How can we bridge the gap between chlorine dispenser awareness and practice?
INCREASING CHLORINE ADOPTION IN UGANDA
To answer the above question, I teamed up with Evidence Action, a nonprofit that scales research-backed social interventions throughout the developing world, through projects that include Dispensers for Safe Water (DSW).
What resulted was one of my most rewarding research experiences to date, not only for the incredible impact we had on chlorine adoption rates throughout Uganda - taking them from 27% to 66% - but also for the opportunity to work and learn alongside such a welcoming, inspiring team and to learn about such an exciting corner of the world.
Please enjoy the work that follows (and the unbelievable photos, all taken by the team throughout)!
OVERALL CHALLENGE - Help Evidence Action better understand its DSW consumers, their motivations to use chlorine, and the barriers they perceive to using these dispensers
CLIENT PARTNER - Evidence Action
PHASES - Research + Strategy
TEAM - ELEVEN: 1 Researcher | Evidence Action: 1 Regional Manager, 7 Program Associates, 1 Director of Global Communications & Advocacy, 1 Country Expansion Manager, 1 Manager of Research, Innovation, Accountability and Learning, 1 Data Quality and Information Systems Manager
DURATION - March - April 2015
LEARNING TARGET - Users who affect chlorine adoption behavior [key home influencers (mothers, grandmothers, fathers), Promoters, and other influencers (children, educators, councilmen, health workers, Evidence Action team)], in eastern Ugandan villages that represent a range of low to high adoption rates
CORE RESEARCH CHALLENGE - How can we quickly but thoroughly understand the web of personal, community-level, and cultural considerations that affect chlorine adoption, and emerge with clear, prioritized recommendations that are effective amidst these many factors?
PRIMARY METHODS/TOOLS -
“What We Know” sessions (phone, in person) - previous learning integration, strengths & opportunities brainstorm
In-depth interviews (97+)
Synthesis + action plan creation sessions
Qualitative research capability-building sessions
KEY DELIVERABLES -
Assorted overview insights/learnings
Detailed user profiles
User needs framework
Communication principles + sample messages
Chlorine/use principles + sample messages
Recommended plan of action: overarching goals, proposed implementation including prioritized delivery channels, messages, materials, and other considerations, measurement/analysis questions and methods
Final report (design + delivery)
PRIMARY CONTRIBUTIONS - key stakeholder interviewer, research plan designer, “What We Know” session presenter and leader, interviewer, synthesis/action plan session leader, qualitative research teacher, driver of subsequent analysis, executive presentation builder + deliverer, and client point person throughout
SKILLS THIS HIGHLIGHTS - I share this project in order to demonstrate my swift yet immersive, flexible yet focused research style, paired with collaboratively-created, detailed action plans that yielded dramatic results - from 27% to 66% chlorine adoption rates, climbing immediately after our work in April 2015
What we set out to learn
Measurably increase usage of chlorine in drinking water in eastern Ugandan districts with dispensers, through a deeper understanding of user, Promoter, community, and Evidence Action team behavior.
We sought to better understand dispenser customers, their motivations to use chlorine, and any barriers they perceive to using Dispensers for Safe Water: who are the key chlorine use decision makers? Why do those people use or not use? Which channels and messages would most effectively influence them?
CONTEXT + CONSIDERATIONS
By March 2015, Evidence Action had seen worrisome declines in user adoption of Dispensers for Safe Water in Uganda (as low as 27%) and wanted to balance their own quantitative analysis with a more qualitative, behavior-based approach.
The team provided a thorough, thoughtful analysis of potential contributing factors, including supply chain issues, staff transitions, and negative rumors about chlorine. In addition, their education and outreach messages had previously focused on rational reasons why people should be using dispensers, and the EA team felt these messages were potentially not effective enough, but had very little data on why people are actually using or not using dispensers, or how they feel about chlorine more broadly.
As a final consideration, EA was also eager for me to teach the local and wider team to conduct qualitative research themselves, through dedicated sessions and in-the-field practice throughout our collaboration.
Together we built a research plan aimed at integrating a wealth of existing, system-wide knowledge from the global and local Evidence Action teams with the new-to-them lens of a deeper, qualitative exploration of user needs, wants, and constraints.
| METHODS |
STAKEHOLDER INTERVIEWS - Conducted interviews with key Evidence Action teammates, to introduce upcoming research and to better understand previous work, their expert perspectives, and major goals
“WHAT WE KNOW” SESSIONS - Led in-person and phone sessions to review previous work, discuss key learning goals, brainstorm strengths and potential opportunities in the current system, and review and update the discussion and observation guides and other methods accordingly
TARGET USER ETHNOGRAPHY - Conducted in-depth in-person interviews and immersions focused on key users and communities. When possible, we conducted early synthesis throughout to capture key learnings and insights while they were fresh, and adjusted research plans as needed
DEEP DEBRIEF SESSION - Concluded research with the expanded team by turning major observations and stories into insights, and ultimately into action plans they could implement immediately
CAPABILITY-BUILDING SESSION - Led the expanded EA team through a design research and strategy capability-building session, to apply these methods to future work in Uganda and other important markets, and across a range of projects
| TARGETS |
PEOPLE - In order to more fully understand the true reasons behind low or high adoption rates, we wanted to focus on a range of interviewees and observations, representing as many steps in the process as possible:
> Key home influencers (42 mothers, 12 grandmothers, 29 fathers)
> Promoters (10 Promoters, 3 Assistant Promoters)
> Other influencers (6 children, 1 educator, 6 councilmen, 4 health workers)
> Chlorine dispensers (sites, appearance, installation, instructions, refill, maintenance)
> Evidence Action (Community Education Meeting, Field Officers, training)
PLACES - We focused on three districts in eastern Uganda (and villages within those), that represented a range of very low to admirably high adoption rates:
> Kibuku (26% adoption, 352 dispensers)
> Budaka (45% adoption, 497 dispensers)
> Mbale (12% adoption, 859 dispensers)
Through an in-depth look into users’ overall lives, and how health, water, and chlorine fit in, we learned that a few key barriers are impacting adoption rates today: chlorine concerns, the need to change one’s routine, and not enough knowledge reaching key influencers (women, men, and Promoters).
