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Open AccessArticle

Barriers and Facilitators to Chlorine Tablet Distribution and Use in Emergencies: A Qualitative Assessment

1
Department of Civil and Environmental Engineering, Tufts University, 200 College Ave Medford, Medford, MA 02155, USA
2
Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel St, London, Bloomsbury WC1E 7HT, UK
*
Author to whom correspondence should be addressed.
Water 2019, 11(6), 1121; https://doi.org/10.3390/w11061121
Received: 17 April 2019 / Revised: 13 May 2019 / Accepted: 24 May 2019 / Published: 29 May 2019
(This article belongs to the Special Issue Water Disinfection: Safe Water for All)
Chlorine tablets are commonly distributed for household water treatment in emergencies. However, confirmed use after distribution ranges widely (from 7–87%), which raises concerns about chlorine tablet effectiveness, as measured by acceptance and appropriate use. To investigate chlorine tablet effectiveness, we conducted nine key informant interviews (KIIs) on tablet distribution in emergencies in general, five KIIs on chlorine taste and odor acceptance and rejection specifically, and a literature review on chlorine taste and odor concerns. We found: (1) chlorine tablets are regarded as one of the most effective water treatment methods and are often considered appropriate in emergency response, (2) dosing confusion and taste and odor rejection are perceived as the main problems limiting effectiveness, and (3) the primary solutions suggested for these problems were social and behavioral. We recommend that social and behavioral scientists are routinely integrated into chlorine tablet programming to improve user feedback and behavioral interventions for chlorine tablet promotion in emergencies. We also suggest that more research is conducted on chlorine taste and odor rejection in vulnerable populations, and that improved guidance is developed to facilitate intra-agency coordination and select, promote, and monitor tablets appropriate for each context. View Full-Text
Keywords: chlorine; chlorine tablets; drinking water; emergency; outbreaks; water disinfection; drinking water; water treatment chlorine; chlorine tablets; drinking water; emergency; outbreaks; water disinfection; drinking water; water treatment
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Mitro, B.; Wolfe, M.K.; Galeano, M.; Sikder, M.; Gallandat, K.; Lantagne, D. Barriers and Facilitators to Chlorine Tablet Distribution and Use in Emergencies: A Qualitative Assessment. Water 2019, 11, 1121.

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