Community leaders' experiences of hepatitis E in a Namibian informal settlement: A qualitative study.

Background: The hepatitis E virus (HEV) is a major global health concern, with an estimated one-third of the human population infected. It is particularly prevalent in developing countries, especially in informal settlements where inadequate sanitation and limited access to clean water contribute to its spread. Aim: The study aimed to explore and describe community leaders' experiences regarding the spread of HEV in the Havana informal settlement, Khomas region, Namibia. Setting: This study focused on Havana informal settlement in the Namibian capital of Windhoek, which is in the Khomas region. The Havana informal settlement is predominantly populated with unemployed people. Methods: Individual in-depth interviews were conducted with 15 community leaders, aged 24 years to 65 years, who were knowledgeable of the spread of HEV in the informal settlement. Thematic qualitative analysis was used to analyse data. Results: The themes identified included HEV risk awareness, contextual factors influencing the spread of HEV, action drivers for change and actions taken to activate change. Overall, there was a good understanding of HEV, although some individuals in the community held incorrect information and harboured myths and misconceptions about HEV. Inadequate access to water, sanitation facilities and unhygienic cultural practices were identified as primary routes of transmission, fuelled by overcrowding. Conclusion: The study highlighted the importance of government-private sector cooperation, community health education, access to clean water and improved infrastructure in preventing the spread of HEV. Addressing these factors is essential for overcoming health challenges in informal settlements. Contribution: This research underscores the critical role of community engagement in mitigating HEV outbreaks in informal settlements.