Report on Try and Buy pilot HWTS - Dera Woreda Ethiopia Triggering household investments in household water treatment technologies through trying before buying

Table of contents 1 Introduction 1 1.1 Aim of the Try and Buy pilot 1 1.2 Methodology & approach 2 2 Monitoring results 5 2.1 Starting point 5 2.2 Midterm results 6 2.3 End line results 8 2.4 Key results from interviews 9 3 Conclusions and recommendations 11 3.1 Answers to key questions for this pilot 11 3.2 Conclusions and recommendations 13 Annex 1: Baseline survey questionnaire 16 Annex 2: Questions Key Informant Interviews 21 1 Introduction 1.1 Aim of the Try and Buy pilot

In line with the target of Sustainable Development Goal 6, Aqua for All is committed to contribute for access to safe water in one of the Sub-Saharan countries, Ethiopia by adapting new innovative approaches, including piloting a fast track marketing approach which was named ‘Try and Buy”.

The Try and buy pilot, which is part of the Self-supply Acceleration program, is jointly implemented with the Millennium Water Alliance (MWA) and Implementing partners (CARE Ethiopia, CRS and World Vision). It is aimed at triggering private household investments in new and improved safe water supply technologies for safe water at point of use. Access to products and services is a prerequisite for this and this was materialized. Involving private sector is vital program activity in accelerating self-supply and ensuring sustainable safe water supply (chains) in rural Ethiopia. To accelerate the introduction of new technologies to households particularly on safe water supply, Aqua for All who is working in partnership with Ethiopian government by focusing on private sector engagement and finance solutions through innovative approaches, initiated a new approach in Dera Woreda of Amhara Region, Ethiopia as a pilot. This pilot is meant to fast track the introduction of safe water products. In this pilot, selected households with access to Self-supply water source and with other unsafe sources got the opportunity to try and test a HWTS (Household Water Treatment and Safe Storage) technology. Therefore, this fast track marketing is a new approach of introduction of the use and benefit of the household water treatment products to the target customer in one of the self-supply (SS) implemented woredas (Dera Woreda) who own Self-supply scheme among others. The pilot was also tried in other kebeles that use unsafe water sources in order to test the products and service before purchase. The majority of the households water sources are unprotected dug wells (60%), followed by protected dug wells and unprotected springs. Only 7% of the households use river water as their main drinking water source.

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In this marketing strategy, customers/users were expected to be in direct contact with the private sectors (suppliers) – facilitated by Aqua for All in collaboration with the local government authorities and CARE. The following HWTS technologies were applied in this pilot:

Sawyer water filter (supplied by Gemshat importer PLC) Helioz/WADI solar water disinfection indicator (supplied by Helioz GmbH) Bishan Gari water purification sachets (chlorine product, supplied by Bishan Gari Purification Industries

PLC.) Tulip Syphon filter (supplied by Tulip Addis water filter)

As part of the pilot research in the selected Kebeles, three consecutive surveys were conducted including baseline survey, mid line survey and end line survey. The baseline survey was conducted at start up on distribution of the HWTS products and then the midterm review was conducted at the end of 2 months try period; and finally the end line survey was conducted on the fifth month from start of the try period (two months delayed). Different questionnaires wereused for the survey. During the baseline survey household characteristics, ability to pay, existing water sources status and health conditions of the trying customers were surveyed as a bench mark. During the midterm evaluation, the water treatment preferences, the water treatment mechanisms and usage of the distributed HWTS were surveyed. During the end line survey, the households were asked on how they valued the products (acceptability of the product), uptake and continued use of the product, the health related impacts of the HWTS and whether they could/would purchase the product, or return it. In addition to the households, local government authority’s including water office, facilitating NGO in the area (CARE), the local Kebele leaders and the private sector suppliers of the products who were involved in this pilot were interviewed through Key Informant interviews (KII). The pilot was coordinated and implemented by Aqua for All. The KII questionnaires for the above stakeholders are annexed here with the report. Key questions to be answered in this pilot: What is the interest of households in a given HWTS products and to what extent are they satisfied with the

individual products How do households value the HWTS Products in monetary units (money) – their interest to purchase? Are private sector suppliers capable to market their products directly to households? Does the NGO play the right supporting role? Are the HWTS products affordable to the users? Is there horizontal diffusion effect for the HWTS products where demand is created? What role is crucial for the local government? What can we learn to scale up safe water at household level through a market based approach? Answers to these questions are included in chapter 3. 1.2 Methodology & approach Pilot area selection Dera woreda was selected for this pilot after consultation with the private sector partners, the Implementing NGO (CARE) and the local government authorities. The woreda matches with some of the most crucial criteria apart from being one of the self-supply woredas: ­ The proposed pilot area is challenged with water quality problems particularly with flooding and inundation of

its water sources (raw, self-supply, and protected water sources) with flood including those hand dug wells

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(HDWs) and springs constructed by government and NGOs. The flooding comes from the upper catchment during the rainy season since part of Dera woreda Kebeles are located on the flat Fogera plain and exposed to flooding from Guna catchment that has lost all its vegetation cover. Lack of regular disinfection of the water supply sources (community and private) is also another contributing factor for the water quality challenge.

­ Crucial stakeholders in this pilot area were all interested and committed to support the pilot. The implementing NGO was committed and assigned staff to sustain the effort; and the woreda WASH team has shown greater interest and was committed to implement the pilot and pursue post pilot support for ensuring private sector engagement. The private sector partners all indicated to have an agent or other sales outlets in that area but also are committed to provide after sales services.

­ A certain level of purchase power (wealth) is available in this area, which is required for the pilot to be successful (source: SSA Baseline data conducted by IRC,2015)

­ Dera woreda is located in relative close proximity to a larger town (Bahir Dar), which makes it interesting and accessible for suppliers.

In total, 4 different household water treatment products, which were supplied by 4 different private suppliers were included in this pilot:

o Tulip filter – a Holland product supplied by Tulip Addis o Sawyer filter – An American product supplied by Gemshat PLC o Helioz – WADI – Supplied by Helioz from Austria o Bishan Gari – Supplied by Bishan Gari PLC produced in Ethiopia

A fifth supplier (PSI Ethiopia – chlorine product) was invited to join but could not join .

