Co-Developing Community- Based Interventions: Lessons from a Handwashing Initiative in Low-Income Areas of Mombasa, Kenya

Abstract

Sustained handwashing behavior change in low-income urban settings requires context-sensitive interventions that go beyond generic health messaging. This paper describes the development of a community-based handwashing with soap intervention in the Kisauni Sub-County of Mombasa, Kenya, implemented between September 2023 and June 2024 as part of the broader RECKITT study. Using the Trials of Improved Practices methodology, the study engaged 56 randomly selected participants alongside community health promoters, local leaders, and households to co-design contextually appropriate strategies. Activities included household visits, community dialogue sessions, and practical demonstrations targeting identified barriers to handwashing. By the close of the intervention development phase, over 70% of participating compounds had established dedicated handwashing facilities and reported improved practices. The paper draws lessons on the value of participatory co-design, the facilitative role of community health promoters, and the scalability of community-led hygiene models in low-income urban Africa.