Beyond a facility: water, sanitation and hygiene service levels and informal social accountability in childcare centres in informal settlements

Growing up in a safe environment is every child's right. Access to clean water, sanitation and hygiene (WASH) services not only keep children thriving, but also gives them a healthier start in life. Social accountability is potentially a contributor to improved WASH services in childcare centres. This study assessed the association between informal social accountability mechanisms (iSAMs) and the levels in the WASH service ladder in childcare centres. A cross-sectional survey was conducted with childcare providers in Korogocho and Viwandani in Nairobi, Kenya. We explored the association between the WASH service ladder variables (dependent variable) and iSAM (independent variable), using multinomial regression with a robust error variance estimator. Access to basic WASH was relatively higher on the measurement ladder in childcare centres in Korogocho than in Viwandani. A higher proportion of centres had access to basic WASH services compared to limited and no services in both study sites. In the model comparing basic service vs no facility/services, participants who used rewards, sanctions and responsiveness (versus not used) in sanitation services were more likely to have basic services. Data contribute towards a significant understanding of the role of iSAMs as a key component for strengthening WASH service delivery in childcare centres. HIGHLIGHTS Safe environment with access to water, sanitation and hygiene (WASH) is every child's right. Informal social accountability mechanism (iSAM) is key in strengthening WASH service delivery in the context of a weak formal service delivery structure. Improved access to WASH services can be attributed to WASH interventions that emerged during the Covid-19 outbreak.