Beyond a facility: A cross-sectional survey on WASH service levels and informal social accountability in childcare centres in Nairobi's informal settlements

Abstract

Abstract Access to clean water, sanitation, and hygiene (WASH) services is crucial for a healthy start in life. Social accountability has a potential for enhancing WASH services in childcare centres. However, there are inadequate studies to understand how informal social accountability mechanisms contributes to WASH service provision. To address this gap, we conducted a cross-sectional survey in Korogocho and Viwandani informal settlements in Nairobi, Kenya, to explore the relationship between different levels of WASH services (ranging from basic to limited or nonexistent) and indicators of informal social accountability, including rewards, sanctions, voice, and responsiveness. We employed multinomial regression analysis, utilizing a robust error variance estimator to account for potential biases. Our findings revealed disparities in WASH service provision between the two studied areas, with childcare centres in Korogocho exhibiting higher access to basic WASH services compared to those in Viwandani. Our analysis also highlighted a significant association between informal social accountability mechanisms and the provision of WASH services. Notably, the sanction mechanism exhibited a correlation with all WASH services, suggesting its pivotal role in shaping service delivery outcomes. In light of these findings, it is imperative to prioritize efforts aimed at reinforcing social accountability mechanisms in WASH service delivery frameworks.