Key Mechanisms of An Intersectional Gender and Socially Inclusive Community Engagement and Participatory Design Approach in the RISE Program in Makassar, Indonesia and Suva, Fiji

Globally, more than one billion people live in urban informal settlements and experience suboptimal access to safe water, sanitation and hygiene (WASH). Participatory approaches are increasingly being promoted in WASH interventions, but the key elements of these approaches are not well-defined. The Revitalising Informal Settlements and their Environments (RISE) program launched in 2017 uses a participatory approach to co-design water-sensitive infrastructure with residents of 24 urban informal settlements in Makassar, Indonesia and Suva, Fiji. Our objective was to identify key mechanisms of a gender and socially inclusive participatory approach for engaging diverse people in RISE. We conducted semi-structured in-depth interviews (IDIs) with 49 RISE program staff; IDIs with 42 residents from RISE settlements in Indonesia and Fiji; and 12 focus group discussions (FGDs) with RISE residents in Fiji in 2020-2021, after participatory design activities were complete. Resident participants were purposively selected for representation of women and men; high and low participation in RISE; and different levels of disability/impairment. The question guides were informed by the Consolidated Framework for Implementation Research (CFIR), which defines 39 constructs (grouped into five domains) that describe an intervention. The IDI and FGD transcripts were analysed thematically with deductive codes based on the CFIR. For each of the five CFIR domains, the construct that was most relevant to mechanisms for the engagement of diverse people was used for the final analysis. The findings identified several key mechanisms for engaging diverse residents in programs like RISE. Four of these are recommended for future implementation and scale-ups of RISE and similar programs: engaging with residents at the household level (and potentially the individual level); incorporating flexibility and adaptability throughout the program; having a diverse team; and maintaining regular contact and positive rapport between the staff and participants