WASH, vulnerability, severity, and the response of urban slum dwellers to the COVID-19 pandemic

Urban slum dwellers lacked water, sanitation, and hygiene (WASH) and health care assistance during the COVID-19 outbreak. This research aimed to investigate the lived experiences of slum dwellers during the COVID-19 pandemic. Data were obtained through 453 questionnaires and 29 semi-structured interviews with community people and organizations from two slum neighbourhoods in Bangkok, Thailand. The results showed that respondents who had no access to WASH perceived the pandemic as more severe (t = -3.807, p < 0.001; df = 451), whereas respondents who had access to WASH had a higher protective intention towards COVID-19 (t = -3.947, p < 0.001; df = 431). However, there are no differences between the two groups in terms of knowledge, practice, vulnerability, perceived self-efficacy, response efficacy, or response cost between accessibility and non-accessibility to WASH. The Structural Equation Modelling (SEM) results showed that the knowledge of slum dwellers drives their current practice (beta = 0.456, p < 0.001) and perceived vulnerability (beta = 0.180, p < 0.001), wherein the current practice is influenced by their perceived vulnerability (beta = 0.163, p = 0.002). Their current practice also influences their perceived self-efficacy (beta = 0.314, p < 0.001), response efficacy (beta = 0.557, p < 0.001), and severity (beta = 0.198, p = 0.003). Their perceived severity affects their protective intention (beta = 0.102, p = 0.043) and perceived self-efficacy promotes their protective behaviours (beta = 0.308, p < 0.001). Future pandemic prevention programmes should improve the awareness about COVID-19 protection, self-efficacy, and response efficacy through community sensitization.