Assessing factors affecting the use of chlorine dispensers for household water treatment in rural Kenya, Malawi, and Uganda

ABSTRACT Although chlorination is widely accepted as a safe and cost-effective water treatment method, its adoption by the rural populations remains low. This leaves about 26% of the world's population – including 70% in Sub-Saharan Africa – with a lack of access to safely managed drinking water and exposure to hazards of drinking unsafe water. This work used data collected in a repeated cross-sectional study conducted between 2021 and 2022 in Kenya, Uganda, and Malawi to assess factors that influence a community's adoption of chlorine to treat water. The results indicate that households that observed good water storage and handling practices, had knowledge on the benefits of chlorine, understood the correct procedure of using chlorine dispensers, received promotional messages, and used functional chlorine dispensers were more likely to have chlorine residual in their drinking water. Conversely, households where children collected the drinking water were less likely to have chlorine residual in their drinking water. Community promoters who themselves used chlorinated water were associated with a higher chlorine adoption by the communities they serve. The study recommends continuous community education on chlorine water treatment; training on water collection, storage, and handling practices; extending water treatment education to children; and ensuring robust chlorine supply chains.