We took overarching insights into people’s typical days, what’s important to them, health and water’s value, existing water use and treatment practices, chlorine perceptions, and influencer realities and needs, and synthesized them further into some key realizations about life and how EA fits in:
People already have plenty to do and to worry about, so why would they change their routines now… especially if they worry the fix might be bad for them? But they really do want what’s best for them and their families, and once they more fully understand and engage in a discussion, chances are they’ll choose to try, and to continue.
With this, and the barriers discussed above, the following became clear: We must build true motivation, and ensure that the education and ultimately the practice easily fit their lives.
Action Plan - Overarching Goals
Action Plan - Overarching Approach
User Needs Principles
Promoter-related action items
Together at the end of research, and through further analysis after I left the team, we built a set of recommendations aimed at being immediately actionable, as well as offering principles and other important considerations that could shape a more long-term plan, or evolve with the one we proposed.
I can discuss some more of the strategy specifics in person, and for now can share the following:
| USER NEEDS PRINCIPLES |
We must build true motivation, and ensure that the education and ultimately the practice easily fit their lives:
> MOTIVATION - True motivation will spark an interest, build understanding, and allow people to choose for themselves
> EASE - Easily fitting into their lives will ensure it’s heard and will make it stick
These guidelines were then developed into specific communication and communication/use principles, with sample marketing messages for each.
| ACTION PLAN |
OVERARCHING GOALS -
> Build the strongest support and supply base possible
> Reassure women that it’s safe and that they’re using it correctly
> Make men your advocates
> Continue to support women’s and men’s biggest influencers
For each of the above goals, we outlined and prioritized the actions Evidence Action could take that we expected would best accomplish each of these goals. This list of actions was then funneled into a specific, step-by-step proposed implementation plan, with details on delivery channels to utilize, actions related to each channel, specific content and other considerations for each, and how the user needs principles were met through each.
OVERARCHING APPROACH - The overarching approach is as follows and, again, I’m happy to discuss more extensive recommended strategy in person as well:
1. Start by building the strongest local program base possible
2. Get the message out in the open, via the most pervasive (trusted) channels
3. Target key influencers’ other top sources + channels
4. Measure, analyze, and potentially pivot. Repeat. Discuss/share throughout
5. Consider targeting other influencers, sources, channels, and/or principles
Dispensers for Safe Water Adoption Rates
Thanks to Evidence Action!
I'm elated to report that our collaboration yielded dramatic results, both immediately and continuing long after our work in April 2015.
Adoption rates went from 27% in April to 46% by July, and are currently 66%, in a change that Evidence Action is calling “The Great Turnaround of 2015.” We’ve stayed in touch since, to continue to try to support the team, and simply because these are some of the best people we’ve worked with.
Three cheers for Evidence Action’s great work!
WHY THIS PROJECT STANDS OUT
My intro to Africa and their intro to ethnography
One thing that made this such a rewarding collaboration is how much we learned from and alongside each other. Not only did I learn more about life in rural Uganda, but also learned how to be incredibly flexible in my research methods to fit the realities of planning ethnographies in such a market, and had to intuit along the way what the team on the ground most needed in order to be equipped to implement as soon as I left. In turn, I taught them how to do qualitative research and to make it their own, and we developed a plan for incorporating such research into their work thereafter.
MAKING IT ACTIONABLE END-TO-END
Pairing research with reality throughout
In order to make sure our insights created impact, even with a one-time collaboration of only a few weeks, we wanted to be sure the ideas were built to live in the real world. We pulled important knowledge from program directors and field officers alike, analyzed more angles than we were even asked for, and ultimately provided analysis with as many specifics as we could. We created the action plan together in person, to incorporate a range of voices, and answer important questions, then later added even more detail so the plan could offer clear guidance long after our work together ended.
REAL, IMMEDIATE IMPACT
27 to 66%, and rising
With an action plan in hand immediately, and an even more detailed, wider-ranging set of recommendations to follow, the Evidence Action has followed through and created incredible change in chlorine adoption rates.
“We are very happy to report that we have completely turned declining user adoption around in Uganda and are now at an astonishing 53% adoption rate as of July . […] We owe a debt of gratitude to Jeanette and her team who gathered information with keen insight and understanding of our customers and their agency and dignity."
Evidence Action team