Household Visits. Household visits are a theme related to behavior change in household water treatment that reached saturation in our data. In every program region, although not in all of the communities that Gadyen Dlo operates in, there was a Gadyen Dlo agent that was described as conducting household visits to check the Special bucket for cleanliness and test the drinking water for chlorine residuals. These home-visits served a dual purpose, to inspire positive water treatment practices and high adherence through a desire to please on the part of program participants and positive-reinforcement given by Gadyen Dlo agents as well as reassure community members of the safety, efficacy and correct usage of water treatment products.
Household Visits. Although CSRA has largely overcome the issue of residents refusing home visits, the time spent visiting the houses is another challenge, and perhaps it is a weakness of the program. Because some residents are not home at the time of the house visit, have moved since the last visit, or the house cannot be found, the auxiliary nurses spend much of their time visiting homes without being able to deliver the intended service. When asked what has been done to try to make the time of the auxiliary nurses more fruitful, the supervisor of the Montero program said that it is difficult to address this challenge. ―The only way of identifying whether the people have moved is to visit the home to find out,‖ the supervisor responded. To address the issue of visiting homes when the women from the Villa Cochabamba health district were working in the market, CSRA held large meetings with the market leaders and with the market sellers to obtain permission to visit the women and their children in the market. The auxiliary nurses now go to the market stalls to vaccinate the women and children. Regarding the large amount of time required to conduct household visits, Xx. Xxxxxx and the District Supervisor of the Ministry of Health replied that the time and cost required to conduct visits is worth the benefit derived (Interviews #13, 19). Xx. Xxxxxx said, ―This has a cost but compared to the benefit, it‘s very cheap. Because the success of this visit has such a great benefit in the community that it will help to save the life of children and women, and this is our objective. That‘s our goal—that children don‘t die. [...] The model [CBIO principles] tells me that visits shouldn‘t have a cost; they have to be an investment. We‘re investing; it‘s an investment‖ (Interview #13, p.15). The District Supervisor of the Ministry of Health said that the preventive care and health promotion provided during household visits are economical and cost-effective in the long run because they prevent illness and thereby reduce care-seeking at the health center and the city hospital (Interview #19).
