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Cited by 61Child Nutrition and Water AccessWater Treatment and DisinfectionHealth Policy Implementation Science

Understanding why women adopt and sustain home water treatment: insights from the Malawi antenatal care program.

Wood, Siri, Foster, Jennifer, Kols, Adrienne·2012·Social Science & Medicine
DOI 10.1016/j.socscimed.2011.09.018
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Abstract

In many settings in Africa, social marketing has proven more successful in generating brand recognition for chlorine water treatment products than in promoting their use. To promote household use of one such product in Malawi, WaterGuard, the Ministry of Health (MOH) and Population Services International (PSI) distributed free hygiene kits that included WaterGuard to pregnant women attending antenatal clinics in 2007. Follow-up surveys documented a sustained increase in WaterGuard use three years after the initial intervention. In 2010, PATH (www.path.org) conducted qualitative research on the factors motivating women to adopt, sustain, or discontinue use. To provide context, interviews were also conducted with their friends, relatives, and husbands. Interviews revealed that sustained use of WaterGuard does not necessarily imply consistent use. Most respondents reported switching back and forth between WaterGuard and stock chlorine distributed for free by the government, and many treated water seasonally rather than year-round. Qualitative findings suggest that two program strategies strongly influenced women's decisions to adopt, purchase, and continue using WaterGuard. First, positive, ongoing contacts with health care workers, especially during home visits, raised awareness of the need to treat water, encouraged trial use, and supported continuing use. Second, an extended free trial of the product overcame initial cost barriers and allowed women and their families to experience the health benefits of WaterGuard, appreciate its value and relevance to their lives, and get used to its taste. Social support-from like-minded relatives, friends, neighbors, health care workers, husbands, and children-was also a critical factor that promoted consistent, ongoing use of WaterGuard. The findings confirm the importance of interpersonal communication in prompting adoption of household water treatment and suggest that consumers assess the perceived value of a product, not simply its cost. Further research is planned to investigate questions raised about patterns of ongoing use.

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Crossref · 10.1016/j.socscimed.2011.09.018

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  • When interventions improved water availability or treatment, women reported experiencing fewer vaginal infections and seeing fewer illnesses in their families.

    “When interventions improved water availability or treatment, women reported experiencing fewer vaginal infections [63] and seeing fewer illnesses in their families [81,208].”

    From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [208]

  • Constraints on women's time limit access to safe water or resources needed to treat or boil water; women also spend considerable time caring for family members ill with water-related diseases.

    “Constraints on women's time limit access to safe water or resources needed to treat or boil water [92,118,197,199,208]. Women also spend considerable time caring for family members ill with waterrelated diseases [26,63,111,177,193,239,240,248,259].”

    From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [208]

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Authors
Wood, S., Foster, J., & Kols, A.
Affiliations
Program for Appropriate Technology in Health (US)
Corresponding author
Wood, Siri
ORCID
Venue
Social Science & Medicine
Publisher
Elsevier BV
Published
2012-08
Volume
75
Issue
4
Pages
634-642
ISSN
0277-9536 (ISSN-L)
DOI
10.1016/j.socscimed.2011.09.018
OpenAlex
W2006040396
Cited by
61
References
28
Citations by year
2026: 1 · 2025: 1 · 2024: 2 · 2023: 3 · 2022: 6 · 2021: 2 · 2020: 8 · 2019: 3 · 2018: 4 · 2017: 8 · 2016: 7 · 2015: 7 · 2014: 5 · 2013: 1 · 2012: 3
FWCI
2.66
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Social Science & Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
Funders
  • Bill and Melinda Gates Foundation
  • UNICEF
  • Centers for Disease Control and Prevention
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Water Treatment and Disinfection
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Keywords
household water treatment, prenatal care, pregnant women, technology adoption, sustained use, social marketing, social support, interpersonal communication, perceived value, Malawi
MeSH terms
Female, Health Promotion, Housing, Humans, Malawi, Male, Pregnancy, Prenatal Care, Women, Program Evaluation, Health Behavior, Water Purification, Qualitative Research

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