Evidence-Based Development: A Trend Whose Time Has Come? The Case of Chlorine D...

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1 Register Login Funders' Forum HOME ABOUT CONTACT BLOG FUNDING MAP FINDING SOLUTIONS KNOWLEDGE CENTER FUNDER TOOLKIT SEARCH Funders working together to solve the world's water crisis WASHfunders > Blog > Evidence-Based Developme Evidence-Based Development: A Trend Whose Time Has Come? The Case of Chlorine Dispensers for Safer Water Editor s Note: This guest blog post is authored by Alix Zwane, Executive Director of Evidence Action. In her post, Alix lauds the increased attention given to evidence-based innovations in development and describes the Dispensers for Safe Water initiative as an example of a WASH intervention grounded in this data-driven approach. Evidence-based development innovations are finally all the rage. The UK's Department for International Development and USAID announced the Global Development Innovation Ventures (GDIV) Fund almost exactly a year ago to focus development investments on innovative approaches with proven, radically successful results. Just a few weeks ago, USAID launched its Global Development Lab that aims to test and scale breakthrough development innovations. And even more recently, a senior policy advisor to the president of the European Commission argued that evidence should trump politics and diplomacy for deciding on aid investments. One example of how aspirations for data-driven development translate into actual, real projects that improve millions of peoples lives is the Dispensers for Safe Water initiative. Chlorine dispensers currently serve over two million people in East Africa and are on track to grow to four million people by the end of this year, and 25 million by Enter your TAGS 3 Questions (4) 5 Questions (5) A Child s Right (2) Action-Research (1) Advocacy (4) Afghanistan (1) Africa (9) African Ministers Council on Water (1) Aguaconsult (1) Akvo (1) American Standard (1) Asia (7) Asian Development Bank (2) Awards (4) Bangladesh (1) Bill & Melinda Gates Foundation (11) Blue Planet Network (7) BPD Water and Sanitation (1) Burkina Faso (2) Cambodia (3) CARE (1) Caterpillar Foundation (1) Catholic Relief Services (1) SUBSCRIB 1 of 7 7/25/14 4:23 PM

2 Chlorine dispensers installed directly at the water source represent an important innovation in the rural water sector. They solve a number of challenges that have hindered sustainable, quality services for cleaner water to date -- despite the billions that have been spent on water and sanitation projects. And because the approach has been vigorously tested, we can say definitively that chlorine dispensers work at a fraction of the cost of typical water projects, and at high adoption rates by people most in need of clean water. What Are Chlorine Dispensers? Dispensers are installed directly at the water source and contain enough chlorine for a community using the water source for about a month. A person collecting water turns a knob that releases enough chlorine to clean 20 liters of water -- the typical amount that people collect from the source and carry home. The dispensers are rugged and durable, and maintained and marketed by local health promoters who educate the community about the utility of adding small amounts of chlorine to the drinking water, and check and refill the dispensers as needed. charity: water (1) Children (6) China (1) Circle of Blue (1) Cisco (1) Coca-Cola (1) Collaboration (8) Conrad N. Hilton Foundation (6) Corporate Philanthropy (8) Data Collection (3) Diarrhea (3) Dilemmas (1) Dispensers for Safe Water (2) dlo Haiti (1) dlohaiti (1) Dominican Republic (1) Earthwatch Insitute (1) East Meets West Foundation (2) Education (7) Engineers Without Borders (1) Ethiopia (1) Event (6) Events (5) Evidence Action (1) Failure (1) FEMSA Foundation (1) FLOW (2) Food Security (3) Foundation Center (5) Foundations (4) Fundacion Avina (1) Funders (1) Funding Map (5) Ghana (2) GLAAS (1) Global Fund for Women (1) Global Handwashing Day (1) Global Philanthropy Forum (1) Global Water Challenge (4) Governments (2) 2 of 7 7/25/14 4:23 PM

A local health promoter in Teso district, Kenya, teaches community members about the health benefits of chlorinated water, and how the chlorine dispenser works.

3 A local health promoter in Teso district, Kenya, teaches community members about the health benefits of chlorinated water, and how the chlorine dispenser works. Credit: Andy Chen for Evidence Action Chlorine is very cheap and effective at killing most bacterial and viral pathogens. Safety concerns with dilute chlorine are minimal, and it is widely used as a disinfectant in water treatment plants around the world. Chlorine can also provide residual protection for up to three days (depending on storage conditions), which means that it not only disinfects water, but can also prevent re-contamination. Are People Healthier Because of Chlorine in their Water? So what do we know about improving water quality for people? There have been a number of review articles recently that have assessed the evidence for drinking water quality interventions in developing countries. One meta study that analyzed 65 separate evaluations concluded that Gram Vikas (2) Grants (7) H&M (1) Haiti (2) Health (6) HSBC (1) Human Rights (1) Humanitarian Innovation Fund (1) Hygiene (4) IATI (1) IBM (1) ide Cambodia (1) Ikea Foundation (1) Imagine H2O (1) Impact (3) Improve International (1) India (11) Infographic (7) Innovation (13) Innovations for Poverty Action (1) Integrated Water Resource Management (1) International Women s Day (1) IRC (2) JMP (2) Jobs (1) Kenya (5) Keurig Green Mountain (1) Laird Norton Family Foundation (1) Leona M. and Harry B. Helmsley Charitable Trust Liberia (1) Market-Based Solutions (7) Menstrual Hygiene Day (1) Merck (2) Mexico (1) Michael & Susan Dell Foundation (1) Microfinance (3) Middle East (2) Millennium Development Goals (2) Monitoring & Evaluation (16) Mozambique (2) 3 of 7 7/25/14 4:23 PM

