Building sustainable markets to ensure access to safe drinking water

Picture of of a street in Port au Prince, Haiti with cars on the road and rows of houses on a hill in the background.
Only 14% of the population in Haiti has access to potable water in their homes. | Credit: Emily Mangone

A history of hurricanes and flooding has made Haiti vulnerable to cholera and diarrhea, two preventable diseases. However, with 70% of water sources contaminated and only 14% of the population having access to potable water in their homes, the country struggles to control these epidemics. Since the cholera outbreak in 2010 following a devastating earthquake, the government developed a national plan to eliminate the disease by 2022 and prevent future epidemics by increasing access to and use of chlorine-based home water treatment products. SHOPS Plus aims to increase overall demand for home water treatment products as a way to ensure a sustainable supply.

Developing markets for home water treatment products

Haiti has seen numerous home water treatment brands introduced into the market following disasters or during outbreaks. Typically, the products were free or heavily subsidized. Sales were predominately geared towards nongovernmental organizations and government entities, which in turn drastically affected the demand for these products outside the cholera season, when people think that their drinking water is clean. The first step in fostering a sustainable market for the home water treatment products was to look at supply.

Strengthening product awareness

SHOPS Plus is working in partnership with two companies that have home water treatment brands.

  • Aquatabs are water purification tablets manufactured by Medentech and distributed nationally by Propharma. Due to the heavy association with free distribution during natural disasters and outbreaks, consumers are not willing to pay for it. In addition, both companies had previously focused on institutional sales, which was lucrative but unsustainable. With support from SHOPS Plus, the product was relaunched under a new brand, Puritabs, and both the manufacturer and the distributor have developed a more consumer-centered strategy resulting in an affordable price for consumers. Aquatabs still exist but are reserved for free distribution.
  • Gadyen Dlo (water guardian in Haitian creole) is a sodium hypochlorite liquid solution. It was introduced into the market almost two decades ago, and is distributed primarily through community-based agents that conduct household visits. This approach, although seemingly effective because of the agents’ ability to deliver products as well as health messages, is not cost-effective, which has resulted in little market penetration. SHOPS Plus is providing product marketing support and business advisory services to increase brand competitiveness through cost recovery and coverage expansion. As a result, in 2017 Gadyen Dlo recorded sales volume growth despite a price rise. 
Billboard with Puritabs logo and woman and child with clean water in a glass next to them.
Puritabs is a water purification tablet that helps combat waterborne diseases.

Changing attitudes through a communications campaign

Looking at the demand side of the market, SHOPS Plus found that with the history of free, the willingness to pay for home water treatment is very low. The project team also found the misconception that apart from cholera outbreaks, there was no need to treat water at home. SHOPS Plus launched a communication campaign to make treating water at home a habit.  The project helped develop a non-branded campaign focused on what was identified as the two main determinants of uptake of these products: willingness to pay and low risk perception. It focused on encouraging users to develop a more active role in using the products. The campaign was carried out using flipcharts, spots on radio call-in shows, and text messaging. The project trained more than 7000 community members, mostly in Artibonite and Centre—two cholera-prone areas—whose role it was to speak to others about water safety.

Creating a conducive environment

SHOPS Plus continues to facilitate the development of a self-sustaining market that does not depend on donor grants and free distribution. This has included supporting the development of a national strategy to protect private sector manufacturers by limiting free distribution during emergencies so that they no longer focus only on institutional sales. The project will continue to increase the capacity of the private sector. It will build the local capacity of the public sector to assess and enforce the quality of home water treatment products, improve cost recovery through strengthening business management skills, and track key performance indicators for the market.  

Learn more about our work in Haiti.




Sustaining Health Outcomes through the Private Sector (SHOPS) Plus is a five-year cooperative agreement (AID-OAA-A-15-00067) funded by the United States Agency for International Development (USAID). This website is made possible by the generous support of the American people through USAID. The information provided on this website is not official U.S. government information and does not represent the views or positions of USAID or the U.S. government.

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