Soapy Water Handwashing Stations in Kenya

Regular handwashing with soap is one of the best ways to prevent diarrheal and respiratory disease, which are two of the primary causes of death among children worldwide. In many places in the developing world, however, soap is a luxury and water must be carried long distances, and handwashing with soap is not always practiced at critical times. In Kenya, researchers have partnered with Innovations for Poverty Action to introduce an innovative handwashing system in a variety of settings, to evaluate the technology, and to identify ideal pricing structures for a potential scale-up.

Research shows that regular handwashing with soap after defecation and before food preparation is one of the best ways to prevent diarrheal and respiratory illness, two of the primary causes of death among children worldwide. It is estimated that universal adoption of handwashing with soap could save 1 million lives annually. In addition to the mortality burden, diarrheal and respiratory illness lead to school absenteeism, reducing human capital development and potentially depressing productivity in the long-run. While the positive effects of handwashing are established, it is less clear how to make the practice of handwashing with soap more widespread. Some efforts focus on advocating handwashing through public health messaging or through the promotion of simple handwashing stations, but ensuring soap is available for handwashing is rare. This project introduces an innovative Soapy Water Handwashing Station, evaluates adoption of the technology, and identifies ideal pricing structures for a potential scale-up in Kenya.

Diarrheal disease and pneumonia account for 30 percent of child mortality in Kenya alone. Due to the large potential benefits of improved hygiene, Kenya and other East African countries have become more active in promoting safe handwashing practices, particularly through behavior change programs in schools and public campaigns. However, purely educational and behavior change efforts that just instruct people to wash their hands have had limited results. This study is being conducted in densely populated areas surrounding Kisumu, in western Kenya, specifically among households, public health clinics and public primary schools that currently lack access to reliable piped water and handwashing facilities.

Researchers are evaluating the acceptability and scale-up potential of an innovative handwashing system developing by Innovations for Poverty Action among 400 households, four public health clinics, and 30 public primary schools in peri-urban areas of Kisumu, Kenya.

Working together, Innovations for Poverty Action and Catapult Design used a human centered design approach to improve upon an existing “tippy-tap” handwashing station to create a more functional, durable, and cost-effective system. The water-efficient, soap-frugal handwashing system is portable and adaptable to multiple settings, with an innovative soap foam dispenser that conserves soap and a swinging water tap that is hygienic, easy to use, and conserves water.

To gauge the demand for the handwashing stations and identify the optimal pricing structure for them, researchers are conducting a willingness-to-pay evaluation among 400 households just outside the city of Kisumu, and also testing the technology at schools and clinics. Among the households, researchers will investigate the optimal pricing structure by randomly assigning the 400 households three different offer prices (from 0-75 percent subsidy) for two different models of the handwashing systems. This component of the study will provide information on the demand for the systems and the price that households are willing and able to pay. This information will inform the target market prices for scale-up opportunities. The research team will follow-up with households that purchased the systems to gather information on usability and maintenance.

At the 30 primary schools and four health centers, researchers are assessing adoption and user perceptions of the handwashing systems using questionnaires, rapid observations of handwashing stations, structured observations of handwashing with soap after toilet use, and remote monitoring of water and soap usage. While all schools in the study will receive the systems during the study period, the schools will be randomly assigned to receive them at three different points in time, enabling the research team to compare schools with the systems to those without them. The clinics will receive the systems at around same time.

Results forthcoming.