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Optimization and acceptance of fluoride removal options for drinking water in rural Ethiopia

English title Optimization and acceptance of fluoride removal options for drinking water in rural Ethiopia
Applicant Johnson Annette
Number 124000
Funding scheme Resource not found: 'bd31932a-e257-46d9-9dba-079f6f2c77c6'
Research institution Eawag
Institution of higher education Swiss Federal Institute of Aquatic Science and Technology - EAWAG
Main discipline Other disciplines of Environmental Sciences
Start/End 01.05.2009 - 31.10.2012
Approved amount 452'797.00
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All Disciplines (6)

Discipline
Other disciplines of Environmental Sciences
Inorganic Chemistry
Psychology
Sociology
Political science
Geochemistry

Keywords (13)

fluoride; defluoridation; drinking water; bone char; aluminium hydroxide; behavioral change; habits; intervention; acceptance ; perception; institution; governance; stakeholders

Lay Summary (English)

Lead
Lay summary
The aim of the research project is to further develop and compare the acceptability and technical performance of fluoride removal filters and to explore ways of sustainably implementing these in rural Ethiopia. According to estimates of the Ethiopian Ministry of Water Resources more than 14 million people in Ethiopia rely on drinking water contaminated by fluoride in the Rift Valley region. Over 40% of deep and shallow wells are contaminated and concentrations, up to 26 mg/L, are significantly higher than the present international WHO guideline value of 1.5 mg/L. The main source of fluoride are the basaltic rocks in the Rift Valley. Over 80% of children suffer from different degrees of dental fluorosis and skeletal fluorosis is increasing, mainly among older people. The mitigation of this health problem has been hampered mainly by the lack of a suitable, inexpensive removal method. A switch to treated surface waters for drinking is being discussed, but it is accepted that fluoride removal systems for rural communities are required. To date there has been no successful implementation of such a system in Ethiopia.This project aims to combine technical and social research at both Eawag and University of Addis Ababa, including field work together with NGOs to find a solution to the mitigation of fluorosis. Not only the suggested removal techniques but also the inter- and transdisciplinary research approach is innovative. Intensive interaction of engineering and social sciences is indispensable in this project, because even the best technical solution is useless when it is not accepted by the population. This collaborative project also has an important goal of capacity and human resource development in Ethiopia. It aims at strengthening the knowledge and research capacity of the Ethiopian university and the participation of NGOs will consolidate the ties between research and implementation. Furthermore, the results will be applicable not only to Ethiopia but also for other fluorosis-affected developing countries.Two fluoride removal systems that can cope with the elevated fluoride concentrations will be further developed and tested in the field. The first, based on filtration with aluminium (Al) oxide, has been developed in the Chemistry Department of Addis Ababa University. Laboratory tests have shown a very high removal capacity, but still further laboratory and field testing is required. The second filter material is based on a calcium hydroxyapatite, including bone char, that is successfully being developed and currently implemented by the Catholic Diocese of Nakuru (CDN) in Kenya. Preliminary implementation studies with bone char filtration in Ethiopia, carried out by the NGO consortium Swiss Interchurch Aid (HEKS) / Oromo Self-Help Organisation (OSHO) in collaboration with CDN and Eawag have shown that the water composition, the high fluoride concentrations, possible turbidity and microbial contamination, are a particular challenge as is the question of filter regeneration.Apart from the functionality of mitigation options from a technical point of view, fluoride removal systems require compatibility with social, cultural, economic, and institutional settings. Therefore, people's perceptions of fluoride and fluorosis and other important influencing factors on the acceptance and use of mitigation options will be assessed in this project in parallel to the technical tests. We will monitor people's use of the mitigation options and design and investigate interventions suitable to achieve acceptance and continuous use of the defluoridation methods. A stakeholder analysis will be performed to assess the institutional barriers to the implementation of fluoride removal techniques.This current proposal will be a component of a cross-cutting Eawag project "Water Resources Quality" (WRQ). WRQ aims at developing a mitigation framework to successfully tackle geogenic contamination affecting human health in developing countries. It is also an important contribution to the many national Ethiopian initiatives to mitigate the fluoride problem in the Rift Valley.
Direct link to Lay Summary Last update: 21.02.2013

Responsible applicant and co-applicants

Employees

Project partner

Publications

Publication
Determinants of exclusive consumption of fluoride-free water: a cross-sectional household study in rural Ethiopia
Huber Alexandra C. Bhend Sarah Mosler Hans-Joachim (2011), Determinants of exclusive consumption of fluoride-free water: a cross-sectional household study in rural Ethiopia, in J. Publich Health, 20, 269-278.
Determining behavioral factors for interventions to increase safe water consumption: a cross-sectional field study in rural Ethiopia
Alexandra Claudia Huber a & Hans-Joachim Mosler, Determining behavioral factors for interventions to increase safe water consumption: a cross-sectional field study in rural Ethiopia, in International Journal of Environmental.
Determining the differential preferences of users of two fluoride-free water options in rural Ethiopia
Alexandra C. Huber & Hans-Joachim Mosler, Determining the differential preferences of users of two fluoride-free water options in rural Ethiopia, in J. Public Health.

