Household water treatment and safe storage: from household chores to national policy
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1) Promoting chlorine-based point-of-use water treatment in Indonesia required understanding local boiling traditions and overcoming perceptions that boiling was the only safe method. 2) Using an ecological framework, factors at multiple levels influenced adoption of the new technology, including social networks, community institutions, gender norms, and exosystem events. 3) Lessons included gaining government support, ensuring product availability, mobilizing communities, and addressing individual motivations like taste and smell through promotion and advocacy across different systems.
Household water treatment and safe storage: from household chores to national policy
- 1. lessons learned from promoting chlorine-based point-of-use water treatment technology AMAN TIRTA 2006-2010
- 2. INDONESIA Binjai, Medan Makasar, Maros, Bantaeng Serang, Tangerang, Jakarta Malang, Surabaya
- 3. Boiling the main drinking water treatment method % of households that boil their drinking water 0 50 100 Binjai Bantaeng Maros Tangerang
- 4. People boil… ? To make water safe to drink: ? to kill germs ? to get rid of limestone ? believed to have no side-effect like chemical substance ? To serve better drinks: ? warm or hot drinks ? tastes better
- 5. boiling is believed as… ? A tradition: “our parents, our ancestors boiled their drinking water, and so do we. It’s a tradition” ? Practical! ? For smart people: “people here are smart and knowledgeable, they know that water needs to be boiled”
- 6. Percentage of households with E.coli contaminated boiled, ready to drink water 0 10 20 30 40 50 60 70 Household drinking water % Tangerang Mauk Binjai Bantaeng
- 7. “there are ways that are as good as boiling to make drinking water safe” agree 40.36% disagree 41.73% neutral 18%
- 8. 1) creating a commercial, non subsidized sustainable product 2) creating demand for a new technology, through community mobilization activities, media campaign 3) enabling environment to foster sustainability through advocacy and collaboration with institutions. AMAN TIRTA
- 9. CREATING SUSTAINABLE PRODUCT muRAH -- economical Mudah -- easy to use sehAT -- healthy 1.25% sodium hypochlorite PT Tanshia Consumer Product Rp. 5,000 per 100cc bottle to treat 660 liters of water
- 10. DISTRIBUTION ? Traditional distribution scheme ? drugstore kiosk, traditional market modern trade (local minimarket) ? Non-traditional distribution scheme ? Community leaders and community health kaders
- 11. PROMOTING Air RahMat ? Above the line: TV commercial, TV and radio talk show ? Below the line: experiential marketing
- 12. Advocacy and partnership Community mobilization ? community ? school
- 13. Can the new drinking water treatment replace boiling an existing, culturally accepted behavior?
- 14. Ecological System Framework microsystem mesosystem exosystem macrosystem MOTHER neighborsleaders PKK Posyandu Arisan community Quran reading work market collectivism Gendered norms Hot drinks paternalism
- 15. Microsystem “… a pattern of activities, roles and interpersonal relations experienced by a developing person in a given setting with particular physical and material characteristics” (Bronfenbrenner, 1979 p. 22). Bi-directional relationships with: ? Husband –AR users had positive attitudes toward AR, had spoken to their husbands about AR, and have their husbands’ approval. ? Children –don’t like the smell and taste of AR treated water but aware of the benefit of using AR
- 16. Microsystem Mothers’ Social Network ? Health kaders ? retailers ? Community – religious leaders ? retailers ? Extended family ? Neighbors ? Friends areas with supportive health kaders and community-religious leaders were more likely to have AR users. However, people were suspicious that they got profit from selling AR Example from Bojong Renged Tangerang
- 17. Mesosystem is the next level that covers interrelations between two or more microsystem settings. The number and quality of settings in the developing person’s microsystem that connect to each other determines the quality of mesosystem. ? Community ? husband-neighbors (M/F)- community leaders-health kaders-friends ? PKK (women’s welfare movement) ? Arisan (women’s savings and loans club) ? Religious groups (Qur’an reading) ? Posyandu (integrated health service post for children under 5 years old) ? Puskesmas ? Work place ? Market place ? product outlets
