Policy promises and sanitation realities: analysing WASH practice constraints in a South African peri-urban settlement

Introduction Despite sustained investments in water and sanitation infrastructure, peri-urban communities in South Africa continue to experience unreliable access to water, sanitation, and hygiene (WASH) services, limiting the translation of sanitation aspirations into everyday practice. This study examines the existing gap between WASH aspirations and actual practices in Nompumelelo, a peri-urban settlement in East London. Methods Employing a mixed-methods approach that includes interviews with key informants and surveys of 264 residents, the research identifies behavioral, infrastructural, sociocultural, and systemic barriers to achieving sustainable WASH outcomes. Grounded in the Theory of Planned Behaviour and Social Practice Theory, the study explores the factors influencing the realisation of effective WASH practices. Results The findings indicate that the realities of water access, sanitation behaviours, sanitation infrastructure, resource scarcity, inadequate hygiene practices, governmental inefficiencies, and imposed decisions are key factors that contribute to the challenges in the realisation of effective WASH practices, despite the existing enthusiasm for their implementation. Community feedback emphasizes the shortcomings of top-down interventions in addressing local realities, highlighting the necessity for participatory, context-sensitive approaches. Discussion The study advocates for co-designed solutions that incorporate local knowledge, adaptive infrastructure models, and responsive policy frameworks. These strategies are essential for transforming WASH aspirations into equitable, sustainable, and dignified public health outcomes in peri-urban areas.