Globally, 200 million people are at risk of developing dental/skeletal fluorosis by drinking groundwater containing toxic levels of fluoride that surpass the WHO limit. Although many defluoridation technologies have proven to be effective in labs, most are technologically and/or culturally inappropriate for remote rural areas like Nalgonda, India. Given the pressing need for a more sustainable removal method, this project proposes to: I) use raw bauxite ore to develop a defluoridation technology that is locally sourced and affordable, highly effective, culturally appropriate, technically feasible, robust, and requires minimal operation/maintenance, and II) design business models based on successes and failures of previous services targeted at low-income users to provide a reliable source of defluoridated water at an incremental price that encourages user uptake.