Tulip syphon filter Sawyer filter Wadi product Bishan Gari sachets

To keep the pilot manageable, it was agreed to select 100 households for this pilot. With this sample size, a good impression can be achieved on the key research questions for this pilot, while keeping costs for follow up and monitoring reasonable. The households were selected on the basis of affordability, willingness to pay (if they like the product after trying), known water quality challenges, located in clustered 3 kebeles easy for follow up; but also possessing strong local level leadership to try the pilot and kebeles where filters were not distributed on free hand out basis by NGOs as part of other programs. These were the most important criteria for selecting the pilot kebeles. Within Dera woreda the three different kebeles selected for the Try and Buy pilot were: Korata, Mirafe Mariam and Wonchet. Water quality Water quality was also one of the criteria to select the pilot area. Water quality tests have not been performed as part of this pilot. However, in March 2016 and February 2017 CARE Ethiopia conducted water quality tests in two of the three kebeles (Korata and Mirafe Mariam). IRC had also conducted microbiological water quality tests (E-coli) in Korata Kebele during the baseline survey of Self-supply acceleration. The result of the tests suggested that there are acute water quality problems in those 2 kebeles. Microbiological water quality problems are overall

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prevalent in the studied kebeles1. As a result, the issue of water quality was not questionable by the users and the local government authorities. When we see the context of the target area, in general, the top 5 diseases related to health in the whole woreda based on the woreda health office data are:

1. Diarrhea 2. Eye diseases-Trachoma 3. Intestinal parasites 4. Malaria 5. Acute Water Diarrhea (AWD)

This underlines the necessity of water treatment and the potential (sleeping) demand for HWTS products. Selected HWTS products The different products were distributed systematically – to ease follow up and monitoring by the private sector suppliers, local government and Aqua for All. The number of filters distributed with the list of kebeles are as follows:

­ 50 Tulip filters in Wonchet Kebele ­ 30 Sawyer filters in Korata Kebele ­ 10 WADI products in Mirafe Mariam Kebele ­ Bishan Gari sachets were supplied enough for 10 households in Mirafe Mariam Kebele

Finally pricing and sales of product was expected to be determined by negotiation between user and supplier. The ambition is not to sell the products at lower prices than the average commercial price. It was agreed that if households are not interested in the product at its commercial rates, the products shall be returned. Aqua for All signed an MoU with each of the private supplier partners for the pilot which included rules of engagement. In this MoU a negotiated risk sharing was included with all suppliers up to 50% to cover an eventual gap between the price clients are willing to pay and the cost price suppliers of HWTS products need to receive. Kick off workshop Before the distribution of HWTS to the potential customers, a general kick off workshop called by the woreda WASH team took place with government officials on 6th December 2016, followed by a large public meeting with the respective households. The following participants were present: The Woreda Administrator/Head, Woreda Administration office head, woreda water head, woreda Education head, woreda Health head, woreda Women & Children Affairs head, woreda Finance and Economic Development head, representative from Amhara Credit and Saving Institution (ACSI), 3 representatives of the Implementing NGO (CARE); One representative of World Vision; Hamusit Town representative, woreda administration officers, woreda water experts, 3 Chairmen’s of the 3 selected pilot kebeles, 3 managers of the 3 kebeles and 3 respective kebele Health Extension workers. Through this kick off workshop these key government decision makers had endorsed the pilot and vowed to carry it forward to achieve the objective of this fast track marketing in the Self-supply Acceleration (SSA). Besides, the Implementing partner CARE Ethiopia North office was in attendance and represented by the CARE North Program Manager and two other officers, who are directly relevant for the implementation of this pilot at Dera woreda. World Vision in the area was in attendance via their representative staff for their respective support, follow up and learning towards harmonized approach. On top of this the representatives of the four private sector suppliers including two staff of Bishan Gari (marketing manager and water quality specialist); two staffs of Helioz (the global

1 CARE water quality monitoring data

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CEO and her Ethiopian counterpart from Bahir Dar University); the marketing manager from Tulip Addis and three staffs from Gemshat PLC (the manager of SAWYER for Ethiopia, the Amhara representative and a water quality expert based in Amhara region) were in attendance and presented, displayed and demonstrated their respective HWTS products including the explaining the manuals. Through this workshop the role and responsibility of each actor was discussed and endorsed in line with the content initially shared on the plan of approach. However joint visit and review meetings among stakeholders did not take place according to the plan due to timing constraints. Though the kick-off workshop attendants were only male representatives of the households, after the workshop, majorly both the women and male representatives of the households as well as all other family members of each household were gathered for demonstration and saw how each HWTS products works. The private suppliers handed over their product in the respective kebeles for trial for 3 months. During the workshop and the next two days at community level, all suppliers organised their own demonstration / detail explanations about use of their product. Bishan Gari has assigned its agent (a pharmacy owner at Hamusit) where the sachets were kept for any additional need. Even if the Hamusit pharmacist did not visit and promote for the customers, the head office Bishan Gari team has visited them more than two times and has checked by phone from distance for any inquiry. The Bishan Gari team had also provided pamphlet in local language as a manual. Tulip Addis agent was based in Bahir Dar, hardly monitored each individual household except two times visit for collecting the filter prices from two customers. The manual was supported with pictures and was both in local language and in English which is embedded with the product. For Sawyer filters the manuals were in English while the end users (women) are illiterate and cannot even read the local language. Sawyer assigned a local agent that is responsible for Amhara region. That person is either in Addis Ababa or Gondar and a number of other sites since his main job is running an electricity shop and maintenance. Also for Helioz, the agent they assigned for the pilot project was a university student at Bahir Dar and she visited the area two times, at market centres. The manual works through international symbols to tackle the issue that target group is largely illiterate. Monitoring results show however that the symbols were not known by the user community. 2 Monitoring results Annex 1 includes the baseline, mid-term and end line questionnaires. Annex 2 includes the questions for key informant interviews. 2.1 Starting point To benchmark the starting point of the situation before the products were distributed, and monitor progress and results at household level, the pilot collected baseline information (December 2016), mid-term (February 2017) and end line (April 2017) information using AKVO Flow mobile technology. Enumerators visited all selected households during baseline and end line survey, and visited almost 50% of the targeted households during mid-term monitoring. This section describes a summary of the monitoring results. Household characteristics targeted in the pilot ­ The average household size is 6 people ­ 79% of the male head of the household head can read but only 21% of the female head of the household can

read. ­ In over 80% of the households, it is the male head of the household who normally buys large household

purchases (e.g. mobile phone, electrical appliances) but also health items (medicine, filter, water container). ­ 91% of the respondents indicate they have a bank savings account and another 3% indicates they have a sacco

account. This seems very high for rural areas but can also be due to the selection of households to participate.

