Increasing equity of access to point-of-use water treatment products through social marketing and entrepreneurship: a case study in western Kenya

摘要

Point-of-use water chlorination reduces diarrhoea risk by 25–85%. Social marketing has expandednaccess to inexpensive sodium hypochlorite for water treatment, at a cost of less than US$0.01 pernday, in Kenya. To increase product access, women’s groups in western Kenya were trained toneducate neighbours and sell health products to generate income. We evaluated this programme’snimpact on equity of access to water treatment products in a cross-sectional survey. We surveyedn487 randomly selected households in eight communities served by the women’s groups. Overall,n20% (range 5–39%) of households in eight communities purchased and used chlorine, as confirmednby residual chlorine observed in stored water. Multivariate models using illiteracy and the poorestnsocioeconomic status as a referent showed that persons with at least some primary education (ORn2.5, 95% CI 1.8, 3.5) or secondary education (OR 5.4, 95% CI 1.6, 17.5) and persons in the fournwealthiest quintiles (OR 2.5, 95% CI 1.0, 6.0) were more likely to chlorinate stored water. While thisnimplementation model was associated with good product penetration and use, barriers tonaccess to inexpensive water treatment remained among the very poor and less educated.