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Lived Experiences of Patients with Podoconiosis on Access to Water, Sanitation, and Hygiene (WASH) in Butaro, Rwanda
Date Issued
2025-02-04
Author(s)
Nina Sandra Natasha Ngowi
University of Global Health Equity
Dr. Pacifique Ufitinema
University of Global Health Equity
Abstract
Background:
Podoconiosis is a highly preventable but neglected disease caused by prolonged barefoot exposure to volcanic soil. It is characterized by disabling lower limb swelling which is managed through cost-effective home-based management (HBM). This includes regular foot washing with clean water and soap, and consistent use of protective footwear highlighting the critical role of accessible WASH in effectively managing and preventing podoconiosis. However, it has been evident that some patients do not adhere to HBM but the reason is unknown. Therefore, This study explored podoconiosis patients' experiences in accessing WASH and identified the human, animal, and environmental barriers and facilitators of HBM in the Butaro sector.
Methods:
In this qualitative phenomenological study, in-depth interviews with podoconiosis patients were conducted and supplemented by observation and photographs. To identify study participants, all households in Butaro were screened. From the probable cases identified, a random selection was conducted, stratified by gender. Only those confirmed to have podoconiosis were invited for the interview. Transcripts were inductively coded using Dedoose (version 9.0.80) and analyzed through thematic analysis.
Results:
26 interviews were conducted in all five cells of the Butaro sector. Most participants were female (61.5%), farmers (53.8%), livestock owners (57.7%), and 92.3% had uncovered mud floors. Limited knowledge about podoconiosis, distant water sources, and lack of fitting shoes were overarching responses. Additionally, participants expressed encountering significant barriers to practicing HBM, including physical limitations, poverty, and stigma, which hindered their access to WASH and HBM essentials. However, social support and the seasonal variations facilitated access to water and enabled HBM. Animal waste generated income enabled the participants to buy essential items to practice HBM.
Conclusion:
These findings highlight the impact of socioeconomic factors and WASH accessibility on podoconiosis management. Addressing these challenges through multisectoral collaboration and tailored interventions can lead to broader public health improvements and contribute to poverty alleviation by empowering affected communities with the tools and knowledge needed for effective HBM.
Podoconiosis is a highly preventable but neglected disease caused by prolonged barefoot exposure to volcanic soil. It is characterized by disabling lower limb swelling which is managed through cost-effective home-based management (HBM). This includes regular foot washing with clean water and soap, and consistent use of protective footwear highlighting the critical role of accessible WASH in effectively managing and preventing podoconiosis. However, it has been evident that some patients do not adhere to HBM but the reason is unknown. Therefore, This study explored podoconiosis patients' experiences in accessing WASH and identified the human, animal, and environmental barriers and facilitators of HBM in the Butaro sector.
Methods:
In this qualitative phenomenological study, in-depth interviews with podoconiosis patients were conducted and supplemented by observation and photographs. To identify study participants, all households in Butaro were screened. From the probable cases identified, a random selection was conducted, stratified by gender. Only those confirmed to have podoconiosis were invited for the interview. Transcripts were inductively coded using Dedoose (version 9.0.80) and analyzed through thematic analysis.
Results:
26 interviews were conducted in all five cells of the Butaro sector. Most participants were female (61.5%), farmers (53.8%), livestock owners (57.7%), and 92.3% had uncovered mud floors. Limited knowledge about podoconiosis, distant water sources, and lack of fitting shoes were overarching responses. Additionally, participants expressed encountering significant barriers to practicing HBM, including physical limitations, poverty, and stigma, which hindered their access to WASH and HBM essentials. However, social support and the seasonal variations facilitated access to water and enabled HBM. Animal waste generated income enabled the participants to buy essential items to practice HBM.
Conclusion:
These findings highlight the impact of socioeconomic factors and WASH accessibility on podoconiosis management. Addressing these challenges through multisectoral collaboration and tailored interventions can lead to broader public health improvements and contribute to poverty alleviation by empowering affected communities with the tools and knowledge needed for effective HBM.
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