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Safe Water System (SWS) - Where Has the SWS Been Used?
- Zambia
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| Safe Water Home
> Where?
> Zambia
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Project Partners
 Population
Services International, PSI
USAID/Zambia
Ministry of Health, Central Board of Health, District
Health Management Team
CARE
Rotary Club of Estes Park, Colorado
CDC
Target Population and
Location
.
In initial field trial, parents with children under
five years, primarily in low income urban areas.
Project grew to national scale after severe cholera
epidemic during field trial, and has continued to
grow since that time.
Project Implementation
Date
October 1998
Project Design
This project started as a field trial in Kitwe,
Zambia, and then grew into a pilot social marketing
project in 3 compounds in Lusaka, 3 compounds in
Kitwe, and Ndola. Following the successful social
marketing project, the social marketing campaign
expanded to all provinces of Zambia according to
the time frames detailed in the map below.
.
 Intervention
Elements
Sodium hypochlorite disinfectant
produced locally by PSI. The brand name is Clorin.
Locally available plastic 2.5-liter, 5-liter,
and 20-liter jerry cans for water storage, and
the CDC safe water storage vessel.
Social marketing of Clorin at a subsidized price.
Results of Project Evaluation
Health Impact: A water quality
intervention that consists of water treatment,
safe storage, and community education was field
tested in Kitwe, Zambia. A total of 166 intervention
households were randomly selected from one community
and 94 control households from another.
Baseline surveys were conducted and the intervention
distributed. Weekly active diarrhea surveillance,
biweekly water testing, and a follow-up survey
were conducted. Compliance was high in intervention
households: 97% reported using disinfectant and
72 to 95% had measurable chlorine in their water
in biweekly testing. The percentage of intervention
households storing water safely increased from
41.5% to 89.2%. Stored water in intervention households
was significantly 
less contaminated with Escherichia coli than water
in control households (p < 0.001). Diarrheal
disease risk for individuals in intervention households
was 48% lower than for controls (95% confidence
interval=0.3, 0.9).
This intervention is a useful tool for preventing
waterborne diseases in families in developing
countries who lack access to potable water. This
research
PDF 415KB was published in the American
Journal of Tropical Medicine and Hygiene. This
paper won the Charles C. Shepard Science Award
in the Disease Prevention and Control category.
Behavior Change Methods: An SWS program was
initiated in Zambia with one group receiving
the standard practice of health education (comparison
group) and one group receiving Motivational
Interviewing (MI) (experimental group). MI is
a person-centered, stage-based approach to encourage
change in personal habits by resolving ambivalence
and eliciting a person's own arguments for change.
In the first field trial, the majority of users
used the system correctly, but no statistical
difference in usage rate was seen between the
education-only and MI groups. A second field
trial improved the MI training and resulted
in significantly higher purchase rates, with
an average of 0.71 more bottles per month in
MI households than education-only households
(Thevos,
et al, 2000
PDF 200KB). A third field trial again
improved the MI training, and compared MI with
social marketing. 
Indicators of safe water practices (including
residual chlorine levels in water stored in
households) and knowledge improved dramatically
in the MI group than the social marketing group
alone (Thevos,
et al, 2000
PDF 415KB).
Follow-up research 16 months after the third
field trial showed that the MI group still had
double the rate of correct use of the SWS as
measured by chlorine residual as the social
marketing group alone (Thevos,
et al, 2002
PDF 61KB).Thus, MI is a promising method
for motivating the adoption and sustained use
of safe water behaviors.
Sales have been strong and steadily
increasing in Zambia since the beginning of the
project, as shown by the chart below. Each year
since 2001, PSI has sold over 1 million bottles
of Clorin in Zambia, a nation of approximately
10 million people.
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Date:
July 24, 2006
Content source: National Center for Infectious Diseases
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