Scaling up household water treatment among low-income populations

The primary aims of this report are to review the development and evolution of leading household water treatment technologies (HWTS) in their efforts to achieve scale; to identify the main constraints that they have encountered; and to recommend ways forward. The report defines scale in terms of both coverage and uptake by a vulnerable population. Section 2 examines efforts to scale up other important household-based interventions: sanitation, oral rehydration salts, guinea worm filters and insecticide-treated mosquito nets for lessons of potential value to scaling up HWTS. Section 3 presents case-studies of the most common HWTS products and technologies: boiling, safe water system (SWS), sodium dichloroisocyanurate (NaDCC) tablets, solar disinfection, ceramic filters, bio-sand filters, middle-market commercial filters, and flocculation/disinfection products. The report lists the special constraints that HWTS must overcome before it can achieve scale and concludes that current efforts to scale up HWTS will fall far short of meeting the actual need. Shortcomings in existing products, delivery strategies and a basic understanding of what householders want continue to hamper efforts to achieve widespread coverage and uptake. Ten steps that warrant particular priority are presented in the final section of this report.