Pilot in Vietnam to employ health staff as sales agents

For years, boiling has been the sole recommendation for household water treatment by the government of Vietnam. While this message has been motivating, (nearly 100% of respondents in PATH’s recent segmentation survey in Vietnam say they boil their drinking water) there is evidence that people boil intermittently and incorrectly (Clasen 2008) and that they may prefer inexpensive and simple alternatives for household water treatment. In partnership with Ireland-based Medentech and Hong Kong-based Zuellig Pharma, PATH is testing an integrated market approach for Medentech’s dissolvable chlorine tablet, Aquatabs™, using a distribution channel operated by Zuellig and employing government health staff to sell the tablets at the commune level.

How it works

In this pilot, we are working in 21 communes throughout 2 districts, and training 63 health collaborators on the basics of water treatment, hygiene, and interpersonal communications. While the health collaborators are paid government staff, PATH is providing a travel allowance and Zuellig is offering a small commission on sales as an incentive to promote the product. Our partners are supporting marketing efforts including billboards, posters, and sales presentation flipbooks.

The pilot launches in each commune with a social marketing event where up to 200 participants receive a free 30-day supply of the product and (in half the communes) a free safe storage container. Starting the pilot this way raises awareness and gives us an opportunity to monitor the impact of free trials on uptake and sustained use. Over six months, health collaborators will travel throughout their local area discussing water treatment and hygiene with clients and selling Aquatabs as an affordable alternative to boiling.

Building upon previous learning

The pilot builds on insights gleaned from previous pilots, our recent segmentation research, as well as a successful intervention in Malawi that was conducted in 2001 by Population Services International and the US Centers for Disease Control and Prevention.

Based on earlier pilots, we refined a rigorous reporting, monitoring, and evaluation component to fully understand the impact of the pilot on everyone involved from individual households to health collaborators to distributors to funders. We made the pilot large enough to control for variations in the strategy. Our monitoring and evaluation efforts include both qualitative and quantitative studies at baseline and after six months.

From our recent segmentation research, we learned that people’s opinions about fast moving consumer goods HWTS products, such as Aquatabs tend to change for the better after they have tried it. By offering free product trials, we can observe the impact they have on attitudes and behavior.

From the Malawi intervention, we learned that health workers and free safe storage containers might contribute significantly to uptake, but the study was not designed to isolate the impact of each. This pilot will set up a control group to compare uptake in communities with and without free safe storage containers.

From a commercial viability standpoint, the pilot is testing whether distribution of the tablets can successfully be carried out through government partners such as the local district medical centers and whether using health collaborators as salespeople can successfully increase uptake and sustained use. If so, health collaborators can earn a modest income, manufacturers can scale up product sales, and households can gain more access to household water treatment options other than boiling.

Impact of results

Local authorities in Vietnam are very interested in the pilot as it represents a major shift in strategy from promoting boiling alone to supporting alternative or complementary HWTS solutions through novel public-private partnerships. If successful, all stakeholders may be willing to scale up the effort nationwide and/or replicate it with new partners and additional products. If the strategy proves to be unsustainable, it will provide critical evidence to support ongoing exploration with commercial and nongovernmental organization partners who are interested in HWTS.

Globally, our goal is to contribute to a growing body of evidence around how to (or how not to) successfully reach low-income consumers with products and information that can promote good health and hygiene.

Results from this pilot will be compiled in the fall of 2011 and will be available on this website and disseminated through the Safe Water Project's emailed Newsflash.

References

Clasen T, Thao H, Boisson S, et al. Microbiological effectiveness and cost of boiling to disinfect drinking water in rural Vietnam. Environmental Science & Technology. 2008; 15;42(12):4255–4260.

Photo: PATH.