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Preventing Illness Through Improved Flooring

A design and construction service provided to marginalized families, integrated with a campaign that educates communities on the link between housing and health. It tackles the problem of disease caused by dirt floors in homes where children under 5 are most vulnerable by: replacing dirt floors with new cement floors and providing educational workshops on disease prevention in the home. [Updated 12/19]

Photo of ARCHIVE Global
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Here's the Idea:
Imagine a young baby or child exploring and crawling around in their home. They may be playing with toys, and at some point are probably putting those toys and/or their hands in their mouths. Classic baby behavior, right?

Now imagine that this baby is living in a home with a dirt floor; a dirt floor that is proven to be a prime breeding ground for harmful bacteria. As you can probably imagine, the transmission of disease is rapid.  For millions of kids, their homes are making them sick.

Diarrhea is one the most prevalent illnesses young children in the developing world face, but by replacing dirt floors with impermeable and cleanable surfaces, like concrete, we can reduce the risk of diarrhea and infection by 50% and 75% respectively.
 
A User's Perspective: [Updated 12/26]
Check out our User Experience Map in our Image Gallery! [Updated 12/19]

The implementation of our pilot lasted 14 days total. Before, during and after the pilot implementation, we were able to collect valuable end user feedback. This was retrieved through a mix of focus groups, semi-structured interviews, short-surveys, and social mapping exercises conducted by ARCHIVE and ADESH. The responses showed that:

A. During Implementation:
i) More than 80% of people were interested in helping to support an expanded community program on flooring and health (Response: We plan to include a Trainer of Trainers programme in our scaled up programme);
ii) There was interest in pairing the flooring project with a sanitation project (Response: Our selection criteria means we only work with residents who agree to purchase a new toilet in the long-term);
iii) More knowledge desired about the importance of flooring to improve housing asset (Reponse: We would invest in more training sessions in any future programme with local MFIs who could advise residents on this );
iv) People wanted to know how beneficiaries were selected (Response: We subsequently made selection criteria public);
v) parents were not attributing their children’s illnesses with the presence of a dirt floor in their homes (Response: We made this connection clear in our community training);

B. Post-Pilot:
vi) Time was saved by women who no longer needed to invest in weekly floor maintenance;
vii) 70% of residents were able to make financial contribution/investment to the cost of their new floor

[Updated 12/26]
 
Prototyping the Idea: [Updated 12/26]
Check out our Design Prototyping in our Image Gallery! [Updated 12/26]

Our first pilot was launched in Spring 2014. With the help of ADESH (a local NGO in Bangladesh) and BRAC University we set out to improve the lives of 20 children under 5 in Savar district in Bangladesh. We chose Savar, which is a Hindu community (in a Muslim majority country) because our initial research suggested it has a history of unequal access to public services as a minority community. 10 families with children under 5 - 57 residents in total - received modest home improvements (replacement of dirt floors) aimed at delivering improved health outcomes. In addition, ADESH provided training to 132 residents in the community on the impact of poor housing on health, and facilitated focus group discussions on sound hygiene practices.

The training of residents in floor installation was designed by ARCHIVE, in conjunction with architects from BRAC University, and coordinated locally by ADESH. A selection of local masons and other skilled workers were identified to receive the training. At least one member of each beneficiary household received training. This was often the same person who contributed ‘sweat equity’ on the project, allowing for a unique style of ‘learning by doing’ where the benefit is not only in upskilling but results in tangible outcomes for beneficiary families. We would like to scale-up this component of the project by identifying a greater number of skilled masons in each new area we work.

In the immediate future, we expect to scale-up this project in Bangladesh through: 

1) Early consultation with new communities to localize the approach (e.g. use materials, skills, methods that might be indigenous to the area)

2) Deliver wide public awareness on the project beyond immediate end-users

3) Involve a range of key stakeholders including CBOs, private companies (such as hardware stores) and local/regional government (e.g. municipal offices on housing, environment and/or health)

4) Provide local financing opportunities for end users

5) Provide training for residents to start micro-entrepreneurship projects in floor installation i.e to reduce reliance on ARCHIVE in the long-term and to increase overall project sustainability

[Updated 12/26]

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ARCHIVE Global has piloted a flooring replacement project in Bangladesh, and here's what they've found:
+Dirt floors are a common feature of poor quality housing in both rural and urban areas of the developing world, and prove to be ideal carriers of parasites, viruses, and bacterium, which cause diarrheal, skin, and respiratory diseases. These illnesses contribute to anemia, parasitic infestation, and malnutrition. 


A family and their new floor, from our Pilot Project.

+ Replacing dirt floors with concrete can lead to significant reductions in diarrhea and other parasitic illnesses in both young children and adults. In the community where this project was piloted 0 cases of diarrhea were reported 4 weeks after construction was completed.

+In homes that received new floors, women reported spending 2-3 hours less each week cleaning their floors. This means that they have more time to work, rest, or take care of their children.

+Replacing floors in sub-standard housing also increases a families access to credit. In Bangladesh, replacing the floor can lead to an almost 50% increase in overall home value.

+By requiring that one household member participate in the construction process, individuals are receiving training in skilled labor that may result in economic opportunities in the future.

