Household water management at Global WASH Forum
Participants at the 29 November - 3 December 2004 WASH Forum recognized the importance of managing water in the home.
Session notes from WHO side event (1 December 2001)
- Household water treatment and safe storage (HWTS) represents a cost-effective solution not only for those lacking "improved" access, but also for those who have access to water, but whose supplies are unsafe
- HWTS Network serves as a forum, information clearing house and vehicle to promote research and collective, bilateral and individual action on the part of all stakeholders; WHO provides secretariat
- 60+ members working under five-year strategic plan and annual action plans around advocacy, communication, research and implementation of HWTS
Refining the dominant paradigm
- Esrey’s conclusions that interventions to improve water quality at the point of distribution (POD) can reduce diarrhoeal disease by only 15%-17% became the dominant paradigm
- 30 recent field trials of HWTS interventions at the household level suggest that POU water treatment can reduce diarrhoeal diseases by approximately 40%, or more than twice that of improving water quality at the source. This is supported by recent systematic reviews, suggesting the need to refine the dominant paradigm
- HWTS Network is continuing research to explain heterogeneity in field trials, assess cost-effectiveness and examine longer term uptake of HWTS interventions
Panel Discussion: Case studies of certain technologies
- Solar disinfection represents an effective and low-cost alternative for HWTS which EWAG/Sandec and local partners have introduced to more than 1 million in diverse settings.
- PUR sachets, which combine flocculation and disinfection, have been extensively tested for microbiological efficacy and health impact, and may be particularly suitable for highly turbid water and emergencies
- Higher quality porous ceramic filters have been shown to be effective in lab and field studies, seem to require less programmatic involvement and can be manufactured locally
- Household chlorination (CDC Safe Water System) has expanded to 5 million homes in 17 countries; this and other HWTS interventions follow a combination of public, commercial and social marketing strategies
- Successful scaling up requires leveraging existing commercial structures, donor funding for campaigns (but not product subsidies), MoH support, community-based approaches, collaboration by all partners
- USAID has accepted the refinement of the dominant paradigm and the need to support HWTS technologies that are shown to be effective, sustainable, scalable and affordable
- Need to translate technologies into programs and support with implementation documentation
- Bilaterals can support dissemination of information, launches, monitoring/evaluation, etc.
Issues raised by participants
- Should HWTS be targeted toward the most vulnerable populations based on risk (e.g., households with children <5 years, HIV+/AIDS and other immuno-compromised)?
- To what extent are HWTS technologies effective against arsenic, fluoride, and other non-microbial pathogens)?
- What about waterborne diseases other than diarrhoea (typhoid, hepatitis E, etc.)?
- What about any adverse effects (e.g., chlorine, technology failures, etc.)?
- Potential implementers need a simple field manual to explain case for HWTS and provide information on the various options (advantages/disadvantages, costs, settings, etc).
- Need for better (and cheaper) tools for field monitoring of water quality and confirming effectiveness of household-based interventions in practice.
- Potential implementers need more information on actual programmatic experience, uptake, scaling up and sustainability of HWTS options