title: Effectiveness of chlorine dispensers in emergencies: case study results from Haiti, Sierra Leone, Democratic Republic of Congo, and Senegal.
abstract: Dispensers are a source-based water quality intervention with promising uptake results in development contexts. Dispenser programs include a tank of chlorine with a dosing valve that is installed next to a water source, a local Promoter who conducts community education and refills the Dispenser, and chlorine refills. In collaboration with response organizations, we assessed the effectiveness of Dispensers in four emergency situations. In the three initial and four sustained response phase evaluations, 70 Dispenser sites were visited, 2057 household surveys were conducted, and 1676 water samples were analyzed. Across the evaluations, reported Dispenser use ranged from 9 to 97%, confirmed Dispenser use (as measured by free chlorine residual) ranged from 5 to 87%, and effective use (as measured by improvement in household water quality to meet international standards) ranged from 0 to 81%. More effective Dispenser interventions installed Dispensers at point-sources, maintained a high-quality chlorine solution manufacturing and distribution chain, maintained Dispenser hardware, integrated Dispensers projects within larger water programs, remunerated Promoters, had experienced project staff, worked with local partners to implement the project, conducted ongoing monitoring, and had a project sustainability plan. Our results indicate that Dispensers can be, but are not always, an appropriate strategy to reduce the risk of waterborne diseases in emergencies.
authors.affiliation: †Innovations for Poverty Action, New Haven, Connecticut 06510, United States.|‡Department of Civil and Environmental Engineering, Tufts University, Medford, Massachusetts 02155, United States.
authors.forename: Travis M
authors.initials: TM
authors.lastname: Yates
authors.affiliation: †Innovations for Poverty Action, New Haven, Connecticut 06510, United States.
authors.forename: Elise
authors.initials: E
authors.lastname: Armitage
authors.affiliation: †Innovations for Poverty Action, New Haven, Connecticut 06510, United States.
authors.forename: Lilian V
authors.initials: LV
authors.lastname: Lehmann
authors.affiliation: ‡Department of Civil and Environmental Engineering, Tufts University, Medford, Massachusetts 02155, United States.
authors.forename: Ariel J
authors.initials: AJ
authors.lastname: Branz
authors.affiliation: †Innovations for Poverty Action, New Haven, Connecticut 06510, United States.|‡Department of Civil and Environmental Engineering, Tufts University, Medford, Massachusetts 02155, United States.|§Sustainability Science Program, Center for International Development, Harvard University, Cambridge, Massachusetts 02138, United States.
authors.forename: Daniele S
authors.initials: DS
authors.lastname: Lantagne
mesh_terms: D000328:Adult; D017954:Africa South of the Sahara; D002713:Chlorine / Q000627:therapeutic use*; D003140:Communicable Disease Control / Q000379:methods / Q000706:statistics & numerical data; D004632:Emergency Medical Services; D005191:Family Characteristics; D005260:Female; D006205:Haiti; D006801:Humans; D008297:Male; D008875:Middle Aged; D018508:Water Purification / Q000379:methods*; D060753:Water Quality
chemical_list: D002713:Chlorine