Water, sanitation, and hygiene for schistosomiasis prevention: a qualitative analysis of experiences of stakeholders in rural KwaZulu-Natal

uMkhanyakude District in KwaZulu-Natal province is one of the districts in the six provinces in South Africa where schistosomiasis is endemic. While it is well established that schistosomiasis is a public health problem in the district and that efforts to prevent and control the disease have been made, very little has been done to involve stakeholders in the implementation of water, sanitation, and hygiene (WASH) strategies for schistosomiasis control. Hence, this study sought to document current WASH practices and explore how engaging diverse stakeholders can contribute to the prevention and control of schistosomiasis. Qualitative data were collected through eight key informant interviews with community leaders, nurses, community caregivers, and pre-school teachers; and four focus group discussions with community members during the dry season. The study adopted a grounded theory approach. Data were analyzed using the six steps of thematic analysis. Findings show that the key players in the promotion of water, sanitation, and hygiene were not clearly defined. Although effective implementation, promotion, and adoption of WASH can be fully achieved with the involvement of various stakeholders, we found that there was a limited collaboration among WASH stakeholders.