Going to Scale with Household Drinking Water Disinfection: Opportunities and Challenges in Social Marketing in Madagascar

Access to safe drinking water is a daily struggle for more than one billion people in the developing world. Population Services International (PSI) is working in collaboration with local governments, NGO partners and the commercial sector to promote and ensure access to chlorine-based household water treatment solutions. Complementary to water infrastructure projects, household water treatment is safe, cost-effective, rapid-toimplement, and can be rolled out on a national or regional scale.PSI Madagascar collaborated with the Centers for Disease Control to develop and introduce a household drinking water treatment program in 2000. The program was initially introduced to respond to cholera and cyclone emergencies and quickly expanded nationwide through the promotion of Sur Eau water treatment for every day use. Over 2.1 million bottles of Sur Eau have been provided in Madagascar through commercial and community-based channels.The Sur Eau program has generated awareness of household water treatment and hygiene practices by influencing determinants of behavior change. A household survey was conducted in 2004 and 2006 to investigate levels of household water treatment, progress over the years and evaluate which determinants translate into use.With just under ten years of experience implementing household water treatment programs, PSI has gathered a wide range of lessons in scaling up household water treatment. Through the lens of PSI Madagascar, the session will discuss the challenges and opportunities of the Sur'Eau program