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Results and Lessons Learned from the POUZN Project POU Program Susan Mitchell, Project Director Abt Associates

Results and Lessons Learned from the POUZN Project POU …hwts.web.unc.edu/files/2014/09/2._Susan_Mitchell_-_Results_and_Lessons_Learned_from...POUZN Project POU Program Susan Mitchell,

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Page 1: Results and Lessons Learned from the POUZN Project POU …hwts.web.unc.edu/files/2014/09/2._Susan_Mitchell_-_Results_and_Lessons_Learned_from...POUZN Project POU Program Susan Mitchell,

Results and Lessons Learned from the

POUZN Project POU Program

Susan Mitchell, Project Director

Abt Associates

Page 2: Results and Lessons Learned from the POUZN Project POU …hwts.web.unc.edu/files/2014/09/2._Susan_Mitchell_-_Results_and_Lessons_Learned_from...POUZN Project POU Program Susan Mitchell,

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.

Page 3: Results and Lessons Learned from the POUZN Project POU …hwts.web.unc.edu/files/2014/09/2._Susan_Mitchell_-_Results_and_Lessons_Learned_from...POUZN Project POU Program Susan Mitchell,

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

Page 4: Results and Lessons Learned from the POUZN Project POU …hwts.web.unc.edu/files/2014/09/2._Susan_Mitchell_-_Results_and_Lessons_Learned_from...POUZN Project POU Program Susan Mitchell,

Program Strategy

Promotio

n

PlacePrice

Product

Awareness

Trial

Use

Page 5: Results and Lessons Learned from the POUZN Project POU …hwts.web.unc.edu/files/2014/09/2._Susan_Mitchell_-_Results_and_Lessons_Learned_from...POUZN Project POU Program Susan Mitchell,

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

Page 6: Results and Lessons Learned from the POUZN Project POU …hwts.web.unc.edu/files/2014/09/2._Susan_Mitchell_-_Results_and_Lessons_Learned_from...POUZN Project POU Program Susan Mitchell,

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

Page 7: Results and Lessons Learned from the POUZN Project POU …hwts.web.unc.edu/files/2014/09/2._Susan_Mitchell_-_Results_and_Lessons_Learned_from...POUZN Project POU Program Susan Mitchell,

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)

Page 8: Results and Lessons Learned from the POUZN Project POU …hwts.web.unc.edu/files/2014/09/2._Susan_Mitchell_-_Results_and_Lessons_Learned_from...POUZN Project POU Program Susan Mitchell,

Place/Distribution

• Commercial distribution through a range of commercial

sector retail outlets

• NGO Based Distribution (Benin, Haiti & DRC)

• Public Sector Distribution (Benin, DRC, Rwanda)

Page 9: Results and Lessons Learned from the POUZN Project POU …hwts.web.unc.edu/files/2014/09/2._Susan_Mitchell_-_Results_and_Lessons_Learned_from...POUZN Project POU Program Susan Mitchell,

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)

Page 10: Results and Lessons Learned from the POUZN Project POU …hwts.web.unc.edu/files/2014/09/2._Susan_Mitchell_-_Results_and_Lessons_Learned_from...POUZN Project POU Program Susan Mitchell,

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

Page 11: Results and Lessons Learned from the POUZN Project POU …hwts.web.unc.edu/files/2014/09/2._Susan_Mitchell_-_Results_and_Lessons_Learned_from...POUZN Project POU Program Susan Mitchell,

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

Page 12: Results and Lessons Learned from the POUZN Project POU …hwts.web.unc.edu/files/2014/09/2._Susan_Mitchell_-_Results_and_Lessons_Learned_from...POUZN Project POU Program Susan Mitchell,

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

Page 13: Results and Lessons Learned from the POUZN Project POU …hwts.web.unc.edu/files/2014/09/2._Susan_Mitchell_-_Results_and_Lessons_Learned_from...POUZN Project POU Program Susan Mitchell,

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

Page 14: Results and Lessons Learned from the POUZN Project POU …hwts.web.unc.edu/files/2014/09/2._Susan_Mitchell_-_Results_and_Lessons_Learned_from...POUZN Project POU Program Susan Mitchell,

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

Page 15: Results and Lessons Learned from the POUZN Project POU …hwts.web.unc.edu/files/2014/09/2._Susan_Mitchell_-_Results_and_Lessons_Learned_from...POUZN Project POU Program Susan Mitchell,

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

Page 16: Results and Lessons Learned from the POUZN Project POU …hwts.web.unc.edu/files/2014/09/2._Susan_Mitchell_-_Results_and_Lessons_Learned_from...POUZN Project POU Program Susan Mitchell,

Behavior Change Model

SUSTAINED USE

TRIAL

AWARENESS

Page 17: Results and Lessons Learned from the POUZN Project POU …hwts.web.unc.edu/files/2014/09/2._Susan_Mitchell_-_Results_and_Lessons_Learned_from...POUZN Project POU Program Susan Mitchell,

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