4 point-of-use (or, in the case of dispensers, point-of-source) water quality interventions appear to be highly effective -- and indeed, more effective than water supply or source treatment in reducing diarrhea -- but that this is very sensitive to the ability of the program to sustain high rates of product adoption. Obviously, a product cannot provide health benefits if people don t use it. Another systematic review of the evidence showed that there are reductions of up to 40% of childhood diarrhea among people using the product. Are People Actually Using Chlorine Dispensers? The case for cost-effective impacts for dispensers rests not only on the potential for health impact. People actually have to use water treatment products if they are to be effective. The sustained use of dispensers has been documented via a rigorous randomized controlled trial (PDF) in which adoption held at about 50% for three years in the treatment group assigned to dispensers. We continue to see average adoption rates over 40% in areas where baseline water treatment with chlorine is less than 10%. For anyone in the WASH field, these are impressive rates. Adoption of chlorine at the point of service is high because it is cheap, convenient, salient, and public. Ned Breslin (2) Nicaragua (1) NTDs (2) Nutrition (1) ONE DROP (1) Osprey Foundation (1) Overseas Development Institute (1) P&G (1) Pacific Institute (2) Partnerships (13) Peer Review (2) PepsiCo (1) Philanthropy (12) Podcast (1) Project WET Foundation (1) PSI (1) Reinvent the Toilet Challenge (6) Reporting (1) Rio+20 (1) Rockefeller Foundation (3) Roddenberry Foundation (1) Rural Water Supply Network (2) Safe Water Network (3) Sanergy (2) Sanitation (23) Sanitation and Water for All (3) Sanitation Community of Practice (1) Sesame Workshop (1) Sierra Leone (1) Silicon Valley Community Foundation (1) Skat Foundation (5) Skoll Foundation (2) Social Entrepreneurship (3) South Africa (1) South America (1) Splash (2) STARS Foundation (3) Stone Family Foundation (4) Strategy (2) Support My School (1) 4 of 7 7/25/14 4:23 PM

5 Average adoption rates in areas where chlorine dispensers are introduced exceed 40%. Credit: Andy Chen for Evidence Action Dispensers are Sustainable and Cost-Effective Chlorine dispensers are inexpensive, costing less than $0.50 per person per year at scale. This is considerably lower than the large infrastructure programs that may not be sufficiently invested in over time, and then fall into disuse. The low cost per person has also allowed us explore new financing models, such as using carbon credits. Chlorine reduces the need for boiling water, so dispensers can be financed that way. And because chlorine dispensers are inexpensive to maintain, carbon revenue covers the costs even as the initiative expands to serve 25 million people in We believe that evidence and rigorous testing of new development approaches is critical in order Survey (3) Susan Davis (2) Sustainability (16) Sustainable Development Goals (1) SWASHplus (1) Tanzania (1) Technology (12) the Pacific (1) Twitter (1) Uganda (5) Unilever (2) Unique Identifiers (1) United Nations (3) United States Water Partnership (1) USAID (3) Video (6) Vietnam (3) WASH (129) WASH Advocacy Initiative (1) WASH Advocates (5) WASH Grantmakers Network (1) WASH Monitoring Exchange (1) WASH Sustainability Charter (1) WASHCost (3) WASHCost India (1) WASHplus (1) WASHTech (2) Water For People (5) Water School Uganda (1) Water-Energy Nexus (1) Water.org (3) Water4 (1) WaterAid (11) Webinar (7) Wherever the Need (1) Winrock International (1) Women (5) World Bank (3) World Business Council for Sustainable Developm (1) World Toilet Day (2) 5 of 7 7/25/14 4:23 PM

6 to scale what works to reach millions, and are pleased that the global development field is moving in the direction of being more rigorously data-driven and evidence-based. 07/14/ :23 AM TAGS: EVIDENCE ACTION, DISPENSERS FOR SAFE WATER, SUSTAINABILITY, WASH Comments Log in or create a user account to comment. World Toilet Organization (5) World Water Day (4) World Water Relief (1) World Water Week (5) WWF (1) Zambia (1) Zimbabwe (1) ARCHIVE July 2014 June 2014 May 2014 April 2014 March 2014 February 2014 January 2014 December 2013 November 2013 October 2013 September 2013 August 2013 July 2013 June 2013 May 2013 April 2013 March 2013 February 2013 January 2013 December 2012 November 2012 October 2012 September 2012 August 2012 July 2012 June 2012 May 2012 April 2012 March 2012 February of 7 7/25/14 4:23 PM

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U.S. Funding for International Nutrition Programs

April 2016 Issue Brief U.S. Funding for International Nutrition Programs SUMMARY The U.S. has a long history of supporting global efforts to improve nutrition and is the largest donor to nutrition efforts