Social outcomes of a community-based water, sanitation and hygiene intervention

Social benefits of water, sanitation and hygiene (WASH) interventions are less documented compared to health benefits such as the reduction of diarrheal diseases. Although most decisions in WASH investments are based on potential health outcomes, interventions may also lead to social benefits, such as income generation, increased school enrollment, improved levels of dignity, self-esteem and civic pride, which can have a significant value both personally and to the wider community. This qualitative case study was used to assess the perceived social outcomes of purposively selected stakeholders from a WASH intervention study in Malawi. In-depth Interviews (n = 10), focus group discussions (n = 4) and key informants interviews (n = 10) were conducted with caregivers (male and female), community leaders, traditional leaders and community coordinators. Thematic analysis identified eight social outcomes: formation and strengthening of relationships (n = 32), becoming role models to community members (n = 23), women empowerment (n = 20), time-saving (n = 17), change of status (n = 12), receiving awards (n = 12), reduced medical costs (n = 11) and obtaining new skills (n = 7). Social capital among caregivers was also found to be high. No negative outcomes from the intervention were reported. WASH interventions have multiple, important, but difficult to quantify social benefits which should be measured, reported and considered in WASH investment decision-making.