+By providing a locally run, day-long, Community Health Training, participants were able to discuss and learn about disease prevention in the home. Our post-training surveys showed that 95% of participants could identify at least one strategy to preventing diarrheal-disease in the home.

+It is a one-time, cost-effective project that does not require complex behavior modification.

+In countries such as Bangladesh, where villages are increasingly susceptible to flooding and periods of heavy rain, fecal matter, garbage, and other debris often flow freely throughout fields, roadways, and homes. By replacing the floors, families can easily and efficiently clean out any refuse or bacteria that may linger after a flood.

The big picture for children under 5? 
+1600 children die every day from diarrhea-related causes and over 200 million children under the age of 5 are not reaching their full phyiscal and cognitive potential by the age of 10. 

+Simply replacing dirt floors provides young children clean, stable and healthy foundations to grow and develop

+It means that a child can crawl, sleep, and play in a home that isn't breeding bacteria.

Who will benefit from this idea and where are they located?

This project has been tested in both Bangladesh and Mexico with households that have at least one child under the age of 5. However, given the simplicity and scaleability of the project, ARCHIVE Global believes that this project can be implemented all over the world, in communities and for children with the greatest need.

How could you test this idea in a quick and low-cost way right now?

ARCHIVE Global has already tested this idea in the Spring of 2014. It was a great success and thus ARCHIVE seeks to expand and grow this project further.

What kind of help would you need to make your idea real?

ARCHIVE Global is currently seeking new ideas for the materials used to replace floors. Although concrete is available and cost-effective in Bangladesh, this may not be the case everywhere. Recycled, local, sustainable material solutions would greatly enhance the scaleability of this project. Of course any further feedback, comments, or ideas are welcome!

Is this an idea that you or your organization would like to take forward?

  • Yes. I am ready and interested in testing this idea and making it real in my community.

Attachments (1)

Comments & Questions.pdf

Our responses to the comments and questions from the Amplify Team, the OpenIDEO Team, and the OpenIDEO Community. [Updated January 6]

64 comments

Join the conversation:

Comment
Photo of Taz Fear
Team

Hi All

This is a great idea to help family health but also to help increase the value of people's homes! Your boards mapping out you concept and solution look great and explain your idea really well! You mentioned the problem of flooding and I wanted to know that would this mean that work would stop during monsoon season and continue for the rest of the year? Also, if your business model is squeezing your margins to reduce costs and the flooring is to support low-income families, who pays the cost if flooding occurs during works and damages some of the flooring, I assume that it would be very expensive and difficult to get insurance against such risk in areas of high risk of flooding?

Kindest regards

Tara Fear

Photo of ARCHIVE Global
Team

Thanks for your insight, Tara! There are indeed many challenges that go along with effectively rolling out a project like this one in Bangladesh, ranging anywhere from seasonal weather constraints, to political disruptions, to social or economic instability, all of which can unexpectedly increase costs through delays in construction, labor strikes or a rise in the cost of materials.

With regards to the monsoon season and flooding specifically, we actively plan for a reduction in the pace of construction during the monsoon season and we specifically plan our construction in flood-prone communities outside of these rainy months. As for the work we do conduct during the rainy season, the cost of large tarps is included in our per-house budget, and these are utilized both to protect any household items removed from the home during construction, as well as to cover the concrete floor as it dries.

Photo of Laura Schwecherl
Team

These user maps are great! The idea is fascinating.

I'm curious about the cost of the floors and how families will be able to pay. I know the maps discuss carving out one month for families to attend workshops and save up for the floors.

Have you found any challenges around families being resistant because of the immediate, lifestyle change (finding time to attend workshops, save up money, and then move out) to install the floors?

Photo of ARCHIVE Global
Team

Dear Laura,
Thank you! Earlier this year, we prototyped the idea in Bangladesh and we have been able to get the cost of each floor down to USD$395. As mentioned in a previous response, we are constantly working to reduce this cost and believe the price-point will need to be adjusted to match local specificities. Eg. prevailing labor rate and material availability. One of the incredible feedback we have already received on this forum is to consider the use of modular systems. eg. mosaics. We are keen to examine this further, particularly if we can localize the manufacture of such units close to site. This would certainly help in controlling/reducing cost.

Families pay 10% currently, but our intention is that as demand builds and price drops we will increase this investment ratio. Those who find it difficult to pay at once are provided with an financing option through our local MFI partner.

The challenges have been minimal (if any) in the adaptation of a new floor. Most see it as a dramatic improvement to their most important asset - the home. We work creatively with families through a series of discussions to ensure minimal disruptions caused by attendance to workshops. We require at least one adult representative from each household to attend. At times two will be present though. Regarding moving out, so far in the pilot, this didn't seem very problematic as residents would stay with friends close by or other relatives. At times we noticed they had set up temporary shelter right next to the home being repaired. This could become challenging if there were heavy rains, but then again, our construction would also be delayed. Where we have experienced challenges is in limiting the size of the units that we will be agree to repair. For obvious reasons, if a family has a larger than average home, even if the condition of that home is still lacking, the cost and therefore the investment requirement will increase. Sometimes people don't immediately understand why they cannot be included if they aren't able to make the required investment. One way we hope to tackle this is through a series of public education campaigns in which we better articulate the costs, investments and the expected return on investments. When we have introduced the topic of cost savings resulting from a decrease in health expenditures for the child or a decrease in the number of days a parent needs to take off from work to take child to clinic, we have seen tremendous curiosity in learning more. We intend to refine this further. Hope this answers some of your questions. Feel free to let us know if it raises new ones. Thanks again for your interest!

