This systematic review assesses the quantity and quality of evidence for the sustainability of household water treatment (HWT) since the World Health Organization (WHO) recently endorsed HWT based on growing evidence of HWT's ability to improve microbial water quality, effectiveness at reducing diarrheal disease, cost-effectiveness, and rapid application and acceptance. A large portion of the world population still relies on unsafe sources of drinking water, but whether HWT can support scaling-up efforts and be considered sustainable, it remains to be seen. Ultimately this systematic review found limited evidence of a sustained uptake and usage of HWT interventions, and results from studies that found high levels of confirmed usage after one year must be considered alongside their methodological quality.
- Kind of Study: Systematic Review.
- Sample Size: 20 articles.
- Timing of Study: October 30, 2010
- Studies Reviewed: All articles published in the past 12 years. Reviewed 14 post-implementation evaluations and 6 intervention trials of one year or longer.
- Selected studies represented 12 countries: Kenya (30%) and Guatemala (15%) the most commonly studied.
- Chlorination was the most represented HWT intervention (25%), followed by combined interventions (20%) involving either: chlorination and flocculant-disinfectant; or boiling, solar disinfection, and chlorination. Results/Implications for Programming:
- We still lack quality evidence of a sustained, long-term change in practices as a result of household water treatment (HWT) interventions.
- Further studies are still needed to explore the acceptability and effectiveness of different HWT interventions (particularly new technologies such as the biosand filter for arsenic removal), under different geographic, cultural, economic, and logistical circumstances.
- To ensure the quality of evidence for sustainability of HWT interventions, standard approaches and indicators (i.e.. confirming usage of boiling) should be developed for the comparable evaluation of HWT implementation.
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- Copyright 2011 Center for Global Safe Water, Emory University.
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