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Title: Midstream Players Determine Population-Level Behavior Change: Social Marketing Research to Increase Demand for Lead-Free Components in Pitcher Pumps in Madagascar
Lead (Pb) exposure through water contamination is an important issue at the intersection of public health and water, sanitation, and hygiene (WASH). Behavior-change programs designed to address this pressing problem rarely take a behavioral-science-informed approach, nor do they consider the role of intermediate players who often influence and support behavior change. Social marketing segments the population and focuses on the consumer/user throughout program development and implementation. To illustrate the social marketing process, this cross-sectional, qualitative design study investigates the use of Pb in the construction and maintenance of household pitcher pumps for potable water in Madagascar. A sample of 18 technicians were interviewed on their current practices, motivators, barriers, and communication channels for knowledge exchange. The results reveal the importance of peers, those considered experts or “market mavens”, and the need for information on the dangers of Pb as an outdated practice for any future intervention. This study advances the notion of a design shift within engineering WASH projects, whereby social/behavioral approaches are used to consider the needs, concerns, and current behaviors of the consumer. We also advocate for engaging intermediate players who often influence behavior change in the rollout of an engineering innovation.
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International Journal of Environmental Research and Public Health
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National Science Foundation
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    The importance of Water Sanitation and Hygiene (WASH) projects for the protection of health is embedded in the sustainable development goals. However, within the development and humanitarian fields sustainability of WASH projects is still a challenge with 30–50% of projects failing within two to five years of implementation. Though failure is not linked to any one source, a common theme speaks to a greater need for community engagement and integration of the wants and needs of the end-user in the design process. Social marketing, with its focus on the consumer and use of commercial marketing strategies to achieve behavior change is a promising approach that can be integrated into ongoing WASH initiatives to meet program outcomes and to achieve long-term sustainability.

    Priority audience

    Primary audience includes technicians who manufacture and repair pitcher pumps. Secondary audience includes community members in Toamasina, Madagascar, who will experience a decrease in exposure to lead through their water supply.

    Behavioral objectives

    Decrease exposure to lead (Pb) introduced through the use of a decentralized, self-supply water system, the pitcher pump. Specifically, decrease use of leaded components in the manufacturing and repair of pitcher-pumps


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