Published: March 30, 2011

r 2011 American Chemical Society 2522 dx.doi.org/10.1021/es2004683 | Environ. Sci. Technol. 2011, 45, 2522–2522

PERSPECTIVE

pubs.acs.org/est

Why Do People Choose What They Choose? And, Do They Use WhatThey Choose? SE S S S S S S S S S S&T’s Top Policy Paper 2010SBarbara Booth*

When JeffAlbert attended aWHO-sponsored symposium onhousehold water treatment in Beijing in 2006, he and

Aquaya cofounder Ranjiv Khush noticed participants “energeti-cally debating” explanations for low adoption of point-of-usewater treatments. But, Albert and Khush realized that they “hadnot seen any rigorous field research assessing consumer prefer-ences for these products among the developing world poor.”

With this as motivation, Albert enlisted David Levine, UCBerkeley. With experience in the measurement of consumerbehavior, Levine was looking for opportunities to study decision-making by low-income consumers regarding health-relatedgoods. Levine recruited Jill Luoto, a Ph.D. student in economicsat Berkeley, currently at the Rand Corporation.

The resulting paper has been namedES&T’s TopPolicy Paper of2010: “End User Preferences for an Performance of CompetingPOU Water Treatment Technologies among the Rural Poor ofKenya”by JeffAlbert, Aquaya Institute, SanFrancisco,California; JillLuoto, Department of Agriculture and Resource Economics, andDavid Levin, Haas School of Business, University of California,Berkeley (Environ. Sci. Technol. DOI 10.1021/es1000566).

“Too often we see another 'miracle water treatment device’ in themedia. The problem is that these devices work well in the laboratory,but their success depends upon one crucial moving part: the user.There is a real dearth of research into which sorts of water treatmentmethods users will adopt and into the relationship between useradoption and the local cultural values around water. This paper, I

hope, will inspire a research agenda which has so far been neglected”says Ron�an Conroy, Royal College of Surgeons in Ireland.

According to Albert “Point-of-Use [POU] water products includean array of filters and chemical disinfectants that households can use toremove or inactivate microbial pathogens. These products have greatpotential because theyempower thepoor to render their drinkingwatersafe. Production, distribution, and sale of POU products also mayprovide acommercial opportunity.At the same time,with theexceptionof boiling in some regions, large populations have not adopted safewater products in the way they have adopted, say, cellular telephones.”

The study took place in Western Kenya. It set competingproducts against one another, comparing use of, effectiveness,and preference for three products: a dilute sodium hypochloritesolution (“Waterguard”), a disinfectant flocculant combination(PUR), and a dual chamber gravity-driven silver coated porousceramic filter. Enumerators visited 400 households, presentinginformation on each product, providing each household a two-month free trial of each product.

“This paper highlights the challenges of introducing householdlevel treatment technologies meant to remedy health disparities thatare ultimately governed by human behavior. These technologies,when implemented in the context of holistic community develop-ment strategies and health education, will eventually result in systemicimprovements in global health. It appears that the “keep it simple”axiom applies in this case with ceramic filters being preferred despitethe somewhat inferior, yet adequate, performance shown during thetime scale of the study,” says Craig Just, University of Iowa.

“We were fortunate enough to work with the Kisumu office ofCARE Kenya, whose personnel (specifically Sam Ombeki andGordon Oluoch) have been involved in field research in waterand sanitation for many years. Their committed and experiencedfield staff members were instrumental in executing this complexstudy. We feel particularly blessed to have worked with such anamazing team (see photo by Jill Luoto) of enumerators andtechnicians based in Bondo town (not far from the ancestral homeof President Obama): Salome Aoko, Maureen Mbolo, AkaboMutuli, Davis Ochieng, Emeldah Orowe, Susan Leah Osanjo, andGeorge Spencer Wambiya.” Brad Lang, at the time of our work anMBA student and former Peace Corps volunteer in this part ofKenya, played an essential role in the initial field coordination of thestudy says Albert. The team has completed a similar study inBangladesh among urban poor, a very different population.

’AUTHOR INFORMATION

Corresponding Author*est@uiowa.edu.

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