Abstract
BackgroundThere is increasing recognition of the complexity underlying WASH conditions in developing countries. This article explores the complexity by assessing the vulnerability of a specific area to poor WASH conditions using a qualitative approach.MethodsWe present our findings for the district of East Sumba in Indonesia. This area is known as one of the poorest regions in Indonesia with inadequate WASH services, indigenous belief that hinder the practice of WASH-related behaviours, and has a high rate of children malnutrition. All the factors that contribute to poor WASH conditions were discussed through the lens of the Financial, Institutional, Environmental, Technological, and Social (FIETS) framework. We then summarised the factors and visualized the “system” using a mind map which shows how factors are interconnected and helps to find the root causes of poor WASH conditions.ResultsThere are three main challenges that inhibit the improvement of WASH conditions in this area: inadequate institutional capacity, water scarcity, and poor socio-economic conditions. We found that a village leader is the most important actor who influences the sustainability of WASH services in this area and healthcare workers are influential WASH promoters. This study also shows how culture shapes people’s daily lives and institution performance, and influences the current WASH conditions in East Sumba. The mind map shows there is an overlap and interconnection between FIEST aspects and WASH conditions in the study area.ConclusionWASH conditions are influenced by many factors and are often interconnected with each other. Understanding this complexity is necessary to improve WASH conditions and sustain adequate WASH services in developing countries. Finally, WASH interventions have to be considerate of the prevailing cultural practices and should involve multidisciplinary stakeholders.
Highlights
Water supply, sanitation, and hygiene (WASH) are focal points in the Sustainable Development Goal (SDG) 6, which aims to “ensure availability and sustainable management of water and sanitation for all” [1]
The FIETS framework could be applied to all WASH contexts, e.g., water, sanitation, or hygiene, unlike other sustainability frameworks, e.g., UNICEF’s Sustainability Check and GIFT
Applying the FIETS framework to identify factors related to WASH services Financial aspect Respondents from district agencies and village boards often mentioned a lack of funds as an obstacle for sustainable WASH services in East Sumba
Summary
Sanitation, and hygiene (WASH) are focal points in the Sustainable Development Goal (SDG) 6, which aims to “ensure availability and sustainable management of water and sanitation for all” [1]. The latest WHO/UNICEF Joint Monitoring Programme (JMP) report showed the progress made in the provision of WASH services in 2017: 71% of the global population had safely managed drinking water services, 45% safely managed sanitation services, and 60% of the global population had basic handwashing facilities with soap and water availability at home [2]. This indicates that billions of people, especially in low-middle income countries (LIMCs), still lack adequate WASH services. This article explores the complexity by assessing the vulnerability of a specific area to poor WASH conditions using a qualitative approach
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