Did you know that you can get more people to wash their hands if a pair of eyes is placed above the washbasins in public washrooms? It may sound creepy, but the feeling of being watched prompts people to do the right thing. This insight was shared during a presentation on applications of behavioral science in the Water, Sanitation and Hygiene (WASH) sector. ‘Basically you are shaming the person into doing the right thing,’ Sharon Njavika from the Busara Center for Behavioral Economics explained, ‘and shame is a powerful emotion.’
The presentation was one of several discussed at the Learning Forum hosted by APHRC and the Ministry of Health on October 18, 2017 at Nairobi’s InterContinental Hotel. Over 80 people gathered for a day of deliberations on the latest research findings in Kenya’s WASH sector and how these can be used to inform policy and practice as the country works towards meeting Sustainable Development Goal Six on universal access to safely managed water and sanitation.
Six clusters, one theme
Discussions at the Learning Forum were grouped into six clusters: Disease Prevention; School WASH; Menstrual Health Management; WASH and Nutrition; Urban Sanitation; and WASH Innovations. The forum’s theme was ‘WASH in Kenya: From research to policy to practice.’
As part of the disease prevention cluster, Prof. Mohamed Karama from Umma University delivered a presentation on the cholera outbreak that has affected several parts of Kenya, including Nairobi. “The major predictor of cholera is low economic status which is associated with the use of unsafe drinking water and poor sanitation,” Prof. Karama stated.
He explained that outbreaks were likely to occur when risk factors like population displacement and low socio-economic status converge with natural disasters like floods that disrupt water and sanitation services. In the Kenyan context, social gatherings like funerals or weddings where food and drinks are being consumed by lots of people from different backgrounds are hotspots for spread of the cholera bacteria. This helps explain the reported cases of infections occurring at high-end hotels which caught the nation’s attention in mid-2017.
The association of disease outbreaks with low-income neighborhoods highlights the need for safe, cost-effective water and sanitation interventions. APHRC research indicates that informal settlements in Africa’s rapidly urbanizing centers will continue to grow well into the 21st century. Ensuring that these populations are able to access safely managed water and sanitation systems requires innovative thinking and fresh ideas. This is one of the critical challenges of our times as diarrheal diseases are the second-leading cause of death for children under five years, even though they can largely be prevented through provision of safe water and sanitation systems (WHO, 2017).
Connecting research to policy
Besides teaching at Umma University, Prof. Karama is the Head of the Policy, Advocacy and Research Technical Working Group formed by the Ministry of Health to coordinate WASH initiatives that link research and policy. APHRC which has a track record of using evidence to inform policy is an active member of this technical working group. The Center not only advocates for use of evidence-based policy, we also strive to equip researchers and policy makers with appropriate skills to facilitate the translation of research to policy. This is especially vital in the sanitation sector which is not considered ‘sexy’ and therefore easily overlooked, even though it has major impacts on public health.
Government on its part recognizes the need for evidence-based policy. This came out clearly in the remarks made by Dr. James Mwitari, the Deputy Director of Public Health at the Ministry of Health. “The greatest challenge faced in policy formulation is the disconnect between research and the packaging of studies in a way that is easily understood by policy makers,” he stated. “Research already influences WASH practices in the field, but it needs to be embedded in policy.” Benjamin Murkomen from the WASH-Hub at the Ministry of Health urged researchers to consolidate their findings in an easily accessible platform which would advance knowledge sharing and help prevent duplication of projects.
This last idea about a knowledge sharing platform seemed especially relevant for the learning forum. A total of twelve presentations were delivered during the daylong deliberations and it would be impossible to discuss all of them adequately here. In fact, the day seemed too short and a number of participants requested that the next one should run for two days. A refreshing comment on a topic that is seldom discussed. Keep an eye out for more details on the next WASH learning forum. Until then, remember to wash your hands, even when no one is watching.