.pdf
http://www.ehproject.org/PDF/ehkm/LessonsLearnedFinal.pdfhttp://www.ehproject.org/PDF/ehkm/LessonsLearnedFinal.pdf


16/75

Commercial test marke Vietnam, Guatemala, Philippin

2000: sachets, cost $0.04, p

We just couldnt sell it fast e

positive return. Dr. Greg Allg

Non-commercial appro Childrens Safe Drinking Wa

2005: Sell at production cos 57 M sachets in 2 years

(3 M in commercial phase)

Social marketing, NGO Emergency model, (Ca

Example: P&G Purifier of Water

Source: Procter & Gamble
http://childrensafedrinkingwater.typepad.com/.a/6a00d83452215469e2015437e112bf970c-pihttp://childrensafedrinkingwater.typepad.com/.a/6a00d83452215469e2015437e112bf970c-pi


17/75

Unsafe water, effectiveconsistent use

Few today care little abof invested capital

SODIS Samaritans purse Bios

Not-for-profit


18/75

Supported by Samarita Implemented 67,000 by end

Goal: 15,600 new filters

Demand Schools and general commu

Train community health prom

150,000 requests

Supply Built on site, travelling teams

In-kind contributions

Monitoring Visits after 1, 3, 6, and 12 m

Example: Biosand filters, Clear Cambodia

Source: WSP 2010


19/75

Full cost = US$60 Transport, labour, education

Sell at full cost to NGO

Subsidize filters for the US$4 to partially pay for the

Contribute labour

Transport the filter to their ho

Attend the BSF promotion mand hygiene promotion meevisit

Example: Biosand filters, Clear Cambodia


20/75

Microcredit

Mobile payments

Carbon credits revenu Water doesntneed to be b

Market crash

Innovations in financing

C


21/75

877 000 filters freely dist Social mobilization, education

30 M USD initial investment 120 M USD cost over ten yea

Monitoring twice yearly Randomly selected 10,0001

Carbon credits 2.6 M tonnes per year

Reinvested in project

Example: Carbon for Water, Western Kenya

Source: Vestergaard Frandsen

F i f i


22/75

For more information

http://www.wpro.who.int/environmental_health/documents/household_water_treatment_safe_storage_trainer/en/

http://www.wpro.who.int/environmental_health/documents/household_water_treatment_safe_storage_participant/en/

http://www.wri.org/publication/next-4-billion

http://www.ifc.org/wps/wcm/connect/REGION__ns/SubSaharan+Africa/Advisory+Services/Suster_Sanitation/Water/

F i f ti
http://www.wpro.who.int/environmental_health/documents/household_water_treatment_safe_storage_trainer/en/http://www.wpro.who.int/environmental_health/documents/household_water_treatment_safe_storage_trainer/en/http://www.wpro.who.int/environmental_health/documents/household_water_treatment_safe_storage_participant/en/http://www.wpro.who.int/environmental_health/documents/household_water_treatment_safe_storage_participant/en/http://www.wri.org/publication/next-4-billionhttp://www.ifc.org/wps/wcm/connect/REGION__EXT_Content/Regions/Sub-Saharan+Africa/Advisory+Services/SustainableBusiness/Water_Sanitation/Water/http://www.ifc.org/wps/wcm/connect/REGION__EXT_Content/Regions/Sub-Saharan+Africa/Advisory+Services/SustainableBusiness/Water_Sanitation/Water/http://www.ifc.org/wps/wcm/connect/REGION__EXT_Content/Regions/Sub-Saharan+Africa/Advisory+Services/SustainableBusiness/Water_Sanitation/Water/http://www.ifc.org/wps/wcm/connect/REGION__EXT_Content/Regions/Sub-Saharan+Africa/Advisory+Services/SustainableBusiness/Water_Sanitation/Water/http://www.ifc.org/wps/wcm/connect/REGION__EXT_Content/Regions/Sub-Saharan+Africa/Advisory+Services/SustainableBusiness/Water_Sanitation/Water/http://www.ifc.org/wps/wcm/connect/REGION__EXT_Content/Regions/Sub-Saharan+Africa/Advisory+Services/SustainableBusiness/Water_Sanitation/Water/http://www.ifc.org/wps/wcm/connect/REGION__EXT_Content/Regions/Sub-Saharan+Africa/Advisory+Services/SustainableBusiness/Water_Sanitation/Water/http://www.ifc.org/wps/wcm/connect/REGION__EXT_Content/Regions/Sub-Saharan+Africa/Advisory+Services/SustainableBusiness/Water_Sanitation/Water/http://www.wri.org/publication/next-4-billionhttp://www.wri.org/publication/next-4-billionhttp://www.wri.org/publication/next-4-billionhttp://www.wri.org/publication/next-4-billionhttp://www.wri.org/publication/next-4-billionhttp://www.wri.org/publication/next-4-billionhttp://www.wpro.who.int/environmental_health/documents/household_water_treatment_safe_storage_participant/en/http://www.wpro.who.int/environmental_health/documents/household_water_treatment_safe_storage_participant/en/http://www.wpro.who.int/environmental_health/documents/household_water_treatment_safe_storage_participant/en/http://www.wpro.who.int/environmental_health/documents/household_water_treatment_safe_storage_trainer/en/http://www.wpro.who.int/environmental_health/documents/household_water_treatment_safe_storage_trainer/en/http://www.wpro.who.int/environmental_health/documents/household_water_treatment_safe_storage_trainer/en/


