Using market forces to improve access to better water, air, sanitation, and hygiene

Stooping through the front door, Chaya pauses to let her eyes adjust from the bright sunlight to her darkened home. Her daughter, weak from a bout of diarrhea, coughs as she stokes the fire in the middle of the room. The air is thick with soot.

In this part of Cambodia, families like Chaya’s struggle to make a living through farming. The village lacks sanitation facilities, and sewage drains into the nearby stream that serves as the drinking and agricultural water supply and washing facility. In the wet season, diarrhea-causing microbes and malaria-spreading mosquitoes flourish.

Last year, Chaya borrowed money so she could buy a water filter for her home. The filter cost US$20, more than her family makes in a month.

That’s a steep price to pay, even for safe water. Where governments have been unable to supply safe drinking water, PATH has been working with public and private-sector partners to make appropriate and affordable household water treatment options available.  Building on our success with water filters, we’ve been working to improve sanitation, indoor air quality, and hygiene, too. In India, Cambodia, Vietnam, Kenya, Uganda, and Tanzania, our goal has been to create and refine solutions that give families the tools they need to live healthier lives.

Designing for the consumer

Whether focusing on household water filters, latrines, clean cook stoves, solar lanterns, or hand-washing stations, we begin by taking stock of currently available products and practices. What do current practices look like? Which products are available? How much do they cost? Who is using them, and how are they working? Our engineers identify and test a range of products, and our behavior and commercialization experts gauge consumer willingness to try new practices or buy new products.

Next we assess the capacity of manufacturers and distributors within the market. Are there opportunities to scale up efforts—to manufacture products that work for those who will use them and sell them for less? After we establish manufacturing and distribution for the products and ensure that they can be priced affordably, we help local entrepreneurs learn to effectively market these health goods to consumers.

Getting to market

Our inclusive market approach brings together the expertise of commercial product manufacturers and marketers, microfinance institutions, nonprofit institutions, and governments. Working together, each type of institution helps ensure that we create and market attractive, effective, and affordable products—and that consumers can acquire them.

Proven results

While our market-based approach has increased use of household and community water solutions in India, Kenya, and Cambodia, the most dramatic results are in Cambodia, where families like Chaya’s still struggle to get safe drinking water.

When we started working in Cambodia in 2006, ceramic pots that filter water had been sold or given away for a decade, but only 6 percent of the population used them. Our research suggested that the product was sufficiently effective, but not aesthetically appealing to consumers. Working with consumers and a Cambodian manufacturer of the ceramic water pot, we made recommendations for improved product design and a new marketing strategy. We also paired the manufacturer with a microfinance lender who offered low-cost loans to families that wanted to buy the filter.

Good design, better sales

The result? The improved ceramic water pot outsold the earlier design 17 to 1 when offered with microfinance loans. After 11 months, use had increased to 43 percent among microfinance members, nearly all of them low-income consumers. What’s more, at the end of the 11-month project, 90 percent were still using their ceramic water pot filters. Both commercial partners recovered all of their costs, allowing them to expand the model without more donor support.

Now, we’re applying this approach to health-enhancing products around the world, bringing us one step closer to the goal of improving health and well-being of all families, no matter where they live.