Improving Access to Safe Water through Microenterprise

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Improving Access to Safe Water through Microenterprise

Kenya
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

Most of the 4.5 million people in Nyanza Province rely on unsafe water sources to meet daily needs. As a result, diarrhea is a leading cause of morbidity and mortality, particularly for children <5 years old and people living with HIV/AIDS. Provision of water infrastructure is expensive and takes years to implement. Interventions that can protect and improve health in these populations, and thereby facilitate economic and social development, are needed now. The objective of the Rotary Safe Water Project (RSWP) is to decrease water related illnesses in Kenya?s Nyanza Province, and provide income generation for rural women, through sales of inexpensive household water treatment and safe storage (HWTS) products by rural HIV/AIDS self help groups to marginalized populations with minimal access to services. HWTS interventions have been proven to prevent diarrhea and death. Access to HWTS products has been difficult in Nyanza Province because poor roads make distribution difficult and poverty limits disposable income. By mobilizing local groups for product distribution, the project will improve access to HWTS.

About You
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Your idea
Focus of activity

Disease Prevention and Health Promotion

Start Year

2004

Positioning in the mosaic of solutions
Main barrier addressed

Limited reach of healthcare infrastructure

Main principle addressed

Adopt market-based models as a scaling-up strategy

Innovation
Description of health product/service offering:

Most of the 4.5 million people in Nyanza Province rely on unsafe water sources to meet daily needs. As a result, diarrhea is a leading cause of morbidity and mortality, particularly for children <5 years old and people living with HIV/AIDS. Provision of water infrastructure is expensive and takes years to implement. Interventions that can protect and improve health in these populations, and thereby facilitate economic and social development, are needed now. The objective of the Rotary Safe Water Project (RSWP) is to decrease water related illnesses in Kenya?s Nyanza Province, and provide income generation for rural women, through sales of inexpensive household water treatment and safe storage (HWTS) products by rural HIV/AIDS self help groups to marginalized populations with minimal access to services. HWTS interventions have been proven to prevent diarrhea and death. Access to HWTS products has been difficult in Nyanza Province because poor roads make distribution difficult and poverty limits disposable income. By mobilizing local groups for product distribution, the project will improve access to HWTS.

Description of innovation:

The RSWP creates a potentially sustainable decentralized distribution approach engaging small community based HIV/AIDS self help groups, mostly women, in delivering public health messages and affordable products to rural and peri-urban communities with poor access to water and sanitation services. The incentives of access to microcredit and income generation drive an activity that benefits self-help groups even as they serve communities that will not likely benefit in the foreseeable future from water infrastructure projects. To our knowledge, this is the first time that a combined commercial/ decentralized sales strategy has been used to make safe water accessible to marginalized communities. PSI is currently marketing SWS products in over 15 countries, which has greatly increased consumer access, but the use of local HIV/AIDS self help group as a sales force to extend the reach of the program is, in our experience, a unique feature of the project. By using members of our target population to promote and distribute the intervention, we are succeeding in lowering economic, educational, and social barriers to access.

Operational model:

The Rotary Safe Water Project combines four program elements into a novel approach to overcome barriers to safe water in Nyanza Province. First, locally available household water treatment and storage interventions that are available through commercial distributors or local artisans are procured. Second, local HIV/AIDS self-help groups are mobilized to teach fellow community members about health and home-based approaches to making water safe. Third, the self-help groups become local distributors of products to marginalized communities. Fourth, the self-help groups are provided with two powerful incentives to distribute the products: income generation and access to microcredit. The project?s implementation process involves 1. Mobilizing HIV/AIDS self help groups, 2. Training groups and women in the SWS and business, 3. Providing access to loans, 4. Establishing and maintaining a product supply chain, 5. Refining the process to increase product sales and 6. Ongoing monitoring & evaluation.

Human resources:

The current RSWP team consists of a program manager (team leader), a trainer, a driver, an administrator and three field officers (one of whom is also a business consultant). Support from the Development Marketplace will allow for the addition of a second trainer and two more field officers who will be based in satellite offices to expand outreach. The program manager (team leader) has a wide range of skills and experience that enables her to supervise project staff; assist with all logistics including trainings, field visits, ordering supplies and products; managing the monthly budget; recruiting partner organizations, including donors; and compiling monthly reports. The field officers are Kenyans who represent the communities they serve, schedule and visit community groups, collaborate with microfinance organizations to enable groups to gain access to credit, and follow-up with groups to help ensure their success. The RSWP trainer is experienced at training individuals and large groups in the SWS, business, and other health related topics. The administrator handles the day-to-day cash flow, the ordering and managing of product stock, and keeping records of pr

Key operational partnerships:

The CGSW provides technical support to the RSWP for project implementation; program monitoring and evaluation in collaboration with Kenyan Masters students; and providing reports to project partners. The CGSW brings its expertise in the monitoring and evaluation of safe water projects to the RSWP. The Center?s affiliation with Emory University provides the opportunity to access faculty expertise from a broad range of disciplines for technical assistance in making refinements to the project. The CGSW also collaborates with the Tropical Institute for Community Health and Development in Africa, which enables the project to obtain local expertise on program implementation issues and provide African graduate students the training and opportunity to evaluate similar projects in the region.