Photo of Laura Schwecherl
Team

This definitely does, thanks so much for the thoughtful responses. Looking forward to seeing this become refined even more!

Photo of Bettina Fliegel
Team

Hi. That is a great point you bring up regarding the economics around childhood illness - parents lost days at work leading to lost wages. This effects individuals as well as society - decreased productivity. Great to bring that into the discussion as a motivating factor for families to participate in this initiative. I wonder if it might motivate private industry to contribute to costs, or local governments?
Is all health care in this community fee for service? (You mention health expenditures as another motivating factor.)
Is this something you plan to collect data on?

Photo of Bettina Fliegel
Team

Hi Archive Global!
Great "Cost of a Floor" graphics!

Photo of ARCHIVE Global
Team

Dear Laura,
We also look forward to refining. It's a constant activity here at ARCHIVE.

Photo of ARCHIVE Global
Team

Thanks Bettina!

Photo of ARCHIVE Global
Team

Hi Bettina,
Regarding your earlier question on multi-stakeholder involvement, we think the business model can be helped by private industry making contribution but haven't yet nailed down how they can be incentivized to make this monetary. As mentioned earlier, they are uniquely poised to subsize material costs though. In other programs we've seen that the savings they will realize in work absenteeism (to care for child) is enough incentive for contributing to preventative care. In the case of Bangladesh, the households involved are among the BOP (bottom of pyramid) group and as such are most informally employed.

Your point on government contribution is a really good one. We are examining ways for local govt to play a greater role though as child-health prevention models are already a proven case for lowering government health expenditures (currently 3.6% of total GDP).

We don't believe all care is fee for service but do not have hard data on this yet. Your suggestion to consider collecting is well taken as it would certainly help prove the case to government. We do know that some households pay for varying degrees of care while others don't but it would be valuable to better quantify. Thank you!

Photo of Bettina Fliegel
Team

Hi all! Congratulations on being selected as a Winning Idea! I love this public health initiative - based on evidence! Looking forward to reading more about your experiments with different materials going forward! Hopefully costs can decrease and more families can participate.
As to the issue of how to incentivize private industry to contribute to a project like this - In what type of work are the parents informally employed? Can these employers be incentivized to contribute based on similar ideas - lost days at work when a child is sick which effects productivity?
Are there community economic development groups that one can approach to discuss your project? A place where there may be "key influencers" within the local business community?

Photo of Taz Fear
Team

I agree with you Bettina. Considering the benefit to productivity of the workforce through less sick days, it would be a great idea to seek private company and community contributions to support the workforce in the area!

Photo of Adam Reterski
Team

I am so happy that this idea reached the "top idea" point. I remember reading your post at an early stage of this challenge and thinking: this could actually be beneficial. I printed out your idea to show to my class. They saw a big opportunity in it. Simple but effective, not forgetting about the fact that a simple part of the house- a floor- can also make a huge change to family bonds. What used to be a place where they live now is a real home. Great!

Photo of ARCHIVE Global
Team

Adam, thanks for your encouraging feedback and for helping us spread the word!

Photo of Irene Blas
Team

Curious! I havent thought about flooring! Great idea!

Photo of ARCHIVE Global
Team

Thanks, help us spread the word!

Photo of Dafne Melo
Team

Very good image and research! Great idea

Photo of ARCHIVE Global
Team

Thanks Dafne!

Photo of Ayman Hanafi
Team

Dear Archive, this is a great idea. Well worth the hard work if it succeeds.In time, will every family avail of a new floor.? It won't be just a case of some needy people getting floors and others not, I HOPE.

Photo of ARCHIVE Global
Team

Hi Ayman, thanks for your support. Our goal is certainly for every family to have a suitable floor. What's great about our idea is that it can (and should!) be replicated all over the world.

Photo of Chioma Ume
Team

Hello ARCHIVE Global! We've been having early childhood experts take a look at the ideas in Refinement and one has asked about whether people are likely to cover their concrete floors with rugs or mats that might harbor the bacteria your idea is meant to limit exposure to. Is this something that you've considered? We'd love to hear your thoughts!

Photo of ARCHIVE Global
Team

Layers of fabric are used as mats for sitting, at times lying, and placing valuable household items. These occupy limited surface areas and so together with size and material do not appear to undermine the integrity of flooring as a health model. Nonetheless, integrating sessions for cleaning and maintaining mats would prove useful here. This is something we may have overlooked in our first community training and may prove even more relevant as we scale to other countries/cultures where practices with washing household linens differ.

