sustainability Article Integration of Household Water Filters with Community-Based Sanitation and Hygiene Promotion—A Process Evaluation and Assessment of Use among Households in Rwanda Abigail Bradshaw 1 , Lambert Mugabo 2 , Alemayehu Gebremariam 3, Evan Thomas 1,* and Laura MacDonald 1 1 Mortenson Center in Global Engineering, University of Colorado Boulder, Boulder, CO 80309, USA;
[email protected] (A.B.);
[email protected] (L.M.) 2 Amazi Yego Ltd., Kigali 20093, Rwanda;
[email protected] 3 Catholic Relief Services, Kigali 20093, Rwanda;
[email protected] * Correspondence:
[email protected] Abstract: Unsafe drinking water contributes to diarrheal disease and is a major cause of morbidity and mortality in low-income contexts, especially among children under five years of age. Household- level water treatment interventions have previously been deployed in Rwanda to address microbial contamination of drinking water. In this paper, we describe an effort to integrate best practices regarding distribution and promotion of a household water filter with an on-going health behavior messaging program. We describe the implementation of this program and highlight key roles includ- ing the evaluators who secured overall funding and conducted a water quality and health impact trial, the promoters who were experts in the technology and behavioral messaging, and the implementers who were responsible for product distribution and education. In January 2019, 1023 LifeStraw Family Citation: Bradshaw, A.; Mugabo, L.; 2.0 household water filters were distributed in 30 villages in the Rwamagana District of Rwanda. Thomas, E.; MacDonald, L. Approximately a year after distribution, 99.5% of filters were present in the household, and water Integration of Household Water was observed in 95.1% of filters.