COMPARING THE EFFECT OF COMMUNITY ENGAGEMENT ON WATER FILTER USAGE IN RURAL GUATEMALA

Abstract

Abstract Purpose: The purpose of the study was to compare the effect of a community engagement (CE) strategy on sustainability of a safe drinking water initiative. Methods: A natural, quasi-experimental study design was conducted using community-based participatory research principles. We collaborated with two local community-based organizations in Guatemala to distribute table-top water filters in selected villages in rural Guatemala in 2014 and in 2018. One-year post-distribution, surveys were completed by the head of household. We compared data from three villages (n=38) who participated in a CE strategy with data from one village (n=56) that did not participate in CE (non-CE group). Findings: A major finding of this study was that households who participated in the CE strategy had almost five times higher odds of having a working water filter one year later (OR = 4.7, p = 0.022). Secondary findings were that the CE group was comprised of more adults/household (OR = 2.78, p = 0.017) and fewer children/household (OR = 5.76, p < 0.0001). Also, households in the CE group were more likely to have a concrete or wood floor (OR = 11.65, p = 0.002). However, using logistic regression we found the single best predictor that explained the working water filters in these households was the CE strategy. Conclusions: Community engagement strategies that support family dignity and ownership may be key to sustainability of public health initiatives especially those with collaborative global partnerships. Future work should include linking villages with local and international organizations that can ensure access to safe drinking water and evaluate sustainability. Clinical Relevance: These results suggest that community engagement in the form of monetary incentives could sustain safe drinking water initiatives.