Community Engagement & Social Entrapreneurship for Distribution of Household Water Treatment & Storage Products

Transcription

1 Community Engagement & Social Entrapreneurship for Distribution of Household Water Treatment & Storage Products Cliff Ochieng Deputy Director Safe Water and AIDS Project Kisumu, Kenya

2 Project Location: Western Kenya

3 Burden of Disease in Children Under-5 in Nyanza Province, Western Kenya High mortality rate 257 per 1000 live births High diarrhea burden 17% have diarrhea in the preceding two weeks High anemia prevalence 60-70%

4 Decreasing the burden of disease in under-5 children Challenges in Nyanza Province Poverty Poor water and sanitation infrastructure Poor food security Interventions to protect health Prevent diarrhea: WaterGuard Chlorine solution produced and marketed Prevent anemia: micronutrient Sprinkles Iron and 13 other micronutrients Innovative distribution approaches needed

5 Safe Water and AIDS Project Program goals Prevention of water-related diseases and other leading causes of childhood illness and death, such as malaria, malnutrition and respiratory infections. Improvement of the health of people in HIV support groups, as well as that of the general public, by promoting the use and selling safe water and health products Supporting the generation of income for HIV support groups and other community self help groupsprogram start date: November 2002 Started as an NGO: January

6 SWAP Implementation Model Community-Based Entrepreneurship Social Marketing Community mobilization for behavior change

7 SWAP network SWAP- Organized network of communitybased self-help groups (~800 active groups and over 4867 individual vendors) Vendors trained in Safe Water System, other household health products and business practices Purchase products at wholesale prices from SWAP offices and resell at market price in their villages Vendors keep money earned or return earnings to group

8 Approach to Provision Safe Water Safe water storage Household Water Treatment through disinfection with dilute sodium hypochlorite Behavior change community mobilization & social marketing

9 SWAP Activities Identify Community self help groups Demonstrate household water treatment & storage products Conduct trainings Safe Water Business skills Leaders orientation Workshops Behavior change Sell HWT& S products to groups at wholesale Groups sell products at retail and keep the profit Offer linkage to micro-finance services Respond to Cholera Outbreaks

10 SWAP Marketing Approach Grounded in a social-ecologic framework Mobilizes community through Local community structures & leaders (opinion/religious, schools, group) Community launches Vendor & consumer incentives and product promotions at community level Informal peer to peer promotion Linkage with Microenterprise to strengthen capital base

11 SWAP Products Waterguard Dilute bleach PUR Coagulation / n High Protein Flour Aquatab Disinfection Tablet Moringa Handwashing & antiseptic Soap Safe Water Storage Vessels Mordified Claypots Ceramic Filters Sanitary Pads Diapers Supanet Mosquito nets Mosbar Mosquito repellent Condoms Family Planning Pills Skin Infection Treatment Economical Stoves Solar Lamps

12 Community Training Health objectives of products Demonstration of products Other household Interventions Business skills and Marketing Micro-finance Follow-up in small groups: Business counseling Take orders/deliver supplies Follow up on savings and loan repayments

13 Approaches to Product Distribution Door to door At Chief/ Community meetings Community launches & exhibitions During Home-based Care

14 Product Sales Water Treatment Products sold in ,345 bottles of waterguard 104,901 Pur satchets 41,187 Aquatab strips Water Storage Products 205 Modified clay pots 1233 water storage buckets 263 handwashing basins

15 Program Evaluation

16 Objective To evaluate the ability of SWAP-trained entrepreneurs to increase access to evidence-based health care products. WaterGuard Sprinkles

17 Study Design Random selection of 60 villages Year 1: Intervention: social marketing + SWAP (30 villages) Comparison: social marketing (30 villages) Year 2: Intervention: social marketing + SWAP (60 villages)

18 Methods Households with children 6-36 months Baseline cross-sectional survey Follow-up evaluations Year 1 Year 2 (some newly selected households) Data collected on Personal Digital Assistants (PDAs) Analyzed in SAS

19 Timeline Baseline March 2007

20 Timeline Baseline Implementation in Intervention Villages March 2007 May 2007 Feb 2008

21 Timeline Baseline Implementation in Intervention Villages Follow up (FU 2008) March 2007 March 2008

22 Timeline Baseline Follow up (FU 2008) Implementation in Comparison Villages March 2007 May 2008 Feb 2009

23 Baseline Timeline Follow up (FU 2008) Implementation in Comparison Villages Final Survey (FU 2009) March 2007 March 2008 March 2009

24 Results

25 Enrollment 1696 HH Eligible 142 LTF (ineligible, unavailable, refused) 1248 HH Selected 1106 HH Enrolled Baseline 574 HH Baseline 532 HH Intervention FU HH FU HH Comparison FU HH FU HH

26 Baseline Household Demographics 96% female respondents Median age: 26 years (range years) 45% of mothers completed primary school 86% of households are in the poorest socioeconomic quintile for Kenya

27 Households Visited by SWAP p <0.01

28 Households Purchasing WaterGuard from SWAP p <0.01

29 Households Purchasing Sprinkles from SWAP p <0.01

30 Households Reporting Current Use of WaterGuard p <0.01

31 Limitations Not generalizable Recall bias Courtesy bias Hawthorne effect

32 Conclusions SWAP entrepreneurs effective in reaching rural population SWAP entrepreneurs effective in selling WaterGuard and Sprinkles Household use of WaterGuard improved over time SWAP improved access to health products

33 Benefits to SWAP Groups & Vendors Improved access to household water treatment & storage products among other health products Improved income of SWAP groups/vendors Increased access to training opportunities Improved health of SWAP group members and their families Increased access to microfinance services Recognition from their community as leaders

34 Benefits to Communities Improved access to preventive health products in resource-poor settings Improved community awareness on health Reduced reports of cholera outbreaks Improved health status

35 Thank You!