Project

For Safe Water, Deliver Chlorine at its Source

Organization : Innovations for Poverty Action

Project Overview

Project Summary

Chlorine dispensers were installed directly at community water sources, and local paid promoters also encouraged use.

Impact

The number of households using chlorine increased by 53 percentage points over the course of three to six months.

Cost

The intervention cost about $1.05 per person per year at scale.[1]

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Challenge

In sub-Saharan Africa, diarrheal disease from unsafe water is common and remains one of the primary causes of death among young children. Increasing chlorine use could reduce child mortality rates, but for many years, few people have treated their water. For example, in 2006, just 10 percent of Kenyans treated their water with chlorine, despite years of vigorous social marketing and the availability of inexpensive chlorine, which could be bought at stores for the equivalent of $0.30 for a month’s supply.

Design

Chlorine dispensers installed near water sources offer a number of benefits to community residents

In Kenya, chlorine dispensers were installed directly at community water sources and calibrated to deliver a precise dose of chlorine solution to treat the most common-sized water transport containers. Dispensers were designed to boost chlorine usage by making water treatment convenient, and by serving as a visual reminder to chlorinate water. The implementation process was also designed to encourage peer-learning and habit formation by making the decision to use chlorine public.

In combination with the physical dispensers, a local promoter was selected in each community to take care of the dispenser, teach families how to use it, and monitor its usage.

Impact

A randomized evaluation found that installing chlorine dispensers at water sources, in combination with the paid promoters, substantially increased the number of households that treated their water. Chlorine use increased by 53 percentage points relative to communities where chlorine was sold in stores. The increase was sustained 30 months into the program, even after payments to promoters ended.

What worked best?

  • Promoters who were socially well-connected were more successful in promoting the use of dispensers.[2]

Implementation Guidelines

Inspired to implement this design in your own work? Here are some things to think about before you get started:

  • Are the behavioral drivers to the problem you are trying to solve similar to the ones described in the challenge section of this project?
  • Is it feasible to adapt the design to address your problem?
  • Could there be structural barriers at play that might keep the design from having the desired effect?
  • Finally, we encourage you to make sure you monitor, test and take steps to iterate on designs often when either adapting them to a new context or scaling up to make sure they’re effective.

Additionally, consider the following insights from the design’s researcher:

  • Community engagement on a regular basis is essential: Community promoters who are regarded in the community as leaders and responsible for refills and upkeep of dispensers are essential; implementer Evidence Action also found that promoters who are using dispensers themselves increase adoption.
  • Prevent the dispensers from being in poor repair or empty: On average, households are 20% less likely to have chlorine in their drinking water in places where the chlorine dispenser has been found empty.[3]

Cost effectiveness

At scale, unit costs for the Dispensers for Safe Water program are about $1.05  per year, which is cheaper than the retail sale or home delivery of individual chlorine bottles. This cost includes:

  • Hardware
  • Chlorine refills
  • Dispenser management and maintenance
  • Community training and engagement

Would this work elsewhere?

A program involving chlorine dispensers with community promotion is being implemented by the nonprofit Evidence Action in Kenya, Uganda, and Malawi (there with public health workers), targeting 4.7 million users.

Evidence Action is using volunteers rather than paid promoters and innovative engagement strategies that have resulted in consistently high adoption rates. Adoption rates, the percentage of people who have measurable chlorine in their drinking water, are currently at a steady 55% in Malawi, Uganda and Kenya.[4] Rates have previously been as low as 30% and as high as 91%, depending on the context and implementation.

How it works at scale

Evidence Action works closely with local authorities and trained staff to install and maintain chlorine dispensers in rural districts of Kenya, Malawi, and Uganda. Weeks ahead of the actual installation in a new area, Dispensers for Safe Water staff map water points and meet with and familiarize community leaders on how and why dispensers work and seek their approval for a dispenser.

Community members elect a volunteer community promoter who is charged with maintaining and refilling the dispenser, and who reports any problems to the Evidence Action call center. The promoter also educates community members on how chlorine and the dispenser work.

In steady state, once the dispenser is installed and is regularly filled, Evidence Action provides ongoing maintenance of the dispensers through a network of circuit riders on motorbikes who visit a target number of dispensers daily in their catchment area, deliver a three-month supply of chlorine to the promoter in charge of the dispenser in a given village, and repair anything that needs to be fixed. Promoters and circuit riders use mobile phone technology for tracking this work.

Project Credits
Researchers:

Michael Kremer Contact Harvard University

Jessica Leino Stanford University

Edward Miguel University of California, Berkeley

Alix Zwane Global Innovation Fund

Sendhil Mullainathan Harvard University

Claire Null Mathematica Policy Research

[1] Evidence Action (September 2016)
[2] Ibid.
[3] As of September 13, 2016
[4] The Great Turnaround of 2015: Adoption Rates for Dispensers For Safe Water Highest Ever

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