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Designing compound-led initiatives to promote handwashing in low-income urban, RECKITT

KENYA, 2022
Population Dynamics and Urbanization in Africa (PDAU)
Sheillah Simiyu
Last modified June 12, 2025 Page views 10840 Metadata DDI/XML JSON

Identification

IDNO
DDI-KEN-APHRC-RECKITT-2022-V10
Title
Designing compound-led initiatives to promote handwashing in low-income urban, RECKITT
Subtitle
RECKITT
Country
Name Country code
KENYA KEN
Abstract
Handwashing with soap is necessary for promoting the public health of communities as it contributes to
the prevention of adverse health outcomes such as diarrhoeal disease and acute respiratory infections.
The availability of handwashing facilities, which are necessary for handwashing to happen, is notably low
in sub-Saharan Africa. In Kenya, available literature shows disparities in access to handwashing facilities
in urban and rural areas, but scanty and inconsistent data is available on access to handwashing facilities
within low income urban settlements in Kenyan cities. In addition to handwashing facilities that are
nonexistent, residents of low-income urban settlements also face challenges of access to water and
sanitation facilities within their compounds.
This study aims to evaluate the status of handwashing practices in Kenya, and design handwashing
facilities that will be managed and maintained by community members in low-income urban settlements
within Nairobi, Kisumu, and Nakuru. This will be a multi-stage study where a mixed-methods approach
will be applied. The first phase of the study will entail a cross-sectional survey, in-depth interviews, and
focus group discussions to assess and explore handwashing practices and their determinants in the lowincome urban settlements. A second co-design phase will build from the first phase and will entail
designing and testing compound-led initiatives for improving hand hygiene within the settlements. This
second phase will be a participatory phase that will entail co-designing appropriate handwashing facilities
and the accompanying messaging to encourage handwashing with soap with selected residents in the
low-income urban settlements. Results from these two phases will inform a subsequent trial to evaluate
the effectiveness of these interventions. The study will be conducted in three cities in Kenya; i.e. Nairobi,
Nakuru and Kisumu. The three cities have been selected because they reflect urban cities in Africa; Nairobi
represents a capital city, Kisumu a mid-size secondary city, and Nakuru represents a rapidly urbanizing
and expanding secondary city. The three cities will provide a reflection of different urban environments
in Africa, and a comparison of hand hygiene practices in three different contexts. Results from this study
will provide evidence on hygiene facilities and their determinants in poor settings in urban Kenya,
evidence that is useful for decision making, planning, and practice. At the global level, the evidence will
provide data on global monitoring and reporting of hygiene, in urban areas of Sub-Saharan Africa.

Version

Version Date
2023-12-05
Version Notes
N/A

Coverage

Geographic Coverage
Low and Middle income settlements in Kenyan cities
Unit of Analysis
families/households
Universe
Household members residing in Low and Middle income settlements in Kenyan cities

Producers and sponsors

Authoring entity/Primary investigators
Agency Name Affiliation
Sheillah Simiyu African Population and Health Research Center
Producers
Name Affiliation Role
Phylis Busienei APHRC Research Officer
Bonface Ingumba APHRC Data Governance Officer
Funding Agency/Sponsor
Name Abbreviation Role
Reckitt Global Hygiene Institute RGHI Funder

Sampling

Sampling Procedure
Household Survey
Prevalence of handwashing facilities in low income urban settlements in the four cities was used to
estimate the sample size, i.e 66% in Kisumu (ResilienceThink, 2021), 18.6% in Nakuru (County Government
of Nakuru, 2018), 27% in Mombasa (Jason Cardosi & Rufus, 2007), and 21.1% in Nairobi (Kamau & Njiru,
2018).
The sample size determination formula for finite population was used
?? = (
(??)
2 × ??(??)
(??)
2
)
Where,
n = Desired sample size
Z = Critical value and standard value for the corresponding level of confidence (At 95% CI of 1.96
P = Expected prevalence based on previous research
q = 1-p
d = Margin of error or precision (at 5%)
The estimated sample sizes was adjusted upwards by 10% to cater for refusals and/or drop outs.
Based on the formula, the final estimated sample size in each of the three cities was be 379 respondents
in Kisumu, 260 respondents in Nakuru, 333 respondents in Mombasa, and 280 respondents in Nairobi.