Additionally, while fabrics can harbor disease-carrying parasites, the major cause of these diseases is the dirt floor itself. Soil-transmitted pathogens are reliant on dirt (and, by extension, dirt flooring) for their survival and propagation. For example, intestinal worms, which are primary contributors to high rates of malnutrition, anemia, and physical/cognitive stunting worldwide, require access to soils in order for their eggs to become infective. Once in the dirt, these eggs can remain infective for up to 10 years or more! This avenue for transmission is blocked when dirt floors are replaced with healthier building materials.

Photo of Chioma Ume
Team

Very informative - thanks for this answer!

Photo of OpenIDEO
Team

Congratulations on making the Zero to Five Refinement list, ARCHIVE Global! We love the simplicity of your idea and your clear articulation of it. We’re also happy to see all of the collaboration happening around your idea and your thoughtful responses to our community. We’d love to know more about what you have learned in your initial pilots of your idea and how you will apply it to future plans. How big was your first pilot? Have you gathered any user feedback that you can share? Who is doing the training of the families that install concrete floors? How do you imagine scaling that component of your idea up? How are people paying for the floors? Is financing an option? Is ARCHIVE Global a social enterprise? A non-profit? Are you hoping to expand in Bangladesh or in other countries? Please create a a User Experience Map http://ideo.pn/0to5-map and check out tips for Refinement http://ideo.pn/0to5-tips-refine here.

Photo of Chioma Ume
Team

As part of your early selection into Refinement, IDEO designers in New York and Shanghai took a look at your idea and have shared their feedback. They think this is a great cause and the current concrete floor program seems pretty sound. Here are some things they suggest you consider as you refine your idea:

THE PRODUCT

- Finding a substitution for the uniformity and durability of the surface of concrete is maybe a challenge. There may be opportunities to look at a modular system of bricks, pavers or other modular tile-like units and maybe even considering in some locations a wood alternative.

- The trick will be to locate a material that allows for the irregularity of the dirt substrate. Old churches in Venice used floors of mosaics to allow for the upheaval of the soft, marshy ground.

- Use a global lens to research what other materials families used have in creating flooring systems to help generate new ideas.
A hard-wearing sheet material like tarping or linoleum to lay over the dirt floors may be more feasible to install than the resources and manpower needed to pour concrete.

- How long-lasting is concrete flooring in certain climates and conditions? Concrete is known to crack and chip in certain cases and when not properly maintained, can lead to more potential issues for the safety of the children.

- Who are the local manufacturing and industrial companies on the ground with the potential available materials on hand, that can be sponsors or partners in supplying the materials?

- If whole sheets are not available, what are the indigenous hard-wearing materials that can be salvaged and reconstituted by the villagers themselves to make new flooring? (E.g. local dried palm leaves, plastic wrapping, etc that can be woven together)

CONSIDER THE MOTIVATIONS OF YOUR USERS

- Think about non-functional ways to talk about the product that will have immediate benefit for the user so they are more excited about it. Nearly every base of the pyramid consumer I speak to has some aspiration of improving their home, and for the most part, it's a status thing.

Example: An FMCG company once did a consumer value study on their product, trying to understand which product attributes drive perceived value to the user. To their surprise, many people loved the sachet (which until then, people thought only serve the purpose of selling and transporting the laundry detergent). What people said was that they proudly display the sachet because it was beautiful and indicates to their neighbors that they can afford branded product.

- Plastered wall and concrete floor in my experience has been highly aspirational as a home improvement thing. But people cannot do it mostly because of cost and lack of know-how. So if you can focus on the process and logistics of delivering the product in a cost-effective way, I think there is a lot of potential to advance their idea / social impact agenda.

Photo of ARCHIVE Global
Team

Dear OpenIDEO,
Thanks for the detailed feedback! We are excited to be a part of this next phase of the challenge and look forward to refining our idea with the help of the OpenIDEO community! Stay tuned for updates… Regarding your questions above: Our first pilot was launched back in February 2014. With the help of ADESH (a local NGO in Bangladesh) and BRAC University we set out to improve the lives of of 20 children under 5 in Savar district in Bangladesh. We chose Savar since it is a Hindu community (in a Muslim majority country) and our initial research suggested there has been a history of Savar’s unequal access to public services. These children and their families - 57 residents in total, received modest home improvements (replacement of dirt floors) aimed at delivering improved health outcomes. In addition, ADESH provided training to 132 residents in the community on the impact of poor housing on health, along with focus group discussions on sound hygiene practices. The implementation of this pilot lasted no more than 14 days total. Before, during and after the pilot implementation, we were able to collect valuable end user feedback. This was retrieved through a mix of focus groups, semi-structured interviews, short-surveys, and social mapping exercises conducted by ARCHIVE and ADESH. The responses showed that: A. During Pilot Implementation: i) More than 80% of people were interested in helping to support an expanded community program on flooring and health (Response: We plan to include a Trainer of Trainers program in our scaled up project); ii) There was interest in pairing the flooring project with a sanitation project (Response: our selection criteria means we only work with residents who agree to purchase a new toilet in the long-term); iii) More knowledge desired about the importance of flooring to improve housing asset (Response: We would invest in more training sessions in any future program with local MFIs who could advise residents on this ); iv) People wanted to know how beneficiaries were selected (Response: we subsequently made selection criteria public); v) parents were not attributing their children’s illnesses with the presence of a dirt floor in their homes (Response: We made this connection clear in our community training); B. Post-Pilot: vi) Time was saved by women who no longer needed to invest in weekly floor maintenance; vii) 70% of residents were able to make financial contribution/investment to the cost of their new floor;