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­ Primary income activities of the household are: farming food/cash crops (91%), government employees (4%) and business/retail (3%).

­ Typical household assets already owned by the households are: mobile phone (26%), latrine (25%), solar panel (14%), Television (2%).

Drinking water situation of households ­ From the sampled 100 households, almost 80% of the respondents source their water from unprotected dug

wells, unprotected springs, rivers and surface water. The other 20% of the households have access to water from protected springs and protected dug wells.

­ On average households collect water four times a day, of which almost 90% takes less than 15 minutes to collect water.

­ For the majority of the households (91%), it is a female member of the household older than 15 years responsible for collecting water.

­ 83% of the respondents currently do not use a treatment method to make the water safe to drink. Households that do treat the water, are using the following techniques: Chlorine (3%), boiling (3%), (cloth) filter (11%). For those that treat the water, the majority indicates their reason to do so is to make the water safe and prevent diseases.

­ Before households received the product in this pilot, they indicated the main reasons for not (always) treating their water are: no access to treatment product (43%), too much time to treat water (38%), lack of knowledge (14%), price of treatment (2%), the remaining 3% responded unclear.

­ Only 12% ever received a message or training on water treatment (at community meetings from health workers), 88% never received such message. The people who did receive a message or training, received this during a community meeting, by the community health workers. Surprisingly, only 6% of the households indicated that anyone in their household experienced any water borne illnesses, such as diarrhoea. This is most probably due to natural adaptation to/coexistence with pathogens.

­ Only 4% of the households know where to buy a water treatment products at this moment. Preferably they would purchase water treatment products in the general store in the future.

2.2 Midterm results Sample size for midterm results was 40% (40 out of 100 households) consisting of: Tulip: 18 households; Sawyer: 10 households; Wadi: 6 households Bishan Gari: 6 households During the pilot implementation, the most notable results concerning use of the product and satisfaction are as follows: ­ A high variability was observed in the correct use of the different technologies. The tulip filter appeared to

show most challenges and in many cases was not used at all, or installed incorrectly (average 70%). Major reasons mentioned by Tulip households why filters were not used are: Lack of knowledge how to use the product. Although during the distribution households (both male and

female representatives) received a (group demonstration), it turned out it still remains a challenge to understand the use. Necessary follow up with the households did not take place well enough (differs per product).

It takes too much time / speed of filtration

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Installation and use of tulip filters in households ­ For Sawyer almost 60% of the households were using the product in a correct way incl. cleaning of filter.

Installation and use of sawyer filters in households ­ For Bishan Gari all surveyed households showed the right application of the product (add, stir, wait, strain

water with cloth)

Application of Bishan Gari in households ­ For WADI 2/3 of the respondents did not use the product correctly. Households did not fill the bottles of water

and expose to sun with the wadi product and wait until ready.

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Use of WADI filter ­ Households that actually used the product were satisfied about the taste of the water, regardless of the

product they used. ­ Areas where people responded negatively about: speed of filtering / flow rate, speed of disinfection process. ­ Most respondents didn’t experience any change in their health condition (or from their family) after starting

using the HWTS product, however all respondents that did use the product correctly, didn’t visit the clinic for health reasons in the last month.

­ Most people received a manual with the product but did not read it / cannot read. ­ Halfway the pilot, only 25% of the respondents indicated they had were contacted by the supplier of the

product (for ‘after sales’). This 25% cannot be accounted to only 1 supplier. Most households mentioned they were mainly in touch with Bishan Gari and to a lesser extent Sawyer.

­ During midline survey only 12.5% of the respondents know where to buy new products or spare parts for the water treatment method. All positive responses came from Bishan Gari product.

During mid-term evaluation the evaluators demonstrated the product to the visited households in the correct way. Mid-term results resulted in action towards demanding increased attention from the private sector suppliers for household follow up. Also the kebele managers were trying their best to provide demonstration. A field visit has taken place by Aqua for All. 2.3 End line results For the end line evaluation all 100 households were visited. After termination of the pilot, the most notable results concerning use of the products, satisfaction and supply chain were as follows: ­ 52 % of all households (all treatment systems) did use the product over the 3 months of the pilot period, of

which only 11% used it every day. Reasons for not using the product were: o Afraid to use it – as they thought they had to then buy it (13% of the respondents) o Didn’t know how to use it (15% of the respondents) – mainly related to the Tulip filter o People didn’t like the product (50% of the respondents) – mainly related to the WADI device,

followed by Sawyer and then Tulip filter. ­ At the end of the pilot, about 50% of the households were visited by the supplier for sales/after sales. ­ Out of 100 households, 5 (17%) sawyer filters were sold and 2 (4%) tulip filters were sold, by upfront cash

payment. The other products were returned after the pilot, which means all of the WADI devices were returned. Returning of products is not possible for Bishan Gari. 10 households using Bishan Gari product used the sachets for free the first 1,5 months of the pilot, and then paid for the product for the remaining 1,5 months. The preferred payment option is to pay small amounts over time instead of total price upfront.

­ 75% of the households commented they thought the price for the products was too high – this counts for all four technologies (households were informed on the price during demonstration and follow up visits) and 15% responded they thought it was ok.

­ Almost 90% doesn’t know where to buy products or spare parts – even though half of the households were visited by the supplier.