Collaboration

Group / person Country
Types of collaboration
HEKS with local partner OSHO Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
- Exchange of personnel
- Industry/business/other use-inspired collaboration
Catholic Diocese of Nakuru Kenya (Africa)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
26th European Health Psychology Conference 21.08.2012 Prague, Czech Republic
Water Technologies for Emerging Regions 24.10.2011 Oklahoma, USA
25th European Health Psychology Conference 20.09.2011 Hersonissos, Greece
35th WEDC International Conference 06.07.2011 Loughborough, UK
International Congress of Applied Psychology 11.07.2010 Melbourne, Australia


Knowledge transfer events

Active participation

Title Type of contribution Date Place Persons involved
Water Safety Conference 13.11.2012 Kampala, Uganda
RSWN Network 27.11.2011 Kamala, Uganda


Self-organised

Title Date Place
Fluorosis Mitigation in the Ethiopian Rift Valley: Optimization and Acceptance of Fluoride Removal Options for Drinking Water in Rural Ethiopia 23.04.2012 Addis Ababa

Associated projects

Number Title Start Funding scheme
117992 Optimization of coprecipitation processes in apatite-based filter materials for the removal of fluoride from drinking water 01.01.2008 Project funding (Div. I-III)

Abstract

The aim of the research project is to further develop and compare the acceptability and technical performance of fluoride removal filters and to explore ways of sustainably implementing these in rural Ethiopia. According to estimates of the Ethiopian Ministry of Water Resources more than 14 million people in Ethiopia rely on drinking water contaminated by fluoride in the Rift Valley region. The main source of fluoride are the basaltic rocks in the Rift Valley, which have both elevated fluoride content and low soluble calcium concentrations. Over 40% of deep and shallow wells are contaminated and concentrations, up to 26 mg/L, are significantly higher than the present international WHO guideline value of 1.5 mg/L. Over 80% of children suffer from different degrees of dental fluorosis and skeletal fluorosis is increasing, mainly among older people. The mitigation of this health problem has been hampered mainly by the lack of a suitable, inexpensive removal method. A switch to treated surface waters for drinking is being discussed, but it is accepted that fluoride removal systems for rural communities are required. To date there has been no successful implementation of such a system in Ethiopia.This project aims to combine technical and social research at both Eawag and University of Addis Ababa, including field work together with NGOs to find a solution to the mitigation of fluorosis. Not only the suggested removal techniques but also the inter- and transdisciplinary research approach is innovative. Intensive interaction of engineering and social sciences is indispensable in this project, because even the best technical solution is useless when it is not accepted by the population. This collaborative project also has an important goal of capacity and human resource development in Ethiopia. It aims at strengthening the knowledge and research capacity of the Ethiopian university and the participation of NGOs will consolidate the ties between research and implementation. Furthermore, the results will be applicable not only to Ethiopia but also for other fluorosis-affected developing countries.Two fluoride removal systems that can cope with the elevated fluoride concentrations will be further developed and tested in the field. The first, based on filtration with aluminium (Al) oxide, has been developed in the Chemistry Department of Addis Ababa University. Laboratory tests have shown a very high removal capacity, but still further laboratory and field testing is required. The second filter material is based on a calcium hydroxyapatite, including bone char, that is successfully being developed and currently implemented by the Catholic Diocese of Nakuru (CDN) in Kenya. Preliminary implementation studies with bone char filtration in Ethiopia, carried out by the NGO consortium Swiss Interchurch Aid (HEKS) / Oromo Self-Help Organisation (OSHO) in collaboration with CDN and Eawag have shown that the water composition, the high fluoride concentrations, possible turbidity and microbial contamination, are a particular challenge as is the question of filter regeneration.Apart from the functionality of mitigation options from a technical point of view, fluoride removal systems require compatibility with social, cultural, economic, and institutional settings. Therefore, people’s perceptions of fluoride and fluorosis and other important influencing factors on the acceptance and use of mitigation options will be assessed in this project in parallel to the technical tests. We will monitor people’s use of the mitigation options and design and investigate interventions suitable to achieve acceptance and continuous use of the defluoridation methods. A stakeholder analysis will be performed to assess the institutional barriers to the implementation of fluoride removal techniques.This current proposal will be a component of a cross-cutting Eawag project “Water Resources Quality” (WRQ). WRQ aims at developing a mitigation framework to successfully tackle geogenic contamination affecting human health in developing countries. It is also an important contribution to the many national Ethiopian initiatives to mitigate the fluoride problem in the Rift Valley.
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