In May 2010, Malawi hosted the All-African Environmental Health Congress in Lilongwe. There, government stakeholders, academics and NGOs came together to discuss how better to control diarrheal disease, the second leading cause of child death in the country.
Diarrhea causes approximately 11 percent of deaths in children under five in Malawi. One of the poorest nations in the world, Malawi is a mostly rural, land-locked country tucked between larger neighbors Mozambique, Tanzania, and Zambia. Safe drinking water and sanitation are scarce, and much of the population has no access to health care. In addition to diarrhea, the country also struggles with better-known and better-funded diseases such as HIV/AIDS, malaria, and tuberculosis. As a consequence, more common, easily preventable, and easily treated causes of childhood morbidity and mortality can lose critical airtime and attention in the national policy debate.
A group of committed stakeholders wanted to raise the priority of diarrhea, and they decided to start at the level of policy and political will. Over the course of the year, a committed group of stakeholders from across sectors and departments engaged in a process of dialogue and policy analysis that produced a roadmap for policy change and reprioritization of diarrheal disease control in the country. Read about what the group found and their recommendations for the way forward here.
In 2007 the US Centers for Disease Control and Prevention (CDC) reported remarkable uptake of the liquid chlorine water treatment product, WaterGuard, when the product was provided and marketed by Population Services International (PSI) as part of a free hygiene kit at antenatal clinics in Malawi. At baseline, only 2% of the program participants had used WaterGuard. Nine months later, 61% of the participants were using WaterGuard and 55% reported having purchased the product. Among friends and relatives of program participants, confirmed water treatment increased from 2% at baseline to 25% at follow-up.
PATH recently supported the CDC to learn whether women from the original study were still treating their water, three years after the intervention. The CDC found that 26% of the original participants had confirmed use of WaterGuard and 54% used either WaterGuard and/or a chlorine solution distributed for free by the Ministry of Health. These encouraging results suggest that pregnant women and new mothers may be excellent targets for ongoing and future efforts to increase household water treatment behavior in developing countries.
Contributed by PATH
The negative consequences of contaminated water extend far beyond health issues such as diarrheal disease. For example, in Malawi contaminated drinking water and the diarrheal disease it causes led to children missing many days of school.
The Midzemba ADP Schools Safe Water Project, a partnership between Procter and Gamble’s Children’s Safe Drinking Water Program, World Vision, and Population Services International/Malawi, worked to reduce diarrheal disease episodes and absenteeism in target area schools.
The projects implemented point-of-use water treatment in target schools using WaterGuard Wa Ufa (known as PUR in the United States). A small four-gram satchel of the powdered treatment has the capacity to clean ten liters of water by killing bacteria and viruses while removing solid materials in about 20 minutes. The partners provided the water disinfectant to participating schools, promoted complementary diarrheal disease intervention methods, including hand-washing with soap after using the restroom, and increased the number of pit latrines available to students.
The project led to a 90 percent reduction in diarrheal disease in target schools and a 57 percent reduction in school absences. Additionally, pit latrine coverage increased by 75 percent. Broader benefits were also realized in the general community. Children brought their improved hand-washing habits to their families, leading to a more than 50 percent decrease in diarrheal disease in this Malawi community.
Contributed by World Vision