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Table 2 Illustrative quotations from hygiene kit recipients and programme implementers from a cholera outbreak in Kasansa, Kasai-Oriental, Democratic Republic of Congo

From: Distribution of hygiene kits during a cholera outbreak in Kasaï-Oriental, Democratic Republic of Congo: a process evaluation

Process evaluation dimension Quotation Number Quotation
Delivery format 1 “The cholera programmes are challenging from logistics point of view. In Mbuyi Mayi [provincial capital], it’s not possible to find P&G Purifier of Water™ and Aquatabs™. So, everything comes from Goma or Kinshasa. All of our staff come from Goma or Kinshasa. And our money does too- we are waiting for people to make signatures on the delivery of products and money to pay local RECOs [community health workers]. “
- Respondent #12, female
2 “It was loud in the CTU, and new patients were always arriving. Because it was small, there was not a big space for the demonstrations. The RECO [community health workers] also had to repeat parts many times. Sometimes there were differences between sessions.”
- Respondent #2, male
Dose delivered and implementation fidelity 3 “At the beginning, I gave the kit to the cases who had confirmed cholera. Then I gave them to all the patients. But some patients had no family. I had to give directly to the patient.”
- Respondent #3, female
4 “In the intervention, we gave the kits at admission. But this was not happening at the beginning. At the beginning, I gave the kit to the cases who had confirmed cholera …. At the end I was giving them to everyone at admission to the CTU.”
- Respondent #3, female
Dose received, reach and acceptability 5 “Our water source is far away and has a lot of sediment, maybe 45 min, I walk. And the filter valve provided to filter the water does not easily pass water especially when the water is dirty from the river. It takes a long time to filter.”
- Respondent #21, female
6 “If I have the necessary means and enough, I will buy kits for my wives, but the lack of money makes it difficult. I have 3 wives in three separate houses and there are not buckets to share.”
- Respondent #24, male
Barriers to intervention use 7 “Yes, I need several more elements than just the hygiene kit. I would like some foufou (maize flour), milk, clothes for the family, land my children need money to support school.”
- Respondent #21, male
8 “So, we have no measure of impact for the kits we planned gave out. We need to conduct post distribution monitoring to see what has been used in kits and to also check precisely on the diversity of use. Some of the utensils of the kit including the bucket with tap served as storage of things rather than handwashing bucket. We also need to check if supplies need to be redistributed.”
- Respondent #5, male
9 “So, I have the feeling that all of us are doing really short interventions, like the distribution of Aquatabs™, P&G Purifier of Water™, chlorination points. But the biggest challenge here is the lack of water. So, we were discussing also with the Hub, the WASH Cluster in Kasaï-Oriental today and also, he was thinking that maybe would have been better to focus funding durable solutions. So yes, it’s true that there is the need now but maybe now that the cholera cases are reducing, we would be better looking at...maybe...financing new water points or chlorination points for 2 months. We could decide to rehabilitate the existing infrastructure or having, in this case, huge funding for rehabilitating the water gravity scheme that is here.”
- Respondent #12, male