發(fā)展中國(guó)家中的家用水處理和安全的存儲(chǔ)選擇：對(duì)目前執(zhí)行實(shí)踐的一個(gè)回顧中英文翻譯、外文文獻(xiàn)翻譯、外文翻譯

外文資料theUnitedNations’InternationalDrinkingWaterSupplyandSanitationDecade(1981–1990)failedtoachieveitsgoalofuniversalaccesstosafedrinkingwaterandsanitationby1990(WorldHealthOrganization[WHO],2003).Eventhoughservicelevelsrosebymorethan10percentduringthedecade,1.1billionpeoplestilllackedaccesstoimprovedwatersupplies,and2.4billionpeoplewerewithoutadequatesanitation,in1990(WHO/UNICEF,2000).Reasonscitedforthedecade’sfailureincludepopulationgrowth,fundinglimitations,inadequateoperationandmaintenance,andcontinuationofatraditional“businessasusual”approach(WHO/UNICEF,1992).TheworldisonscheduletomeettheMillenniumDevelopmentGoal(MDG),adoptedbytheUNGeneralAssemblyin2000andrevisedaftertheWorldSummitonSustainableDevelopmentinJohannesburg,to“halve,by2015,theproportionofpeoplewithoutsustainableaccesstosafedrinkingwaterandbasicsanitation”(WorldBankGroup,2004;WHO/UNICEF,2004).However,successstillleavesmorethan600millionpeoplewithoutaccesstosafewaterin2015(WHO/UNICEF,2000).Inaddition,althoughtheMDGtargetspecificallystatestheprovisionof“safe”drinkingwater,themetricusedtoassesstheMDGtargetistheprovisionofwaterfrom“improved”sources,suchasboreholesorhouseholdconnections,asitisdifficulttoassesswhetherwaterissafeatthehouseholdlevel(WHO/UNICEF,2004).Thus,manymorepeoplethanestimatedmaydrinkunsafewaterfromimprovedsources.HOUSEHOLDWATERTREATMENTANDSAFESTORAGEToovercomethedifficultiesinprovidingsafewaterandsanitationtothosewholackit,weneedtomoveawayfrom“businessasusual”andresearchnovelinterventionsandeffectiveimplementationstrategiesthatcanincreasetheadoptionoftechnologiesandimproveprospectsforsustainability.Despitegeneralsupportforwatersupplyandsanitation,themostappropriateandeffectiveinterventionsindevelopingcountriesaresubjecttosignificantdebate.Theweaklinksamongthewater,health,andfinancialsectorscouldbeimprovedbycommunicationprogramsemphasizinghealth1—aswellasmicro-andmacroeconomic—benefitsthatcouldbegained.Thenewfocusonnovelinterventionshasledresearcherstore-evaluatethedominantparadigmthathasguidedwaterandsanitationactivitiessincethe1980s.Aliteraturereviewof144studiesbyEsreyetal.(1991)representstheoldparadigm,concludingthatsanitationandhygieneeducationyieldgreaterreductionsindiarrhealdisease(36percentand33percent,respectively)thanwatersupplyorwaterqualityinterventions.2However,amorerecentmeta-analysiscommissionedbytheWorldBankcontradictedthesefindings,showingthathygieneeducationandwaterqualityimprovementsaremoreeffectiveatreducingtheincidenceofdiarrhealdisease(42percentand39percent,respectively)thansanitationprovisionandwatersupply(24percentand23percent,respectively)(Fewtrell&Colford,2004).Thediscrepancybetweenthesefindingscanbeattributedinparttoadifferenceininterventionmethodology.Esreyetal.