Water, Sanitation, and Hygiene Practices and Challenges during the COVID-19 Pandemic: A Cross-Sectional Study in Rural Odisha, India

• Type of Material: Article
• Authors: Valerie Bauza, Emory University; Gloria D Sclar, Emory University; Alokananda Bisoyi, Independent Consultant, Berhampur; Fiona Majorin, London School of Hygiene and Tropical Medicine; Apurva Ghugey, Gram Vikas; Thomas Clasen, Emory University
• Language: English
• Date: 2021-06-01
• Publisher: AMER SOC TROP MED & HYGIENE
• Publication Version: Final Published Version
• Copyright Statement: © The American Society of Tropical Medicine and Hygiene
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.4269/ajtmh.21-0087
• Title of Journal or Parent Work: AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE
• Volume: 104
• Issue: 6
• Start Page: 2264
• End Page: 2274
• Grant/Funding Information: This research was supported in part by grants from the Bill & Melinda Gates Foundation (OPP1125067) and National Institute of Environmental Health Sciences, USA (T32ES012870 to VB). The American Society of Tropical Medicine and Hygiene has waived the Open Access fee for this article due to the ongoing COVID-19 pandemic.
• Keywords: Tropical Medicine; KNOWLEDGE; Public, Environmental & Occupational Health; BEHAVIOR; Life Sciences & Biomedicine; Science & Technology; QUESTIONNAIRES; ATTITUDE
• Research Categories: Psychology, General

Abstract

Water, sanitation, and hygiene (WASH) practices emerged as a critical component to controlling and preventing the spread of the COVID-19 pandemic. We conducted 131 semistructured phone interviews with households in rural Odisha, India, to understand behavior changes made in WASH practices as a result of the pandemic and challenges that would prevent best practices. Interviews were conducted from May through July 2020 with 73 heads of household, 37 caregivers of children < 5 years old, and 21 members of village water and sanitation committees in villages with community-level piped water and high levels of latrine ownership. The majority of respondents (86%, N = 104) reported a change in their handwashing practice due to COVID-19, typically describing an increase in handwashing frequency, more thorough washing method, and/or use of soap. These improved handwashing practices remained in place a few months after the pandemic began and were often described as a new consistent practice after additional daily actions (such as returning home), suggesting new habit formation. Few participants (13%) reported barriers to handwashing. Some respondents also detailed improvements in other WASH behaviors, including village-level cleaning of water tanks and/or treatment of piped water (48% of villages), household water treatment and storage (17% of respondents), and household cleaning (41% of respondents). However, there was minimal change in latrine use and child feces management practices as a result of the pandemic. We provide detailed thematic summaries of qualitative responses to allow for richer insights into these WASH behavior changes during the pandemic. The results also highlight the importance of ensuring communities have adequate WASH infrastructure to enable the practice of safe behaviors and strengthen resilience during a large-scale health crisis.