article · Frontiers in Environmental Health
Peri-urban communities in South Africa frequently face unreliable access to water, sanitation, and hygiene services despite ongoing infrastructure investment. An investigation in the peri-urban settlement of Nompumelelo in East London surveyed 264 residents and interviewed key informants to understand why community sanitation aspirations fail to translate into daily practice. The findings reveal that effective sanitation practices are hindered by physical water access issues, behavioural patterns, resource scarcity, and inadequate infrastructure. In addition, governmental inefficiencies and imposed, top-down decisions fail to address local conditions, despite strong community enthusiasm for improved hygiene. To overcome these systemic and sociocultural barriers, the findings highlight the necessity of moving away from top-down interventions. Developing co-designed solutions that integrate local community knowledge, adaptive infrastructure models, and responsive policy frameworks is critical for achieving sustainable, equitable, and dignified public health outcomes in peri-urban environments.
Infrastructure funding alone does not ensure effective sanitation in peri-urban settlements if local context is ignored. Recognising how governmental inefficiencies and imposed planning limit daily hygiene behaviours helps municipal planners and public health authorities design participatory interventions. Understanding these real-world constraints ensures public investments translate into dignified, equitable, and lasting public health improvements for underserved communities.
The findings provide actionable insights for municipal authorities, development agencies, and civil engineering consultancies designing peri-urban municipal services. Rather than presenting a commercial product, the research offers an applied framework pointing towards co-designed sanitation systems and adaptive infrastructure models. This work sits at an early strategic stage, highlighting the participatory requirements needed before new municipal service technologies or infrastructure investments can be successfully deployed and sustained.
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Introduction Despite sustained investments in water and sanitation infrastructure, peri-urban communities in South Africa continue to experience unreliable access to water, sanitation, and hygiene (WASH) services, limiting the translation of sanitation aspirations into everyday practice. This study examines the existing gap between WASH aspirations and actual practices in Nompumelelo, a peri-urban settlement in East London. Methods Employing a mixed-methods approach that includes interviews with key informants and surveys of 264 residents, the research identifies behavioral, infrastructural, sociocultural, and systemic barriers to achieving sustainable WASH outcomes. Grounded in the Theory of Planned Behaviour and Social Practice Theory, the study explores the factors influencing the realisation of effective WASH practices. Results The findings indicate that the realities of water access, sanitation behaviours, sanitation infrastructure, resource scarcity, inadequate hygiene practices, governmental inefficiencies, and imposed decisions are key factors that contribute to the challenges in the realisation of effective WASH practices, despite the existing enthusiasm for their implementation. Community feedback emphasizes the shortcomings of top-down interventions in addressing local realities, highlighting the necessity for participatory, context-sensitive approaches. Discussion The study advocates for co-designed solutions that incorporate local knowledge, adaptive infrastructure models, and responsive policy frameworks. These strategies are essential for transforming WASH aspirations into equitable, sustainable, and dignified public health outcomes in peri-urban areas.
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DOI: 10.3389/fenvh.2026.1862734
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