Perspectives and Practices on Water, Sanitation, and Hygiene from a Fishing Community along Lake Malombe, Southern Malawi

People living in fishing communities have a high burden of preventable water, sanitation, and hygiene (WASH) related diseases but have often been neglected in research and policy. We explored practices and perspectives on WASH among fishing villages around Lake Malombe, Malawi. We employed a mixed methods design, and data were initially collected through participant observations (five weeks), followed by a second phase of qualitative interviews (n= 16), focus group discussions (n= 7), and quantitative surveys (n= 242). We observed that safe water sources were scarce; latrines were basic; and handwashing facilities were limited. Seventy-one percent (n= 174) of households collected water from unsafe sources (open wells and the lake). Eighty-six percent (n= 207) of households had basic short-term latrines. Twenty-four percent (n= 59) of households had handwashing facilities with soap. Qualitative data supported these observations and identified additional factors which compounded poor WASH practices including, a high transient population associated with the fishing trade, poor infrastructure design and construction which lacked consideration of the environmental factors, context and social and cultural norms. As such, fishing communities are underserved and marginalised with constrained access to WASH services, which must be addressed through behaviour-centered and context appropriate solutions.