23/75

Yunus et al., Building SocModels: Lessons from the

Experience. Long Range Hart, Stuart L., and C. K. P

Fortune at the Bottom of thStrategy + Business , 2002

Gebauer H, Saul CJ, Busininnovation in the water seccountries, Science of the TEnvironment, 2014.

Rangan, V. Kasturi, and MSinha. "Hindustan UnilevePurifier." Harvard Business

For more information

www.coursera.org/course/water May 26!

S
http://www.sciencedirect.com/science/article/pii/S0048969714002204http://www.sciencedirect.com/science/article/pii/S0048969714002204http://www.sciencedirect.com/science/article/pii/S0048969714002204http://www.sciencedirect.com/science/article/pii/S0048969714002204http://www.coursera.org/course/waterhttp://www.coursera.org/course/waterhttp://www.sciencedirect.com/science/article/pii/S0048969714002204http://www.sciencedirect.com/science/article/pii/S0048969714002204http://www.sciencedirect.com/science/article/pii/S0048969714002204http://www.sciencedirect.com/science/article/pii/S0048969714002204http://www.sciencedirect.com/science/article/pii/S0048969714002204http://www.sciencedirect.com/science/article/pii/S0048969714002204http://www.sciencedirect.com/science/article/pii/S0048969714002204


24/75

Different business mod

Profit maximization

Social business

Not for profit

Demand

Supply

Financing

Summary


25/75

Targeted approaches



Introduction


26/75

Schools

Health interventions

Introduction

Unsafe

water

CEffective

Option

Schools


27/75

School dem Household

Supporting

Governme

Subsidy

Schools

Demand

Supply

Financing

Example Safe Water School in Bolivia


28/75

Project region: Tiquipa

WASH approach includ Safe water station

SODIS

Chlorination (generated with

Soap production

Example: Safe Water School in Bolivia

Credit: Fundacin SODIS Credit: www.antenna.ch

http://www.antenna.ch/http://www.antenna.ch/


29/75

Planning with local aut Monitoring: school com

local authorities

Water quality testing Monitoring

Demand creation

Entertainment

Handing over process training, monitoring, funding


Credits: Fundacin SODIS, Eawag

Possible impacts


30/75

Improved enrolment, acompletion

Better academic perfo

Less diarrheal disease

Improved WASH condpractices At schools and in homes (?)

Awareness about WAS

Possible impacts

Evaluation in Kenya (Freeman 2013)
http://www.ncbi.nlm.nih.gov/pubmed/23702047http://www.ncbi.nlm.nih.gov/pubmed/23702047


31/75

Improved practices in all schools Access to improved sources of drinking wate

Students reported much greater availability o

handwashing water, and soap

Reduction in diarrhea 56% less risk in water-scarce schools

Evaluation in Kenya (Freeman, 2013)

Credit: SODIS Reference Centre

Water-available schools Water-sca

Hygiene promotion Hygiene

Water treatment Water t

(Sanitation Improvements) (Sanitation I

Wate

http://www.ncbi.nlm.nih.gov/pubmed/23702047http://www.ncbi.nlm.nih.gov/pubmed/23702047


