Abstract
Background: The most recent COVID-19 pandemic has demonstrated how easy it is for outbreaks of disease to spread from person to person, irrespective of age or gender. Communities in low-socioeconomic, developing countries have faced huge hardships trying to cope with pre-existing, strained resources. Commonly referred to as “slums”, informal settlements are home to an excess of one billion people worldwide. People who reside in informal settlements are more prone to contracting diseases. Substandard living conditions and lack of basic public health services such as the provision of adequate water supply and sanitation are the main drivers in the spread of disease.
Aim: The study aimed to determine the lack of adequate water and sanitation in Diepsloot informal settlement and the potential influence of these factors on the spread of the COVID-19 pandemic.
Setting: The study was conducted in Diepsloot informal settlement, situated within the jurisdiction of the City of Johannesburg (Region A), in Johannesburg, South Africa.
Methods: A quantitative cross-sectional study was conducted. The cohort comprised 344 participants. The participants were recruited using the non-probability (convenience) sample method. The data was collected using a closed-ended questionnaire and analysed using version 29 of the IBM Statistical Package for the Social Sciences (SPSS) software. The study was conducted with adherence to all ethical requirements, including informed consent, ethics clearance, and approvals.
Results: The evidence showed that the lack of adequate water and sanitation supply in Diepsloot informal settlement may have contributed to the spread of the COVID-19 pandemic.
The total percentage of participants who indicated they tested positive for COVID-19 or were exposed to a household member that tested positive for COVID-19, comprised 59% of the study population. A sizeable portion of participants (32.9%) indicated they were moderately aware of the symptoms associated with COVID-19.
More than half, 189 (56.6%) of participants agreed that there was provision of water facilities in the area. The odds ratio for the provision of water to the area was 0.668 (95% confidence interval [CI = 0.512 – 0.871]) is less than 1, indicating that the outcome will decrease as the predictor increases, thereby indicating a reduced likelihood of exposure. A total of 137 (41.0%) of participants indicated their main source of water supply was from communal taps. The odds ratio for the main source of water supply to the area was 0.690 (95% CI: 0.527 – 0.903). Similarly, A large number 197 (59.0%) of participants agreed that there was provision of toilet facilities in the area. There were 197 (59.0%) participants who indicated that the communal
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toilets were located more than 500 meters from their households. The odds ratio for the provision of toilet facilities in the area was 0.468 [95% CI = 0.348 – 0.627], which is less than 1, indicating that the outcome will decrease as the predictor increases, thereby indicating a reduced likelihood of exposure. Many, 125 (37.4%) participants indicated that it was very difficult to access communal toilets during the pandemic. The odds ratio was 0.543 [95% CI: 1.348 – 2.831]. A total of 120 (35.9%) participants communicated that the toilets were sometimes serviced. The results indicate that an increase in the availability, accessibility, and servicing of the toilets in the area, will significantly decrease the number of people exposed to COVID-19.
The odds ratio of both variables (lack of adequate water supply and lack of adequate sanitation), indicate that an increase in the amount of provision to the area and an increase in the number of communal taps provided to the community will significantly decrease the number of people exposed to COVID-19.
Conclusion: Despite government initiatives to supply the Diepsloot informal settlement with water and sanitation, the community expressed their dissatisfaction with their efforts. The study's findings suggest the lack of adequate water and sanitation contributed to the spread of the COVID-19 pandemic.
Contribution: Previous research publications have contributed significantly to our understanding of the socio-economic and environmental vulnerabilities experienced by people living in informal settlements. This research study adds to the body of knowledge on the interconnection between lack of adequate water and sanitation in Diepsloot informal settlement and the influence that deficits in either of these factors have on the spread of the COVID-19 pandemic.
Keywords
COVID-19, informal settlements, lack of sanitation, lack of water, slums, socio-economic