Community involvement key to successful water quality interventions

Recent evidence shows that as high as 95% of diarrheal deaths among children under the age of 5 can be prevented by water, sanitation and hygiene (WASH) related interventions that include handwashing, proper excreta disposal and most importantly improved water quality. Evidence from developing countries shows that interventions promoting the filtering of water and safe storage are most effective at the household level but face the limitation of lack of sustained use in the long run.

The paper titled 'Perception of drinking water safety and factors influencing acceptance and sustainability of a water quality intervention in rural southern India' published in the journal BMC Public Health, informs that Vellore in Tamil Nadu is a region with highly contaminated water supply. It has been found that the use of low-cost water quality interventions such as solar disinfection, closed valved containers and domestic chlorination have been most effective at disinfecting or preserving the quality of water. However, barriers to acceptance and sustained use prevent communities from benefiting from these interventions, placing children at a higher risk of water related diseases.

Acceptance of water quality interventions in Vellore, Tamil Nadu: The study

The paper describes the findings of a study that aimed at understanding the barriers encountered in the acceptance of water quality interventions in the rural areas of Vellore. The study explored:

• Parental perceptions on the health effects of unsafe drinking water and household drinking water treatment practices
• Factors that influenced acceptance and sustainability of ongoing water quality interventions

Three villages (two intervention villages and one control village) were chosen for the study and all households having a child less than two years of age were included to participate. Data was collected through focus group discussions and key informant interviews.

Findings of the study:

• Parents of young children linked unsafe water not only with diarrheal disease but also with other unrelated diseases such as cough, cold and fever.
• Boiling water which is an expensive method, and using cloth for filtering which is an ineffective method were the most common household water treatment methods practised. Boiling was used only in case of illness for adults and for young children. Some families also practised warming of water before giving it to young children.
• Parents placed emphasis on clean appearance and good taste of the water, which conferred a false sense of protection. A few parents reported that the water lacked taste (saltiness) while others described the water as bitter.
• Distance of households from the water distribution centres was an important factor affecting compliance to the intervention.
• Lack of support from the male members to fetch water was found to negatively influence household compliance even though women of the house recognised the benefit of filtered water for their children.
• Willingness to pay for future maintenance of the membrane filter was an important decision that mothers would not make without consulting their husbands.

Faulty perceptions of water treatment and a false sense of protection from locally available water sources increased the risk of children to diarrhoeal diseases. Taste and odour were key factors influencing the acceptance of drinking water. Lack of consistency of beliefs related to illness causation negatively influenced acceptance of interventions, calling for the need for educational and behavioral change in these communities.

The paper ends by arguing that there is a need to effectively involve communities at important stages of implementation for the long term success of water quality interventions. Timely research on the factors influencing response to water quality interventions before implementation can ensure their greater acceptance and sustainability in low income settings.

A copy of the paper can be downloaded below.