Journal of Public Health

, Volume 21, Issue 2, pp 183–192 | Cite as

Determining the differential preferences of users of two fluoride-free water options in rural Ethiopia

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



In the Ethiopian Rift Valley, 8.5 million people depend on water sources with excessive fluoride. In one rural village, a fluoride-removal community filter was implemented; a personalized reminder was distributed to change people’s behavior and increase the usage of the in-village community filter. During this promotion phase, an alternative fluoride-removal option was installed in a neighboring village.

This study examines psychological factors that explain the differences in preference between the two options and their influence on the usage of the different sources. In addition, the effectiveness of the applied behavior change technique, a personalized reminder, on the use of the in-village community filter was analyzed.

Subject and methods

In a complete longitudinal survey, 180 households, with access to both mitigation options, were interviewed through structured, face-to-face interviews. Logistic regressions were carried out to reveal factors predicting the usage of the two mitigation options and the effect of the implemented behavior change intervention.


The results showed that the better the taste, the lower the effort and the lower the costs for using the in-village community filter are perceived; in addition, the lower the perceived vulnerability to contract disease, the more the in-village community filter is used. Moreover, it was found that the personalized reminder also had a positive effect on the usage of the in-village mitigation option.


Based on the results, possible recommendations for practitioners and researchers are made to help plan and implement mitigation options.


Fluoride removal filter Behavior change Perceived costs Perceived taste Effort Personalized reminder intervention 



The present study is part of the Water Resource Quality (WRQ) project at EAWAG. First of all, we would like to extend thanks to Tesfaye Edosa, our field research assistant, and Feyisa Lemma, our social worker from the Oromo Self-Help Organization (OSHO). Without their professional input, valuable contribution, and great collaboration during the fieldwork, we would not have been able to accomplish the project. Second, our thanks go to all of our interviewers and health promoters, who contributed significantly to the success of the survey. Finally, 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.

Conflicts of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.Eawag: Swiss Federal Institute of Aquatic Science and TechnologyDuebendorfSwitzerland

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