Regarding the training of residents in floor installation: The training was designed by ARCHIVE, in conjunction with architects from BRAC University, and coordinated locally by ADESH. A selection of local masons and other skilled workers were identified to receive the training. They were tasked with training at least one member of each household that receives a new floor. Usually this is the person who contributes ‘sweat equity’ on the project. This allows for a unique style of ‘learning by doing’ where the benefit is not only in up-skilling but results in tangible outcome for their families. We would scale up this component of the project by identifying a greater number of skilled masons in each new area we work.

We expect to scale-up this project in Bangladesh through: 1) early consultation with new communities to localize the approach (e.g. use materials, skills, methods that might be indigenous to the area; 2) deliver wide public awareness on the project beyond immediate end-users; 3) Involve a range of key stakeholders including CBOs, private companies (such as hardware stores) and local/regional government (e.g. municipal offices on housing, environment and/or health); 4) Provide local financing opportunities for end users; 5) Provide training for residents to start micro-entrepreneurship projects in floor installation i.e to reduce reliance on ARCHIVE in the long-term and to increase overall project sustainability.

In terms of costs: It currently costs us approximately $400/floor. People currently make a 10% contribution to the cost of their floor as well as in-kind support such as providing meals for the workers. If we are successful in reducing the cost of the floor to our target of $200/floor and in increasing demand we intend to increase this percentage from 10%. Currently we provide a 12-month financing option through our local partner who has a record providing financing throughout the district.

ARCHIVE Global is a non-profit organization. It is our intention to scale strategically to where the tripartite burden (poor housing, poor health and poor economic productivity) of children’s need is greatest. From our research we know this burden is faced by residents across Bangladesh as well as in other parts of South Asia and the world.

Photo of ARCHIVE Global
Team

Dear Chioma,
Thanks too for the very detailed feedback! The comments ignited a really great discussion here at the office which has since continued.

Regarding comments on the Product:
We like the modular idea very much, as it allows for users to purchase/acquire/install incrementally. Also, we have already noticed wearing of the concrete floors in two homes due to ‘dirt substrate’ you mentioned. So a modular system would go far in alleviating this pressure. One immediate constraint which prevented us from pursuing this in the pilot phase was the capital requirement to invest in this system. As we think about scale. we would be very interested in working with residents and harness our relationship with universities to develop such a system. We already utilize concrete-earth blocks in other projects around the world. We therefore think that a technology which is localized, cost-effective, and easily adaptive is very applicable for flooring. Having a global lens is also critical for scaling. Our early brainstorming with residents revealed that concrete adds social value (of the kind mentioned in the FMCG example) and financial value, substantially giving increase to home as a collateral base. Material substitution has been on our radar and we think this should be nuanced according to local conditions. Linoleum and other such covers may not suffice in many settings because their ability to limit dirt intrusion can become compromised by excess water and heat. Concrete has been proven to be effective in many warm countries and/or places without extreme climate variations. Concrete is among the most durable building materials available today. Its use create a relative permanence often desirable by many residents. With this said, we will certainly build a taxonomy of material substitutes that can be locally applied. In the case of the community in Bangladesh, the residents are particularly susceptible to flooding - justifying a raised floor system for them - in this case: concrete. Private manufacturers would serve as an ideal partner to assist in supplying materials. Our initial investigations speaking with such companies in Dhaka and Savar suggested that they are willing to be an at-cost partner rather than a ‘sponsor’. Eg. We initially thought we could access ‘found’ materials for reuse to help lower costs but quickly found that such materials are already widely sold and demand is strong. Such is most often the case in other low-resource countries. As we think about indigenous materials, we are keen to ensure such materials are renewable where possible, great at withstanding wear/tear and easy to maintain. By bringing key stakeholders together in a localized fashion, we are confident we can achieve this.

Regarding your comments on User Motivations:
We very much like and agree with the benefits of ‘non-functional ways’ in creating user excitement. Floors aren’t exactly a popular topic. We’ve tried adding bright colors to floors to help them stand out in the community. This has worked to an extent, but so far our pilot is relatively small to observe/measure precise gains. They do understand (proven through our focus groups) that this means they have increased economic capital, which sometimes translates to increased social value too. We would like to invest in shoring up the non-functional message, as there is an even greater opportunity than what we’re currently taking advantage of.

Photo of Meena Kadri
Team

Wow – lots of great info. Be sure to collect all your responses to questions / suggestions from OpenIDEO + IDEO and fill out the Word form found on our challenge brief. You can then export it to a PDF and upload here with your idea. See http://ideo.pn/0to5-tips-refine for more tips.

We'd also encourage you to look over other ideas here in the Refinement shortlist and post questions, feedback and suggestions. Collaboration is central to how we roll on OpenIDEO – and we feel your organisation adds some really unique experience and perspectives to the mix. Let's work together to improve these stellar concepts to improve the lives of children from zero to five!