­ Almost 90% of the households discussed their experience, either positive or negative, with family or neighbours. Almost none of the respondents know of others that also treat their water at home.

­ People responded that they think that price is the major reason why people will or will not buy the product. Second reason is health impact and information on use.

­ As the biggest disadvantage of using the product, households indicated the time before consumption (flow rate for filtration by Tulip, waiting time for WADI to disinfect etc.).

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2.4 Key results from interviews During finalisation of the pilot project, key informant interviews were held with people involved in the pilot:

Government stakeholders – woreda water office The 4 private sector suppliers Points of contact for the implementing NGO on the ground (CARE) 3 local community (kebele) leaders (2 managers and 1 chairman)

The interviews were focussed on evaluating the experience regarding this pilot, discussing draft conclusions and exploring lessons learnt and starting points for improvement for future programs and interventions. ­ All stakeholders indicate the relevance of awareness raising and education on the importance of safe water.

Only after this is done, but equally important is the need for very clear instructions and training per product type is required to get households use products in the correct way. It is clear from this pilot that products don’t sell themselves.

­ All stakeholders confirm the relevance of involvement of local government, all the way up to the kebele management. They are trusted by community and they should play a leading role. Follow up by local government together with private sector suppliers is crucial for successful introduction of new technologies and approaches and for the success of marked-led approaches.

­ At local government level, there are many activities that might be competing for kebele management attention. Combining efforts on community mobilisation effectively should be supported.

­ All stakeholders (government and NGO’s) should align and harmonise approaches and messages. In some woredas people were somehow informed about free gifts in other kebeles, which discourages people from wanting to buy, they rather wait until government or NGO’s pass by to support or provide for free. The government structure should take the leadership and coordination role. Kebele chairman: “Dependency syndrome is a real challenge that will affect the business model”. All stakeholders in an area working on safe water should follow the same strategy and communication messages should be aligned.

­ Private sector suppliers and others should send reliable messages concerning use and life span of products. ­ In general, all interviewed stakeholders supported the ambition and effort of the Try and Buy pilot approach.

The woreda water office: “Such an approach can bring real change to the sector. I believe success for market based approaches is heavily dependent on delivering government role and cascading the same to local level kebele leadership.”

­ Demand creation for HWTS should be promoted and followed up by woreda government office, both water and health bureaus (through its health extension program), combined with marketing activities by private sector.

­ The zonal government structure should be engaged in any effort and plan regarding market led solutions in access to safe water. This was missed in the Try and buy pilot.

­ All private sector partners realised their commitment to support demand creation, do marketing and promotion is essential in getting the products sold. Extra effort is required, but well organised and harmonised with government, development partners and the target groups/households. Local agents close to the end users can make a huge difference.

­ Timing of technology introduction like HWTS should be well considered in relation to affordability. Payment time for these products should preferably overlap with harvesting season (and not the planting season).

­ The approach gave ideas to private sector suppliers to think about different marketing practices, especially for rural areas. Some private sector partners have already approached local institutions or partners to play a role in their supply chain. The approach, however, seems less suitable for boosting sales at scale (a.o because of the intensity of attention and follow up), more for promotional purposes and customer feedback.

­ For boosting sales at household level in the future, the following suggestions were provided:

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o Engage relevant government sectors at all levels and appoint agents or ‘middle men’ at community level.

o The role of the regional health bureau is crucial for support and facilitation at woreda level. o Promotion could also take place through different media (local TV, Radio etc.) o Prices of some HWTS products will go down drastically if national government waives import

taxes. This should be discussed and advocated at national level. o Though the technologies tried in this pilot are believed to be low cost technologies, Kebele

managers indicated that the prices are still high when calculated on monthly bases. Important is to communicate clearly to potential customers what the life cycle costs are of the different technologies/products. In this case we calculated the life cycle cost of each product used per annum. The following results per product are (not taking retail profit margins into account):

For a family of 5 members, if they use 20 litre per capita per day (l/c/d); for Bishan Gari, this costs 43 Birr per month and 516 Birr per year.

For Tulip syphon filter for same family size and even bigger family size the total cost of the filter is 395 Birr and works for minimum of 2 years. This means that the life cycle cost per annum will be 200 Birr for same or more family size. After 2 years, the ceramic candle can be replaced with Birr 150 and again works for another 2 years and will continue for more and more years.

For Sawyer filter for same family size or more, the total cost of the filter is 1000 Birr and works for more than 2 years. This means that the life cycle cost per annum will be 500 Birr for same or more family size. For this product, since it is claimed to serve for longer years the life cycle cost per annum can go lower with proper management but has no spare parts.

For WADI, for same family size or more, the total cost of the product is 1000 Birr and works for more than 2 years. This means that the life cycle cost of the product per annum will be 500 Birr for same family size or more. For this product too, since it is claimed to serve for longer years the life cycle cost per annum can go lower with proper management but has no spare parts.

o Parallel efforts by private sector suppliers to do demonstrations on big meetings (like bazaars, exhibitions, regional expos, regular weekly markets) at woreda level. Different private sector players could cooperate.

o NGO’s could play a crucial role in demand creation and advocacy at government levels to prioritise safe water and influence policy and practice.

­ If any new Try and Buy pilot would take place, the following recommendations should be taken into account: o the area selection should be carefully considered not to be close to areas where free handout is or

has taken place. The willingness to pay results might have been influenced by this aspect. o Follow up by both government and private sector has to be done properly. This could improve the

actual use and uptake of the technologies. o The gender aspect has to be taken into account when informing, training and interviewing

households (include both male- decision maker; and female – actual user).

