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Understanding why women adopt and sustain home water treatment: Insights from the Malawi antenatal care program

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  • Wood, Siri
  • Foster, Jennifer
  • Kols, Adrienne

Abstract

In many settings in Africa, social marketing has proven more successful in generating brand recognition for chlorine water treatment products than in promoting their use. To promote household use of one such product in Malawi, WaterGuard, the Ministry of Health (MOH) and Population Services International (PSI) distributed free hygiene kits that included WaterGuard to pregnant women attending antenatal clinics in 2007. Follow-up surveys documented a sustained increase in WaterGuard use three years after the initial intervention. In 2010, PATH (www.path.org) conducted qualitative research on the factors motivating women to adopt, sustain, or discontinue use. To provide context, interviews were also conducted with their friends, relatives, and husbands. Interviews revealed that sustained use of WaterGuard does not necessarily imply consistent use. Most respondents reported switching back and forth between WaterGuard and stock chlorine distributed for free by the government, and many treated water seasonally rather than year-round. Qualitative findings suggest that two program strategies strongly influenced women’s decisions to adopt, purchase, and continue using WaterGuard. First, positive, ongoing contacts with health care workers, especially during home visits, raised awareness of the need to treat water, encouraged trial use, and supported continuing use. Second, an extended free trial of the product overcame initial cost barriers and allowed women and their families to experience the health benefits of WaterGuard, appreciate its value and relevance to their lives, and get used to its taste. Social support—from like-minded relatives, friends, neighbors, health care workers, husbands, and children—was also a critical factor that promoted consistent, ongoing use of WaterGuard. The findings confirm the importance of interpersonal communication in prompting adoption of household water treatment and suggest that consumers assess the perceived value of a product, not simply its cost. Further research is planned to investigate questions raised about patterns of ongoing use.

Suggested Citation

  • Wood, Siri & Foster, Jennifer & Kols, Adrienne, 2012. "Understanding why women adopt and sustain home water treatment: Insights from the Malawi antenatal care program," Social Science & Medicine, Elsevier, vol. 75(4), pages 634-642.
    • Handle: RePEc:eee:socmed:v:75:y:2012:i:4:p:634-642
    DOI: 10.1016/j.socscimed.2011.09.018
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    References listed on IDEAS

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    1. Ram, P.K. & Kelsey, E. & Rasoatiana & Miarintsoa, R.R. & Rakotomalala, O. & Dunston, C. & Quick, R.E., 2007. "Bringing safe water to remote populations: An evaluation of a portable point-of-use intervention in rural Madagascar," American Journal of Public Health, American Public Health Association, vol. 97(3), pages 398-400.
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    Cited by:

    1. Holly Ann Williams & Joanna Gaines & Molly Patrick & David Berendes & David Fitter & Thomas Handzel, 2015. "Perceptions of Health Communication, Water Treatment and Sanitation in Artibonite Department, Haiti, March-April 2012," PLOS ONE, Public Library of Science, vol. 10(11), pages 1-17, November.
    2. Schäfer, Andrea I. & Hughes, Gordon & Richards, Bryce S., 2014. "Renewable energy powered membrane technology: A leapfrog approach to rural water treatment in developing countries?," Renewable and Sustainable Energy Reviews, Elsevier, vol. 40(C), pages 542-556.
    3. Bisung, Elijah & Elliott, Susan J. & Schuster-Wallace, Corinne J. & Karanja, Diana M. & Bernard, Abudho, 2014. "Social capital, collective action and access to water in rural Kenya," Social Science & Medicine, Elsevier, vol. 119(C), pages 147-154.
    4. Aboud, Frances E. & Singla, Daisy R., 2012. "Challenges to changing health behaviours in developing countries: A critical overview," Social Science & Medicine, Elsevier, vol. 75(4), pages 589-594.
    5. Bisung, Elijah & Elliott, Susan J., 2014. "Toward a social capital based framework for understanding the water-health nexus," Social Science & Medicine, Elsevier, vol. 108(C), pages 194-200.

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