H2O Health Plus Demonstrates the Unique Power of Sustainable, Safe Drinking Water

Helping 80,000+ Ugandans achieve measurable improvements in health, safety, economic vitality and education.

Of Uganda's 30 million population, approximately 36% are without access to clean water and 52% are without sanitation.

H2O Health Plus (H2O+) seeks to ameliorate the dire health and socio-economic situation confronting impoverished villagers in Uganda, especially women and girls. The water crisis facing Uganda is well documented. Approximately 36% of the population, including 39% of the population in the Apac District, lacks access to clean water and 52% lives without proper sanitation. These conditions undermine public health, anti-poverty and education efforts. Indeed, water-borne disease is the leading cause of childhood mortality in Uganda, where infant mortality stands at 54 deaths per 1,000 live-births and nearly 13% of the population dies before reaching the age of five. In Sub-Saharan Africa, water-borne diseases (such as diarrheal infections) are ranked as the third leading cause of morbidity, but first among children under five.

Women and girls must walk long distances to existing unclean water sources, causing high numbers of child/infant death, low rates of girls' enrollment in school, and opportunities for women to live productive lives.

How is H2O+ addressing the problem and how many people do you plan to help?

H2O+ is demonstrating the unique power of sustainable safe drinking water to provide measurable improvements in community, childbirth and maternal health, health clinic capacity, economic vitality, and girls' enrollment in school. Beneficiaries of H2O+ include: Phase I (2012) 25,600 people; Phase II (2013-2014) 32,500 people, and Phase III (2015-2016) 65,000 people.

A young girl filling jerricans at the Obutet Health Center in the Pallisa district, southeast Uganda.

Blue Planet Network will combine its sector-leading evaluation, monitoring and tracking services with its partners' field expertise to implement sustainable sources of clean water that will dramatically improve community health and health clinic capacity. H2O+ has been designed with a goal to scale up to be a nationwide program in Uganda and eventually across Sub-Sarahan Africa.

H2O+ expects to reduce morbidity and mortality rates by 5%-10% in the Apac district of Uganda. Expected direct impact will include:

What makes H2O+ unique?

There are many great organizations implementing water and sanitation solutions in Uganda; however, very few are implementing a holistic, user-centric approach to improving community health and producing a rigorous case study to prove it. H2O+ is designed to have a greater positive long-term impact at a lower cost than if each element, e.g. water, sanitation and/or clean cook stoves, were implemented on its own.

Filling jerricans at a new borehole.

In 2013, Blue Planet Network received a $445,000 grant from The Conrad N. Hilton Foundation to launch a three-year Clean Cook Stoves for Health (CCSH) program with its H2O+ partners, International Lifeline Fund, the University of Notre Dame Initiative for Global Development and Africa Ahead. The CCSH program, which is part of the H2O+ initiative, is designed to: (1) replace the use of open fire cooking with clean and efficient cook stoves; (2) reduce the exposure to air pollution produced by such open fire cooking thereby reducing negative effects on health for nearly 15,000 people; and (3) publish an in-depth final CCSH program study that will contribute to the sector and inspire comprehensive clean cook stove initiatives by other organizations. In addition, the project will reduce CO2 emissions and improve livelihoods by reducing time spent collecting firewood and cooking, as well as expenses purchasing firewood and charcoal. The CCSH program will support the production, distribution and monitoring of more than 3,000 clean cook stoves in the District of Apac in northern Uganda. CCSH partners will conduct robust random-control research on how the project impacts community health.

The Conrad N. Hilton Foundation was created in 1944 by international business pioneer Conrad N. Hilton, who founded Hilton Hotels and left his fortune to help the world's disadvantaged and vulnerable people. The Foundation currently conducts strategic initiatives in six priority areas: providing safe water, ending chronic homelessness, preventing substance abuse, helping children affected by HIV and AIDS, supporting transition-age youth in foster care, and extending Conrad Hilton's support for the work of Catholic Sisters. In addition, following selection by an independent international jury, the Foundation annually awards the $1.5 million Conrad N. Hilton Humanitarian Prize to a nonprofit organization doing extraordinary work to reduce human suffering. From its inception, the Foundation has awarded more than $1 billion in grants, distributing $92 million in the U.S. and around the world in 2013. The Foundation's current assets are approximately $2.4 billion.

Blue Planet Network and its partners are thankful for the many generous supporters of H2O+, including S.L. Gimbel Foundation and The Community Foundation serving the Counties of Riverside and San Bernardino, Aqua for All, Generosity Water and Water to Thrive. Aqua for All is a Dutch foundation dedicated to the poorest people in the world, connecting public and private organizations to mobilize resources, expertise and finances from the Dutch water sector toward development aid projects focused on water and sanitation. Generosity Water – a non-profit organization that tackles the water crisis one community at a time – has funded 470 projects serving 291,876 people in 19 countries. Water to Thrive is a faith-based non-profit dedicated to the mission of bringing clean, safe water to those who need it in rural Africa.

Who are the partners of H2O+?

