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. HIGHLIGHTS This paper informs the reader about the experiences of stakeholders in the adoption of WASH in a low-income community for schistosomiasis prevention.; The paper uses qualitative methods with a grounded theory approach to understand the stakeholder's perspectives.; Findings show that the key players for the promotion of WASH were not clearly defined.; Effective implementation, promotion, and adoption of WASH for schistosomiasis prevention seemed to be the responsibility of various stakeholders with little coordination, thus indicating limited stakeholder collaboration.