Evidence-Based Development: A Trend Whose Time Has …...Evidence-Based Development: A Trend Whose Time Has Come? The Case of Chlorine Dispensers for Safer Water Editor’s Note: This

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Evidence-Based Development: A Trend Whose Time HasCome? The Case of Chlorine Dispensers for Safer WaterEditor’s Note: This guest blog post is authored by Alix Zwane,Executive Director of Evidence Action. In her post, Alix laudsthe increased attention given to evidence-based innovations indevelopment and describes the Dispensers for Safe Waterinitiative as an example of a WASH intervention grounded in thisdata-driven approach.

Evidence-based development innovations are finally all the rage.The UK's Department for International Development and USAIDannounced the Global Development Innovation Ventures(GDIV) Fund almost exactly a year ago to focus developmentinvestments on “innovative approaches with proven, radically successful results.” Just a fewweeks ago, USAID launched its Global Development Lab that aims to “test and scalebreakthrough development innovations.” And even more recently, a senior policy advisor to thepresident of the European Commission argued that evidence should trump politics anddiplomacy for deciding on aid investments.

One example of how aspirations for data-driven development translate into actual, real projectsthat improve millions of peoples’ lives is the Dispensers for Safe Water initiative. Chlorinedispensers currently serve over two million people in East Africa and are on track to grow to fourmillion people by the end of this year, and 25 million by 2018.

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Chlorine dispensers installed directly at the water source represent an important innovation in therural water sector. They solve a number of challenges that have hindered sustainable, qualityservices for cleaner water to date -- despite the billions that have been spent on water andsanitation projects. And because the approach has been vigorously tested, we can say definitivelythat chlorine dispensers work at a fraction of the cost of typical water projects, and at highadoption rates by people most in need of clean water.

What Are Chlorine Dispensers?

Dispensers are installed directly at the water source and contain enough chlorine for a communityusing the water source for about a month. A person collecting water turns a knob that releasesenough chlorine to clean 20 liters of water -- the typical amount that people collect from the sourceand carry home. The dispensers are rugged and durable, and maintained and marketed by localhealth promoters who educate the community about the utility of adding small amounts of chlorineto the drinking water, and check and refill the dispensers as needed.

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A local health promoter in Teso district, Kenya, teaches community members about the health benefits ofchlorinated water, and how the chlorine dispenser works. Credit: Andy Chen for Evidence Action

Chlorine is very cheap and effective at killing most bacterial and viral pathogens. Safety concernswith dilute chlorine are minimal, and it is widely used as a disinfectant in water treatment plantsaround the world. Chlorine can also provide residual protection for up to three days (depending onstorage conditions), which means that it not only disinfects water, but can also preventre-contamination.

Are People Healthier Because of Chlorine in their Water?

So what do we know about improving water quality for people? There have been a number ofreview articles recently that have assessed the evidence for drinking water quality interventions indeveloping countries. One meta study that analyzed 65 separate evaluations concluded that

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point-of-use (or, in the case of dispensers, point-of-source) water quality interventions appear tobe highly effective -- and indeed, more effective than water supply or source treatment in reducingdiarrhea -- but that this is very sensitive to the ability of the program to sustain high rates ofproduct adoption. Obviously, a product cannot provide health benefits if people don’t use it.Another systematic review of the evidence showed that there are reductions of up to 40% ofchildhood diarrhea among people using the product.

Are People Actually Using Chlorine Dispensers?

The case for cost-effective impacts for dispensers rests not only on the potential for health impact.People actually have to use water treatment products if they are to be effective. The sustained useof dispensers has been documented via a rigorous randomized controlled trial (PDF) in whichadoption held at about 50% for three years in the treatment group assigned to dispensers. Wecontinue to see average adoption rates over 40% in areas where baseline water treatment withchlorine is less than 10%. For anyone in the WASH field, these are impressive rates. Adoption ofchlorine at the point of service is high because it is cheap, convenient, salient, and public.

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Average adoption rates in areas where chlorine dispensers are introduced exceed 40%. Credit: Andy Chen forEvidence Action

Dispensers are Sustainable and Cost-Effective

Chlorine dispensers are inexpensive, costing less than $0.50 per person per year at scale. This isconsiderably lower than the large infrastructure programs that may not be sufficiently invested inover time, and then fall into disuse. The low cost per person has also allowed us explore newfinancing models, such as using carbon credits. Chlorine reduces the need for boiling water, sodispensers can be financed that way. And because chlorine dispensers are inexpensive tomaintain, carbon revenue covers the costs even as the initiative expands to serve 25 millionpeople in 2018.

We believe that evidence and rigorous testing of new development approaches is critical in order

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07/14/2014 11:23 AM

TAGS: EVIDENCE ACTION , DISPENSERS FOR SAFE WATER , SUSTAINABILITY , WASH

to scale what works to reach millions, and are pleased that the global development field is movingin the direction of being more rigorously data-driven and evidence-based.

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Evidence-Based Development: A Trend Whose Time Has …...Evidence-Based Development: A Trend Whose Time Has Come? The Case of Chlorine Dispensers for Safer Water Editor’s Note: This