Scoping provision of WASH services for unsheltered individuals: practitioners’ experiences from the West Coast (U.S.)

Abstract This study focuses on five West Coast cities in the United States (U.S.) to understand current access to water, sanitation, and hygiene (WASH) interventions targeted toward individuals experiencing homelessness. The study explores how services are provided, funded, and measured for impact and how key partners in service provision are identified. While individuals experiencing homelessness often rely on public sources like water taps and porta-potties, they also face barriers such as economic constraints and stigma that can lead to the formation of informal governance systems for accessing WASH services. This research assesses institutional interventions by governments and nonprofits to improve decision-making for public health and inform funding and intervention designs. Key findings show that local individuals in nonprofit organizations, local government agencies, and utilities champion most WASH intervention programs. Such programs provide essential services while helping cultivate trust as a bridge to other social programs. Motivation for these interventions stems from public health concerns, ensuring WASH is a human right, recognizing homelessness as a humanitarian emergency, and wanting to provide a fresh start for individuals. However, the ad hoc nature of the work presents a challenge for securing long-term funding and navigating local government programs.