In-Depth Interviews (IDI)
Households were selected randomly if they live within the selected settlements in Nairobi, Mombasa, Nakuru and Kisumu cities.
Participants comprised adult male and female household heads, including landlords, who
consented to participate in the study. Field staff randomly selected respondents who were residents within
the study sites, and purposively select landlords who provided insights on barriers and opportunities
for handwashing interventions.

Key Informant Interviews
Eligible stakeholders werel identified and purposively sampled from already existing listing of Key
stakeholders (at national and county levels) involved in handwashing interventions, and they comprised
individuals from the Ministry of Health (MoH), Ministry of Water, Sanitation and Irrigation (MoWSI), and
development and implementing organizations such as the United Nations Children’s Fund (UNICEF)
Deviations from the Sample Design
N/A
Response Rate
N/A
Weighting
N/A

Data Collection

Dates of Data Collection (YYYY/MM/DD)
Start date End date
2022-10-03 2022-12-12
Mode of data collection
Face-to-face [f2f]
Supervision
Field interviewers were supervised by Team Leaders, Research Officer and Project manager to ensure data quality and integrity
Type of Research Instrument
Household questionnaire
A cross sectional household survey was conducted to assess the availability of handwashing facilities at
the household level in the low income urban settlements. The surveyl also provide information on the
availability of hygiene and handwashing facilities, hygiene commodities such as soap, availability of water,
and challenges in practicing hand hygiene or handwashing with soap.


KII tool guide
Key Informant interviews (KIIs) wiere conducted with stakeholders at the policy level at national and
county levels and stakeholders from organizations involved in handwashing interventions. The aim of the
KIIs was to understand barriers and opportunities related to handwashing in low income urban
settlements, including handwashing interventions that have been implemented within low income urban
settlements, policies on handwashing with soap, coordination mechanisms, sources of funding, and
monitoring and evaluation approaches.


IDI tool guide
IDIs were conducted with households from each of the four study sites to get deeper understanding of
existing handwashing infrastructure and hygiene practices; including where handwashing facilities are
located, how and when handwashing is done, why handwashing is done the way it is done, barriers for
handwashing, and opportunities for improvement.

Data Processing

Cleaning Operations
Data was collected using the Ipsos iField application on android tablets
Other Processing
N/A

Data Appraisal

Estimates of Sampling Error
N/A

Data access

Contact
Name Email
African Population and Health Research Center datarequest@aphrc.org
Conditions
All non-APHRC staff seeking to use data generated at the Center must obtain written approval to use the data from the Director of Research. This form is developed to assess applications for data use and facilitate responsible sharing of data with external partners/collaborators/researchers. By entering into this agreement, the undersigned agrees to use these data only for the purpose for which they were obtained and to abide by the conditions outlined below:

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"This research uses livelihoods data collected under the longitudinal Nairobi Urban Health and Demographic Surveillance System (NUHDSS) since 2006. The NUHDSS is carried out by the African Population and Health Research Center in two slums settlements (Korogocho and Viwandani) in Nairobi City."

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Citation requirement
Use of the dataset must be acknowledged using a citation which would include:
- the Identification of the Primary Investigator
- the title of the survey (including country, acronym and year of implementation)
- the survey reference number
- the source and date of download

Metadata production

Document ID
DDI-KEN-APHRC-RECKITT-2022-V10
Producers
Name Abbreviation Role
African Population and Health Research Center APHRC Documentation of DDI
Date of Production
2023-12-05
Document version
Version 1.0