Nepal’s community close-watch system keeping COVID-19 at bay

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Maintaining person-to-person contact despite a pandemic lockdown

By Renu Kshetry

KATHMANDU, Nepal – 60-year-old Sabitri knew that handwashing and staying home were critical measures in preventing the spread of COVID-19. But until she received a phone call from a researcher, she admitted she had not been taking them seriously.

“But since you called,” she told Menuka Thapa, a total sanitation worker on the phone. “I have been washing my hands with soap much more and working hard to keep a safe distance from others.”

Sabitri lives in Changunarayan Municipality, just east of the capital Kathmandu, in Nepal’s Bhaktapur District. Hers is one of almost 19,000 households across the country that have been reached over the past month as part of an initiative to gather information on health and hygiene practices.

The effort, known as the community close-watch system, was launched in April by UN-Habitat, the executing agency of WSSCC’s Global Sanitation Fund (GSF) in Nepal, to provide data that can inform the development of strategies by local governments to prevent the spread of COVID-19.

The research is being conducted by volunteers using mobile technology to collect and relay data in four categories: health with a specific focus on COVID-19; handwashing and sanitation; hygiene and cleanliness; and water, sanitation and hygiene. The information is being fed into a central database where it will be analyzed, verified and then forwarded to municipal governments to help them formulate policies and strategies on handwashing, hygiene and sanitation.

“With this community close-watch system, we are hopeful that it will increase monitoring capacity of the local governments to fight COVID-19 or any other outbreaks,” said Rajesh Manandhar, Water and Sanitation Coordinator at UN-Habitat.

“And it will be beneficial for continuing promotion of activities through distance communication and promotion of the total sanitation campaign through WASH messaging,” he said.

Though Nepal has reported relatively fewer cases of COVID-19 so far, it remains at risk of increased infection due to its porous borders with India and China. The community close-watch system, launched for a three-month period when the country’s lockdown was announced in April, is intended to help mitigate that risk. It is being conducted in 16 of Nepal’s 77 districts: Arghakhanchi, Bara, Bardiya, Bajura, Bhaktapur, Dhanusha, Jhapa, Mahottari, Morang, Nuwakot, Parsa, Rautahat, Saptari, Sarlahi, Siraha and Sunsari.

Within one month, the team of more than 1,000 volunteers, 200 sanitation facilitators, local government and district coordinators and the staff of implementing partners reached out to 18,886 households and delivered 42,825 messages on handwashing, hygiene and sanitation.

In the process, they gathered data on a variety of questions such as the number of households where people are exhibiting COVID-19 symptoms, whether people know that handwashing is crucial in the fight against COVID-19, whether they are teaching handwashing to family members, whether handwashing and staying home are actually being practiced, how many households have handwashing facilities and the need for distance messaging on handwashing and toilet use, among others.

The findings indicate that people in most households in the 16 districts are responding well to the current crisis by staying home. A majority of households (81%-100%) reported having knowledge that handwashing is crucial in the fight against COVID-19, with 100 % of households in Nuwakot and Arghakhanchi reporting that they are practicing handwashing in the current crisis, followed by Bardiya (97%) and Dhanusha (96%). At the same time, the study revealed a complete absence of handwashing facilities in 8% of the households in Parsa and 10% of the households in Siraha.

“The community close-watch survey will provide us with actual data on handwashing behaviour, sanitation and hygiene which will give us an insight into the hygiene and sanitation situation, which will be crucial for designing further interventions to fight COVID and other outbreaks,” said Mr Manandhar.

Despite the lockdown, person-to-person communication, typically conducted through door-to-door visits and mass meetings, is made possible to continue through the use of messaging via mobile devices, a communications platform that can be used to trigger positive WASH behaviour into the future, while maintaining social distance.

“We are working towards ensuring that handwashing, hygiene and sanitation shall be always be practiced to prevent us from being infected, not only during COVID-19,” said Sudha Shrestha, chief technical advisor of UN-Habitat. “It should be a norm, and we did not want lockdown to deter our ongoing campaign on sanitation and hygiene,” she said.

It is estimated that more than 100,000 households will be reached in the next three months through mass communication and distance messaging.