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3 Conclusions and recommendations 3.1 Answers to key questions for this pilot What is the interest of households in HWTS products and how are they satisfied with the individual

products? The effort through Try and Buy approach had given households the opportunity to test only one type of product during the try period but not the other choices. Accordingly, related to the product they tested, the satisfaction level was mostly positive – in cases where households actually used the product - with various degrees of satisfaction. While they are mostly sure of the value addition, the households were rather suspicious about payment issues, like whether the right to try and return was true (will not be compelled to pay if they start to use the product- i.e., fear of depreciation costs of filters used); why a business model this time - unlike other times that deliver free hand out; after kick off why government engagement was limited (as witnessed by kebele managers response) unlike a number of other follow up agendas by government; also in some cases suspicious of the product whether it serves the purpose long term without spare parts (Sawyer) and whether the treated water has sustained water quality (uncertainty if next day the bacteria survives again), and time taking to treat (Helioz, Tulip). These issues were challenging the satisfaction levels and real demand creation for them to decide to buy (and pay). How do households value the HWTS Products in monetary units (money) – their interest to purchase? For majority of the cases (68%), they valued the different products as expensive and indicated the price level a major challenge to purchase. This relates to the financial capacity of the households and community priority including the timing which overlapped with agricultural season (input purchase time). This, however, may also result from free hand out practice and limited awareness raising and information. Given that there is huge water quality challenge in the area and that reaching every one with safe water is still far away, a business model approach for HWTS seems the only way forward to realise safe water at point of use at scale. This however requires harmonised approaches from all stakeholders. Are private sector suppliers capable to market their products directly to households? It was observed that majority of the private sector suppliers - except Bishan Gari – are not yet equipped to market their products directly to households in these areas. This seems currently still a too expensive sales strategy for most suppliers. For example, immediately after demonstration of the product there were 18 requests coming from Korata Kebele for Sawyer, but the regional representative from Sawyer did not avail the products for the whole pilot period. This could be because the price the regional representative from Sawyer wanted to sell the product at higher prices than what the supplier agreed to deliver as part of the pilot (Birr 1000/Sawyer against Birr 1300/Sawyer). Being equipped to market the products directly to households is best explained by local presence from the suppliers, providing after sales services, availing readable manuals and explaining for those who do not read (including follow ups) and monitoring. This appeared to be a challenge for most of the suppliers in the pilot as they do not have local agents or branches at woreda / kebele level. Does the NGO play the right supporting role? Unfortunately, the supporting role of the involved NGO (CARE) was limited during pilot implementation, except during kick off meeting. Clarity on roles and responsibilities, close follow up and exchange of progress reports could have contributed to improve the situation. Unfortunately this was not done sufficiently by Aqua for All. For any future activities regarding market led activities in HWTS it is advised to plan and implement carefully together with all stakeholders active at woreda/kebele level. Given the fact that a) there is a huge free handout practice in the area for HWTS in earlier days and b) there is competing priorities by government who were not able to do the follow up for this specific pilot (which could have played a crucial role for demand creation and change the practice of free hand out) and c) that the approach of Try and Buy was a new paradigm for the area and beyond, the local

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NGO should play a strong and visible role to increase the success of such new approaches. Clearly, NGO’s play a crucial role in market-led solutions to achieve full coverage in safe water. Moving forward with activities without clear agreements with all stakeholders on next steps should be discouraged. Are the HWTS products affordable to the users? The affordability issue, as was observed from the wealth survey of households, where 39% are classified as rich and 61% are classified as middle income and also that 91% of the respondents indicate they have a bank savings account with primary income activities being farming food/cash crops, the assumption is that the HWTS products are affordable to pay by majority of the users. The users also possess solar power, mobile phones and possess fertile agricultural area. Responses from households regarding the price of the products being too high could be used as pressure for getting free hand out. Conclusions regarding affordability and price should therefore carefully be interpreted. Affordability and the interest to buy products are strongly related to awareness raising and information. Yet in order to be fully inclusive, still installing different payment mechanisms like instalment approach need to be considered with a proper system to enforce the agreed approach for payback. Is there horizontal diffusion effect where demand is created? No results so far is registered about a horizontal diffusion effect (based on sales records from private sectors)- whether demand is created through information from customers and that the products are sold outside the pilot distributed customers. Households did however indicate that they discussed their experience (either positive or negative) with family or neighbours. The experience for other self-supply technologies is that there is high copying of neighbours one from another/self-replication. What role is crucial for the local government? The local government role in try and buy as repeatedly explained by all stakeholders involved in this pilot – including households – indicates that they are crucial. The community trusts and prioritizes the awareness creation and sensitization role played by the local government. In addition, the realization of a harmonized approach (shift towards market led models for safe water), promoting the agenda in different public meetings and platforms, as well as considering it during budgetary process (to allocate budget for HWTS from government treasury as well as NGOs) is purely the crucial leading and coordination role to be played by the local government in the Ethiopian context. Also when a private sector led instalment approach to increase sales at rural communities is planned, the engagement of government and endorsement is mandatory. What can we learn to scale up safe water at household level through a market based approach? There should be continuous, sustained and harmonised effort by all partners to create demand at scale as this cannot be achieved within short run and through one time campaign and certainly not only by private sector partners only. Informing people and changing their current practices and attitudes and opinion for new products that should be paid for, is naturally a slow process but the end result is rewarding for the business entities, the decision makers, the sector professionals and above all for the community. The consistency of the business model should be committed if transformational change is to be achieved. As a result, there should be sustained and relentless effort by actors as well as influencing government policies and practices for this breakthrough agenda in the WASH sector. This pilot clearly shows that moving forward with activities without clear understanding and consensus with all stakeholders on timing, roles, responsibilities, planning and corrective activities should be discouraged. The “Try-and-buy” approach should therefore not be pushed further as a viable marketing and sales approach. However it is a good way to showcase different technology options to households directly and obtain relevant marketing information.

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3.2 Conclusions and recommendations Based on the overall experience in the Try and buy pilot in Dera Woreda (a.o. collected with the AKVO survey tool and Key Informant Interviews), the following summarised conclusions are drawn. 1. As for the success of the Try and buy pilot itself, we can conclude the following areas for improvement in case

we would like to replicate such an approach: preconditions for success are clearly: joint and inclusive planning, carefully orchestrated demonstrations, agreed role and responsibility division among all stakeholders involved, close follow up and joint monitoring and reviewing sessions with stakeholders, continuous promotion and visionary engagement of private sector, importance of timing of the pilot period within the activities of households in the agricultural calendar. Also discussion about a representative sample size could be considered, and offering different technology options at the same time for users instead of offering them 1 choice. A customized approach to ensure affordability by households should be developed. Different payment modalities could be explored.

