Journal of Public Health

, Volume 20, Issue 3, pp 269–278 | Cite as

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



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 filter Behavior change Status norm Perceived behavior control Attitudinal beliefs Habit 



This study is part of the Water Resource Quality (WRQ) project at EAWAG. Most of all, we would like to extend thanks to Esayas Samuel, Tesfaye Edosa, and Feyisa Lemma from the Oromia Self Help Organization (OSHO)for their professional input, valuable contribution, and great collaboration during the field work. Further, we want to name the Swiss National Science Foundation (SNF) and the Swiss Agency for Development and Cooperation (DEZA) as the project’s financial support. Finally, our acknowledgment also goes to the Swiss Interchurch Aid (HEKS), which provided the project with the household filters.

Conflicts of interest

The authors declare that they have no conflict of interest.


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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

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