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Where has the Safe Water System been used?

Programme MAHAVITA

Project Partners

  • CDC
  • CARE
  • CARE CDC Health Initiative
  • National CDC Foundation
  • Population Services International (PSI)
  • Centre National de Recherches sur l'Environnement
  • Catholic Relief Services

Target Populations/Location

  • Urban flood zone of Antananarivo in CARE’s Programme MAHAVITA (Household Livelihood Security)
  • Populations affected by cholera epidemic of 2000
  • Populations affected by Cyclones Eline and Hudah

Project design

  • A large-scale implementation project funded by the CARE/CDC Health Initiative that is being incorporated into CARE’s Programme MAHAVITA. The methodology employed includes the community mobilization process that characterizes Programme MAHAVITA. In addition, PSI has been incorporated into the project to conduct a social marketing campaign.


Intervention elements

  • Sodium hypochlorite solution produced locally by PSI. The brand name is Sur’Eau.
  • Locally available, 20-liter plastic jerry cans
  • Community mobilization
  • Social marketing

Project start date

  • April 2000

Results of project evaluations

  • Sur’Eau
    • Most households that used Sur’Eau were able to maintain adequate free chlorine residuals that were significantly higher than those families not using Sur’Eau.
    • Observed use of Sur’Eau was 11.2%, which is acceptable for the first 6 months of a social marketing campaign.
    • Sur’Eau users were more likely to purchase a jerry can, indicating that they were more likely to prioritize spending their money to improve their health.
    • A decreased percentage of people reported using Sur’Eau daily as compared to the baseline survey and a lower percentage of respondents said that they would use it in the future. In addition, the percentage of repeat buyers of Sur’Eau appeared to be declining. However, the baseline survey was done during a cholera epidemic and the follow-up survey was conducted in the dry season when diarrhea cases tend to decrease.
    • Alternative water treatment methods, specifically boiling, were found to be common practices in this survey. This finding may reflect both cultural practices and the time of year, for during cold weather, the custom is to drink hot rice water rather than cool water.
    • Brand name recognition of Sur’Eau has increased since the baseline survey, which attests to the effectiveness of the social marketing campaign.
    • Only about one-fourth of follow-up survey respondents spontaneously said that Sur’Eau was for preventing diarrhea and cholera.
    • Survey findings suggested that lower educational levels of female heads of household and lower estimated household wealth serve as potential barriers to purchase and use of Sur’Eau products.
    • Among non-users of Sur’Eau, 10% said they did not use Sur’Eau because they did not know where to buy it.
  • Jerry cans
    • Use of the jerry can increased from 2.9% to 12.2% during the first 6 months of the project.
    • Bucket use still remains high.
    • The cover on the bucket does not seem to make a difference in the ability of the treated water to maintain its free chlorine concentration.
    • The free chlorine levels did not appear to be higher in the jerry can.
  • FAMOA process
    • FKT’s that had completed the FAMOA process exhibited a statistically significant higher proportion of households using Sur’Eau and jerry cans than FKT’s that are at an earlier stage of the FAMOA process.


  • Project to expand nationwide through USAID funding
  • CDC safe water vessels to be market-tested
  • CARE to establish a technical support and coordination service for partners network for the nationwide expansion of Sur’Eau

For more information




Centers for Disease Control and Prevention
National Center for Infectious Diseases
Division of Bacterial and Mycotic Diseases
Foodborne and Diarrheal Diseases Branch

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