32/75

Vulnerable populations Credible channels

Mutual reinforcements

Child and maternal he Antenatal care

HIV/AIDS

Dengue fever Safe storage

Nutrition


Antenatal care (ANC) intervention


33/75

Malawi, 2007-08 PSI, PATH, UNICEF, M

Free hygiene kits and

provided during ANC v 15,000 pregnant women

WaterGuard samples, refills

visits

Follow-up home visits by he

CDC: Baseline survey

followups (2008, 2010 Surprise visits, residual chlo

Antenatal care (ANC) intervention

Credit: PATH

Antenatal care (ANC) results


34/75

High uptake after 10 m From 1% to 62% among par

From 1 to 27% among friend

higher among rural, less edu

wealthy respondents

Decline after 3 years 28% of participants, 17% of

Credibility of health sean important factor in c

Higher access to healt

services

Antenatal care (ANC) results

HIV/AIDS


35/75

Vulnerable populations Immunocompromised

Cryptosporidium

HWTS: element of pre High uptake

Reduced diarrhea

Reduced CD4 counts

HIV/AIDS

HIV/AIDS Intervention


36/75

Peri-urban Zambia Randomized control trial

100 HIV+, 20 HIV- mothers Water filter plus two 5 L stor

50% intervention, 50% contr

Training by project field Monthly visits

Followup at 1 and 2 ye Surprise visits

Diarrhea, Water quality

Nutritional outcome: Weight

HIV/AIDS Intervention

Credit: R. Peletz

HIV/AIDS Results


37/75

96% reported use Confirmed in 82-87% of visit

Exclusive use 95% 2 filters eaten by rats

2.2 LRV thermotoleran Detection limits

2.7 vs 181 TTC/100 mL, inte

6.1 TTC/100 mL in stored wa 53% reduction in diarrh Dose-response: higher colifo

No significant difference in W

HIV/AIDS Results

Additional resources


38/75

Schools

Freeman MC et al. Assessing the impact of a school-based water treatment, hygiene

and sanitation programme on pupil absence in Nyanza Province, Kenya: a cluster-

randomized trial. Tropical medicine & international health. 2012;17(3):380-91.

Freeman MC et al. The impact of a school-based water supply and treatment,

hygiene, and sanitation programme on pupil diarrhoea: a cluster- randomized trial.

Epidemiology and infection. 2013:1-12.

Antenatal Care

Sheth AN et al. Impact of the integration of water treatment and handwashing

incentives with antenatal services on hygiene practices of pregnant women inMalawi. American Journal of Tropical Medicine and Hygiene. 2010;83(6):1315-21.

Wood S et al. Understanding why women adopt and sustain home water treatment:

Insights from the Malawi antenatal care program. Social Science and Medicine.

2012;75(4):634-42.

HIV/AIDS

Peletz R et al. Assessing water filtration and safe stor

children of HIV-positive mothers: a randomized, controOne. 2012;7(10):e46548.

Peletz R et al. Water, sanitation, and hygiene interve

people living with HIV/AIDS: a systematic review. AID

2013;27(16):2593-601.

Peletz R et al. Preventing cryptosporidiosis: the need

World Health Organ. 2013;91(4):238-8a.

Walson JL et al. Evaluation of impact of long-lasting inpoint-of-use water filters on HIV-1 disease progressio

2013;27(9):1493-501.


