A systems approach to characterise the dissemination process of household water treatment systems in developing countries

Abstract: Starting in the 1980s, household-level water treatment and safe storage systems (HWTS) have been developed as 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. Although existing literature related to HWTS and innovation diffusion theories proposed ample critical factors and recommendations, there is a lack of holistic and systemic approach to integrate these findings. It is proposed that system dynamics modelling can be a promising tool to map the inter-relationships of different critical factors and to understand the structure of HWTS dissemination process, which may lead to identifying high impact, leveraged mitigation strategies to scale-up HWTS adoption and sustained use.