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Measuring User Compliance and Cost Effectiveness of Safe Drinking Water Programs: A Cluster-Randomized Study of Household Ultraviolet Disinfection in Rural Mexico.
Reygadas, Fermín; Gruber, Joshua S; Dreizler, Lindsay; Nelson, Kara L; Ray, Isha.
Afiliação
  • Reygadas F; Fundación Cántaro Azul, Chiapas, Mexico.
  • Gruber JS; Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California.
  • Dreizler L; Warren Alpert Medical School, Brown University, Providence, Rhode Island.
  • Nelson KL; Department of Civil and Environmental Engineering, University of California, Berkeley, Berkeley, California.
  • Ray I; Energy and Resources Group, University of California, Berkeley, Berkeley, California.
Am J Trop Med Hyg ; 98(3): 824-834, 2018 03.
Article em En | MEDLINE | ID: mdl-29363448
Low adoption and compliance levels for household water treatment and safe storage (HWTS) technologies have made it challenging for these systems to achieve measurable health benefits in the developing world. User compliance remains an inconsistently defined and poorly understood feature of HWTS programs. In this article, we develop a comprehensive approach to understanding HWTS compliance. First, our Safe Drinking Water Compliance Framework disaggregates and measures the components of compliance from initial adoption of the HWTS to exclusive consumption of treated water. We apply this framework to an ultraviolet (UV)-based safe water system in a cluster-randomized controlled trial in rural Mexico. Second, we evaluate a no-frills (or "Basic") variant of the program as well as an improved (or "Enhanced") variant, to test if subtle changes in the user interface of HWTS programs could improve compliance. Finally, we perform a full-cost analysis of both variants to assess their cost effectiveness (CE) in achieving compliance. We define "compliance" strictly as the habit of consuming safe water. We find that compliance was significantly higher in the groups where the UV program variants were rolled out than in the control groups. The Enhanced variant performed better immediately postintervention than the Basic, but compliance (and thus CE) degraded with time such that no effective difference remained between the two versions of the program.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Água Potável / Desinfecção / Conhecimentos, Atitudes e Prática em Saúde / Purificação da Água Tipo de estudo: Clinical_trials / Evaluation_studies / Health_economic_evaluation Aspecto: Implementation_research Limite: Humans País/Região como assunto: Mexico Idioma: En Revista: Am J Trop Med Hyg Ano de publicação: 2018 Tipo de documento: Article País de afiliação: México País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Água Potável / Desinfecção / Conhecimentos, Atitudes e Prática em Saúde / Purificação da Água Tipo de estudo: Clinical_trials / Evaluation_studies / Health_economic_evaluation Aspecto: Implementation_research Limite: Humans País/Região como assunto: Mexico Idioma: En Revista: Am J Trop Med Hyg Ano de publicação: 2018 Tipo de documento: Article País de afiliação: México País de publicação: Estados Unidos