(1991)reviewedstudiesthatlargelymeasuredtheimpactofwaterqualityimprovementsatthesource(i.e.,thewellheadorcommunitytap).Since1996,alargebodyofpublishedworkhasexaminedthehealthimpactofinterventionsthatimprovewaterqualityatthepointofusethroughhouseholdwatertreatmentandsafestorage(HWTS;Fewtrell&Colford,2004).Theserecentstudies—manyofthemrandomizedcontrolledinterventiontrials—havehighlightedtheroleofdrinkingwatercontaminationduringcollection,transport,andstorage(Clasen&Bastable,2003),andthehealthvalueofeffectiveHWTS(Clasenetal.,2004;Quicketal.,1999,2002;Conroyetal.,1999,2001;Relleretal.,2003).In2003,astheevidenceforthehealthbenefitsofHWTSmethodsgrew,institutionsfromacademia,government,NGOs,andtheprivatesectorformedtheInternationalNetworktoPromoteHouseholdWaterTreatmentandSafeStorage,housedattheWorldHealthOrganizationinGeneva,Switzerland.Itsstatedgoalis“tocontributetoasignificantreductioninwaterbornedisease,especiallyamongvulnerablepopulations,bypromotinghouseholdwatertreatmentandsafestorageasakeycomponentofwater,sanitation,andhygieneprogrammes”(WHO,2005).HWTSOPTIONSThisarticlesummarizesfiveofthemostcommonHWTSoptions—chlorination,filtration(biosandandceramic),solardisinfection,combinedfiltration/chlorination,andcombinedflocculation/chlorination—anddescribesimplementationstrategiesforeachoption.3Weidentifyimplementingorganizationsandthesuccesses,challenges,andobstaclestheyhaveencounteredintheirprojects.Weconsidersourcesoffundingandthepotentialtodistributeandsustaineachoptiononalargescale,andproposegoalsforfutureresearchandimplementation.Thisarticlefocusesonpoint-of-usedrinkingwatertreatmentandsafestorageoptions,whichcanacceleratethehealthgainsassociatedwithimprovedwateruntilthelonger-termgoalofuniversalaccesstopiped,treatedwaterisachieved.Bypreventingdisease,HWTSpracticescancontributetopovertyalleviationanddevelopment.Theirwidespreaduse,inconjunctionwithhygieneeducationandsanitation,couldsavemillionsoflivesuntiltheinfrastructuretoreliablydeliversafewatertotheentireworldpopulationhasbeencreated.WeuseaconsistentevaluationschemeforeachoftheHWTSoptionsdiscussed(seeTable1):1.DoestheHWTSoptionremoveorinactivateviral,bacterial,andparasiticpathogensinwaterinalaboratorysetting?;2.Inthefield,istheHWTSoptionacceptable,canitbeusedcorrectly,anddoesitreducediseaseamongusers?3.IstheHWTSoptionfeasibleatalargescale?Thesodiumhypochloritesolutionispackagedinabottlewithdirectionsinstructinguserstoaddonefullbottlecapofthesolutiontoclearwater(ortwocapstoturbidwater)inastandard-sizedstoragecontainer,agitate,andwait30minutesbeforedrinking.Infourrandomizedcontrolledtrials,theSWSreducedtheriskofdiarrhealdiseaseby44–84percent(Lubyetal.,2004;Quicketal.,1999,2002