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POUZN Project Releases New POU Lessons Learned Report for India

The USAID-funded POUZN Project just released a new Lessons Learned study entitled "Public-Private Partnership Model for Point-of-Use Water Disinfection among Lower Income Households." The report is the latest in an installment of Lessons Learned documents on POU and zinc treatment in India, Tanzania, and Indonesia. The study focuses on the POU program in India, which was launched in 2006 and was initially envisioned as just a year-long demonstration, now scheduled to end in late 2010. The program was carried out in Uttar Pradesh (UP), India’s poorest state, with a population of 180 million and among the country’s highest rates of childhood mortality.

Click here to download the full report (PDF, 4.7mb)

The report provides a thorough explanation of the project objectives, POU water treatment, and strategies adopted to promote POU uptake. A summary of key lessons outlined by the report are presented below.

Key Lessons Learned

The public and private sectors were willing in this project to adopt a new business model together in order to reach those below the poverty line. The engaged commercial sector was able to reach a substantial new market by partnering with NGOs and micro-finance institutions. Companies also learned to select NGOs carefully and interact with them on a regular basis. NGOs have been able to raise awareness about clean drinking water, and also provide a solution to the problem. This has raised their standing in the community, and has also provided jobs for NGO workers as demonstrators and micro-distributors.

The role of a catalyst is essential in building a public-private partnership, but can be reduced over time. Commercial and socially active NGOs speak different languages and move at different paces. Industry is focused on the bottom line and prefers cash rather than credit transactions; NGOs are reluctant to be sellers and distrust the private sector. POUZN was able to build an enthusiastic alliance that served mutual interests—including those of low-income consumers. The commercial partners are expanding the model at their own expense in new blocks in UP and elsewhere in India Major donor inputs to this collaboration should not be required over the long term.

Good feedback systems and the openness and agility to adjust strategies is central to the success of a development project. The project’s original vision was adjusted in major ways as field realities emerged. This included offering more product options to consumers, shifting from the plan for SHG-based micro-distributors to more direct collaboration with NGO staff, and altering the behavior change strategy in rural areas. Refining credit and subsidy strategies has been an ongoing process and especially sensitive.

A demonstration project for a new business model enhances the potential for learning and “getting it right” at scale. By their nature, smaller projects can be more agile and adjust faster and more cost-effectively to on-the-ground lessons. Start-up can begin without expensive and time-consuming research if target audience perspectives are understood and monitored regularly. A demonstration project offers a smaller element of risk to partners and provides necessary proof of concept to attract additional partners for scale-up.

Women’s self-help groups are an effective channel for promoting POU methods and practices. They provide a good entry point for communities because women are typically responsible for drinking water, and SHG members tend to be entrepreneurial and socially aware. Groups can provide mutual support for adopting new behaviors. Group members can be an effective channel for conveying information and modeling new behaviors to the wider community.

Self-help groups with access to micro-finance provide a feasible platform for purchase of expensive filter devices. This was demonstrated in the initial project period, particularly in urban areas. At current prices, filter sales will not be successful in the absence of credit.

NGOs can be trained to become effective product demonstrators and micro-distributors. The original model relied on the commercial sector field agents as product demonstrators, but this was not scalable. The project hoped that SHG members could become micro-distributors, but this proved unworkable. Members lacked the skills, motivation, and mobility to sell to the larger community. As an unbiased and trusted source, the NGO workers were able to provide information to SHGs about POU “in their own language” and were effective demonstrators and micro-distributors of products. A Jal Mitra contact for each community helped consolidate orders and POUZN made time-limited contributions toward their salaries, to supplement the low margins they were able to earn on sales.

Urban and rural audiences require different approaches. POUZN found that awareness of water contamination, aspiration for and access to products, availability of credit, and other factors created entirely different barriers for urban and rural audiences. Lack of awareness of water contamination was the chief barrier in rural areas. Providing visual evidence of contamination (through H2S test kits) was a cheap, participatory, and effective behavior change tool to address this barrier. The lack of community bonds in urban areas was a major limitation on the growth of self-help groups with micro-finance activities there.

Target audiences know what products they prefer. The project ultimately sold more filters in urban areas because families saw the products were owned by their wealthier neighbors and aspired to have filters themselves. (As filters start to appear in rural areas, they may also become status symbols there.) Liquid chlorine was especially popular in rural households, while tablets were preferred in urban areas. The reason for this difference in preference deserves further investigation.

Need for mid-range products. Currently there is a large gap in the product line (between the least expensive liquid chlorine product costing under Rs10, and multi-stage filters). Entry into the market of the Tata’s Swach filter at half the price (at Rs 999) of those offered by HUL and Eureka-Forbes will interject competition into the market and prices can be expected to keep falling. POUZN is investigating bringing Tata on as a Jal Mitra partner in the program areas.

Converting people to using POU devices/methods takes time and family consensus. The project found that multiple sessions were needed to bring about behavior change, and that home visits (where primary decision makers such as husbands and mothers-in-law can be involved) were most successful. A filter purchase required a capital outlay that had to be decided by the head of the household. Even the purchase and use of chlorine required endorsement by the decision maker in the household.

Behavior change takes place in stages and requires support. The goal for a POU intervention is first trial of a behavior, then regular use, and finally consistent use. Self-report of behavior may not be an accurate way to determine consistent use. Ultimately, testing water at the point of use is needed to confirm treatment. POUZN saw a drop-off over time in use of chlorine by users. The project also found that in some homes with multi-stage filters, disinfecting cartridges were lasting much longer than would be expected—indicating low usage. In both urban and rural areas, sustained attention to the importance of clean water at the point of use will be essential to bring about a change in practices over the long term.

Next Steps

As this report is published, the project is beginning work in an additional 745 slum clusters in Lucknow and two new UP cities reaching almost 149,000 new families. The rural component is expanding into 500 villages in the four intervention districts, reaching an additional 100,000 rural families. By the end of the project in September 2010, a total of 758,737 families will have been reached in both urban and rural areas. The haat pilot is also being expanded to selected rural markets in all the rural intervention areas.

Although the program model was conceived as operating independently of government delivery systems to the poor, POUZN is sharing the model and lessons learned with federal and state agencies involved in health, urban welfare, and water and sanitation. The potential for involving community outreach workers (such as Anganwadi and ASHA workers) is great. Collaboration with other USAID projects also offers possibilities (POUZN’s zinc program in India has already made linkages with the POU NGOs.)

A number of organizations have expressed their interest in joining with AED/POUZN in expanding the model. These include Michael & Susan Dell Foundation, PATH, Water Aid, Medentech, Vestergaard-Frandsen, Ion Exchange, Halopure, and a number of national and international NGOs.

This case study will be updated when results of evaluation research that is now ongoing have been analyzed.

Additional Lessons Learned Reports

Posted June 2010

Contact

Camille Saade
POUZN Director
+1 (202) 884-8959
csaade@aed.org