About 20 Million (73%) people in Nepal still do not have access to safely managed drinking water service and 22 million (79%)do not treat their drinking water before consumption. Few studies have addressed the combination of socio-economic characteristics and psychosocial factors that explain such behaviour in a probabilistic manner. In this paper we present a novel approach to assess the usage of household water treatment (HWT), using data from 451 households in mid and far-western rural Nepal. We developed a Bayesian belief network model that integrates socio-economic characteristics and five psychosocial factors. The socio-economic characteristics of households included presence of young children, having been exposed to HWT promotion in the past, level of education, type of water source used, access to technology and wealth level. The five psychosocial factors capture households’ perceptions of incidence and severity of water-borne infections, attitudes towards the impact of poor water quality on health, water treatment norms and the knowledge level for performing HWT. We found that the adoption of technology was influenced by the psychosocial factors norms, followed by the knowledge level for operating the technology. Education, wealth level, and being exposed to the promotion of HWT were the most influential socio-economic characteristics. Interestingly, households who were connected to a piped water scheme have a higher probability of HWT adoption compared to other types of water sources. The scenario analysis revealed that interventions that only target single socio-economic characteristics do not effectively boost the probability of HWT practice. However, interventions addressing several socio-economic characteristics increase the probability of HWT adoption among the target groups.@en

Household water treatment (HWT) can effectively reduce exposure to unsafe drinking water at home. Understanding the characteristics of target groups who successfully adopt HWT, such as perception about water quality and usefulness of HWT, income, or parental education, is essential for enhancing the adoption of HWT in developing countries. The objective of this study is to analyze the interactions between such socio-environmental characteristics, rather than a single characteristic, in order to explain the adoption of HWT. Five socio-environmental characteristics and behavior determinants were analyzed using Qualitative Comparative Analysis (QCA) from 41 case studies in Africa, Asia, and South America. Results show that there is no single characteristic that alone explains the adoption of HWT. QCA identified five pathways leading to high adoption of HWT. Perceived threat due to bad water quality is a pre-condition for three of the pathways. However, perceived threat does not alone explain adoption of HWT and must be accompanied by other conditions. Households connected to piped water schemes can also be potential HWT adopters as long as they perceive poor tap water quality. Finally, households who are able to afford the full cost of HWT tend to adopt it only when they neither have prior experience with HWT nor a connection to a piped scheme. Our findings therefore highlight the necessity to analyze interactions between socio-environmental characteristics of households and behavior determinants in order to determine the adoption of HWT.@en

Access of potable drinking water is still a leading global challenge. Household water treatment (HWT) is one possible means to tackle this issue of non-potable drinking water at household level. Unfortunately, studies have shown that people do not use it regularly which otherwise can make positive impact on people health. Researchers use several psychology concepts or models to explain this phenomenon. These models often mention some psycho-social factors that determine or are responsible for the behavior, for example perception of risk or the perception of benefit using the product. Some of these psychology model also mentioned that socio-environmental characteristics (contextual factors) influence the psycho-social factors and thereby influence the behaviour. Even though the interactions between contextual and psycho-social factors is essential to understand the behaviour of households in WASH research, such interactions are often ignored and remain to be analysed on its own merit. The motivation of this research is to analyse such interactions and then use the result to model the adoption of water treatment by households. We present a novel approach to assess the regular usage of household water treatment (HWT) using data from a cross-sectional study in October 2014. 451 households in 5 villages in mid-western rural Nepal were randomly selected to participate in the study. A Bayesian belief networks (BBN) model that integrates socio-environmental characteristics, such as education and type of water source, and the RANAS psycho-social factors (Risk-Attitude-Norm-Ability-Self regulation) was developed. Preliminary results show that 1) a single socio-environmental characteristic can be associated with multiple psycho-social factors that positively influence households to adopt HWT, 2) Education and location of the households and HWT promotion are the most influential socio-environmental characteristics, 3) Behavioral change intervention should address at least three psycho-social factors to boost the likelihood of using HWT. Our approach can help the implementer to understand the system and develop better intervention to increase the chances of HWT uptake and improve livelihoods of people in developing countries. @en