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Campaign Purpose and Focus 227

CASE STUDY
"Safe Water Saves Lives" Campaign

C A M PA IG N B A CKG ROU N D A N D R ATION A L E

In 2000, following a cholera outbreak after one of the most devastating series of
cyclones in more than 50 years, the government of Madagascar, PSI, CARE, and
CDC partnered to introduce a Safe Water System (SWS) emergency response.
Together, the partners recognized SWS as an essential tool to prepare communi-
ties against future cyclones, flooding, and other natural disasters.
In addition, the need for safe drinking water extended beyond natural
calamities because the majority of Madagascar residents do not have access to
improved drinking water. A Madagascar Ministry of Health survey in 2000
showed that some 75% of the population—up to 88% in rural areas—lacked ac-
cess to an improved source of drinking water, placing them at significant risk of
diarrheal disease (USAID, 2004). There are an estimated 119 deaths per year for
every 1,000 children under the age of 5 in Madagascar (UNICEF, 2007), and ap-
proximately 20,000 under-5 deaths per year are related to diarrhea (Institut
National de la Statistique and ORC Macro, 2005; Parashar, Hummelman,
Bresee, Miller, & Glass, 2003). Large geographic and socioeconomic disparities
exist. Under-5 mortality is 64% higher in rural as compared to urban areas;
among the poorest 20% of the population, children are twice as likely to experi-
ence diarrhea and are nearly three times more likely to die before their fifth
birthday than children from the wealthiest families (USAID, 2005).
The overall situation, emergency and nonemergency, led to the introduc-
tion of a low-cost and easy-to-use chlorination (sodium hypochlorite) product,
expanding the program over the next nine years with UNICEF and USAID fi-
nancial support.

CAM PAI G N PU R PO S E AN D FO C U S

The Madagascar national SWS program was launched to improve the health and
nutritional status of Malagasy children by reducing the incidence and prevalence
of diarrheal disease related to unsafe drinking water. The program was a public–
private partnership among the government of Madagascar (Ministry of Mines and
Water and the Ministry of Health and Family Planning), UNICEF, USAID, PSI,
CARE International, Madagascar NGOs, and the private commercial sector. As a
focus, the partners developed and promoted a home water treatment product and
related health messages using social marketing techniques.