Community response to social marketing: filters for guineaworm control

Guineaworm is a tropical helminthic disease which is responsible for much disability in rural areas from African to South Asia. Control interventions focus mainly on improving the quality of water supply at the health promotion level of prevention. This includes such technologies as dug wells, cloth filters, and chemicals added to pond water. Each technology has an appropriate health education strategy to aid in its promotion. The community of Idere in rural Nigeria was chosen to test the social acceptability of a new monofilament nylon cloth water filter. A social marketing strategy was used that built upon an existing primary health care program that utilized volunteer primary health workers (PHWs). The PHWs proved effective in marketing the filters in Idere as one-third of households in monitored areas purchased a filter during the six-month sales period in 1985-86. Those who bought filters were more likely to live in hamlets/family compounds where PHWs resided, belong to a modern religion, and have a preventive orientation toward health. Those who did not buy complained mostly of lack of money, but other overt and inferred reasons included attitudes that filters were inferior to wells, traditional beliefs that guinea-worm cannot be prevented and availability of cheaper but ineffective alternatives. Filters were found to be a particularly useful technology in the smaller, isolated farm hamlets surrounding the main town. Recommendations are made to improve the marketing strategy through modifications in filter design, price, distribution, and promotion.