Photo of Chioma Ume
Team

Agreed! Excellent User Experience Map and reflection on feedback! Awesome to hear that feedback from IDEO designers has pushed your thinking about materials used in your floors. Thank you for clarifying how these floors are installed and how homeowners are contributing to paying for them. If they are currently footing 10% of the cost, who is paying the remaining 90%? You mention reducing the cost of the floors by half – do you have initial ideas about how you may do this?

Photo of ARCHIVE Global
Team

Dear Meena,
We will be sure to collect and upload our responses as PDF. Thank you for the tip. We have already been poking around the shortlist of amazing ideas here, so we look forward to adding a few comments. They're all incredibly strong!

Photo of Meena Kadri
Team

Friendly reminder to get your PDF of responses up by tomorrow for the close of our Refinement phase.

Photo of Isha Nirola
Team

Really interesting idea!

I am not sure if I missed this in the description or somewhere in the thread below, but I am wondering how the official government lists, that determine who is eligible for a new floor, are managed. And if the caseworkers are employed by a local org, then why are the lists official government lists? Are the government lists that people sign up on only available at clinics or can people sign up to be on this list at other places (ie housing office, or district office)?

Photo of An Old Friend
Team

Great idea...simple to the point. In Uganda especially in the East they use cow dung to smear floors. What does your research say about this practice in relation to infections and diarrhoea?

I also think may be talking about the hardware ...concrete floors with hand washing would create more impact. Just like we have safe water sources and boiling drinking water. How might your idea and Racheal's leverage https://openideo.com/challenge/zero-to-five/ideas/my-clean-little-hands-my-health-insurance-for-life

Photo of ARCHIVE Global
Team

Hi Alex,

Great point you make about using cow dung in floors. As you can imagine, this practice does in fact have significant impacts on human health. Animal fecal matter can carry harmful bacteria, parasites and worms that can cause disease, particularly when ingested. The transmission of bacteria is frequent and rapid especially in young children who play on these floors and are the at age where "exploring" includes putting everything in their mouths. Replacing cow-dung with impermeable materials such as concrete can go a long way in reducing the risk of transmission.

As always, proper hygiene and home maintenance is crucial. Clean water and soap are key and we'd love to work and support local initiatives that promote healthy hygiene, cleaning techniques or products.

A key component of our pilot project in Bangladesh was the Community Health Training run by our local partner. At the day long workshop, in-home health, hygiene, and sanitation were all topics discussed. Our reporting showed that 95% of participants could identify at least one strategy to reducing the risk of diarrheal disease in the home after completing the training. This too, can help reduce the transmission of disease through awareness and simple behavior modification.

Photo of An Old Friend
Team

Thanks! Is cowdung use a common practice in Bangladesh?

Photo of ARCHIVE Global
Team

Dear Alex,
We seemed to have overlooked this question by more than a month. Our apologies. The use of cowdung varies from place to place across the country. Most often it is used as a solid fuel source. We have however seen it being used as a building material. We would initially discourage it's use as a flooring additive until we can properly ensure that occupants - particularly those under 5 are not place in greater harm than they otherwise would have been from dirt floors. With that said, we're very keen to be experimenting with new materials.

Photo of Gina Quattrochi
Team

I love that you continue to find sensible, low tech ways of minimizing disease.

Photo of ARCHIVE Global
Team

Dear Gina,
We hope that we will continue to have an impact on those who are most vulnerable. Keeping it 'low-tech' is one of key ways we have found to maximize uptake. It is a continuous process rather than a static solution. Thanks for your encouragement.

Photo of Meena Kadri
Team

Nice work on the User Experience Maps!

Photo of ARCHIVE Global
Team

Thank you Meena! We hope to have more updates soon.

Photo of Meena Kadri
Team

Sounds you're doing great work, folks! I'm digging the notion of exploring recycled alternatives as well. What is the business model of your current idea? Do residents pay for their floors? How do people living in temporary-style slums feel about this? We'd love to learn more.

Photo of ARCHIVE Global
Team

Hi Meena,

Thanks for your interest, and great questions!

Currently, in collaboration with our local partnering organization in Bangladesh, beneficiary families are expected to contribute about 10% of the total cost of the flooring replacement. For most families, this means credit support from our local partner, by way of a one-year flexible loan.

As far as the issue of temporary slums, for the current scope of this project, ARCHIVE is specifically working with home owners. While there is certainly a broad need to address the poor living conditions in temporary housing, a flooring project of this nature (that includes repairing, building, stabilizing 3 foot standard foundations/retaining walls) may not be efficient.
With that said, with continued innovation and development of flooring materials, we see opportunity to implement some form "flooring" that does not necessarily require digging a foundation, but can still block out the vector for disease.

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Thanks for the info. So how is the remaining 90% of costs on this funded?

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Perhaps the idea of Rematerials (http://re-materials.com/product/), which was shared among comments about one example I posted, is useful as an alterntive with recycled materials. Their work is focused on roof as I saw and their product looks flexible to use as a floor, too.