http://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2011.02927.x/pdfhttp://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2011.02927.x/pdfhttp://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2011.02927.x/pdfhttp://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9129513http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9129513http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9129513http://www.ajtmh.org/content/83/6/1315.full.pdfhttp://www.ajtmh.org/content/83/6/1315.full.pdfhttp://www.ajtmh.org/content/83/6/1315.full.pdfhttp://www.path.org/publications/files/TS_swp_malawi_qual_res_pos.pdfhttp://www.path.org/publications/files/TS_swp_malawi_qual_res_pos.pdfhttp://www.path.org/publications/files/TS_swp_malawi_qual_res_pos.pdfhttp://www.plosone.org/article/info:doi/10.1371/journal.pone.0046548http://www.plosone.org/article/info:doi/10.1371/journal.pone.0046548http://www.plosone.org/article/info:doi/10.1371/journal.pone.0046548http://www.ncbi.nlm.nih.gov/pubmed/24100712http://www.ncbi.nlm.nih.gov/pubmed/24100712http://www.ncbi.nlm.nih.gov/pubmed/24100712http://www.who.int/bulletin/volumes/91/4/13-119990.pdfhttp://www.who.int/bulletin/volumes/91/4/13-119990.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/23324658http://www.ncbi.nlm.nih.gov/pubmed/23324658http://www.ncbi.nlm.nih.gov/pubmed/23324658http://www.ncbi.nlm.nih.gov/pubmed/23324658http://www.ncbi.nlm.nih.gov/pubmed/23324658http://www.ncbi.nlm.nih.gov/pubmed/23324658http://www.ncbi.nlm.nih.gov/pubmed/23324658http://www.ncbi.nlm.nih.gov/pubmed/23324658http://www.ncbi.nlm.nih.gov/pubmed/23324658http://www.ncbi.nlm.nih.gov/pubmed/23324658http://www.ncbi.nlm.nih.gov/pubmed/23324658http://www.ncbi.nlm.nih.gov/pubmed/23324658http://www.ncbi.nlm.nih.gov/pubmed/23324658http://www.ncbi.nlm.nih.gov/pubmed/23324658http://www.ncbi.nlm.nih.gov/pubmed/23324658http://www.ncbi.nlm.nih.gov/pubmed/23324658http://www.ncbi.nlm.nih.gov/pubmed/23324658http://www.ncbi.nlm.nih.gov/pubmed/23324658http://www.ncbi.nlm.nih.gov/pubmed/23324658http://www.ncbi.nlm.nih.gov/pubmed/23324658http://www.who.int/bulletin/volumes/91/4/13-119990.pdfhttp://www.who.int/bulletin/volumes/91/4/13-119990.pdfhttp://www.who.int/bulletin/volumes/91/4/13-119990.pdfhttp://www.who.int/bulletin/volumes/91/4/13-119990.pdfhttp://www.who.int/bulletin/volumes/91/4/13-119990.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/24100712http://www.ncbi.nlm.nih.gov/pubmed/24100712http://www.ncbi.nlm.nih.gov/pubmed/24100712http://www.ncbi.nlm.nih.gov/pubmed/24100712http://www.ncbi.nlm.nih.gov/pubmed/24100712http://www.ncbi.nlm.nih.gov/pubmed/24100712http://www.ncbi.nlm.nih.gov/pubmed/24100712http://www.plosone.org/article/info:doi/10.1371/journal.pone.0046548http://www.plosone.org/article/info:doi/10.1371/journal.pone.0046548http://www.plosone.org/article/info:doi/10.1371/journal.pone.0046548http://www.plosone.org/article/info:doi/10.1371/journal.pone.0046548http://www.plosone.org/article/info:doi/10.1371/journal.pone.0046548http://www.plosone.org/article/info:doi/10.1371/journal.pone.0046548http://www.plosone.org/article/info:doi/10.1371/journal.pone.0046548http://www.plosone.org/article/info:doi/10.1371/journal.pone.0046548http://www.plosone.org/article/info:doi/10.1371/journal.pone.0046548http://www.path.org/publications/files/TS_swp_malawi_qual_res_pos.pdfhttp://www.path.org/publications/files/TS_swp_malawi_qual_res_pos.pdfhttp://www.path.org/publications/files/TS_swp_malawi_qual_res_pos.pdfhttp://www.path.org/publications/files/TS_swp_malawi_qual_res_pos.pdfhttp://www.path.org/publications/files/TS_swp_malawi_qual_res_pos.pdfhttp://www.ajtmh.org/content/83/6/1315.full.pdfhttp://www.ajtmh.org/content/83/6/1315.full.pdfhttp://www.ajtmh.org/content/83/6/1315.full.pdfhttp://www.ajtmh.org/content/83/6/1315.full.pdfhttp://www.ajtmh.org/content/83/6/1315.full.pdfhttp://www.ajtmh.org/content/83/6/1315.full.pdfhttp://www.ajtmh.org/content/83/6/1315.full.pdfhttp://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9129513http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9129513http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9129513http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9129513http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9129513http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9129513http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9129513http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9129513http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9129513http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9129513http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9129513http://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2011.02927.x/pdfhttp://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2011.02927.x/pdfhttp://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2011.02927.x/pdfhttp://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2011.02927.x/pdfhttp://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2011.02927.x/pdfhttp://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2011.02927.x/pdfhttp://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2011.02927.x/pdfhttp://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2011.02927.x/pdfhttp://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2011.02927.x/pdfhttp://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2011.02927.x/pdfhttp://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2011.02927.x/pdfhttp://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2011.02927.x/pdfhttp://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2011.02927.x/pdf


