Low-cost, high efficacy water treatment innovations such as filters and chemical disinfectants have been promoted in developing country contexts for at least a decade, with proponents ranging from small community-based organizations to some of the world’s largest consumer product manufacturers. Published health trials have provided compelling evidence that these innovations can reduce disease when they are adopted by the populations for whom they were designed.
Unfortunately, the targeted populations – low-income strata who are the least likely to be served by municipal water utilities and the most vulnerable to waterborne illness – often prove to be very difficult customers. Getting these populations to consistently use home filters and disinfectants – let alone purchase them with their own money – has proven to be a mighty challenge.
Aquaya recognized early on that the health benefits identified in early health trials of ceramic filters and chlorine disinfectants could only be realized on a grand scale when the proponents of these new technologies had a full understanding of consumer preferences and behavior vis-à-vis household water treatment products. Together with colleagues at UC Berkeley, we initiated a research program in western Kenya to better understand what influences end-user adoption of these technologies. The results of our first study was recognized as one of the top papers of 2010 by Environmental Science and Technology, and in May 2012 the journal published some results from a follow-on study we conducted with colleagues from the renowned International Centre for Diarrheal Disease Research – Bangladesh (ICCDR, B). “Learning to Dislike Safe Water Products: Results from a Randomized Controlled Trial of the Effects of Direct and Peer Experience on Willingness to Pay” (Vol. 46, pp.6244-6251) provides a sobering picture of the challenge of achieving widespread uptake of home water treatment products.
In a study of 800 households in the large informal settlement of Mirpur in Dhaka, Bangladesh, we examined how direct and peer experience with multiple household water treatment products influenced consumer demand. Contrary to expectation, we observed that neither direct experience with these products and the experience of neighbors elevated willingness-to-pay. Instead, those households which received two-month free trials of three different products were less willing to pay for these products than control households which received no such trials.
While we caution that these results are not necessarily generalizable to other geographic settings, urban informal settlements in South Asia do live with a large fraction of the global burden of diarrhea. That experience with home water treatment products appeared to make consumers less likely to purchase these products forces a serious re-thinking of how to bring safe water to these populations, including a consideration of other delivery options (whether via expansion of municipal water services or neighborhood-level water treatment and vending operations.