Difficulties in bringing point-of-use water treatment to scale in rural Guatemala.

In an earlier study, 257 households that received flocculant-disinfectant to treat their drinking water had 39% less diarrhoea than 257 control households. Three weeks after completion of the study, national marketing of the flocculant-disinfectant was extended into the study communities. Six months later, frequency of and characteristics associated with purchase and use of the flocculant-disinfectant was assessed. Of 462 households (90%), 22 (5%) purchased the flocculant-disinfectant within the preceding 2 weeks and used it within the last week. Neither being randomised to the intervention group during the efficacy study nor combined spending on laundry soap, toothpaste, and hand soap in the preceding week was associated with active repeat use. Even after efficacy was demonstrated within their community and a sophisticated marketing approach, few households purchased flocculant-disinfectant for point-of-use water treatment. Am J Trop Med Hyg. 2008;78(3):382-7.