Impact
Financial Sustainability:

<ul><li class="entry-label">Fees charged to clients?: <span class="entry-text">Yes</span></li><li class="entry-label">How do you assure affordability?: <span class="entry-text">Mobilized and trained self help groups are vendors of the Safe Water System, as well as other healthy living products, and charge the population they serve a retail price for the products they sell. The SWS product, WaterGuard, is socially marketed by PSI in Kenya and therefore they control the price of the product. One bottle of WaterGuard, which treats 1000 liters of water for $0.26, is an affordable product. Research has shown that distributing the product in the remote areas is more of a limiting factor than the price. </span></li><li class="entry-label">Earned incomes as a percentage of operating costs: <span class="entry-text">5%</span></li><li class="entry-label">Other funding sources: <span class="entry-text">The RSWP office in Kisumu purchases WaterGuard at below wholesale cost and sells the product to the self help groups at wholesale cost, allowing both the office and the groups to make a profit (the profit for the office is considerably smaller then the profit for the self help groups). Within 2 to 3 years the RSWP will be able to generate revenues of $3200 a month through product sales and providing other services and goods, such as photocopying, for the local community, making the office partially self-sustaining. </span></li><li class="entry-label">Strategy for long-term sustainability: <span class="entry-text">In addition to increasing product sales helping make the project more self- sustaining, the microcredit aspect of our program should be sustainable within the next two years. Our partner micro-finance organization, K-rep, will have generated enough interest during the program cycle to be self- sustaining by the end of their 18-month period and will continue providing loans to individuals throughout Nyanza Province indefinitely. Additionally, the social marketing aspect of the project should also continue to sustain itself if demand for WaterGuard is sustained because PSI is achieving cost recovery for the product. </span></li></ul>

Current and Future Impact:

<ul><li class="entry-label">Total number of clients: <span class="entry-text">60,000</span></li><li class="entry-label">Clients in the past year: <span class="entry-text">60,000</span></li><li class="entry-label">Percentage of low-income clients: <span class="entry-text">100</span></li><li class="entry-label">Impact: <span class="entry-text">Through the increased distribuiton and sales of WaterGuard, the RSWP is reducing the number of water related illnesses throughut Nyanza province. This decrease in disease potentially tranaslates into a reduction in under five mortality, as well as an increase in human capital through the reduction in morbidity. In addition to the health benefits, the self help groups involved are able to earn an income and receive training in the SWS and business, a benefit for them and those they care for.</span></li><li class="entry-label">Overall "market": <span class="entry-text">The need and demand for the services provided by the project is virtually limitless. There are numerous opportunities for expansion. Although the project team has focused their work on northern and eastern Nyanza Province, the demand for participation extends well beyond this region. There are opportunites to initiate the project in neighboring provinces. A model for expansion already exists in Kenya, where small satellite projects were initiated by recruiting other organizations to begin their own projects, training their personnel, and incorporating them into our product supply system. NGOs in neighboring countries have expressed an interest in replicating this project, which would be feasible because Safe Water System projects and HIV self help groups already exist in the countries. </span></li></ul>

Scaling up strategy:
Stage of the initiative:

<i>Scaling Up</i> stage.

Expansion plan:

With partner support, in 4 to 5 years, this project could expand to all 8 provinces of Kenya and to two or three neighboring countries. Expansion is already underway in Nyanza Province and in 2 neighboring provinces. The expansion process involves teaming up with other local NGO's who are capable of mobilizing groups, training the NGO's to initiate the project and bringing on board local micro finance organizations and PSI.

Origin of the initiative:

The idea of mobilizing HIV/AIDS self help groups to sell water treatment and storage products grew out of recognition by the CDC Global AIDS Program (GAP) in Kenya that HIV-infected women participating in HIV support and care activities had an acute need for income generation. Many were widows who were shunned by their communities and lacked the skills to earn a living. In addition, diarrhea was a leading cause of morbidity and mortality in this population, with illness rates up to 6 times that of the HIV negative population. Taking advantage of an existing SWS program in Nyanza Province, GAP implemented a pilot project in Asembo Bay in 2002, training local women?s groups about the purpose and correct use of SWS, and procuring SWS products at wholesale for them to sell at retail. The pilot project was a success, largely because of the demand for the product.

Sustainability
Policy change:

A national government policy calling for better access to improved and safe water sources for all would have a significant impact on the health of the poorest segment of the population in Kenya.

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