There have long been critiques of colonial legacies influencing global health. In recent years with growing public awareness of unjust systems, a new wave of calls for anti-racist initiatives and decolonization of the sector has emerged. This study examined research inequities in the water, sanitation, and hygiene (WASH) sector, centering the perspectives of researchers from low- and middle-income countries (LMICs), to catalyze collective action in a sub-sector of global health. Nineteen semi-structured interviews were conducted with researchers of different backgrounds regarding nationality, gender, and research experience. Researchers from eight countries were asked about their experiences and direct observations of discrimination across various stages of the research process. Five interviews were conducted with key WASH research funders to assess perceptions of obstacles faced by LMIC researchers, successes achieved, and challenges faced by these organizations when working towards more equitable research processes within the WASH sector. The results were analyzed using an emergent framework that categorized experiences based on power differentials and abuse of power; structural barriers due to organizational policies; institutional and individual indifference; othering speech, action, and practices; and context-specific discrimination. The Socio-Ecological Model was also combined with this framework to identify the types of actors and level of coordination needed to address these issues. Respondents were often reluctant to describe actions as discriminatory unless there was clear intent. Researchers who worked in both LMICs and HICs at different career stages were particularly aware of discrimination. Ensuring pro-equity authorship and funding practices were identified as two significant actions to catalyze change within the sector. Sector-wide efforts must center LMIC voices when identifying research questions, conducting research, and dissemination. Individuals, organizations, and the entire WASH sector must examine how they participate in upholding inequitable systems of power to begin to dismantle the system through the intentional yielding of power and resources.

IntroductionThere have long been critiques of colonial legacies influencing global health. With growing public awareness of unjust systems in recent years, a new wave of calls for antiracist and decolonisation initiatives has emerged within the sector. This study examined research inequities in the water, sanitation and hygiene (WASH) sector, centring the perspectives of researchers from low-income and middle-income countries (LMICs), to identify barriers faced by WASH researchers in order to support more equitable changes in this subsector of global health.MethodsNineteen semistructured interviews were conducted with researchers of different backgrounds regarding nationality, gender and research experience. Researchers from eight countries were asked about their experiences and direct observations of discrimination across various stages of the research process. Five interviews were conducted with key WASH research funders to assess perceptions of obstacles faced by LMIC researchers, successes achieved and challenges faced by these organisations when working towards more equitable research processes within the WASH sector.ResultsThe results were analysed using an emergent framework that categorised experiences based on power differentials and abuse of power; structural barriers due to organisational policies; institutional and individual indifference; othering speech, action and practices; and context-specific discrimination. The social-ecological model was combined with this framework to identify the types of actors and the level of co-ordination needed to address these issues. Researchers who worked in both LMICs and high-income countries at different career stages were particularly aware of discrimination. Ensuring pro-equity authorship and funding practices were identified as two significant actions to catalyse change within the sector.ConclusionSector-wide efforts must centre LMIC voices when identifying research questions, conducting research, and in dissemination. Individuals, organisations and the entire WASH sector must examine how they participate in upholding inequitable systems of power to begin to dismantle the system through the intentional yielding of power and resources.