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Hi Andre,

Thanks for the comment! Rematerials looks like a really interesting initiative. Roofing, like floors, is a basic component of a healthy home. Do you know if they are developing any flooring prototypes?

One thing we have found in Bangladesh is that recycled materials are actually a sought after commodity- glass and plastic bottles, for example, come at a higher than expected price - using concrete and brick is (thus far) the most cost-effective and sustainable material solution we have found.

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Hi, I knew about Rematerials through a comment posted by Brian Steel. I don't the details about their work.

His Open IDEO profile: https://openideo.com/profiles/briansteel/

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Thanks Andre!

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Hi. Great initiative! I really appreciate the fact that it is evidence based and a simple solution. The impact in flood zones in particular is a major plus.

I read an article on the NPR website (National Public Radio/ USA) that describes a initiative in Rwanda using local gravel/clay to make earthen floors. Are you aware of this work? It appears to be much less expensive at least in the Rwanda location they are working at. Here is a clip....
http://www.npr.org/blogs/goatsandsoda/2014/09/02/342447826/when-a-home-poses-health-risks-the-floor-may-be-the-culprit
"To construct an earthen floor, a layer of gravel (to prevent water from seeping up and destroying the floor from underneath) is covered by a compressed mixture of sand, clay and natural fibers that is burnished and sealed. The seal creates a waterproof barrier and allows the floor to be washed.
"This is done in modern, beautiful homes in the United States," Datar says. "There was no reason not to do it in Rwanda."
In the United States, earthen floors are commonly sealed with linseed oil, which hardens into a dry, waterproof finish. But linseed oil is not readily available in Rwanda, and it's expensive.
So Datar enlisted Rick Zuzow, a Stanford biochemistry Ph.D. student, to devise an alternative. He uses soya oil, which is relatively inexpensive and easy to obtain in Rwanda. When processed with a proprietary "special sauce," the result is a functional floor-sealing substitute. ("It will also work with corn oil," Zuzow says.). Five liters (1.3 gallons) of the oil, at $2 per liter, can treat floors covering a 20-square-meter (215-square-foot) space. The overall cost of installing a floor is about $50, a tenth the cost of a concrete floor for the same space, Datar says."

Seeing how the effect on children's health is so pronounced have you considered flooring an open public area so that children and families can gather in a larger space to gather and play? I am assuming that most of the homes are small and that children continue to crawl, run, play in shared spaces. Might this be a next step/possibility? How large is the average home that you are working on?

Can you describe the Community Health Training that you are doing in Bangladesh? What are the strategies that you are teaching families? Are you referring to hand washing? Seems that replacing dirt floors with concrete or other flooring will also decrease the disease burden from chemicals and heavy metals such as lead, also found in dirt. Have you considered including any training in these types of environmental exposures as well?
You mention that every floor construction team includes one family member which is great. (sounds like the Habitat for Humanity model )
Have you considered training locals to continue to carry out the project for the long term? Perhaps locals can build a business and your team can become consultants, something like this?

As a pediatrician who also has a strong interest in the built environment I am really excited by this work! Looking forward to seeing it expand! Good luck!

(Here is a post I put up during the research phase on lead poisoning in children. https://openideo.com/challenge/zero-to-five/research/the-role-of-environmental-factors-in-children-s-development-in-the-developing-world)

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Hi Bettina,
Thank you for your comments/questions. Firstly thanks for sharing the NPR story. We have been familiar with the great work being done in Rwanda by the Stanford team. Among the reasons we have piloted with concrete is that this has been proven to increase the value of residents home by as much as 30%. Scaling up will allow us to work with locals in creating more specific design solutions. So while upfront capital costs appear high at first glance, they provide homeowners with a higher collateral base from which to access greater credit should they need to. Re your other questions, please see below:

Can you describe the Community Health Training that you are doing in Bangladesh?
Our community trainings have focused on several strategic areas. Initially, we work to engage residents in a discussion of the symptoms, causes, and long term health impacts of diarrheal and other parasitic infections. A key part of this conversation is illustrating how the living environment is related to the transmission of these diseases, particularly for those infections connected to dirt flooring. We also focus on discussing simple strategies, like concrete flooring, that can be used by families to prevent illness.

What are the strategies that you are teaching families?
Trainings with community members cover simple strategies to improve hygiene, like hand washing and the safe removal of child waste. We also focus on simple modifications that can be made to the design of the home that can have a dramatic impact on health (like the installation and maintenance of flooring).

Are you referring to hand washing?
Our trainings do cover hand washing as an important aspect of hygiene.

Seems that replacing dirt floors with concrete or other flooring will also decrease the disease burden from chemicals and heavy metals such as lead, also found in dirt. Have you considered including any training in these types of environmental exposures as well?

Currently we have not included exposure to chemicals and heavy metals in our trainings, although this is an area that would be interesting to address in the future.

You mention that every floor construction team includes one family member which is great. Have you considered training locals to continue to carry out the project for the long term? Perhaps locals can build a business and your team can become consultants, something like this?

