How to sustain long term use
Past experience has shown that high rates of safe water system use are achievable in the short term or during disease outbreaks. However, we do not know yet how well these rates will be maintained over the long term. CDC is studying the impact of community mobilization and social marketing on adoption of safe water systems, and will monitor continued use.
How to ensure economic sustainability
Maintaining long-term use of safe water systems requires sufficient resources to continue project activities such as social marketing, promotion, and product distribution. Full cost recovery is desirable, and attainable in some project countries (Nigeria, Kenya), but in other countries if the prices of products are too high, target populations may not have access to them. If full cost recovery is not possible, donor support will be necessary for continuation of these projects. CDC is currently monitoring the economic progress of ongoing projects.
Optimal mix of chlorination systems with other technologies (e.g., settling, filtering, flocculating)
While chlorination is effective in improving the quality of water from a variety of sources, there are times when additional strategies are needed to augment the effectiveness of point-of-use treatment and safe storage. For example, some communities have very turbid water that must be filtered or allowed to settle before chlorination. CDC, in collaboration with public and private sector partners, is evaluating other promising point-of-use technologies that could be used in combination with chlorination.
Optimal behavior change methods
One of the greatest challenges for safe water projects is encouraging people to modify their behavior to use the safe water systems on a regular basis. CDC, CARE, and PSI are continually evaluating promising behavior change methodologies such as community mobilization, one-on-one communication, and working with health clinics, religious leaders, and community organizations to encourage correct and consistent use.
Effectiveness in making stored water safe for infant formula
HIV-infected mothers in the developing world are increasingly choosing to feed their infants with formula instead of breast milk to reduce the risk of HIV transmission from mother to infant through breast milk. However, many water sources in developing countries are contaminated with fecal waste. As a result, formula made with unsafe water may cause serious diarrheal illness in children receiving it. In Abidjan, Côte d'Ivoire, CDC completed a study investigating the quality of stored water used for infant feeding and formula.