Blue Planet Network is leading the H2O+ initiative by bringing together lead innovators across the health and water sectors. International Lifeline Fund (Lifeline), a member on Blue Planet Network's platform, will drill H2O+'s borehole wells and partner with Africa Ahead to launch Community Health Clubs. Lifeline reduces human suffering through water and sanitation initiatives, fuel-efficient stove programs, and micro-enterprise. They have constructed more than 212 borehole wells in the Districts of Apac, Palissa and Lira, serving over 150,000 people. Africa Ahead, a South African-based organization led by Juliet Waterkeyn, will launch H2O+’s Community Health Clubs (CHC). 

Lifeline drilled a borehole well for the Chelekura Health Center providing safe drinking water for 1,373 children and villagers.

The CHC concept has been employed to date in several African countries including Zimbabwe, Rwanda, Sierra Leone, and South Africa, and has been supported by organizations such as CARE, the U.K. Department for International Development and Danish International Development Agency. Richard Sezibera, Secretary General of East African Community and formally the Minister of Health for Rwanda, is a strong advocate of the CHC model with 45,000 people in 2010 already practicing the model nationwide. He stated, "CHCs requires technical support and motivation…critical towards achieving effective motivation…of preventative health and national poverty reduction. The methodology will promote behavior change and become the engine for social interaction and development." The CHC approach addresses preventable diseases within a holistic framework that understands health promotion as an entry point into a long term process of transformation of social norms and values that ultimately leads to poverty reduction.

The Notre Dame Initiative for Global Development at the University of Notre Dame (NDIGD) has extensive experience on measuring the impact of applied research activities related to global development. NDIGD will serve as the lead research partner, and will monitor, evaluate and produce a final case study on the community health impact of replacing traditional cook stoves with energy-efficient models in over 3,000 households in 35 northern Ugandan villages. ReachScale brings social innovators (corporations, organizations and governments) together to design public-private partnerships using the social enterprise models to drive innovation and impact.

Blue Planet Network’s peer-to-peer collaboration, monitoring tools and online technology services are increasing the impact of water programs around the world, including H2O+. Blue Planet Network leaders will train H2O+ participants to use SMS reporting technology to send progress reports and ongoing project data to Blue Planet Network’s technology platform, which will serve as H2O+’s planning, monitoring and evaluation system.

How are fuel-efficient stoves connected to women empowerment, health and environmental sustainability?

A focus of H2O+ is to train households on environmentally-friendly technologies that save lives, and the forest, such as fuel-efficient stoves. According to the Uganda Bureau of Statistics, approximately 88% of all households in northern Uganda use firewood for cooking. The approximate total market size for wood-burning clean cook stoves in northern Uganda is over 800,000 households, consisting entirely of households that earn less than $1-$3 per day.

A Ugandan woman walking for miles on a dirt road collecting firewood for cooking.

The hazards associated with the use of wood and charcoal for cooking are severe. Nearly 95% of rural households cook on open fires, resulting in the loss of 1/3 of Uganda's forest in the last 25 years and explaining why acute respiratory disease is the second leading cause of morbidity and accounts for over 8% of infant deaths. The victims are those responsible for cooking: women and girls. Women/girls spend 6-8 hours daily collecting water/wood for cooking, leaving little time for income generation or school. The amount of time that women can save by cooking on a more efficient cookstove, collecting less firewood, and feeling healthier allows women more time and freedom to choose to pursue income-generating activities (such as the production and distribution of fuel-efficient stoves), education, and taking care of their families.

Since 2006, Lifeline has produced, distributed and sold approximately 130,000 clean cook stoves - profoundly impacting the lives of approximately 650,000 displaced and impoverished individuals in challenging environments of northern Uganda, Darfur, Kenya's Somali border and Haiti. In the past couple of years, Lifeline has trained 10,000 rural villagers in northern Uganda on the construction and usage of such stoves in partnership with both the World Food Program and German Agro-Action. Currently, Lifeline is the largest stove manufacturer and supplier in the Lango sub-region of northern Uganda. However, this represents only a very small part of the large unmet need in the region.

A Ugandan woman and her baby cooking on Lifeline's fuel-efficient stove.

The rural fuel-efficient stoves program utilitzes local women vendors as the primary distribution network for its stoves. These women are aware of Lifeline's presence in the region, and can speak directly about the benefits to potential customers in their own extensive network. Lifeline also provides marketing training for women vendors to help them expand their businesses. Lifeline's fuel-efficient stove programs have created more than 110 women-focused jobs and income generating opportunities in Uganda. As an environmentally-friendly technology, each rural wood-burning stove reduces CO2 emissions by one (1) ton per year and saves about five medium-sized trees per year. This will reduce overall emissions by 3,000 tons per year and save 15,000 trees in Phase II of H2O+.

Tell us more about H2O+'s results to-date

Thanks to the generous support of the S.L. Gimbel Foundation and The Community Foundation serving the Counties of Riverside and San Bernardino, H2O+ was piloted in 2012 successfully in Pallisa, a district in eastern Uganda. The project brought clean water to rural populations and improved capacity to underserved health clinics as well as communities. Five borehole wells were constructed near health clinics providing 6,392 villagers living in these five communities with direct access to clean water. Additionally, those traveling from afar to these clinics have access to this clean water, which calculates to 4,000 visitors per year per health clinic. Because of the strategic placement of the wells, the program will benefit 25,600 people annually in these five communities. For more on H2O+’s pilot results and the creators behind the model, see this article.