2. The success or failure of the pilot project should not be measured by the amount of HWTS products sold to the 100 households. Ultimately, 7 physical products were sold (5 Sawyer and 2 Tulip). For Bishan Gari 27 households registered and half of them re-purchased the product after the pilot ended and sales are ongoing. No WADI products were sold and all were returned. Although sales figures might seem somehow disappointing, creating sales numbers was not the principle ambition of this pilot. Moreover, the pilot wanted to create awareness with all stakeholders, and create demand and discussion, trigger interest in market-led approaches for HWTS, which shows a path for realising continued safe water at community and household level. The pilot was successful in that sense: it triggered and shifted the mind-set of the local government and NGOs working in the area to avoid free hand out in the future. It also showed the challenges for private sector to sustainably supply households with safe water products. It underlines the necessity for all stakeholders to closely work together to make market-led approaches a success. Also it provided relevant starting points for scaling market-based approaches for HWTS in the future.

3. The GTP2 targets that the then 51.6 million unserved people and future projected population will have access to safe water in 2020 while the non-functionality is still a big challenge and the water quality issue of the current water sources is other bottleneck of the water sector. This reality is true for Dera woreda too where the try and buy pilot project was piloted. Therefore, by taking the lessons learnt from this pilot, there should be a follow up and scaling plan by other NGOs which are actively working on Safe water (like CARE but many more) together with Aqua for All and others. The government should take place on the driver’s seat.

4. Given that there is huge water quality challenge in the area and many other places, and that reaching every household with safe water services by government is not near, availing HWTS near the users for their decision in a business model is the only way to access safe water at point of use at large scale. This was fully appreciated and underlined by all stakeholders involved. Harmonisation of approaches between actors is crucial. Which means: all development partners should carefully strategies with the end in mind before even considering the practise of free handouts. If done in the wrong way, it might kill any current or future appetite for household led investments in safe water and increases the dependency syndrome. Together stakeholders should improve current practices and design sustainable approaches to avoid creating dependency syndrome. Free hand-outs – if considered – should be carefully integrated in a market-led approach.

5. As repeatedly mentioned by different stakeholders (the private sector partners, CARE and woreda water office itself); the role of local government authorities to trigger new ideas and approaches like market-led approaches including try and buy and creating awareness about the value addition of HWTS particularly in low water supply coverage areas, is mandatory and critical for success of such breakthrough efforts. Government actors at all levels, especially those structures close to communities, are the most trusted and influential stakeholders for such developments and also can potentially embed it in the future policies, strategies and

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programs. Apart from creating demand and introducing market based solutions, the focus should also be on the policy influencing dimension.

6. The role of NGO’s on the other hand should be supportive towards demand creation but is also essential in influencing government policies and budgets.

7. Localised water quality information at the start of any market-based HWTS initiative is crucial to start demand creation and awareness raising. The pilot area needs to clearly show water quality challenges. In this pilot, secondary data from CARE and IRC was used. As a result, when the community were asked about what they feel about the water quality issue, 90% of the respondents replied that they are happy with the water they are using (since they have no water quality test data). So, evidence based advocacy and awareness creation is very important. While starting the pilot, baseline water quality information for the pilot localities should be checked in front of the users and be openly informed. There should also be comparison by testing water at pipes and Hand Dug wells (on the source) and then at Household level (at point of use) for comparison. This is in addition to comparison of raw water test data.

8. Careful instruction about proper use of products (incl. follow up instruction meetings), preferably in small groups, on the use of product are crucial. The midterm survey indicated that 60% of the users did not properly use Sawyer; 78% did not use properly for Tulip; 67% did not use properly for WADI while only Bishan Gari product was used 100% properly. During the end line survey, improvement was made since the surveyors during the midline survey were simultaneously demonstrating the proper usage of the respective products during the MTR. Generally the availability of clear manuals in a local language needs attention by all suppliers of HWTS products. Information on product and its use is crucial for uptake and understanding. For target groups in rural areas, self-explanatory and easy to understand manuals (customise manuals according to the local context; eg. pictorial rather than text), demonstration in the presence of end users of the product and enough information supported with follow up visits is crucial for sustained use of HWTS and make the pilot a success. The survey result indicated that majority of the users did not understand the manuals as some of the manuals were written in English and some users even do not read Amharic either. This problem was further accentuated by the fact that the attendants of the kick off meeting (followed by distribution and demonstration) were male households who are not usually using the filter products while the real users are women and girls. This explains the monitoring results of some users not using the product properly or keep it unused.

9. Gender aspects: As mentioned above, water supply and sanitation roles are basically the duty and responsibility of women in the Ethiopian context, especially in rural communities. On the other hand, the decision making of household purchases lies on the hands of male. In this pilot, the kick off attendants were exclusively male. Therefore it is recommended that both the male decision makers and female users’ needs to attend the kick off workshop and any follow up training or meeting for future try and buy or similar approach. This underlines the importance of inclusive and participatory planning.

10. Willingness and affordability to pay: upfront informing on the sales price is necessary and should be clear to potential customers, which was practiced in this pilot. After experiencing the product for 3 months however, the majority of the households indicated challenges with the price level of the product. This underlines the importance of price and willingness to pay against the expected added value of the product (e.g. health impact). However, willingness to pay could be influenced heavily by the fact that the pilot kebeles are close to free handout kebeles and households have limited knowledge and information about HWTS and safe water. Their responses to willingness to pay could be used as pressure for getting free hand out. Conclusions regarding affordability and price should therefore carefully interpreted. Yet in order to be fully inclusive, still installing different payment mechanisms like instalment approach, credit and voucher systems need to be considered with a proper system to enforce the agreed approach for payback. The WASHCOM, the farmers cooperatives and unions, the edir and micro financing institutions should be part of the effort and be stakeholders in the process.

