Health and health related community networks as ...

Generated by Foxit PDF Creator © Foxit Software http://www.foxitsoftware.com For evaluation only.

Health and health related community networks as change agents for household water treatment and storage in peri-urban eco-setting


Contributors Dr. Khin Thet Wai 1 Dr. Pe Thet Zaw 1 Dr. Tin Oo 1 Dr. Hlaing Myat Thu 1 Dr. Zaw Win 2 Dr. Si Thu Ye Naung 2 1 Department of Medical Research (lower Myanmar) 2 Department of Health

• • • • • •

Contact Details

•Dr. Khin Thet Wai, Deputy Director (Research), Dept. of Medical Research (Lower Myanmar) E mail: [email protected] •Dr. Pe Thet Zaw, Research Officer, Dept. of Medical Research (Lower Myanmar) E mail: [email protected]


Description of the solution • Activities of health and health related community networks through advocacies and community meetings for water system installation to solve the problem of water scarcity especially in dry season • Establishment of the Attaran river water installation and distribution project since 2009; River water is pumped to the medium size reservoir located 18 feet above the sea level at the entrance of the study ward • Motivation of householders of low to middle socioeconomic strata in the peri-urban ward of Mawlamyaing District for improving their protective behaviors in household water treatment and storage (HWTS)


Adaptation of Protection Motivation Theory • Exposure to the risk of water contamination and dengue vector breeding sites plus experiences in point of use water treatment products(POU) and integrated dengue vector control linking to improved knowledge and risk perception may enhance adoption and adaptation of locally specific actions. • This may finally lead to potential risk reduction of diarrhoeal diseases and dengue vector breeding.


Location

16°29’ N and 97°37’ E


Catchment Area Attaran River

Thanlwin River

Gyaing River


Key Actors To get water all the year round and to prevent Dengue transmission and Diarrhoea outbreak, following ACTORS are responsible. • The community • Local authorities • Municipal services • Local Health Department

Financial contribution Technical, Administrative & Financial assistance


Problems to solve How can the low and middle socioeconomic strata at peri-urban community improve water scarcity situation?

Water scarcity

Public domain

Domestic domain

• Use of river water without regular water quality testing

• Central reservoir does not have any protection from entry of animals • Only ad hoc water treatment by chlorination in times of outbreak of diarrhoea

• Poor knowledge of disease transmission • Misperceptions • Improper container management • Paying less attention to protective behaviors in relation to diarrhoea and dengue


Problems to solve • Population increase and insufficient water supply leading to reliance mostly on available river water apart from rain water • Water quality of the raw water, treated water and water in the home were not tested for contamination and potential health risks. • There is only ad hoc water treatment by chlorination from local health department with the help of local health authorities and community networks when there is a diarrhea outbreak.


Problems to solve • The central storage reservoir is not protected from entry of animals. • The stored river water is then pumped to the households with voluntary financial contributions for water pumps and pipes. • However, households who cannot afford water pumps arrange to carry manually with containers or buy from water vendors and then store the water for usage.


Problems to solve • Water is stored in 4 different type of containers: metal and plastic drums, cement drums, ceramic jars and large cement tanks with the storage capacity ranging from 20 to 200 gallons. • According to the recent survey completed on water storage practices in randomly selected 200 households in this ward, only 38 % of cement tanks and 48% of ceramic jars had complete covering. Mostly, 80.5% of households had few to abundant water retaining discarded materials in their compounds (Pe Thet Zaw et.al., 2011).


Problems to solve • Poor knowledge of disease transmission, vector breeding, misperceptions and inadequate container management practices favor as potential breeding sites for the dengue vectors as well as the potential water contaminants which can cause diarrheal diseases. • Especially after heavy rainfalls, overflowing of pit latrines in the neighborhood leading to contamination of sources of water supply.


Progress in water use, treatment and storage


Progress in water use, treatment and storage • Water installation systems partially completed as available tap water with the coverage of 720 households with at least 1 child under 5 years old in 30% ( Major change ) • Very few households arrange filtration, flocculation and boiling for drinking as point of source water treatment. • Approximately 60% of households stored river water for domestic use and 35% stored rain water for drinking purpose. Only 5% stored water from shallow wells.


Added values Water challenges in households were partially reduced and social values improved.

Potential reduction of dengue vector breeding sites and incidence of water borne diseases especially in children as a tangible health impact. Socio cultural values in terms of community engagement by integrated approach in HWTS activities.


Monitoring • Extent of community participation • % of households storing water safely • % of households using pipe water from new installation in the ward • Current status of monitoring for HWTS activities in the study site by local health department is only for emergency situations. • Expected to see changes in households 6 months,annually: % of reporting households consistently treating drinking water with POU. • Proportion of households aware and familiar with other environmental household health interventions annually.


Replication and upscaling potential • Importance of community led total sanitation approach(CLTS) for new water system installation costing around USD 150,000. • This model can be replicable in other project areas using river water and rain water favorable for prevention of both dengue and diarrhea in low to middle socioeconomic strata of periurban neighborhoods. • Strong political commitment and interest of regional authorities together with strengthened policy issues


Important factors in motivating the change • Community preferences to improve water scarcity situation in dry season.

• Affordable and easily available water system installation including construction of the central reservoir, machineries and pipe lines from river to the reservoir.


Major challenges in this program • Weak coordination in public and private sector for HWTS technologies • Less participation and interest of health related community networks and households • Weakness in channeling risk communication messages to motivate householders • Time constraints due to engagement in daily livelihood in low to middle peri-urban neighborhoods • Inadequately specified indicators for monitoring and evaluation and lack of arrangements for water quality testing
