Sustainability of Long-Term Take-Up at Point-of-Collection Chlorine Dispensers Provided Free of Charge in Rural Western Kenya

As part of a prior study, in September 2007 35 springs in rural communities in Western Kenya were randomly assigned to either a comparison group (15 springs) or a point-of-collection chlorination program (20 springs) involving installation of a chlorine dispenser near the spring and training of a community-elected chlorine promoter. The chlorine dispenser was designed to reduce the costs of chlorination by switching from individually packaged bottles for each household to a common refill jug for the community. It also provides easier and more standardized dosing than the commercially-available bottled dilute sodium hypochlorite, facilitates social learning by making the treatment decision public, and serves as a visible reminder to treat water at the most salient moment. Take-up was shown to be high (61% of randomly selected households tested positive for at least 0.2 mg/L of total chlorine residual on an unannounced visit) within the first six months of the program when promoters were paid a small incentive (equivalent to US0.29) for every household that tested positive.