JOURNAL OF PUBLIC HEALTH, 2012, DOI: 10.1007/s10389-012-0515-x
Barriers to accessing water, sanitation and hygiene among people living with HIV/AIDS in Gomba and Mpigi districts in Uganda: a qualitative study
Richard Kibirango Mugambe, Nazarius Mbona Tumwesigye and Fiona Larkan
Aim -To explore the challenges that people living with HIV/AIDS (PLWHA) experience in accessing water, sanitation and hygiene (WASH) so as to inform policy and promote pro-HIV/AIDS WASH programs as well as equity in WASH investments.
Methods – This was a descriptive study that utilized qualitative methods for data collection. The study population comprised of PLWHA as well as environmental health officers, water officers, medical doctors and HIV/AIDS care providers in Mpigi and Gomba districts, Uganda. Six focus group discussions (FGDs) with PLWHA (three for men and three for women) and twelve key informants (KIs) interviews were conducted. A moderator and a note taker facilitated the FGDs, which were tape recorded with consent from participants. Qualitative content analysis was done.
Results – The KIs interviews and FGDs revealed that PLWHA in the study districts were facing serious challenges in accessing and utilizing WASH services. It was realized that the safe water coverage in the study area was low and PLWHA had limited access to improved water sources. Additionally, they experienced social prejudices that left them in a position where they felt like they were not good enough, inferior and isolated. Such feelings were affecting access to and utilization of WASH services for some PLWHA. Many PLWHA reported that the cost of water per 20-L jerrican (0.04 USD at some improved sources and 0.4–0.6 USD from water vendors) was high and unimproved sources such as ponds and dams were the alternative. They also had a bad attitude towards Water Guard noting that it causes a bad taste in water and does not reduce the turbidity.
Conclusion – PLWHA face financial, attitudinal, knowledge, social, physical as well as institutional and sustainability barriers to accessing and utilizing WASH services. There is, therefore, a need to design and implement appropriate WASH sensitization programs for PLWHA. Water treatment using disinfectants that do not alter taste and can reduce turbidity of water should be promoted and such disinfectants should be made available in health facilities for PLWHA to get either for free or at subsidized prices.