39/75

Schools Health interven


4.2 Summary
http://www.who.int/household_water/resources/Report_DiscussionsonHWTSIntegration_Health_Final.pdfhttp://whqlibdoc.who.int/publications/2010/9789241548014_eng.pdfhttp://www.sodis.ch/safewaterschool/index_ENhttp://www.unicef.org/wash/schools/http://www.unicef.org/wash/schools/


40/75

Much interest in targetapplications Better chance of health gain

Those at high risk

Trusted communication cha

Efficiency in message and s

Interest but limited evid

for work in schools Evidence about synerg

antenatal care and HIV

4.2 Summary


41/75

Household Water Treatment in Emergenci


Daniele Lantagne, PhD, PE

Tufts University

Emergencies


42/75

Natural disasters Earthquakes, eruptions, landslides, tsunamis, floods, drought

Epidemics possible after flooding, mass displacement Increasing - population, unplanned settlements, climate change

Outbreaks Diarrheal disease: cholera

Increasing, particularly in Africa

Complex emergencies / fragile states UN defined, donor defined

Unlinked to particular health needs

g

Alarmism


43/75

Unless the necessary funds are urgently mobilized and coordina

field we could see as many fatalities from diseases as we have s

actual disaster itselfNabarro, WHO Cris

Another common myth about disasters is that the affected local

helplessly waiting for the western world to save it.

de Ville de

Populations and health needs


44/75

Refugees Formally protected by international law

Literature establishing mechanisms to reduce CMR Food, water, vaccination, care, health information

IDPs Not formally protected by international law

High mortality due to increased background diseases

Entrapped Very little known

HWTS Options


45/75

Ceramic Filtration

SWS

SODIS Biosand Filtration

PuR

Review of HWTS in Emergencies


46/75

Review of literature and survey of implementers Data gap

30 total papers (peer-reviewed and gray literature)

Lessons HWTS can be effective in some circumstances

Current HWTS projects target high-risk emergencies

Product, not users, dominate option selection

Training is crucial to uptake Logistics are important

Product stocks, registration, materials to use

Chlorine dosage needs to be considered

More research necessary

Emergencies


47/75

http://www.ifrc.org/Global/Publications/disaste

Acute Emergency Research Project
http://www.ifrc.org/Global/Publications/disasters/142100-hwt-en.pdfhttp://www.ifrc.org/Global/Publications/disasters/142100-hwt-en.pdfhttp://www.ifrc.org/Global/Publications/disasters/142100-hwt-en.pdfhttp://www.ifrc.org/Global/Publications/disasters/142100-hwt-en.pdf


48/75

Supported by UNICEF and Oxfam to answer:

1.What role, if any, should HWTS play in emergency response?

2.What are the factors associated with feasible, and potentially s

implementation of PoUWT in response to emergencies?

Responses Evaluated


49/75

Jajarkot, Nepal Cholera, August 2009

Pariaman, Indonesia Earthquake, October 2009

Turkana, Kenya Flooding/Cholera, January 2010

Haiti Earthquake, February-March 2010

Summary Data Table


50/75


51/75

Thought Questions


52/75

What research is ethical to conduct in emergencies?

What projects would you donate to in an emergency?

What is success in the emergency context (metrics)?

How should money be tracked in an emergency?

How do you balance the ethic of humanitarianism with scaling-up?

How do we better apply lessons learned in the development context into emerg

How do we link emergencies and development?


53/75

The notion thathumanitarianan

goodare somehinevitably the sam

hard one to shak(Slim, 1997)

I am happy to take ques

daniele.lantagne@tufts


54/75

Roles of government bodies



Introduction


55/75

Profit maximizing busin

Social businesses

Not-for-profit organizat

Role of government?

International Network targets


56/75

By 2015, 30 countries westablished national poli

regulations regarding hotreatment and safe stora

use water treatment; On track (2012), 8 countries ha

policies

By 2020, 50 countries hacountry-wide scale up of

HWTS.

Which government?


