... 26Twosmall water treatment plantshadbeensetupinMambandabyGTZduringtheirfirstproject,drawing and treatingthelow‐qualitygroundwater. Water waspartiallytreated, and pumpedtosixcommunal water pumps,whichweremanagedby water vendors(localentrepreneurs).This water stillrequiredadegreeofdisinfectionbeforedrinking, and wassoldathalfthepriceofthenationallyregulated water, alongwithWG and MMSstoves.Thecommunitythushadtheoptionofbuyingtheir water from1)sixlocally‐treated and ‐mannedpumps,2) water pumpsdrawing water treatedbythenationalauthorities and 3)nearbynaturalsourcessuchasshallowwells and streams. Water fromthesixcommunalpumps(option1)wassoldat25CFA/litreasopposedtothe50CFA/litrechargedatnationally‐controlled water pipes.Peoplecouldbuythis water alongwithWGsustainingboththeGTZ‐initiated water pump and theproduct.WGwassoldtothecommunityat500CFA/bottle.Thispriceprovideda100CFAprofittovendors and 25CFAtoapooledfundmanagedbythelocalprojectcommittee.StovesSixlocalweldingbusinessesoptedtoparticipateintheproject, and weretrainedbyGTZforstoveproduction and use.Communitymemberscouldobtainstovesdirectlyfromthewelders,atanyofthesixcommunalpumpsorfromthecommunityworkers.TheweldersmadeasmallprofitfromthesaleofMMSstoves,thoughthisitemwasmoreexpensive, and neededtobeheavilysubsidized(asdiscussedfurtherinsection2.4.2).ImplementationCommunityworkersfromMambandawereusedformobilization and awareness‐raising.TheyhadbeentrainedtwoyearsearlierbyGTZinthe Water and Sanitationproject, and werebuildingupontheirpreviousexperienceinthisfield,wheretheyhadmadeanameforthemselvesunderthe“MamiPegna”logo(Figure2.2onthefollowingpage).Theyworkedtogetherwiththehealthcentrestaff,ACMS, and projectmanagersinawarenessraisingactivities, and laterintotheproject,wheretheysoldbothproducts.Post‐projectproceedings:unplannedcessationofactivitiesAseriesofeventsledtotheprojecthaltingprematurely.ItendedsequentiallybetweenAugust‐November2009.ByAugust,existingWGstockshadreachedtheirdateofexpiry, and ACMS’WGsupplierswouldnotrenewtheircontract,resultinginnonewstock.ThecessationofsupplyingWGwaslargelyduetofaultybottle‐topsthatwouldeasilybreak,causingspills, and hasteningtheexpiryoftheproductduetoairexposure.Theissuewasnotedbythenationalqualitycontrolbody.Consequently,theonlyimportersofWGhaltedtheirservicestoACMS and beneficiariesbeganreturningWGbottlesinMay2009.ACMSpresence, and newWGstocksthuscametoahaltbyAugust2009.Theproductionofstovescontinued,thoughbyfewerwelders.Inaddition,GTZdidnothaveadditionalfundstomaintaintheirstaffinthearea, and forexternalreasons,movedtheirofficesfromDoualabacktoYaoundé.Theexitstrategyhadbeentotrainthelocalimplementers, and maintainalocal water and sanitationcommitteewhichwouldbeintegratedintothelocalgovernmentstructure.The ... Overallfollow‐up/projectre‐establishmentAnassessmentofthecurrentsituation,giventhecessation(atthistime)oftheprojectwouldbeanappropriatefirstaction.Initialtaskswouldincludeascertainingwhichofthepartnerorganizationsarestilloperational,otheravailablepartners, and thestatusoftheformerMambanda water and sanitationcommittee. Supportforalocal water, sanitation, and indooraircommitteeApproachestoinvolveallstakeholdersinaviablemannerarerequired.Foritsduration,thecommunitycommitteeseemstohavebeensuccessful.Giventhehouseholdleveloftheseinterventions,suchamodelmaystillbeappropriate.Theactiveparticipationoflocalgovernmentwouldalsobeafactortoinclude,togetherwithotherhigher‐levelsupport. ... 13Thisisawell‐managedproject.Itreliesonvendors,usingasustainablecommercialmodelsupportedbylow‐interestloans and innovativeeducationalmethodstoempowerlow‐incomehouseholdswithknowledgeabouthowvariousproductscanimprovehealthoffamilies, and encouragesadoptionthroughexample.Projectfunctioning and achievementsThevendors,localmembersofthecommunitiesdrawnfromHIVsupportgroups and othercommunityselfhelpgroups,areessentiallyrunningsmall‐scalebusinessoperationsfacilitatedby(relatively)low‐costloans, and arekeytothefunctioning and successofthisproject.Theyworkthroughcommunitymeetings and schools, and alsodirectlybyhouse‐to‐housevisits,whilesomealsosellincommunitykiosks and pharmacies.TheSWAPvendorsareofferedtrainingonsafe water and businessskillstohelpthemtobecomemoreefficientinmanagingtheirsmallscalebusinessesincludingsellinghealthproducts.Thepromotionofproductsiscommerciallysustainableasthesearesoldatcostwithasmallmark‐upforthevendors,althoughthisisepisodicallycompromisedbyfreehandoutsbyotheragenciesof water treatment productsduringfloods and othercrises.Overall,thisappearstobeaneffective and robustmodelforsustainabledelivery.LikeallsuchNGO‐ledactivitieshowever,itwasnotentirelyclearhowwellthissystemwould‘survive’ifSWAPfunding and key,highlycompetentpersonnelwerenolongermanagingtheprogramme.Vendorsareverycommitted, and recognizecommunitydemand,butareunsurewhethertheywouldstillbeabletoaccesstheproducts.TheproductsthemselveshavethepotentialtoimpactonarangeofhighprioritydiseaseconditionsforchildsurvivalinKenya,namelypneumonia(Upesistoves),diarrhoea(arangeofHWTSproducts and hand‐washingsoaps),malaria(ITNs) and under‐nutrition(Sprinkles). Water treatment and storageTheHWTSproductscanbeexpectedtobeefficacious,buteffectivenessdependsoncomplianceineverydayuse.Furtherdataanalysisisneededtocompletethepicture,butresultsavailabletodateshowcomplianceacrosstheNICHEareatobemoderate,reachingatbest66%reporteduse and 57%confirmedbychlorineresidualtestinginthe10integratedprojectvillagesamongimprovedstoveusers.Onthebasisofthesedata,theprojecthasreached (and exceeded)thestatedgoalforHWTS.Thislevelofcompliancemayhoweverberelativelygood,intermsofwhatcanbeachievedinpracticewithHWTS.Althoughcomplianceappearstobehighestwherecombinedinterventionshavebeenpromoted and adopted,thisneedsfurtheranalysis,adjustingforsocio‐economic and otherconfoundingfactors.Itisalsoimportanttotakeintoaccounttheeffectofparticipationinastudywithfrequenthomevisitswhichmayinflatecomplianceinanon‐sustainableway.ImprovedstovesTheauthorsarenotawareofanypriorstudiesoftheefficacyoftheUpesistoves,specificallyintermsofHAPreductionsinideal(‘test‐house’)circumstances.However,resultsfromtestingofindoorairpollutionlevelsinthecurrentproject(repeatedearlyin2010)demonstrateverymodestreductionsinPM2.5of10‐20%atbest.However,strongerevidenceofsavingsinfuelwoodofnearly30%wasreported.Basedoneverydayexperienceinthe...