Understanding WASH Actors Response to the COVID-19 Pandemic in Tanzania and Kenya: A Qualitative Case Study Pubblico

Abstract

The COVID-19 pandemic has posed a major public health challenge due to its fast global spread, the novel nature of the virus, and the viruses’ ability to rapidly mutate into new variants. The pandemic response effort has been expansive, involving individuals and organizations from multiple sectors and geographic areas. Notably, WASH organizations have played a crucial role in the advancement of COVID-19 prevention measures given their experience in hygiene promotion and program implementation during crisis situations. As with others involved in response efforts, however, the COVID-19 pandemic has presented unique challenges for WASH actors, who have faced unprecedented circumstances in which to carry out their critical work. This study aimed to understand WASH-related programmatic decision making in this fast paced and high-stress outbreak situation where there was little precedent and constantly evolving evidence to support action, and to prompt reflection within the WASH sector around how to both improve current response efforts and better prepare for future health crises. We describe and compared perspectives from 21 individuals at organizations in Tanzania and Kenya that were involved in coordinating, designing, and delivering hygiene programs during the COVID-19 pandemic. Through comparative thematic analysis, we found that the initial phases of the pandemic were perceived by WASH actors in Tanzania and Kenya as being a potential turning point for the widespread adoption of hand hygiene behaviors. However, despite initial population level adoption of hand washing practices, momentum was lost as community fear dissipated and government priorities changed. Further we found that local small-scale organizations can play a key role in outbreak response efforts, but are often under supported by the sector, donors, and government stakeholders. Finally, the prioritization of M&E and collection of data remains a key challenge for WASH actors in emergency situations.

Table of Contents

CHAPTER 1:

LITERATURE REVIEW………..…………….…………………………………………......…....i

CHAPTER 2:

INTRODUCTION…………………………………………………………………..…….....…....1

METHODS…………………………………………………………………………..……………4

           Study Design and Approach……………………………………………………..………..4

           Study Setting ………………….………………………………………………..…………4

           Participants ...………………….……………………………………………..……………8

           Data Analysis…………………………………………………………………………….10

           Ethics ……... ………………….…………………………………………………………12

RESULTS………………………………………………………………………………………..36

           Programming Prior to the Pandemic…………………………………………………….12

           Phases of the Pandemic…………………………………………………………………..16

           Pandemic Response……...………………………………………………………………19

DISCUSSION……………………………………………………………………………………28

CHAPTER 3:

PUBLIC HEALTH IMPLICATIONS…………………………………………………………...38

REFERENCES…………………………………………………………………………………..41

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Public Health Education
Parola chiave	Pandemic Response COVID-19 WASH Tanzania Kenya Hygiene
Committee Chair / Thesis Advisor	Caruso, Bethany, Emory University

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