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1St Report of the SODIS Sustainability Study – Nepal

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Assessing factors supporting the sustainable long-term application of SODIS in Bolivia, Nepal and Indonesia November 2009 1st Report of the SODIS Sustainability Study – Nepal In cooperation with , Kathmandu, Nepal. 1st Report of the SODIS Sustainability Study – Nepal 2 1st Report of the SODIS Sustainability Study – Nepal 3 Executive summary The SODIS sustainability study was designed to close an important research gap – to collect information on the sustainability of HWTS/SODIS promotion projects at household and institutional levels. Several information sources were included: interviews using standardized questionnaires at household level, with previous promoters, and with previous implementing partner organizations as well as general stakeholder in the water sector. The SODIS sustainability study intends to compare three countries where SODIS promotion at household and institutional level has already been taken place since several years. This first report of the SODIS sustainability study presents the data collected in Nepal. SODIS has been promoted in Nepal since 2004 by a national NGO called ENPHO. Main activities of ENPHO took place in the Kathmandu valley, comprising urban and rural areas of different characteristics. Implementing partners were at first local NGOs, later the focus was shifted to work with municipalities, the health and education sector as well as large international agencies. During the study in Nepal, 1078 households of 21 communities of 5 different project phases (from 2004 to 2009) were investigated. These 21 communities comprised rural, periurban and urban areas as well as low, mixed and middle income areas in 5 different districts of the Kathmandu valley. Results at household level show that half (54%) of the total sample is entirely consuming safe water. The biggest success was achieved in the urban areas of the big cities Kathmandu and Lalitpur, where in some communities almost nobody consumes untreated water anymore. In rural areas as well as in the case of newly installed water treatment plants, people still tend to believe their water is safe to consume (which may or may not be true). Overall, the most popular treatment options used are candle filters (43%), followed by SODIS (21%), boiling (12%), buying water (7%), and chlorination (4%). The approach of using promoters providing group trainings on HWTS as a first intervention, followed by household visits, can be viewed as appropriate and successful. Promoters and household visits have proven to make people trying out SODIS and becoming regular SODIS users. Also, the promoters themselves view these strategies as adequate and successful. Only longer follow-up periods are demanded, as many promoters perceived the given project time frame of usually 12 months as not being sufficient to establish a sustainable behavior change. Motivational factors to consume a certain type of water are of emotional and social nature. Creating positive emotions (e.g. liking the taste of a certain water type), stimulating social influence and social exchange in form of communication are needed. Once people are using SODIS, habit factors like daily routine and automaticity are important to make people regular SODIS users. Here, the same measures as already demanded by the promoters would be helpful – longer follow-up periods to establish stronger habits. Also, planning interventions and reminders should be helpful for habit development. Project implementation in urban areas by either local NGOs or municipalities showed equal effectiveness in making people consume 100% safe water as well as using SODIS as a water treatment option. In rural areas, a very positive experience with regard to SODIS use was made with the health sector as the implementing partner. In general, working with governmental institutions poses great potential, because they are permanent institutions and have a large network at grassroots level. However, the need of local NGOs cannot be neglected; especially in areas with weak governmental structures they could possibly play an important initiative role. Overall, institutional sustainability can be judged as quite elaborated since in all ongoing HWTS promotional activities, SODIS is included as one of the options. 1st Report of the SODIS Sustainability Study – Nepal 4 Table of contents 1 Introduction...................................................................................................................................... 8 2 Methods ........................................................................................................................................... 9 3 Nepal............................................................................................................................................... 10 3.1 Investigated communities ..................................................................................................................11 3.2 Demographics of the investigated communities................................................................................13 3.3 HWTS promotion strategies used by our Nepalese partners ............................................................. 14 4 Water consumption pattern........................................................................................................... 18 4.1 Description of water consumption .....................................................................................................18 4.2 Safe water consumption related to demographic indicators ............................................................. 20 4.3 Safe water consumption in different investigated areas....................................................................21 5 SODIS water consumption.............................................................................................................. 25 5.1 Description of SODIS water consumption .......................................................................................... 25 5.2 SODIS water consumption related to demographic indicators .......................................................... 26 5.3 SODIS water consumption in different investigated areas.................................................................26 6 Promotion campaign influences..................................................................................................... 30 6.1 Different information sources ............................................................................................................30 6.2 Distributed materials .......................................................................................................................... 33 6.3 Reasons for SODIS use and experienced problems ............................................................................33 6.3.1 Reasons to start SODIS use .................................................................................................33 6.3.2 Main problems experienced with SODIS use......................................................................34 7 The behavior change process to using different water treatment options ................................... 35 7.1 Introduction to behavior change models ........................................................................................... 35 7.2 Motivations related to SODIS intention and use ................................................................................36 7.2.1 Explaining the intention to use SODIS ................................................................................36 7.2.2 Explaining the use of SODIS ................................................................................................ 38 7.3 Comparing predictors of SODIS, boiling, filtered and untreated water intention and use ................40 7.3.1 Explaining the intentions to do SODIS, boil, filter and consume untreated water .............41 7.3.2 Explaining the use of SODIS, boiling, filters, and the consumption of untreated water...................................................................................................................................44 8 The status of institutionalization of HWTS in Nepal....................................................................... 46 8.1 Local NGOs..........................................................................................................................................48 8.2 Governmental institutions..................................................................................................................48 8.2.1 Municipalities......................................................................................................................49 8.2.2 Ministry of Health – District Public Health Organizations (DPHOs) ....................................49 1st Report of the SODIS Sustainability Study – Nepal 5 8.2.3 Department of Water Supply and Sewerage (DWSS) ......................................................... 50 8.2.4 Ministry of Education..........................................................................................................50 8.3 International agencies ........................................................................................................................51 8.4 ENPHO ................................................................................................................................................51 9 Summary of results and conclusions.............................................................................................. 53 9.1 Household
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