This is definitely something that we are interested in achieving. Building community-driven demand for concrete floors is essential to the sustainability of this approach. Reducing the cost of the flooring would likely help to improve the scalability of this approach, as community members are very excited about participating in these modifications but can only afford to pay for a portion of the material/installation costs up front. We are working on some methods now to improve training of technicians and are developing low cost, high impact flooring designs that will use locally recycled materials to reduce costs.

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What an excellent idea, and example of the impact that simple infrastructural solutions can have. In our work MASS has seen that applying concrete floors improves health, and in the process can empower families, especially mothers, to gain control over the cleanliness of the environment they provide their children.

Is ARCHIVE looking to work with the government of Bangladesh, both to scale and finance the project as well as to turn it into a public awareness campaign? Would there be value in getting the word out on the health impact of pouring concrete? If incremental housing upgrades are a common practice in Bangladesh, as they are in many urban areas of South Asia, it would be interesting to establish whether cost or awareness is the most significant barrier, and to approach the issue accordingly.

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Dear MASS Design Group,
We seek to partner with local and/or central government where applicable. To date, we haven't gotten the full buy-in from Bangladesh government, though we expect that will change once the project becomes more visible (and based on our past experiences). Yes, there would be great value in awareness of poured concrete. This type of messaging have yielded success in other countries where we work so we will seek to localize this in Bangladesh as well. We see cost, cultural adaptation and public health to be three of the main barriers to scale. Again, over time, with enough patience, willingness to listen/adapt appropriately, our experience has shown that such barriers can be overcome.
Congrats on the work that you do.

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Dear Archive,

this is a very simple and effective way to fight the spread of disease. It is relatively cheap and involves the homeowner too. I like it. Kinderenergy is working on fighting diarrhea-related deaths with soap. While your team is placing the floors we can be teaching the kids and moms to make the habit of using soap to kill the bacteria which kills the children.

Best of luck!

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Hi Elisabeth,
Thank you. It seems that our work does complement each other. We do include hand washing and general hygiene practices in our training. We look forward to learning more about your work though. Keep up the great work!

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Your summary and project is very clear and well written.

It is indicated that one member from household will be required to participate, resulting in training and skills that could get them future employment... Will these same individuals have the opportunity to earn monies and therefore be employed by Archive or the initiative? Who will be trained and paid to install the floors?

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Hi Lisa,
Thank you. We hope to scale the project to other areas of the city and country. With this in mind, trained residents will have the chance to apply for work opportunities as they become available and depending on skills. Currently members of the immediate community are the only ones hired to work in the project area.

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Sometime When I go around peoples home, they ask me to take my shoes off or I see shoes left at the front hallway, of the house.
Perhaps they know something about dirt or they have been taught.
Look into this aspect.
What is outside remains outside

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Khushwant,
We couldn't agree more. Thanks for sharing.

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I like the idea here! Keep up the great work.

In the comments below, you mention your local partner(s). Do you partner with the Government of Bangladesh or the Government of Mexico at the central and national level as well? Do you interact with local governing bodies as well? How did you engage in community and stakeholder buy-in to get your project started?

I'm enjoying the discussion below about recyclable materials and I'm looking forward to hearing about your plans for scale-up!

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Hello Scott,

As far now our major partner is ADESH, a university in Bangladesh. Local governing bodies are sometimes brought into the partnerships when necessary and have mutual goals. We work to bring about as much community involvement and they then can advise us too about suggested ways to get stakeholders to buy-in; sometimes being the government, sometimes private companies, and sometimes universities. At this moment in the project, we are very excited to have the involvement of local partners in Bangladesh!

We are not working at the moment in Mexico, but I do know that there is plenty of areas we would love to start building relationships there as well. Definitely open to hear if you have any suggestions!

Keep up the conversations and let us know if we can clarify any other questions you might have involving partnerships or the scale-up.

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I thought this was a great idea!

In terms of suggestions for locally available materials, I"m wondering if it would be possible to utilize local plastic waste (which unfortunately lines the streets in many communities around the world) to create inexpensive modular floor tiles that could be quickly installed.

There's a group at Michigan Tech that has developed a way to turn plastic waste into filament for a 3D printer
http://www.mtu.edu/news/stories/2013/february/turning-trash-into-cash-saving-energy.html

I'm not sure how scalable this technology currently is, but it seems that at some point in the future it could be possible to address both the issue of an abundance of plastic waste and the need for improved flooring.

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Team

Hi Rachel,

Local waste is always a wonderful alternative for materials, and we have been researching specific ways to gather glass bottles for the foundations as they are sustainable and easy to clean. We have also been researching the plastic waster, although it does tend to get a little tricky, as Bangladesh automatically has a lot of their garbage recycled and re-sold immediately. However, this project from Michigan Tech is a very interesting precedent and something we can look at for the "modular floor tiles." The technology we use on a local scale is not exactly up to that level, but definitely not ruled out, as we can always look at new innovative ways to implement them.

Thanks for the input!

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Congrats on this post being today's Featured Contribution!

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Hi. Please help us to fill our survey question below here. Thank you in advance.
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Do you have feedback for the idea being shared on this page? We think it's only fair that if you want feedback on your idea that you give feedback to others here on OpenIDEO :^) Bring on the collaboration!