Barriers and facilitators to Water, Sanitation and Hygiene (WaSH) practices in Southern Africa: A scoping review

Abstract

A healthy and a dignified life experience requires adequate water, sanitation, and hygiene (WaSH) coverage. However, inadequate WaSH resources remain a significant public health challenge in many communities in Southern Africa. A systematic search of peer-reviewed journal articles from 2010 –May 2022 was undertaken on Medline, PubMed, EbscoHost and Google Scholar from 2010 to May 2022 was searched using combinations of predefined search terms with Boolean operators. Eighteen peer-reviewed articles from Southern Africa satisfied the inclusion criteria for this review. The general themes that emerged for both barriers and facilitators included geographical inequalities, climate change, investment in WaSH resources, low levels of knowledge on water borne-diseases and ineffective local community engagement. Key facilitators to improved WaSH practices included improved WaSH infrastructure, effective local community engagement, increased latrine ownership by individual households and the development of social capital. Water and sanitation are critical to ensuring a healthy lifestyle. However, many people and communities in Southern Africa still lack access to safe water and improved sanitation facilities. Rural areas are the most affected by barriers to improved WaSH facilities due to lack of WaSH infrastructure compared to urban settings. Our review has shown that, the current WaSH conditions in Southern Africa do not equate to the improved WaSH standards described in SDG 6 on ensuring access to water and sanitation for all. Key barriers to improved WaSH practices identified include rurality, climate change, low investments in WaSH infrastructure, inadequate knowledge on water-borne illnesses and lack of community engagement.

WASH interventions and child diarrhea at the interface of climate and socioeconomic position in Bangladesh

“…This study provides evidence of the importance of assessing the interface between socioeconomic position and climate with inequalities and climate change being two of the main barriers in WASH 24 . Our results show that among children in the control group, disparities existed by socioeconomic position and season and that the WASH intervention reduced or even nullified existing disparities.…”

“…This shows that implementing WASH that does not generate inequalities would require a tailored approach 29 . Members of our team have previously assessed equity in the WASH Benefits Bangladesh interventions with respect to measures of adherence 30 and others have assessed barriers and inequalities in effective WASH practices in the African setting 24 , 31 . These previous studies have demonstrated improved equity in WASH practices and this present analysis demonstrates that those improvements in equity carry forward to improvements in equity in child diarrhea.…”

Progress of Using Risk Assessment to Manage Small Drinking-Water Supplies in Rwanda: A Preliminary Study

“…One of the key barriers to WASH improvements can be a lack of community engagement which WSPs can support to drive as they can empower communities to act [15,44]. Governance structures of many services in Rwanda, including drinking-water, are based upon a decentralized, community-centered approach [45].…”

The Impact of the Environment and People’s Attitudes on Greywater Management in Slum Coastal Settlements

“…Critical barriers to improving WASH (water, sanitation, and hygiene) practices identified included low investment in WASH infrastructure, inadequate knowledge about water-borne diseases, and lack of community involvement [56]. To remove these barriers, government intervention is needed to improve sanitation conditions.…”