Cliff Nyaga, University of Oxford
In rural Kenya, Health Care Facilities (HCFs), specifically dispensaries and clinics, provide lifesaving care for millions of people living in remote villages. These areas are characterised by low population densities and high poverty levels, in turn contributing to limited access to social services such as roads, water, health, education, housing, among others.
The COVID-19 pandemic has shed light on the important role played by rural HCFs and the impact that WASH has on the prevention of disease spread. A pilot intervention implemented in 2020 in Kitui, Kenya supported COVID-19 response efforts by the Kitui County Government, while at the same time monitoring service quality and costs to understand WASH service levels and their variation by water source type and location.
The pilot intervention was managed by FundiFix, a local enterprise providing professionalised repair and maintenance service for rural infrastructure, guaranteeing a reliable water service and involved one sub-County hospital and 11 dispensaries in Mwingi North sub-County over a six-month period (October 2020-March 2021) during the COVID-19 pandemic. For the duration of the pilot, the 12 HCFs received a range of services, including:
The insights shared here are based on rural dispensaries only, being the first line of service for most rural communities in Kitui. The study suggests that;
It is well documented that improving WASH in HCFs translates to social and health benefits for rural communities. The COVID-19 pandemic not only underscored the importance of WASH services for all but also presented a window for sector players to dialogue, test, and scale ideals/approaches to improve service delivery. The pilot confirms the capacity of professionalised service providers, such as FundiFix, to deliver high-quality WASH services as part of a ‘utility’ solution for rural areas.
The study also points to a more efficient service delivery approach where professionalised services could be bundled not only for communities but also to include HCFs in an area-wide service approach. The estimated cost of US$1 per patient visit provides empirical evidence on which government planning and partner/funder commitments can be based upon to secure universal WASH services for all. For FundiFix, the study provides better visibility on ways to advance business growth, including demand, costs, and efficient pathways for scaling service coverage.
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