Household perception and use of de-fluoridised water and hygiene behaviour in Naivasha, Kenya : report for WSUP

Excessive amounts of fluoride pose a health risk to those relying on groundwater for drinking in 23 countries worldwide, including Kenya. Water and Sanitation for the Urban Poor (WSUP), a partnership between private sector organisations, civil society and academic institutions is working on a range of water supply issues in urban environments where significant population growth has occurred, often without a corresponding increase in basic services. One such example is the communities of Karagita and Mirera close to the town of Naivasha, Kenya. Since its’ initial planning stage in 2006 the WSUP project has sought to find a sustainable solution to the dual problems of lack of affordable, reliable and safe water supply and high levels of fluoride in the groundwater above the safety guidelines set for drinking water by the WHO. This study comprised of a rapid participatory assessment to explore the lower than expected sales of treated fluoride free water in the pilot project, despite the health risks. 53 semi-structured interviews were carried out, along with participant observation in order to identify water use and hygiene practices, specify the social and economic factors that shape these behaviours and assess the communities’ understandings of the risk of fluorosis. Respondents often appeared to be opting for the cheaper options of untreated water and, whenever possible, collecting rain from their rooftops. Participants reported a number of factors affecting their water use, but the key finding was that use of treated water actually has less to do with economics but is instead dependent on individual awareness of fluoride and the health risks it poses.
The best way to increase the use of treated water in these communities is through an information campaign to disseminate and reinforce educational messages. In collaboration with respondents, some appropriate methods to increase community awareness were developed. [authors abstract]