Determining the differential preferences of users of two fluoride-free water options in rural Ethiopia
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.
KeywordsFluoride 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.
- Albarracín D, Gillette JC, Earl AN, Glasman LR, Durantini MR, Ho MH (2005) A test of major assumptions about behavior change: a comprehensive look at the effects of passive and active HIV-prevention interventions since the beginning of the epidemic. Psychol Bull 131:856–897PubMedCrossRefGoogle Scholar
- Arnold B, Arana B, Mäusezahl D, Hubbard A, Colford J (2009) Evaluation of a pre-existing, 3-year household water treatment and handwashing intervention in rural Guatemala. Int J Hyg Envir Heal 38:1651–1661Google Scholar
- Bem DJ (1972) Self-perception theory, vol 6. Academic, New YorkGoogle Scholar
- Huber AC, Tobias R, Mosler HJ (2011) Evidence-based tailoring of persuasion campaigns: increasing fluoride-free water consumption in rural Ethiopia. Paper presented at the 25th Annual Conference of the European Health Psychology Society, Hersonissos, Crete, Greece, September 2011Google Scholar
- Inauen J, Mosler H-J (2010) Risky consumption of drinking water: predicting the use of arsenic-safe drinking water options in Bangladesh. Oral presentation at the 27th International Congress of Applied Psychology, Melbourne, Australia, July, 2010Google Scholar
- Korir H, Mueller K, Korir L, Kubai J, Wanja E, Wanjiku N, Waweru J, Mattle MJ, Osterwalder L, Johnson CA (2009) The development of bone char-based filters for the removal of fluoride from drinking water. Paper presented at the 34th WEDC International Conference, Addis Ababa, Ethiopia, May 2009Google Scholar
- Krebs R (2002) Anleitung zur Herstellung von MC-Fragen und MC-Prüfungen [Instructions for preparing MC-questions and MC-exams]. http://www.fnl.ch/LOBs/LOs_Public/MC_Anleitung.pdf. Accessed 6 March 2010
- Mosler HJ (2012) A systematic approach to behavior change interventions for the water and sanitation sector in developing countries: a conceptual model, a review, and a guideline. Int J Environ Health Res. doi: 10.1080/09603123.2011.650156
- Mosler HJ, Tobias R (2007) How do commitments work? An agent-based simulation using data from a recycling campaign in Santiago de Cuba. Paper presented at the International Conference on Artificial Intelligence, Las Vegas, NV, June 2007Google Scholar
- Petty RE, Rucker DD, Bizer GY, Cacioppo JT (2004) The elaboration likelihood model of persuasion. In: Seiter JS, Gass RH (eds) Perspectives on persuasion, social influence, and compliance gaining. Pearson, Boston, pp 65–90Google Scholar
- World Health Organization (2004) Guidelines for drinking-water quality, 3rd edn. World Health Organization, GenevaGoogle Scholar