Expanding adoption of drinking water treatment systems in developing countries: a case study from Tamil Nadu, India

Household-level water treatment and safe storage systems (HWTS) are simple, local, user-friendly, and low cost options to improve drinking water quality at the point of use. However, despite conclusive evidence of the health and economic benefits of HWTS, and promotion efforts in over 50 countries in the past 20 years, implementation outcomes have been slow, reaching only 5-10 million regular users. This study attempts to understand the barriers and drivers affecting HWTS implementation. Using a case study example of a biosand filter program in southern India, system dynamics modelling is shown to be a useful tool to map the inter-relationships of different critical factors and to understand the dissemination dynamics. It is found that the co-existence of expanding quickly and achieving financial sustainability appears to be difficult to achieve under the current program structure.