Assessing Participant Compliance With Point-of-Use Water Treatment: An Exploratory Investigation

Field studies on household water treatment and safe storage (HWTS) suggest that positive health outcomes are strongly linked to user compliance. We investigated factors that influenced compliance in a marginalized community of South India where residents worked with researchers to develop a water treatment intervention in absence of government water utilities. Survey and water quality data were collected during a 12-month randomized controlled trial of 124 households. Data were used to construct indices for social, technical, and institutional predictors of compliance including technological effectiveness, gender, community capacity, perceived benefit, and inherent demand. Perceived benefit was the only parameter to be significantly associated with compliance. Households in which participants had very high levels of perceived benefit were over 4 times more likely to comply with instructions on water treatment and maintenance with the HWTS. These findings suggest that compliance, and therefore disease prevention, can be improved by enhancing perceived benefit to the user.