Determinants of caregivers' use and adoption of household water chlorination: A qualitative study with peri-urban communities in the Peruvian Amazon

Jessica D. Rothstein, Elli Leontsini, Maribel Paredes Olortegui, Pablo Peñataro Yori, Pamela J. Surkan, Margaret Kosek

Research output: Contribution to journalArticlepeer-review

Abstract

The gap between the efficacy and the effectiveness of household water treatment in reducing diarrhearelated morbidity indicates the need for a better understanding of the determinants of long-term behavior change. To explore the barriers to drinking water chlorination in the Peruvian Amazon, where diarrhea is endemic among under-5 children, we conducted qualitative research with 23 caregivers from peri-urban communities of Iquitos, Peru. Our inquiry drew on the Transtheoretical Model of behavior change and the Integrated Behavioral Model for Water, Sanitation, and Hygiene to identify the most relevant contextual, psychosocial, and technological determinants of initial action and longterm adoption of chlorination. Our findings suggest that the decision to try out this practice resulted from the combined effect of knowledge of chlorination benefits and product availability and affordability. Progress from action to adoption was influenced by caretakers' understanding of dosage, the packaging of chlorine products, knowledge and skills for multipurpose laundry bleach, the taste of treated water, and reinforcement. This analysis suggests that a focus on these determinants and the household domain may help to improve the sustainability of future intervention efforts.

Original languageEnglish (US)
Pages (from-to)626-635
Number of pages10
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume93
Issue number3
DOIs
StatePublished - Sep 1 2015

ASJC Scopus subject areas

  • Parasitology
  • Virology
  • Infectious Diseases

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