;Semenzaetal.,1998).AtconcentrationsusedinHWTSprograms,chlorineeffectivelyinactivatesbacteriaandsomeviruses(AmericanWaterWorksAssociation,1999);however,itisnoteffectiveatinactivatingsomeprotozoa,suchascryptosporidium.5InitialresearchshowswatertreatedwiththeSWSdoesnotexceedWHOguidelinesfordisinfectionby-products,whicharepotentiallycancer-causingagents(CDC,unpublisheddata).BecausetheconcentrationofthechlorinesolutionusedinSWSprogramsislow,theenvironmentalimpactsofthesolutionareminimal.Chlorination:ImplementationStrategiesSWSimplementationhasvariedaccordingtolocalpartnershipsandunderlyingsocialandeconomicconditions.Thedisinfectantsolutionhasbeendistributedatnationalandsubnationallevelsin13nationalandsubnationallevelsin13countriesthroughsocialmarketingcampaigns,inpartnershipwiththeNGOPopulationServicesInternational(PSI).InIndonesia,thesolutionisdistributedprimarilybyprivatesectorefforts,ledbyalocalmanufacturingcompany.Inseveralcountries—includingEcuador,Laos,Haiti,andNepal—theministriesofhealthorlocalNGOsruntheSWSprogramsatthecommunitylevel.InKabul,Afghanistan,theSWSisprovidedatnochargetopregnantwomenreceivingantenatalcare.TheSWShasalsobeendistributedfreeofchargeinanumberofdisasterareas,includingIndonesia,India,andMyanmarfollowingthe2004tsunami,andalsoinKenya,Bolivia,Haiti,Indonesia,andMadagascarafterothernaturaldisasters.WhenSWSprogramsareinplace,theproduct’sreadyavailabilitygreatlyfacilitatesemergencyresponse.TheCDChasdevelopedanimplementationmanualandprovidestechnicalassistancetoorganizationsimplementingSWSprojects(CDC,2001).SolarDisinfection:BenefitsandDrawbacksThebenefitsofSODISinclude:?Provenreductionofbacteria,viruses,andprotozoa;?Provenhealthimpact;?Acceptabilitytousersbecauseoftheminimalcosttotreatwater,easeofuse,andminimalchangeinwatertaste;and?Unlikelyrecontaminationbecausewaterisconsumeddirectlyfromthesmall,narrowneckedbottles(withcaps)inwhichitistreated.Thedrawbacksinclude:?Needtopretreatwaterthatappearsslightlydirty;8?Lowuseracceptabilitybecauseofthelimitedvolumeofwaterthatcanbetreatedatonetimeandthelengthoftimerequiredtotreatit;and?Requiresalargesupplyofintact,clean,andproperlysizedplasticbottles.SolarDisinfection:ImplementationStrategiesAsavirtuallyzero-costtechnology,SODISfacesmarketingconstraints.Since2001,localNGOsinsevencountriesinLatinAmerica—aswellasinUzbekistan,Pakistan,India,Nepal,SriLanka,Indonesia,andKenya—aredisseminatingSODISbytrainingandeducatingusersatthegrassrootslevel,providingtechnicalassistancetopartnerorganizations,lobbyingkeyplayers,andestablishinginformationnetworks.TheprogramhasbeenfundedbytheAVINAandSolaquaFoundations,privateandcorporatesponsors,andofficialdevelopmentassistance.TheprogramhasshownthatSODISisbestpromotedanddisseminatedbylocalinstitutionswithexperienceincommunityhealtheducation.Creatingawarenessoftheimportanceoftreatingdrinkingwaterandestablishingcorrespondingchangesinbehaviorrequiresalong-termtrainingapproachandrepeatedcontactwiththecommunity.TheSwissFederalInstituteforEnvironmentalScienceandTechnologyhasdevelopedanimplementationmanual,andprovidestechnicalassistancetoNGOsimplementingSODIS.Themethod,whichhasbeendisseminatedinmorethan20developingcountries,isregularlyappliedbymorethanonemillionusers.CeramicFiltration:ImplementationStrategiesPFPisaU.S.-basedNGOwhosemissionistobuildaninternationalnetworkofpottersconcernedwithpeaceandjusticeissues.PFPhelpspotterslearnappropriatetechnologiesandmarketingskillsthatimprovetheirlivelihoodsandsustaintheirenvironmentandculturaltraditions.Afterstaffmemberswereintroducedtotheceramicfilterdesign,PFPestablishedafilter-makingfactoryinManagua,Nicaragua.Fundingfortheprojectinitiallycamefromprivatedonations.Thefilterfactoryisnowaself-financedmicroenterpriseinNicaragua.NGOspayUS$10perfilter,andtransportthefiltersthemselvestoprojectlocations.From1999–2004,PFPmadeandsoldatotalof23,000filtersinNicaragua.PFPhasalsoestablishedfilter-makingfactoriesin12othercountries,contractedbyorganizationsthatprovidefundingfortechnicalassistanceandfactoryconstruction.Inthecurrentmodel,thefactorysellsfilterstoNGOs,whothenimplementawaterprogram.ThismodelisattractivetoNGOsbecausetheydonothavetoproducethefilters,butitsuffersfromalackofconsistenttrainingandeducationforboththeNGOimplementersandtheusers.Poorcleaningandmaintenanceofthefilteroftenleadstorecontaminationoffinishedwater(Lantagne,2001b).Toaddressthisissue,PFPisworkingwithcooperatingNGOstodevelop,implement,andevaluateaneducationalprogramthatincludessafestorage,properproceduresforcleaningthefilter,andfollow-upvisitstoensureproperusecontinuesandbrokenfiltersarereplaced.Thiseducationalcomponentiscriticalfortherealworldperformanceofthefiltertomatchitseffectivenessinthelaboratory,andtotestwhetherfiltersmadewithlocallyproducedmaterialswillpreventdiarrhea.BioSandFiltration:BenefitsandDrawbacksThebenefitsoftheBSFinclude:?Provenremovalofprotozoaandapproximately90percentofbacteria;?Highuseracceptabilityduetoeaseofuse,andimprovedlookandtasteofwater;?Producedfromlocallyavailablematerials;?One-timeinstallationwithfewmaintenancerequirements;and?Longlife.ThedrawbacksoftheBSFinclude:?Lowrateofvirusinactivation;?Lackofresidualprotectionandremovaloflessthan100percentofthebacteria,whichleadstorecontamination;?Thecurrentlackofstudiesprovinghealthimpact;and?Difficultyintransportandhighinitialcost,whichmakescalabilitymorechallenging.TheBSFhasbeenimplementedthroughtwomainstrategies.IntheNGOmodel,employedinCambodiaandothercountries,thecostofthefiltersissubsidized,andaNGOpromotestheuseoftheBSFinthecommunityandprovidesthefilters.Inthemicro-entrepreneurmodel,usedinKenyaandtheDominicanRepublic,localentrepreneursconstructtheBSF,receivetrainingandstart-upmaterials,andthendevelopmicro-enterprisestosellfilterswithintheircommunities.FUTUREWORKAlthoughmuchresearchhasbeencompletedonHWTSoptions,moreisneeded,including:?Healthimpactstudies:?OftheHWTSoptionsthatarewidelydistributedbuthavenotyetbeenproveneffectiveatreducingdisease;?Ofalarge-scalereal-worldproject,suchasoneofthenationalorsub-nationalPSISWSprojects;and?Investigationsoftheeconomicsofmovingtolarge-scaleprojects,includingcostanalysis,economicdemandassessment,andsustainability;and?DeterminationoftherelativeandabsoluteimpactofHWTSoptionsandotherwater,sanitation,andhygiene(WASH)interventions,andresearchinvestigatingoptimalcombinationsofHWTSandWASHinterventions.Inaddition,importantoperationalresearchquestionsremain,including:?WhatmotivatesuserstopurchaseanduseaHWTSoption?;?Whatarecurrentpurchase(use)andrepurchase(sustaineduse)ratesindifferentdemographic,socio-economic,andculturalgroups;andhowdothesecorrelatewithwaterbornediseaseprevalencerates?;?WhatisthehealthimpactofroutineversussporadicuseofHWTSoptionsinthehome?;?Whatareoptimalbehavior-changestrategiesforhygieneandsanitationpractices;andhowdowebestincorporatetheseintodifferentHWTSimplementationstrategies?;and?Whatarethemostsustainableandcosteffectivewaystoreachruralandremoteareas?Toaddresstheseresearchquestions,theHWTScommunityshouldcontinuetoworkwithacademicinstitutionsthatprovidetechnicalknowledgeandstudentlabor.TheUniversityofNorthCarolina,EmoryUniversity,MIT,JohnsHopkinsUniversity,andtheLondonSchoolofHygieneandTropicalMedicine,amongothers,haveexistingprogramsinpublichealthorengineeringdepartmentsthatresearchHWTSoptions.Thispathhasresultedinnumeroussuccesses,suchasithlonger-termendpointsinchildren,includinggrowth,cognitivedevelopment,andmortality.?Developmentofreal-term,practicalparametersandperformancemeasurestopredictsafetyofdrinkingwaterindevelopingcountries;?Investigationsoftheeconomicsofmovingtolarge-scaleprojects,includingcostanalysis,economicdemandassessment,andsustainability;and?DeterminationoftherelativeandabsoluteimpactofHWTSoptionsandotherwater,sanitation,andhygiene(WASH)interventions,andresearchinvestigatingoptimalcombinationsofHWTSandWASHinterventions.Inaddition,importantoperationalresearchquestionsremain,including:?WhatmotivatesuserstopurchaseanduseaHWTSoption?;?Whatarecurrentpurchase(use)andrepurchase(sustaineduse)ratesindifferentdemographic,socio-economic,andculturalgroups;andhowdothesecorrelatewithwaterbornediseaseprevalencerates?;?WhatisthehealthimpactofroutineversussporadicuseofHWTSoptionsinthehome?;?Whatareoptimalbehavior-changestrategiesforhygieneandsanitationpractices;andhowdowebestincorporatetheseintodifferentHWTSimplementationstrategies?;and?Whatarethemostsustainableandcosteffectivewaystoreachruralandremoteareas?Toaddresstheseresearchquestions,theHWTScommunityshouldcontinuetoworkwithacademicinstitutionsthatprovidetechnicalknowledgeandstudentlabor.TheUniversityofNorthCarolina,EmoryUniversity,MIT,JohnsHopkinsUniversity,andtheLondonSchoolofHygieneandTropicalMedicine,amongothers,haveexistingprogramsinpublichealthorengineeringdepartmentsthatresearchHWTSoptions.Thispathhasresultedinnumeroussuccesses,suchasthedevelopmentofacomputermodeltoascertainSODISappropriatenessforanyareaoftheworldusingNASAdata(Oatesetal.,2002).Onequestiontoponder:arestudentsbeingtrainedforjobopportunitiesthatdonotyetexist?TheinterestinHWTSoptionsisveryhighatthestudentlevel.TheHWTScommunityshouldseektoidentifyandcoordinatefuturehumanresourceswiththegrowingnumberofgraduateswithrelevantfieldexperience.Lastly,HWTSoptionsneedtobeimplementedatscale,andinconjunctionwithotherwaterandsanitationprogrammingtohelpreducediseaseburdenandalleviatepoverty.Adiversearrayofcreativepartners,withadequatecapitalandtechnicalsupport,willbeneededtocompletethiswork.DISCUSSIONManyresearchers,privatecompanies,faith-basedorganizations,internationalandlocalNGOs,donors,ministriesofhealth,andendusersareinterestedinHWTSoptionsandinmechanismsfortheirimplementation.Theevidencebasefortheseinterventionsiswell-establishedandgrowing,andanactiveprogramoffurthertechnicalandoperationsresearchisbeingpursuedonmultiplefronts.HWTSimplementationhasenjoyednumeroussuccesses.Firstandforemost,field-basedprogramshavedocumentedreductionsofdiarrhealdiseasesinendusers.Factorsthatcontributedtosuccessfulprogramsinclude:?TheabilitytoobtainqualityHWTSoptioncomponents(andanyreplacementparts)locally;?Behaviorchangecommunicationsincludingperson-to-personcommunicationsand/orsocialmarketing;and?Availabilityofimplementationmaterialsandtechnicalassistancetosupporton-the-groundimplementer.HWTSimplementationprojectshavealsoencounteredsignificantchallenges,including:?Questionsregardingthehealthimpactoftheseinterventionsinlarge-scale“real-world”situations;?Long-termsustainabilityoftheprojects,especiallylong-termaccesstosupplies;and?Scalinguptoefficientlyreachpeoplewithoutaccesstoimprovedwatersources.CONCLUSIONHWTSsystemsareproven,low-costinterventionsthathavethepotentialtoprovidesafewatertothosewhowillnothaveaccesstosafewatersourcesinthenearterm,andthussignificantlyreducemorbidityduetowaterbornediseasesandimprovethequalityoflife.HWTSimplementationshavedevelopedfromsmallpilotprojectsintonational-scaleprograms,andnowfacethechallengeofreachingthemorethan1.1billioninneedofsafedrinkingwater,andeffectivelyworkingwithotherwater,sanitation,andhygieneprogramstoachievethegreatesthealthimpact.Theactive,diverse,andexpandingcommunityofresearchers,privatecompanies,faith-basedorganizations,internationalandlocalNGOs,anddonorsinterestedinansweringthesequestionscanplayamajorroleinhelpingtheworldachievetheMillenniumDevelopmentGoaltohalve,by2015,theproportionofpeoplewithoutaccesstosafewater(WorldBankGroup,2004).Achievingthisgoal,andsurpassingit,willrequirecontinuedcollaboration,investment,andresearchanddevelopment,butitisourbesthopeforrapidlyreducingwaterbornediseaseanddeathindevelopingCountries.中文譯文發(fā)展中國(guó)家中的家用水處理和安全的存儲(chǔ)選擇：對(duì)目前執(zhí)行實(shí)踐的一個(gè)回顧聯(lián)合國(guó)的國(guó)際飲用水供應(yīng)和衛(wèi)生十年（1981-1990），直到1990年也沒(méi)有讓全世界的人都喝上干凈的飲用水和使用良好的衛(wèi)生設(shè)施（世界衛(wèi)生組織，2003）。盡管在這十年間服務(wù)水平有了超過(guò)10%的提升，但是11億人還是無(wú)法使用改善的水供應(yīng)系統(tǒng)，24億人在1990年還沒(méi)有足夠的衛(wèi)生設(shè)備。（世界衛(wèi)生組織/聯(lián)合國(guó)兒童基金會(huì)，2000）十年失敗的原因包括人口的增長(zhǎng)，資金的局限性，使用和維護(hù)的不當(dāng)以及傳統(tǒng)“按部就班”方式的延續(xù)。（世界衛(wèi)生組織/聯(lián)合國(guó)兒童基金會(huì)，1992）.全世界計(jì)劃實(shí)現(xiàn)2000年聯(lián)合國(guó)大會(huì)上提出的“千年發(fā)展目標(biāo)”。在約翰內(nèi)斯堡舉行的有關(guān)可持續(xù)發(fā)展的世界峰會(huì)上，它被修改為“到2015年為止，世界上一半人口可以喝到干凈的飲用水和擁有基本衛(wèi)生設(shè)施。”（世界銀行，2004：世界衛(wèi)生組織/聯(lián)合國(guó)兒童基金會(huì)，2004）但是，到2015年的計(jì)劃未必能成功，因?yàn)檫€有超過(guò)600萬(wàn)的人無(wú)法喝到干凈的水。（世界衛(wèi)生組織/聯(lián)合國(guó)兒童基金會(huì)，2000）.此外，雖然“千年發(fā)展目標(biāo)”明確指出其中“安全”飲用水，但是用來(lái)評(píng)價(jià)“千年發(fā)展目標(biāo)”的標(biāo)準(zhǔn)是水來(lái)自于“改進(jìn)”資源，比如說(shuō)地上鑿洞或者是修建用水管道。因?yàn)閺娜粘Ｓ盟膶用嫔蟻?lái)講，很難判定水是否“安全”。（世界衛(wèi)生組織/聯(lián)合國(guó)兒童基金會(huì)，2004）因此，據(jù)估計(jì)越來(lái)越多的人可能會(huì)喝來(lái)自于改善水源的不干凈的水。家庭水的凈化處理及安全儲(chǔ)存：為解決用戶缺乏安全用水及相關(guān)衛(wèi)生設(shè)施的問(wèn)題，我們必須摒棄傳統(tǒng)弊端，在加大技術(shù)運(yùn)用及提升可持續(xù)前景的過(guò)程中，研究新的干預(yù)方案與有效的補(bǔ)給政策。在發(fā)展中國(guó)家，即使大多數(shù)人支持水源供給及衛(wèi)生系統(tǒng)設(shè)備，最適宜且最有效的干預(yù)方案還是常常遭受相當(dāng)大的質(zhì)疑。通過(guò)執(zhí)行強(qiáng)調(diào)健康及由此取得的宏觀及微觀的經(jīng)濟(jì)利益的交流方案，水、衛(wèi)生和金融領(lǐng)域之間的薄弱環(huán)節(jié)可得以提升。研究者對(duì)新干預(yù)措施的研究焦點(diǎn)集中于再評(píng)估20世紀(jì)80年代以來(lái)的優(yōu)勢(shì)模式。144個(gè)案例的文獻(xiàn)綜述表明：衛(wèi)生實(shí)施的應(yīng)用和衛(wèi)生教育的實(shí)施比采取“水源供給或水質(zhì)干預(yù)”措施大大降低了腹瀉的發(fā)病率（分別減少36%和33%）。然而，受世界銀行委托進(jìn)行的元分析卻反駁了上述結(jié)果。他們認(rèn)為保健教育及水質(zhì)提升能更有效地減少腹瀉發(fā)病率（分別減少42%和39%），而衛(wèi)生設(shè)施及水源供應(yīng)引起的發(fā)病率相對(duì)較高（分別減少24%和23%）。這些研究結(jié)果的差異在某種程度上可歸因于干預(yù)方式的不同。埃斯里的學(xué)術(shù)評(píng)論仔細(xì)分析了水質(zhì)提升在本質(zhì)上帶來(lái)的影響，如水源、公共水龍頭等。自1996年以來(lái)，有相當(dāng)數(shù)量的出版研究考察了通過(guò)家庭水凈化處理和安全儲(chǔ)存來(lái)提升水質(zhì)的干預(yù)方案所起的健康衛(wèi)生影響。這些最新的研究，其中很多是隨機(jī)干預(yù)之法，強(qiáng)調(diào)了飲用水在收集、運(yùn)輸及儲(chǔ)存中受到污染,以及在HWTS影響下的衛(wèi)生價(jià)值。2003年，作為一種受益于HWTS的健康證據(jù)，學(xué)術(shù)界機(jī)構(gòu)、政府、非政府組織和私營(yíng)部門(mén)建立起國(guó)際互聯(lián)網(wǎng)，以促進(jìn)家庭水凈化處理及安全儲(chǔ)存。該組織為世界衛(wèi)生組織，坐落于瑞士日內(nèi)瓦。