Evaluation of a Community-Wide Water Store Intervention in Rural Guatemala 公开

Abstract

Objectives: In 2018, Healing Waters International installed water purification systems in two rural Guatemala communities, Sesajab and Socoyou. This thesis presents an evaluation of the effectiveness of those water purification systems in reducing the number of diarrheal episodes, the number of school days missed, and the number of liters of soda purchased. 

Methods: Baseline household surveys (n=145) were collected in each community in September 2018 and post-intervention surveys (n=160) were collected from water store customers and noncustomers in March 2019. Analysis methods included chi-square analysis between several variables collected in the surveys, logistic regression modeling for the outcome variables, and qualitative analysis from the customer surveys. 

Results: There were trends in the baseline and post-intervention data, showing that there were decreases in the number of diarrheal episodes, number of school days missed, and number of liters of soda purchased by households. At baseline in both communities, households reporting one or more diarrheal episodes were more likely to miss school than households not reporting diarrheal episodes. For the Sesajab community alone, purchasing soda was also found to be a predictor of diarrheal episodes in the baseline households (OR=5.6, p<0.05). Among the post-intervention surveys from Sesajab, customers who drank from the water store were less likely to purchase soda (OR=0.275, p<0.05). Qualitative data also showed a positive impact from the water store on the communities, with households reporting greater convenience obtaining water and improved health because of the new water source.

Conclusion: Due to a lack of comparable samples between baseline and post-intervention results, analyses were limited and actual impact of the water store was difficult to assess. When looking at the number of diarrheal episodes, number of school days missed, and the number of liters of soda purchased, all three outcomes decreased over the course of the study period. However, it was unclear if the decreases seen between the two groups were due to the water store intervention. 

Table of Contents

INTRODUCTION………………………………………………………………………………1

GLOBAL WATER CRISIS……………………………………………………………………….1

HEALING WATERS INTERNATIONAL……………………………………………………..3

LITERATURE REVIEW……………………………………….……………………………….4

SUSTAINABLE DEVELOPMENT GOALS……………………………………………………4

DRINKING WATER STATUS AND CHALLENGES – GLOBALLY……………………….6

HEALTH BURDEN OF POOR WATER – GLOBALLY……………………………………...9

DRINKING WATER STATUS AND CHALLENGES – GUATEMALA ……………….…12

HEALTH BURDEN OF POOR WATER – GUATEMALA…………………………………15

COMMUNITIES IN NEED – HWI SOLUTIONS……………………………………………16

METHODS……………………………………………………………………………………..17

STUDY SITE……………………………………………………………………………………..17

SURVEY METHODS…………………………………………………………………………...19

DATA ANALYSIS………………………………………………………………………………21

RESULTS…………………………………………………………………………………….....22

SESAJAB BASELINE RESULTS……………………………………………………………….22

SOCOYOU BASELINE RESULTS…………………………………………………………….22

OVERALL BASELINE RESULTS……………………………………………………………..25

POST-INTERVENTION RESULTS: SESAJAB COMMUNITY……………………………..27

POST-INTERVENTION RESULTS: SOCOYOU COMMUNITY…………………………..28

OVERALL POST-INTERVENTION RESULTS………………………………………………30

DISCUSSION……………………………………………………………………………….....31

TRENDS IN BASELINE DATA……………………………………………………………….31

TRENDS BETWEEN BASELINE AND POST-INTERVENTION SURVEYS …………….34

SODA CONSUMPTION IN SESAJAB………………………………………………………..37

LIMITATIONS………………………………………………………………………………...38

FUTURE DIRECTION AND RECOMMENDATIONS………………………………….40

CONCLUSION………………………………………………………………………………...41

REFERENCES…………………………..……………………………………………………...43

About this Master's Thesis

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School	Rollins School of Public Health
Department	Executive Masters of Public Health - MPH
Subfield / Discipline	Applied Epidemiology
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
关键词	WASH
Committee Chair / Thesis Advisor	Karen Levy, Emory University
Committee Members	Hana Lokey, Healing Waters International

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