57/75

Multiple sectors Health, Water, Environment

Ministry of Rural Developme Ministry of Education

Bureaus of Standards

Multiple levels National

Regional

District

Local

Municipal

Source: WHO/HSE/WSH/12.07 Status of National

Household Water Treatment and Safe Storage Policies in

Selected Countries

Human right to (safe) water


58/75

Respect

Protect

Fulfill

Facilitate

Promote

Provide

Facilitate


59/75

Access to information Make itself aware of researc

links with health Assess existing water situati

could benefit from HWTS

National health and water co

Facilitate


60/75

Assist, coordinate, moevaluate the efforts of

stakeholders Survey of HWTS activities a

Support local universities an

institutions

Host sector forums

Monitoring and evalua

Credit: Ryan Rowe

Promote


61/75

Allocate funding, includ

branded communicatio

Develop plans for pilot

and scaling up HWTS A range of options should be

Develop policies on hoshould relate to other h

development priorities

Provide


62/75

Possible role of subsid Subsidize products (for poor

Subsidize promotion and dis Relax import duties

Build capacity to suppo

implementation at diffe

A Framework for National Action Planning


63/75

Background and Rationale Assessment and diagnosis

Literature review

Purpose, Guiding Principles Health focus: reduce disease

Target vulnerable groups (greatest gains)

Confirm complementarity with water supply

Goal By XXXX, YY% of the popul

yet have access to safe pipewill be consistently practicing

methods in a manner that re

they use in compliance with

Strategies and Action

Responsibilities

Tanzania: Getting started


64/75

High mortality from dia High use of unsafe drin

HWTS aligned with go

policies, but no coordin

Feb 2009: Internationa

Led by representatives from Supported by International N

WHO, UNICEF, PSI

Preparatory work

Tanzania

83.7

0.1

1.0

10.0

100.0

1000.0

Diarrhealdeathsper

100,0

00p

opulation

YearTotal

improved

Piped onto

premises

Other

improved

Other

unimproved

Surface

water

1990 46% 0% 46% 30% 24%

1995 46% 1% 45% 30% 24%

2000 45% 2% 43% 32% 23%

2005 45% 3% 42% 32% 23%

2010 44% 4% 40% 33% 23%

2012 44% 4% 40% 33% 23%

Estimated coverage 2014 update

Tanzania: Stakeholder workshop


65/75

Bagomoyo, Tanzania, February 2009

108 Participants

Credit: Government of Tanzania, Ministry of Health and Social Welfare

Objectives To learn from internat

Strengthen national iexpanding HWTS

Develop and strength

international partners

Share experience an

different programmes

and outside the coun

Tanzania: Recommendations


66/75

15 Action Points 5 Recommendations

Ministry of Health and Sociadevelop a National Action Pl

MOHSW should strengthen

partnerships

Governments, partners and

should allocate funds

Government should strengththrough M&E, develop stand

Government should develop

coordination and networking

Other regional worksho

Tanzania: Strategy and Plan


67/75

Item Details

Nationalvision and

goal/target

To have communities accessing safe drinking-water at the houTo increase by 20% the usage of acceptable HWTS by 2016.

HWTS in

National

Policies

-National Health Policy

-Health Sector Strategic Plan III

-Environmental health, hygiene and sanitation strategy

Actions to

achieve

goal

-Establish support system for HWTS

-Strengthen coordination

-Increase access to HWTS

-Create awareness

-Mobilize resources

-Monitor and evaluati

Comprehensive country plan for scaling-up HWTS 2011-20

Implementing national strategy, action plan


68/75

Secure political suppo Coordinate and lead

Adequate financing

Implementation of mea Build awareness, capacity

Monitoring and evalua Non-discrimination

Participation and transparen

http://www.who.int/household_water/resources
http://www.who.int/household_water/resources/en/http://www.who.int/household_water/resources/en/http://www.who.int/household_water/resources/en/http://www.who.int/household_water/resources/en/


69/75

Source: WHO/HSE/WSH/12.07 Status of National

Household Water Treatment and Safe Storage Policies in

Selected Countries

Summary


70/75

Respect, Protect, Fulf

Facilitate

Collect and manage informa

Coordinate stakeholders

Promote

Establish policies and strate

Endorse HWTS Cnduct public health campa

Provide

Especially for vulnerable gro


71/75

Key Messages, Week 4



Implementation models


72/75

Demand

Financing

SuN/A Profit-maximizing

business

Social businessNot-for-profit

organization

Targeted approaches


73/75

Credit: Fundacin SODIS

Credit: PATH

HWTS in Emergencies


74/75

Roles of government bodies


75/75

Credit: Ryan Rowe

Credit: Government of Tanzania, MinistrySocial Welfare

week 4 implementation strategies for hwts

Documents