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11. One of the factors that makes the HWTS products, particularly physical filters, expensive (not low cost as they should be to increase sales) is the taxation system of the country (incl. profit tax, VAT and import duties), which increases the price of the filters tremendously. Therefore, in order to avail low cost and affordable products with minimum cost, the joint effort of the HWTS task force led by ministry of health with support of WHO and other stakeholders should produce a duty free privilege for physical filters like the case of chemicals.

12. Sustainable supply chains is purely the result of a market-led approach with a proper value chain where the producer or supplier, the importer, or distributor ensures outreach all the way to the kebele level. Proper supply chains for (spare) parts and after sales service is the corner stone of establishing a market-led approach for sustained use of HWTS. This will automatically follow once enough demand is created and proven.

13. The role and responsibilities of stakeholders should be clarified for all relevant steps in the process and must be realized. Clearly from this pilot, the private sector partners cannot do it all by themselves. The awareness raising and education is such an important part of the success that partnering with local government (health and water office) is mandatory. For example hygiene education, awareness raising and relevance of clean water to health by health office (health extension workers); information on current water quality and mitigation measures by woreda water office, demand creation and demonstration in functionality of the product as well as supply network development/ sales by the private sector partners; use harmonized approach by all NGOs in the area should be materialized.

14. Involvement of MFI’s is important to establish a loan scheme or develop other payment mechanisms– to improve the affordability of these kind of investments by households.

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Annex 1: Baseline survey questionnaire Questions 1. What is your name? 2. New question - please change name 3. What is your phone number (if you don't have a phone in your household can you give us the number of your neighbours or relatives)? 4. Gender of respondent 5. How old are you? 6. What is your marital status? 7. What is your household size? 8. Number of women, age 15-49 9. Number of men, age 15-49 10. Number of children, age <15 11. Can the male head of the household read? 12. Can the female head of the household read? 13. Household location Ability to pay and purchasing behaviour 14. What are the primary income activities of your household? 15. In which wealth category does your household fit? 16. OBSERVE: Type of walls of the house 17. OBSERVE: Type of roof 18. Which of the following does your household have? 19. Who is normally buying health items (such as medicine, water container)? 20. Where do you typically buy health items (such as medicine, water container)? 21. Who is normally buying large household purchases (such as mobile phone and electrical appliances)? 22. Where do you typically buy large household purchases (such as mobile phone and electrical appliances)? 23. If your household wants to use (or continue to use) water treatment products in the future; who will most likely buy these products (such as water filters, chlorine tablets)? 24. Where would you prefer to purchase water treatment products? (such as water filters, chlorine tablets)? 25. Does someone in your household have a money saving account? Drinking water 26. What is your main source of drinking water for your household? 27. How many times each day does your household collect water? 28. How long does it take to go there, get water and come back? 29. Who usually goes to this source to collect the water for your household? 30. When you, or your spouse, are outside of your home, from what source do you drink? 31. How do you store your drinking water? 32. Do you use a treatment method to make the water safe to drink? (including boiling) 33. Which treatment method(s) do you use to make the water safe to drink? 34. What are the most important reasons that you treat your water? (do not read the list, tick those that apply) 35. When do you not treat the water at home before drinking? 36. Why do you not (or not always) use a treatment method? 37. Are you happy with the water you currently drink? 38. Why not happy? 39. Did you ever received a message or training on water treatment products? 40. What type of training did you receive? 41. Who gave you the training? 42. Do you know where to buy new parts (or replace broken parts) for your treatment method? 43. Do you know where to buy a water treatment product?

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44. Does anyone in your household experience any water borne illnesses, such as diarrhea? Health 45. Has anyone in the household had diarrhea in the last two weeks? 46. How many members in your household had diarrhea in the age <5 years? 47. How many members in your household had diarrhea in the age 5-15 years? 48. How many members in your household had diarrhea in the age >15 years?

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Midterm evaluation questionnaire – for almost 50% of the households The following selection was made to receive representative data for all 4 different products:

Tulip: 18 households out of 50 (=36%) Sawyer: 10 households out of 30 (=33%) Bishan Gari: 6 households out of 10 (=60%) WADI: 6 households out of 10 (=60%)

Questions 1. Geographic location 2. What is your name? 3. Gender of respondent 4. Number of people in the household 5. What product/technology was provided to you by the Try & Buy pilot? Use of HWTS product TULIP specific 6. Is the filter installed correctly (minimal 70 cm difference between two containers, clean containers etc, see image in manual).7. Did they add water to upper container with the filter element in it 8. Did s/he opens the tap (or is the tap already open? this is also ok if they have it installed) 9. Make picture of respondent using the product. 10. How did they place the Siphon? 11. Take picture when they place the Siphon 12. What kind and size of containers do they use to save the filtered water? 13. Is the filter wet? 14. Is the filter clean? 15. Do you clean the filter? 16. How do you clean the filter (how do you do the back-washing)? 17. How often do you clean the filter? Sawyer specific 18. Did they add water to the water container 19. Did they store safely 20. How many times they clean filter when dirty during the last week 21. Make picture of respondent using the product. 22. Is the filter assembled correctly? 23. Is the filter wet? 24. Is the filter clean? 25. What do you like most about the filter 26. What improvement would you suggest for the filter? Bishan Gari Specific 27. Is 20 litres of raw water in a bucket ready? 28. Did they add all the contents of one sachet to the water 29. Did they stir the solution rapidly for 2 minutes and then slowly for 3 minutes 30. Did they wait for 30 minutes 31. Did they strain the water with clean strip/cloth/ to clean container 32. Make picture of respondent using the product. 33. Are you satisfied with the turbidity removal efficiency of the product? WADI specific 34. May I observe you how you currently give drinking water for children from this household? 35. Did they fill plastic bottles with water 36. Did they expose bottles and WADI to the sun, press the reset button 37. Did they wait for some hours while the sun disinfects the water and wait for the happy smiley face to appear.

