Evaluation of household drinking water filter distribution programs in Haiti

Household water treatment (HWT) can reduce the diarrheal disease burden in populations without access to safe water. We evaluated five programs that distributed biosand, ceramic, or Sawyer filters in Haiti after the 2010 earthquake and cholera outbreak. We conducted household surveys and tested Escherichia coli and turbidity in stored household untreated and treated water in ∼50 randomly selected households from each program. Across programs, self-reported filter use ranged from 27 to 78%; confirmed use (participants with reported use who also showed the filter with water currently in it) ranged from 20 to 76%; and effective use (participants who used the filter to improve water quality to international guideline values) ranged from 0 to 54%. Overall, programs that more successfully met evaluation metrics: (1) distributed an effective technology; (2) provided safe storage; (3) required cash investment; (4) provided initial training; (5) provided follow-up; (6) provided supply-chain access; (7) targeted households relying on contaminated water sources; and, (8) had experience working in the local context. These findings, similar to results of previous research on HWT, suggest that well-implemented programs have the potential to result in sustained household filter use in Haiti.