Journal of Public Health

, Volume 20, Issue 3, pp 269–278

Determinants of exclusive consumption of fluoride-free water: a cross-sectional household study in rural Ethiopia

  • Alexandra C. Huber
  • Sarah Bhend
  • Hans-Joachim Mosler
Original Article

DOI: 10.1007/s10389-011-0445-z

Cite this article as:
Huber, A.C., Bhend, S. & Mosler, HJ. J Public Health (2012) 20: 269. doi:10.1007/s10389-011-0445-z



The occurrence of high fluoride concentrations in the ground- and surface water all over the world leads to the risk of developing dental and skeletal fluorosis. In Ethiopia, 8 million people depend on water sources with excessive fluoride. In four project areas in the Ethiopian Rift Valley, fluoride removal household filters based on bone char media have been implemented. This study examines possible predictors of consuming filtered water derived from various behavior change theories.

Subject and methods

In a complete cross-sectional survey, 160 filter users were interviewed through structured face-to-face interviews. A logistic regression was carried out to reveal factors predicting consumption of filtered water.


The results show that the consumption of fluoride-free water is mainly related to people’s pride in offering filtered water to guests (status norm) and the feeling of being able to produce enough water with the filter (perceived behavioral control). Moreover, the study showed that the more filter users like the taste of filtered water and the more expensive they perceive the filter media, the more likely users will exclusively consume filtered water (attitudinal beliefs). Furthermore, perceiving the act of filling as a matter of habit (perceived habit) enhances filtered water consumption.


Based on the results, possible intervention strategies to change the influential psychological factors and, hence, increase the consumption of treated water can be designed.


Fluoride removal filterBehavior changeStatus normPerceived behavior controlAttitudinal beliefsHabit

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Alexandra C. Huber
    • 1
  • Sarah Bhend
    • 2
  • Hans-Joachim Mosler
    • 1
  1. 1.Eawag: Swiss Federal Institute of Aquatic Science and TechnologyDuebendorfSwitzerland
  2. 2.Department of Psychology, Division of Social PsychologyUniversity of ZurichZurichSwitzerland