Despite documented health benefits of household water treatment and storage (HWTS), achieving sustained use remains challenging. In prior evaluations of a long-term HWTS program in Haiti, multiple marketing interventions failed to increase use or had prohibitively high costs. Using mobile phones is a potentially cost-effective way to change HWTS behavior. We conducted a randomized experiment to evaluate the impact of sending short-message service (SMS) messages to promote household chlorination in this program in Haiti.
Household spraying in cholera outbreaks: Insights from three exploratory, mixed-methods field effectiveness evaluations
Household spraying is a commonly implemented, yet an under-researched, cholera response intervention where a response team sprays surfaces in cholera patients’ houses with chlorine. We conducted mixed-methods evaluations of three household spraying pro- grams in the Democratic Republic of Congo and Haiti, including 18 key informant interviews, 14 household surveys and observations, and 418 surface samples collected before spray- ing, 30 minutes and 24 hours after spraying.
Effectiveness of water chlorination programs along the emergency transition- post-emergency continuum: Evaluations of bucket, in-line, and piped water chlorination programs in Cox’s Bazar
Supplying safe drinking water in humanitarian emergencies is critical, and source water chlorination is a commonly implemented intervention to provide safe water. We evaluated three different source water chlorination programs (bucket, in-line, and piped water chlorination) in the ongoing humanitarian response in Cox’s Bazar refugee camps in Bangladesh. We used a mixed-methods research protocol including key informant interviews, water point observations, focus group discussions, household surveys, and water quality testing.
Chlorine tablets are often a good choice for water treatment in emergencies because they are widely available, cost-effective, easily transported, and simple to use. However, the availability of multiple tablet sizes in an emergency can result in users treating their water improperly, and some doses may be unpalatable to users. This document provides tools to assess water needs in an emergency and make a recommendation for the best chlorine tablet to avoid confusion and provide water that users will accept.
Barriers and Facilitators to Chlorine Tablet Distribution and Use in Emergencies: A Qualitative Assessment
Chlorine tablets are commonly distributed for household water treatment in emergencies. However, confirmed use after distribution ranges widely (from 7–87%), which raises concerns about chlorine tablet effectiveness, as measured by acceptance and appropriate use. To investigate chlorine tablet effectiveness, we conducted nine key informant interviews (KIIs) on tablet distribution in emergencies in general, five KIIs on chlorine taste and odor acceptance and rejection specifically, and a literature review on chlorine taste and odor concerns.
Water, sanitation, and hygiene access in southern Syria: analysis of survey data and recommendations for response
Background. Water, sanitation, and hygiene (WASH) are immediate priorities for human survival and dignity in emergencies. In 2010, > 90% of Syrians had access to improved drinking water. In 2011, armed conflict began and currently 12 million people need WASH services. We analyzed data collected in southern Syria to identify effective WASH response activities for this context.
Effectiveness of Multilevel Risk Management Emergency Response Activities To Ensure Free Chlorine Residual in Household Drinking Water in Southern Syria
To provide safe drinking water and reduce the risk of disease, emergency responders in southern Syria are implementing a multilevel risk reduction strategy with the aim of ensuring free chlorine residual (FCR) in household drinking water. Responders implemented activities across the water chain (from chlorination station and well operators to water vendors to household members), including distribution of supplies for chlorination and training on chlorine use; activities varied by responder.
Water, sanitation, and hygiene (WASH) interventions are key to reducing the burden of disease associated with outbreaks, and are commonly implemented in emergency response. However, there is a lack of summarized evidence on the efficacy and effectiveness of these interventions. We conducted a systematic review of published and grey literature by developing theory of change models, developing inclusion criteria, conducting the search, selecting evaluations for inclusion, assessing the quality of the evidence, and analysing the included evaluations.
Chlorination of drinking water in emergencies: a review of knowledge to develop recommendations for implementation and research needed
Clean water provision is a critical component of emergency response, and chlorination is widely used in emergencies to treat water. To provide responders with practical, evidencebased recommendations for implementing chlorination programmes and recommend areas for future research, we conducted a literature review of chlorination in emergencies, supplemented with a literature review on chlorination in general.
Effective Use of Household Water Treatment and Safe Storage in Response to the 2010 Haiti Earthquake
When water supplies are compromised during an emergency, responders often recommend household water treatment and safe storage (HWTS) methods, such as boiling or chlorination. We evaluated the near- and longer-term impact of chlorine and filter products distributed shortly after the 2010 earthquake in Haiti. HWTS products were deemed as effective to use if they actually improved unsafe household drinking water to internationally accepted microbiological water quality standards.