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Results and Lessons Learned from the
POUZN Project POU Program
Susan Mitchell, Project Director
Abt Associates
Program Objective
Expand the use of POU
products for diarrhea
prevention using social
marketing approaches that
build on and strengthen
existing in-country
platforms for the
distribution and sale of
other public health
products.
Programs and Time Frame
Country Type Timeframe Annual Budget
Angola Intro 1 year $50,000
Bangladesh Intro N/A N/A
Benin Intro 3 year $350,000
DRC Scale-up 1 year $300,000
Haiti Scale-up 2 year $180,000
Kenya Scale-up 2.5 year $220,000
Malawi Scale-up 4 year $225,000
Rwanda Scale–up 2.5 year $350,000
Senegal Intro 1 year $250,000
Program Strategy
Promotio
n
PlacePrice
Product
Awareness
Trial
Use
Product
PRODUCT MANUFACTURER COUNTRIES
WaterGuard/Sur Eau
Locally Manufactured Angola, Haiti, Kenya,
Malawi, Rwanda
PuR Imported DRC, Kenya, Malawi
AquaTabs Imported Bangladesh, Benin,
Kenya & Senegal
At a sustainable price, WaterGuard and
Aquatabs are affordable for most families
Price/Month (assuming 20 liters/day)
Kenya Benin
DR
Congo* Haiti Malawi* Rwanda Senegal Average
WaterGuard $.15 $.38 $.13 $.33 $.25
PUR $5.28 $3.30 $2.16 $3.58
Aquatabs $.90 $.75 $.75 $.80
*WaterGuard receives a 32% and PUR a 53% subsidy in Malawi and PUR in DRC receives a 45% subsidy
Promotion
• Mass Media (radio and TV)
• Point-of Sale Materials
(posters/danglers etc.)
• Theater/MVU events
• NGO community based
volunteers (all countries)
• Public sector clinics and
Community Health
Workers (Benin, DRC,
Rwanda)
Place/Distribution
• Commercial distribution through a range of commercial
sector retail outlets
• NGO Based Distribution (Benin, Haiti & DRC)
• Public Sector Distribution (Benin, DRC, Rwanda)
M&E Methodology
• Representative sample
of target populations
• Target: Households
with children under five
• Baseline and endline
• Key indicators tracked:
Knowledge & use of
promoted products
Product
Introduction
POUZN
Program
Program/
Study
Geographic
Coverage
Benin 2008 2008-2010
7 departments
(6.1 million) =
70% population
DR
Congo2006 2008-2009
South Kivu
District
(4.7 million) =
7% population
Kenya 2003 2007-2010
Coast Province
(2.5 million) =
7% population
Rwanda 2006 2007-2010National
(10 million)
Knowledge: % of households that know they
need to treat their water
69
31
80 78
94 97
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Benin DRC Kenya
(Coast)
Rwanda
Baseline
Endline
Ever use of promoted POU water treatment products increased significantly
0
12
5
3230
45
19
37
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
Benin DRC Kenya Rwanda
Baseline
Endline
Current use of POU water treatment products
(self-reported) also increased significantly
0
6
2
14
11
28
1
21
0%
5%
10%
15%
20%
25%
30%
Benin DRC Kenya Rwanda
Baseline
Endline
Public sector became an important supplier
% of users Benin DRC Kenya Rwanda
Kiosk/Shop 29.2 12 87.5 31.1
Pharmacy 27.9 48.1 8.6 10.7
NGOs 8.2 11.1 0.2 1.2
Public Health
Clinics/CHW25.9 28.8 3.2 53.8
Other 8.8 0 3.2 0.5
But a gap remains between ever use and
current use
12
6
32
14
45
28
53
21
0%
10%
20%
30%
40%
50%
60%
Benin DRC Kenya Rwanda
Ever Use
Current Use
Reasons that ever users are not currently using
Benin
Aquatabs (%)
DRC
PuR (%)
Rwanda
Waterguard (%)
Too expensive N/A 7.5 24.8
Can’t find 9.5 0.3 34.4
Didn’t have at
home1.2 12.0 N/A
Don’t need 62.9 N/A 7.5
Don’t like 3.4 57.3 16.0
Not right season 1.5 N/A 9.1
Don’t know how to
use8.3 13.8 N/A
Other 13.3 9.0 8.2
Behavior Change Model
SUSTAINED USE
TRIAL
AWARENESS
Lessons Learned
• Building on an existing social marketing platform allows for relatively fast scale-up for relatively small investment $200-300,000 a year.
• Liquid and tablet chlorine products can be offered at a non-subsidized price that is affordable
• Partnering with the public sector for promotion and distribution is a promising extension of social marketing
• The gap between trial and current use is large and needs to be the focus of programs going forward
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