THE EVERYDAY CLEAN/USAFI KILA SIKU PROJECT:

Researching everyday health and hygiene practices in resource-limited settings in Kenya

The Everyday Clean/Usafi Kila Siku project is a collaborative, interdisciplinary project, with initial funding from the BBSRC GCRF project HORN – One Health Network for the HORN of Africa. Our team includes anthropologists, veterinary epidemiologists, and microbiologists drawn from the University of Glasgow, University of Nairobi, University of Liverpool, and the International Livestock Research Institute in Kenya.

Project Team

Research Lead - Prof Jude Robinson

Prof Jude Robinson is a social anthropologist and HORN Co-Investigator, leading a series of collaborative, interdisciplinary projects collectively called ‘Everyday Clean’, or Usafi kila siku in Swahili, to research One Health and Water, Sanitation and Health (WaSH) issues. Working closely with Dr Olivia Howland, (anthropologist and HORN Post-Doctoral Research Associate), the collaborative HORN team on Everyday Clean, includes the following experts: microbiologist Prof Nicola Williams at the University of Liverpool, veterinary scientist and epidemiologist Dr Annie Cook at ILRI and three HORN Training Fellows, Dr Thigu Stephen Gatitu (medicine), Ann Munene and Danait Solomon (both microbiology) and HORN Fellow Hamilton Majiwa (social anthropology).

Dr Zoe Strachan and Dr Zipporah Okoth (Arts-based methods and storytelling) joined the team to work on the stories and book from the project.

Research Team

Dr Annie Cook

Dr Thigu Stephen Gatitu

Dr Olivia Howland

Hamilton Majiwa

Ann Munene

Dr Zippora Okoth

Prof Jude Robinson

Danait Solomon

Dr Zoe Strachan

Prof Nicola Williams

Background

Human and animal health are intertwined with local ecologies, and research has identified hygiene as a One Health issue. Around 60% of human pathogens are zoonotic, and the World Health Organisation (WHO) notes that the impact of many neglected zoonotic diseases (NZDs) is,

‘… most severe on poor households in developing countries… Poor people are least likely to be currently diagnosed and treated against NZDs.’

Shifting environmental conditions and poor or insufficient hygiene facilitates the transmission of bacteria and viruses between and within species of animals; between humans; and between humans and animals.

Around a third of the world’s population lives without regular access to adequate sanitation and even good hygiene practices can be compromised so many people struggle to stay clean.

Although many people in East Africa spend time every day in environments where animals are present, much of the research into WaSH issues does not take account of the presence of animals and related hygiene practices in their study design. Over 50% of people in Sub Saharan Africa live in urban or peri-urban settings often with rapid population growth and many bring animals with them to the cities to keep as a source of food and income. Across East Africa, many farmers keep livestock and a high number of people are directly involved in routine aspects of animal husbandry. This includes feeding, watering, assisting with births, treating sick animals, milking, and the slaughter, butchery and disposal of dead animals, and each of these everyday encounters presents hygiene risks to animal and human health.

Everyday clean practices can benefit the health of people and animals by creating productive and healthy environments that minimise the risk of zoonotic and other infections.

Everyday Clean/Usafi Kila Siku

Through interdisciplinary One Health projects, we have explored how people manage to keep clean in low income environments in Kenya, where people live in close proximity to animals and wildlife. Our approach was informed by theories of capabilities, risk and gender and aims to better understand people’s ideas, beliefs and practices around cleanliness and hygiene. We have taken a participatory approach to data collection and analysis and participants and communities will be involved throughout the research.

The aims for this interdisciplinary project were to:

  1. explore the everyday hygiene practices of people who live alongside animals within two contrasting one-health contexts in Kenya, to identify what could facilitate people achieve better standards of hygiene and so improve their health and reduce their risk of infection;
  2. explore issues of age, gender and hygiene with women and men to identify potential barriers and opportunities for improving health;
  3. gain an insight into how people use and access soap and water in the context of changing economies, rainfall patterns and rapid urbanisation;
  4. critically evaluate the potential to use interdisciplinary teams to co-operate on data gathering and analysis to research hygiene and one health;
  5. assess whether the audio-visual intervention and storytelling approaches we develop and discuss at four community workshops helps to stimulate community thinking around hygiene practices that lead to improved health.

Our objectives were to: establish a participatory, interdisciplinary approach to improving hygiene practices in one health contexts; establish the use of storytelling to deliver complex health messages; and to identify issues for further One Health WaSH research.

For our fieldwork we proposed to combine ethnographically informed observations and interviews with scientific structured observations and microbiological sample collection to undertake two complementary studies to critically assess (methodologically) the best way to positively engage with people to discuss hygiene and health in a one health context.

Study 1

Researchers identified low-income households in Kware, Ongata Rongai, Kenya, a peri-urban community with some areas of socio-economic disadvantage. The anthropologists, microbiologists and veterinary scientists formed a co-operative interdisciplinary team, working alongside one another with the same households.
After conducting a brief community mapping of the research sites, researchers interviewed people at 40 households, and surveyed a further 40 households, taking photos and microbiological samples to record their observations of human and animal interaction, noting who did what and why.

Study 2

Developing a more gendered and age-sensitive approach the team used interviews and photography to explore everyday washing practices with (a) 20 women and with (b) 20 men of different ages across wider geographical areas in Kenya and focus on personal hygiene in relation to their occupation and contact with animals inside and outside their homes.

Findings

Analysis of the full data set is ongoing in 2022, and this website will be updated as we progress.
Journal articles:

Robinson, J., & Howland, O. (2021). Visible and invisible risks: Exploring washing and hygiene
practices with women living on low income in Kenya. Global Public Health, 1-14.
Usafi Kila Siku/ Everyday Clean animation:
We have used some of the early findings to work with Chomoka Studios to develop a short
animation to highlight key messages around everyday health and hygiene:

Stories of Everyday Clean
Working with the community, we have created four stories about everyday health and hygiene:

Thank you to our funders and supporters

The Everyday Clean research project was fully funded by the Global Challenges Research Fund (GCRF) One Health Regional Network for the Horn of Africa (HORN) Project, from UK Research and Innovation (UKRI) and Biotechnology and Biological Sciences Research Council (BBSRC) (project number: BB/P027954/1).
This website is supported by a grant from the Institute for Health and Wellbeing Social Science Research Incentivisation Fund
at the University of Glasgow.