Project Partners

CDC

CARE

Population Services International (PSI)

National CDC Foundation

Ministry of Health

• Ministry of Environment and Natural Resources
• 
  Jet Chemicals, Ltd.
• 
  Society for Women with AIDS in Kenya (SWAK)

Target Populations and Location

• The project began in 2000 in rural communities in Western Nyanza Province that comprise the Water and Sanitation for Health (WASEH) Project of CARE, and expanded to a multi-region project with a PSI-distributed water disinfection product and additional NGO partners in 2003.
  

Project Implementation Date

Stage 1: October 2000

Stage 2: May 2003

Project Design

• The first stage of the Kenya Safe Water System project was a regional implementation project funded by the CARE/CDC Health Initiative that was incorporated into CARE’s existing Dak Achana (Household Livelihood Security) Project. This project was named the Nyanza Healthy Water Project. Community mobilization techniques were utilized by CARE to promote the Safe Water System in areas of three districts in Nyanza Province in Western Kenya.
• 
  The Kenya SWS project has now moved into a second stage. PSI began distributing the water disinfection product at a larger scale in June 2003 using social marketing techniques, and CARE began training other NGOs, such as the Society for Women with Aids in Kenya, on how to implement the Safe Water System in communities. In addition, CARE is continuing to support the communities in the initial regional implementation program. CARE and PSI are working together to merge these two arms of the project.

Intervention Elements

• Sodium hypochlorite disinfectant prepared specifically for the CARE project by Jet Chemicals, Ltd, Kenya, distributed with the brand name Klorin. Jet Chemicals, Ltd also produces the nationally distributed product, marketed by PSI under the brand name WaterGuard. Currently, CARE is phasing out Klorin and adopting WaterGuard.
• 
  Marketing of both modified clay pots with a small opening and a spigot produced by a local women's pottery collective.
• 
  Trial of CDC safe storage plastic containers.
• 
  Hygiene education for behavior change.
• 
  Community mobilization, including community meetings and organizing, orientation of community leaders, and training of volunteer health promoters.
• 
  Social marketing for mass adoption.

Results of Project Evaluations

Due to a strong preference for clay storage containers in the intervention population, a study comparing chlorine residual levels after 24 hours in clay pots, modified clay pots, and plastic jerry cans was completed. Results showed that adequate levels of free chlorine could be achieved in clay pots as well as plastic jerry cans. This research PDF 212KB was published in the American Journal of Public Heath.

Six months after introducing the Safe Water System, product adoption was monitored in a random sample of 20% of households in 12 project villages. Water stored in 58 (33.5%) of 173 households had detectable free chlorine levels, indicating use of Klorin, and 32 (18.5%) of 173 households were using modified clay pots. This research PDF 162KB was published in the American Journal of Public Health.

CARE Kenya and the Centers for Disease Control and Prevention evaluated the impact of this intervention on water quality and diarrhea in March through May 2001. We conducted active diarrhea surveillance in children < 5 years old through weekly home visits in all study communities for 8 weeks and compared disease rates in children in intervention and control communities. Preliminary results show there was a 67% lower risk of diarrhea in intervention communities than in comparison communities. Households using Klorin had a 51% lower diarrhea risk than households not using Klorin, and households with latrines had a 25% lower diarrhea risk than households without latrines. The use of the SWS was shown to be effective at reducing the risk of diarrhea in children < 5 years old. This effect was greater in magnitude than the reduction of risk found with use of latrines or collection of rainwater as a drinking water source. The combined effect of multiple interventions appeared to be greater than any intervention alone, suggesting a synergistic effect. We are currently continuing to analyze the data, and are planning on publishing the results. Please contact rxq1@cdc.gov if you have questions about this study.

Three years after program implementation, a MPH student at the Rollins School of Public Health at Emory University completed a second assessment of Klorin usage rates in communities in the CARE Nyanza Healthy Water Project. In one original Nyanza Healthy Water Project village that was not in the health impact study, 9% of homes had residual chlorine in their drinking water on an unannounced visit. In a village that was in the control group of the health impact study, and received the intervention after the study was completed, 9% of homes had residual chlorine in their drinking water on an unannounced visit. In addition, 20% of homes involved in the Society for Women with AIDS in Kenya (a NGO trained by CARE) SWS program had residual chlorine in their drinking water on an unannounced visit. Results from this study have not yet been published, and for more information, please contact safewater@cdc.gov.

In the first three months of the expanded project (May 2003 to August 2003), PSI sold 60,000 bottles of WaterGuard. PSI is currently working on expanding the distribution network for WaterGuard into other areas of Kenya.

1600 Clifton Road, MS-A38
Atlanta, GA 30333
Phone: +1(404) 639-0231
Email: safewater@cdc.gov