Combining interventions: Improved chimney stoves, kitchen sinks and solar disinfection of drinking water and kitchen clothes to improve home hygiene in rural Peru

Home based interventions are advocated in rural areas against a variety of diseases. The combination of different interventions might have synergistic effects in terms of health improvement and cost effectiveness. However, it is crucial to ensure cultural acceptance. The aim of the study was to develop an effective and culturally accepted home-based intervention package to reduce diarrhoea and lower respiratory illnesses in children. In two rural Peruvian communities we evaluated the performance and acceptance of cooking devices, household water treatments (HWT) and home-hygiene interventions, with qualitative and quantitative methods. New ventilated stove designs reduced wood consumption by 16%. The majority of participants selected solar water disinfection as HWT in a blind tasting. In-depth interviews on hygiene improvement further revealed a high demand for kitchen sinks. After one year of installation the improved chimney stoves and kitchen sinks were all in use. The intervention package was successfully adapted to local customs, kitchen-, home-and hygiene management. High user satisfaction was primarily driven by convenience gains due to the technical improvements and only secondarily by perceived health benefits.