- 18. Exosystem Garbarino and Gilliams (1980) : - an event in exosystem that affects people that are close to the individual, - when decisions by local political institutions and other organizations have effects on the individual. ? New regulation to shift fuel for household use from kerosene into LPG ? kerosene crisis - price of kerosene hiked ? Boiling is the only way to make water safe to drink – kill germs ? Safe water = no color (clear), no smell, no taste ? New water treatment method (Air RahMat) is available ? Children’s HWTS activities at school – Safe Water Day event (students test drinking water from home)
- 19. Macrosystem “consistencies, in the form and content of lower-order systems (micro-, meso-, and exo-) that exist, or could exist, at the level of the subculture or the culture as a whole, along with any belief systems or ideology underlying such consistencies” (Bronfenbrenner, 1979 p. 26). ? Tradition to drink hot drinks (coffee, tea) ? good for health – no germs, no side effects, eliminate limestone, calm bloated stomach, good for cold ? a symbol of manner when served to guests ? Gendered role –women as the homemakers and caregivers ? Collectivism and paternalism
- 20. Chronosystem ? Global HWTS issues ? “instant” lifestyle: ? Fridge ? Water dispenser 1. the patterning of environmental event and transitions over the life course 2. sociohistorical condition
- 21. Behavior Change Communication -- interlink ? Community mobilization ? microsystem and mesosystem ? Advocacy ? exosystem and chronosystem ? Media campaign ? all systems
- 23. Ecological System Framework microsystem mesosystem exosystem macrosystem MOTHER neighborsleaders PKK Posyandu Arisan community Quran reading work market collectivism Gendered norms Hot drinks paternalism chronosystem
- 24. Some insights along the way… ? Mass media creates awareness and enhance product credibility (registered to MoH and the company is accountable) but not enough to convince audience that the AR is safe ? Benefits of AR motivate people to try, but not strong enough to make them continue using ? Smell and taste make people question about safety ? Women in urban areas are more likely to try the product: ? Using the product saves time and money (had to queue to buy expensive kerosene) ? They are more exposed to new information and trends ? They are more open to try new things ? Have electricity in their houses ? More familiar with electronic home appliance (refrigerator, water dispenser)
- 25. ? Perceived safety of source water doesn’t affect the use of AR ? Convinced users help in promoting AR ? Convincing husbands as the secondary target is important since they are the consumer of the wife’s service ? According to mothers, treating water with AR is complicated, compared to boiling – measuring AR is difficult (so that Tanshia produced AR in a sachet)
- 26. RESULTS ? Household Water Treatment and Safe Storage implementation strategy, policy and regulations enacted at local and national levels – from boiling only to chlorine-based and other options of water treatment method (ceramic filter, biosand filter, SODIS, floculation) ? Roll-out in 10 districts – by the Ministry of Health ? Included into STBM (Community Based Total Sanitation) National strategy -- being promoted in 20,000 villages all over Indonesia (target in 2012)
- 27. Four factors to ensure sustainability of the new behavior ? Political will and support ? Availability of product and service ? Community support and favorable norms ? Individual and household’s skill, knowledge and motivation
- 28. LESSONS LEARNED ? Political will and support ? Engage Ministry of Health as a partner from the beginning ? Engage the Ministry of Health in Global HWTS agenda ? Become a resource and a partner with Ministry of Health and local governments in HWTS ? Produce and share data on HWTS
- 29. LESSONS LEARNED ? Availability of product and service ? Partner with and engage a local private sector manufacturer that is committed to the product ? Define a strategy that ensures appropriate distribution mix ? Conduct test markets to define optimal distribution strategy ? Need a certain level of demand for the category/product that is favorable, otherwise be prepared to invest time to create demand
- 30. LESSONS LEARNED ? Community support/ favorable norms ? Engage opinion leaders and civil society to create product support ? Partner and work with organizations to help them meet their goals through water treatment ? Engage community structures and programs ? Emphasize the importance of safe water rather than sales, to avoid misunderstandings about the program goals
- 31. LESSONS LEARNED ? Individuals and households skill, attitude and motivation ? Address taste and smell issues up front validating them in the media ? Deal with strong norms by creating spaces (TV, radio, others) for product advocates (real people/testimonials) ? Create more opportunities for product sampling and trial ? Invest in effective promotion – multiple channels