Context matters: a multicountry analysis of individual‐ and neighbourhood‐level factors associated with women's sanitation use in sub‐Saharan Africa

Abstract

International development goals for sanitation are frequently framed in terms of availability, implicitly suggesting that if facilities are accessible, they will be used. A more nuanced view that takes into account not only the existence of facilities but also the factors influencing their use is needed to understand the dynamics of women's sanitation use in the region. Policies focused on availability may not yield the desired public health benefits from improved sanitation in sub-Saharan Africa. Context-relevant factors must be addressed concurrently to achieve sanitation development goals.

A Spatio-Temporal Pattern and Socio-Economic Factors Analysis of Improved Sanitation in China, 2006–2015

“…Our results also indicated that a one percentage rise in centralized water supply was associated with a 0.191% increase in ISR. The results were mostly in consistence with a host of previous researches about the factors associated with improved sanitation usage [ 50 , 51 ]. It is reasonable that good access to external environmental infrastructures such as sufficient clean water, centralized water supply suggests better environmental conditions, more investment, all of which can help increase the coverage rate of improves sanitation [ 52 ].…”

Exploring the complex relationship between women’s sanitation practices and household diarrhea in the slums of Nairobi: a cross-sectional study

“…For example, over two-thirds of the women in this study identified OD and/or use of bags and buckets (emptied into open drainages) as a primary cause of diarrhea and 70% said avoiding OD and/or use of bags and buckets was a key diarrhea prevention strategy; yet, close to 69% of the women reported that they rely on bags or buckets for urination/defecation at night and an additional 6% reported defecating in the open at night. One explanation for this findings might be, as evidence from other studies corroborates [ 42 , 43 ], that there is a knowledge-behavior gap when it comes to issues of WASH. Women may know, for example, that use of OD and/or bags and buckets is linked to poor health outcomes, but abandoning these practices may be hindered by additional more-pressing factors that prevent women, and their children and family members, from accessing clean water, safe sanitation, and or products for safe hygiene [ 17 , 44 ]. For example, several recent studies have provided evidence that women in sanitation-poor environments, e.g., informal settlements, often face a number of gender-specific barriers to access sanitation such as lack of privacy and dignity [ 18 , 45 , 46 ] and sexual violence and harassment associated with having to rely on community toilets or sites for OD at night or during menstruation [ 22 , 45 – 48 ].…”

Assessing Drinking Water Quality at the Point of Collection and within Household Storage Containers in the Hilly Rural Areas of Mid and Far-Western Nepal

“…We also found that wealthier and more educated respondents were more likely to treat their water at home. This suggests that those factors may thus facilitate the behavioral changes required to perform HWT, as was also found in the context of toilet use in Africa [40]. A comprehensive behavioral study, such as using a system-level approach combining socio-economic and adapted psychological frameworks, was suggested to better understand the root causes of the behavior [15,41].…”