它的官方目標(biāo)是：通過(guò)促進(jìn)家庭水的氯化處理及安全儲(chǔ)存作為水、衛(wèi)生、保健工程的重要組成部分，尤其針對(duì)易感人群，為有效削減水質(zhì)疾病做出貢獻(xiàn)。這篇文章概述了5個(gè)最常見(jiàn)的HWTS方法：氯化、過(guò)濾（生物過(guò)濾法和陶粒過(guò)濾法）、日光消毒、組合過(guò)濾或氯化，以及組合絮凝或氯化；此外還描述了每種方法的補(bǔ)充策略。我們要組織及其在運(yùn)行中遇到的成就、挑戰(zhàn)及障礙。我們要考慮研究成果的來(lái)源及潛力，從而大規(guī)模地分配和維持每一種選擇，為將來(lái)的研究與補(bǔ)給規(guī)劃目標(biāo)。這篇文章強(qiáng)調(diào)了飲用水的凈化處理及安全儲(chǔ)存的方法，用以加速衛(wèi)生獲得與水質(zhì)提升，甚至達(dá)到廣泛使用管道水、處理水等長(zhǎng)遠(yuǎn)目標(biāo)。通過(guò)預(yù)防疾病，HWTS實(shí)踐可致力于扶貧及發(fā)展。該方法的廣泛使用，在保健教育和衛(wèi)生設(shè)施的協(xié)力下，可以拯救上百萬(wàn)生命，直到那個(gè)能將安全用水有效地傳遞到整個(gè)世界的基礎(chǔ)設(shè)施的建立。我們將對(duì)討論過(guò)的每一種HWTS方法使用一致的評(píng)價(jià)方案：1.HWTS方法消除或鈍化了實(shí)驗(yàn)設(shè)置中的水中的病毒、細(xì)菌、寄生蟲(chóng)的病原體嗎？2.在這個(gè)現(xiàn)場(chǎng)里，HWTS方法能被人接受嗎？它能被正確地使用嗎？它能減少使用者中的疾病嗎？3.HWTS方法可大規(guī)模使用嗎？次氯酸鈉溶液裝在瓶子里，和使用說(shuō)明書(shū)包裝在一起。滿一瓶蓋的次氯酸鈉溶液可以凈化一標(biāo)準(zhǔn)尺寸容器里的水（兩瓶蓋則可以凈化渾濁的水），搖動(dòng)后需要放置30分鐘才能飲用。通過(guò)四個(gè)隨機(jī)對(duì)照試驗(yàn)，SWS降低了腹瀉病44%到84%的危險(xiǎn)幾率在HWTS濃度測(cè)試?yán)铮扔行У刈璧K了細(xì)菌以及一些病毒的活動(dòng)（美國(guó)自來(lái)水廠協(xié)會(huì)，1999），然而，氯對(duì)于一些原生動(dòng)物卻不那么有效，例如隱孢子蟲(chóng)。5初期研究表明，在SWS處理下的水沒(méi)有超過(guò)WHO對(duì)于消毒副產(chǎn)物的標(biāo)準(zhǔn)，其中可能含有潛在的致癌劑（CDC，未發(fā)表資料）。因?yàn)镾WS程序所使用氯液濃度很低，所以該液體多于環(huán)境的影響微乎其微。用氯消毒的實(shí)施策略由于當(dāng)?shù)睾献骰锇楹蜐撛谏鐣?huì)、經(jīng)濟(jì)狀況的變動(dòng)，導(dǎo)致了SWS的實(shí)施發(fā)生了一定的變化。這種消毒液已經(jīng)通過(guò)社會(huì)市場(chǎng)營(yíng)銷活動(dòng)分銷到13個(gè)國(guó)家以及次于國(guó)家的層面上，特別是通過(guò)與非政府人口國(guó)際服務(wù)的合作。在印度尼西亞，這種溶液主要是通過(guò)由當(dāng)?shù)刂圃焐坦芾淼乃綘I(yíng)部門(mén)分銷出去的。在一些國(guó)家，包括厄瓜多爾，老撾，海地以及尼迫爾—其衛(wèi)生部門(mén)或是當(dāng)?shù)氐姆钦M織在基層廣泛使用SWS。在阿富汗的喀布爾，對(duì)懷孕婦女提供免費(fèi)的SWS產(chǎn)前護(hù)理。SWS對(duì)于一些災(zāi)區(qū)也同樣實(shí)行免費(fèi)分銷，包括遭受2004年海嘯的印度尼西亞，印度，以及緬甸，當(dāng)然還包括遭受過(guò)其他自然災(zāi)害的肯尼亞，玻利維亞，海地，印尼和馬達(dá)加斯加。有SWS的存在，一些產(chǎn)品在應(yīng)付緊急事故時(shí)就能發(fā)揮更好的作用。美國(guó)疾病控制與預(yù)防中心已經(jīng)建立了實(shí)施手冊(cè)，以及對(duì)于實(shí)行SWS項(xiàng)目的組織提供技術(shù)援助（美國(guó)疾病控制與預(yù)防中心，2001）太陽(yáng)能消毒：實(shí)施策略作為一項(xiàng)幾乎零成本的技術(shù)，太陽(yáng)能消毒實(shí)施策略正面臨市場(chǎng)的限制。2001年以來(lái)，拉美七個(gè)國(guó)家的當(dāng)?shù)胤钦M織同烏茲別克斯坦、巴基斯坦、印度、尼泊爾、斯里蘭卡、印度尼西亞、肯尼亞一樣通過(guò)培訓(xùn)和教育基層用戶，向合作伙伴提供技術(shù)援助，游說(shuō)主要參加者以及建立信息網(wǎng)絡(luò)來(lái)傳播太陽(yáng)能消毒實(shí)施策略。該計(jì)劃由美國(guó)阿維納和Solaqua基金會(huì)，私人和企業(yè)贊助商以及官方提供資金和援助。該計(jì)劃顯示，當(dāng)?shù)匾恍┯猩鐓^(qū)健康教育經(jīng)驗(yàn)的機(jī)構(gòu)使太陽(yáng)能消毒實(shí)施策略得到了最廣泛的傳播和推廣。要使大眾認(rèn)識(shí)到凈化飲用水的重要性并建立相應(yīng)的行為變化需要一個(gè)長(zhǎng)期的培訓(xùn)方法并不斷與社區(qū)聯(lián)系。瑞士聯(lián)邦理工學(xué)院為環(huán)境科學(xué)與技術(shù)專門(mén)制定了一本實(shí)施手冊(cè)，并向?qū)嵤┨?yáng)能消毒實(shí)施策略的非政府組織提供技術(shù)援助。該方法已在20多個(gè)發(fā)展中國(guó)家傳播并擁有超過(guò)100萬(wàn)的定期用戶。太陽(yáng)能消毒的優(yōu)點(diǎn)和缺點(diǎn)日光消毒的好處包括：①保證減少細(xì)菌，病毒以及原生動(dòng)物②保證無(wú)污染③能被用戶接受，因?yàn)橛盟可?，便于使用，以及幾乎不改變水的味道④不可能再次污染，因?yàn)橐后w裝在小的帶瓶蓋的容器里，并能直接使用