Water Filter Adoption and Handwashing Practices Among Households in the Agalta Valley, Honduras 公开

Rusiecki, Laura (2017)

Permanent URL: https://etd.library.emory.edu/concern/etds/gq67js03v?locale=zh
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Abstract

Many rural Hondurans lack access to clean water and practice poor hygiene. HOI (previously Honduras Outreach, Inc.), an NGO based in the Agalta Valley of Honduras is addressing this problem by offering subsidized hollow fiber membrane water filters with stands, soap, and hygiene education to families living in 12 rural villages. We evaluated this program utilizing baseline and follow-up surveys, observations, and water quality testing. We collected baseline survey and water quality data in January 2016. Following program implementation in households and schools in 12 villages from January through July 2016, we conducted a midline survey and tested stored water samples from June 25-August 12, 2016. During this midline evaluation, we measured filter durability and effectiveness, examined filter purchase and adoption, and assessed preliminary filter acceptability. We surveyed 240 households and tested water from a random sample of 52 households. Over 90% of households in project villages purchased a hollow fiber membrane filter and stand. The stands were observed to have a gap between the top (influent) bucket and bottom (effluent) bucket, which could permit post-filtration contamination. From baseline to follow-up, the percentage of stored water samples contaminated by E. coli decreased from 87.5% to 43.7% (p=E. coli; breakthrough contamination and poor stand design may have contributed to this finding. As one of the first program evaluations of hollow fiber membrane filters' field application, the high community uptake and significant water quality improvement results are encouraging for use in other low-income settings throughout Central and South America. Improvements in the stand design could further improve post-filtration water quality and facilitate an evaluation of disinfection effectiveness of the two filters.

Table of Contents

Table of Contents

Chapter 1: Introduction.............................................2

Chapter 2: Review of the Literature............................3

Access to Safe Water.................................................3
Globally.................................................................3
Sustainable Development Goals..................................4
Honduras...............................................................5
Health Burden of Poor Water Quality..........................6
Globally.................................................................6
Honduras...............................................................6
Household Water Treatment and Safe Storage:
Short- to Medium-Term Interventions to Address
Poor Access to Safe Water.........................................
7
Filtration as a Strategy for Household Water
Treatment...............................................................
9
Filtration Systems: Biosand.......................................9
Filtration Systems: Ceramic.....................................11
Filtration Systems: Hollow-fiber Membrane.................15

Chapter 3: Methodology...........................................18

Evaluation Design....................................................18
Population...............................................................18
Sample.................................................................19
Data Analysis...........................................................24
Ethical Considerations...............................................26

Chapter 4: Results.....................................................27

Chapter 5.................................................................34

Discussion................................................................34
Conclusions..............................................................40

References...............................................................41

Appendices..............................................................45

Appendix A: Copy of Non-Research Determination
Letter from CDC Institutional Review Board

Appendix B: Letter of Invitation from HOI
Appendix C: English Version of Household Survey
Appendix D: Spanish Version of Household Survey

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