From Gatekeepers to Enablers: How Mothers Impact Families' Use of a Water Treatment Intervention in Rural Guatemala

Background and Purpose: Throughout the world, 1.1 billion people suffer from disease, dehydration, and malnutrition. Such maladies are fueled by waterborne pathogens that are spread through unsafe water.  In Guatemala, three-fourths of the population and 90 percent of their indigenous people live in poverty (UNDP, 2010).  Because the Guatemalan government has been unable to create nationwide water distribution infrastructures, communities have turned to exported Western technology for solutions (Hunter, 2009). The central role that clean water plays in maintaining health has generated much research and development of point-of-use (POU) water filters as a means to rectify the problem. Such interventions have been implemented in Guatemala and other developing countries through non-governmental organizations (NGOs) with minimal governmental oversight or investment.   

For two years, our team of university engineers, social workers, and local community health practitioners worked with rural communities in Guatemala to build and install water filters directly in people’s homes.  Our ongoing evaluations showed that while most families consistently used the technology, some did not.  This paper presents a study that sought to understand the use of water filters among the families, and identify factors and actors that influenced filter use.  Because the use and maintenance of the filters fall under the purview of “women’s work” (Albelda & Tilly, 1997), this study privileges the perspective of mothers.

Methods: We conducted 26 semi-structured interviews in six Maya communities in rural Guatemala.  The sample included 20 female heads-of-household. All except one were mothers.  To triangulate mothers’ perspectives, we interviewed two male heads-of-household, three community leaders, and one schoolteacher.  Twenty-two of the interviews were conducted in Spanish by the lead author, a bilingual doctoral student. Four were conducted in Spanish and Maya languages (Kachiquel and Tz’utujil), led by the lead author and interpreted by a Guatemalan program manager fluent in those languages.  Informants were identified through snowball sampling initiated by our Guatemalan project partners.  The research team inductively analyzed the Spanish transcriptions and coded the data using thematic analysis.  Our Guatemalan partners verified our findings by reviewing and ultimately validating the codes and interpretations.

Findings: All of the mothers identified themselves as the primary actors who affected whether family members used the household water filter.  Other participants also recognized these women as the primary person who either encouraged or deterred the families’ filter use.  Those who consistently used the water filter understood the time and effort involved as an investment in their children’s health.  Irregular use was attributed to: (1) a misunderstanding of the filter technology; (2) skepticism that the technology could deliver promised health benefits; and (3) missteps within the current program that were reminiscent of previous disappointing development projects.

Conclusions and Implications: This study highlights how family dynamics, development contexts, and relationships between international actors influence the outcomes of development projects.  It suggests that people’s perceptions of new technology and their previous experiences with development projects—positive and negative—help determine intervention use. During project development and evaluation, practitioners must interrogate how such contexts may affect intervention use and outcomes.