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38. Are the bottles without any paper wrapped around 39. Do you see the fingers through the water (turbidity check -is sufficient to see them, must not be clear) 40. Do you always wait with using the water until the system indicates a 'smile'? 41. What improvement would you suggest for the WADI gadget? 42. Was sample of drinking water presented safely? General 43. How is the drinking water stored? 44. What source did this water for the demonstration come from? 45. Do you use the treatment product as provided? 46. Why manual of the product is not available? 47. Why do you use the treatment product? 48. Why do you not (or not always) use the provided treatment method? 49. How many people make use of the filtered/treated water? 50. Who in this households uses the filtered/treated water? 51. How often do members of this household drink the treated water at home? 52. How much water does your household treat daily with the technology provided? (in litres) 53. Does this filter/technology save you firewood or charcoal to boil the water before drinking? Product satisfaction 54. Are you happy with this water treatment product (i.e. the way you collect, treat and store water)? 55. Why you are happy or not with this water treatment product 56. Would you be willing to buy this product? 57. Why you wouldn't be willing to buy this product? 58. How do you evaluate the taste of the treated water? 59. Would you recommend this product to your neighbours or family? 60. What is the reason for not recommending this product to your neighbours or family? Health 61. Do you experience any change in your health condition or from your family after you started using the HWTS product that you are using? 62. Did you or your family member visit the clinic in the last month due to health problem? 63. Was your health problem because of water born disease or not? 64. What did the health officer advice you to do related to the water you are using? Communication/Marketting 65. Did you have contact with the supplier of the product since it was distributed? 66. What was the contact with the supplier about? 67. Did you receive training on how to use the water treatment technology that you are currently using? 68. Who gave you the training? 69. Do you know where to buy new products or parts (or replace broken parts) for your water treatment method?

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End line questionnaire for all 100 households Questions: 1. What is your name? 2. Which water treatment product do you receive? 3. Can you show me the product? 4. Did you use the product the last 3 months? 5. How often did you use it? 6. Why not? 7. Did the supplier of the product visit you recently to sell the product? 8. Did you buy the product? 9. Do you think the market price for this product is good? (regardless of whether you can afford to buy it now) 10. Why did you buy the product? 11. What was the most important reason for you to buy the product? 12. How much did you pay? 13. How did you pay? 14. Which payment option would you prefer? 15. Do you know where to buy new products / spare parts? 16. What is in your experience the biggest advantage of the product? 17. What is in your experience the biggest disadvantage of the product? 18. Do you think your household will continue to use the product? 19. Did you discuss your experience on using the product (either positive or negative) with family / neighbours? 21. What is the most important reason do you think that people in this kebele will or will not buy the product? 22. What is your expectation from either government, private sector or NGO after this pilot of try and buy? 23. What do you think is most important about a water treatment product? 24. Do you have other comments or questions about the product?

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Annex 2: Questions Key Informant Interviews

I. Key informant interview with the Implementing partner (CARE) – mainly focusing on roles and responsibilities for up scaling market based sales strategies:

1. What do you think of the Try and Buy approach? 2. What did you learn from the effort as CARE compared to your practice on HWTS earlier in the area? 3. What could have been done differently if you have some reservation? (Modified or completely different)? 4. What could be the role of CARE (or any other NGO) in creating a market for HWTS, based on demand and

supply? 5. What is your general recommendation or solution for ensuring the availability of water quality products

through a business model? II. Key informant interview with all 4 Private sector partners – mainly focusing on roles and

responsibilities for up scaling market based sales strategies: 1. How did you experience the participation of your company in the Try and Buy approach? 2. What is the most important lesson learned (you obtained) with this pilot? 3. What feedback from households was most helpful? 4. In terms of pricing and affordability, which payment mechanisms could work for you so as to improve

affordability for households? 5. How does this Try and Buy pilot assist in your marketing practices? 6. How do you evaluate this initiative to boost your sales? Is this a sales channel (directly to households) that

could work for your business? 7. What would you need (in terms of support/cooperation/information) to improve sales directly to households? 8. Based on this pilot, what suggestions do you have to improve a strategy to reach all households with HWTS in

a business wise approach? 9. How will you establish a sustainable supply chain in this area? 10. How do you see cooperation with woreda gov’t for future marketing activities (roles/responsibilities)? 11. How do you see cooperation with NGO’s gov’t for future marketing activities (roles/responsibilities)?

III. Key informant interview with woreda government (Woreda water Office) - Mainly focusing on roles and

responsibilities for up scaling HWTS technologies. 1. How do you evaluate the initiative of the Try and Buy approach in Dera Woreda? (explain first and share some

results) 2. In our joint ambition to achieve safe water by 2020, how do you evaluate the ambition to create a market

driven approach concerning HWTS? 3. How do you think such approach will help to meet the GTP 2 plan (on safe water supply/ Hygiene and

sanitation/ School WASH)? Is it aligned to GTP2? 4. Future practices for demand creation – how? What is best way – who should do what? How to reach scale? 5. What role do you see for the Private sector in creating a market for HWTS? 6. What role do you see for the woreda government in creating a market for HWTS? 7. What role do you see for NGO’s in creating a market for HWTS? 8. Which part of the kebeles are prevalent to the water quality problem where the HWTS technology applies? 9. What is your judgement about the different technology types to help the water quality problem? 10. What are the solutions for scattered settlement pattern of communities without access to safe water? What

do you think about HWTS? What about market based solutions? IV. Questions for Woreda Adminstration

1. What role should the administration take for ensuring real integration and role play for ensuring such efforts and similar tasks?

2. Do you think each stakeholder has played its role? 3. Future practices for demand creation – how? What is best way – who should do what? How to reach scale?

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4. Future cooperation with Private sector? 5. How do you think such approach will help to meet the GTP 2 plan (on safe water supply/ School WASH)? What

is the relation between this approach and the government existing effort to meet GTP2? Is it aligned to GTP2? 6. What is your recommendation to make such effort a success in line with the intended target? 7. What is your main reason for not contributing your part as per the commitment you made during the kick off

workshop? 8. General evaluation: Lessons learned from this pilot?

V. Questions for Kebele Managers/Kebele Chairmen: 1. What is the cumulative opinion of the community for the HWTS distributed? 2. In your opinion; what would been a better approach instead of T&B approach we used in your Kebeles? 3. What was the approach of your communication as you are the one who attended the workshop during the

kick off? Do you think this approach worked well? 4. Your general opinion?