Protocol for development and validation of instruments to measure women’s empowerment in urban sanitation across countries in South Asia and Sub-Saharan Africa: the Agency, Resources and Institutional Structures for Sanitation-related Empowerment (ARISE) scales

Sinharoy, Sheela; Conrad, Amelia; Patrick, Madeleine; McManus, Shauna; Caruso, Bethany A.

doi:10.1136/bmjopen-2021-053104

Cited by 15 publications

(22 citation statements)

References 25 publications

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“…Measuring (transformative) social change is complex, non-linear, context-specific and slow 42. Yet, this should not prevent the research community from collecting evidence about transformative outcomes, especially as tools to measure GESI outcomes in the WASH sector are emerging and have the potential to address this gap 43–45. While addressing gender inequalities is often described as a key aim of WASH programmes, regular collection of qualitative46–49 and quantitative gender and equality data and monitoring should be mainstreamed by practitioners to ensure this aim is achieved and to improve understanding of both the extent and direction of change.…”

Section: Discussionmentioning

confidence: 99%

Systematic mapping of gender equality and social inclusion in WASH interventions: knowledge clusters and gaps

et al. 2023

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IntroductionPoor access to water, sanitation and hygiene (WASH) services threatens population health and contributes to gender and social inequalities, especially in low-resource settings. Despite awareness in the WASH sector of the importance of promoting gender equality and social inclusion (GESI) to address these inequalities, evaluations of interventions focus largely on health outcomes, while gender equality and other social outcomes are rarely included. This review aimed to collate and describe available research evidence of GESI outcomes evaluated in WASH intervention studies.MethodsWe applied a systematic mapping methodology and searched for both academic and grey literature published between 2010 and 2020 in 16 bibliographic databases and 53 specialist websites. Eligibility screening (with consistency checking) was conducted according to predetermined criteria, followed by metadata coding and narrative synthesis.ResultsOur evidence base comprises 463 intervention studies. Only 42% of studies measured transformative GESI outcomes of WASH interventions, referring to those that seek to transform gender relations and power imbalances to promote equality. A majority of studies disaggregated outcome data by sex, but other forms of data disaggregation were limited. Most included studies (78%) lacked a specific GESI mainstreaming component in their intervention design. Of the interventions with GESI mainstreaming, the majority targeted women and girls, with very few focused on other social groups or intersectional considerations.ConclusionThe review points to various areas for future primary and secondary research. Given the potential contribution of WASH to GESI, GESI considerations should be incorporated into the evaluation of WASH interventions. Regular collection of data and monitoring of GESI outcomes is needed as well as developing new and testing existing methods for monitoring and evaluation of such data.

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Section: Discussionmentioning

confidence: 99%

Systematic mapping of gender equality and social inclusion in WASH interventions: knowledge clusters and gaps

et al. 2023

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“…This study is a secondary analysis of textual data collected as part of cognitive interviews (CI) carried out in August 2019 as part of the Measuring Urban Sanitation and Empowerment (MUSE) project. The goal of MUSE is to develop and validate scales to measure sanitation-related women's empowerment in urban areas (Sinharoy et al, 2022). The primary goal of the CIs was to confirm the face validity of survey items and ensure they were culturally relevant and understood as intended (Beatty and Willis, 2007).…”

Section: Study Designmentioning

confidence: 99%

“…CIs serve to strengthen the survey tools before large-scale deployment (Beatty and Willis, 2007). The resulting tool, called ARISE (Agency, Resources, and Institutional Structures for Sanitation-related Empowerment), measures subdomains of women's empowerment based on the model developed by van Eerdewijk et al (2017), Sinharoy et al (2022Sinharoy et al ( , 2023. As the CI data included rich responses and went beyond cognitive debriefing, there was scope for further analysis.…”

Section: Study Designmentioning

confidence: 99%

An exploration of sanitation-related decision-making, leadership, collective action, and freedom of movement among women in urban Tiruchirappalli, India

Doma

Patrick²,

Conrad³

et al. 2023

Front. Water

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IntroductionSanitation research in India has emphasized the disproportionate burden that unsafe and inadequate WASH can have on women and girls. However, there is a gap in research exploring women's agency in relation to their sanitation experiences, and agency is an integral domain of their empowerment.MethodsCognitive interviews related to sanitation and empowerment were conducted with women in three life stages in India to validate survey tools that measure urban sanitation and women's empowerment; this paper is a secondary thematic analysis of qualitative data generated from 11 cognitive interviews in Tiruchirappalli, India, that focus on agency, specifically the sub-domains of decision-making, leadership, collective action, and freedom of movement. Women had the freedom to move to and from sanitation facilities and initiatives, with no restrictions from household members.ResultsWe observed differences at the household and community levels with women voicing more confidence, as well as the responsibility, to make sanitation-related decisions in the household than at the community level. Women mentioned strong trust and belief in women's sanitation-related leadership capabilities and support for women-led sanitation initiatives. However, many did not hold leadership positions themselves due to various limitations, from gendered responsibilities to women's lack of self-confidence. Women also discussed anecdotes of collectively working with other women toward improving the local sanitation environment.DiscussionThis analysis highlights the value of strong trust and confidence among women in their ability to make important sanitation-related decisions at all levels of society. Maintaining and strengthening trust in female community members and highlighting women-led groups' achievements in the sanitation space should be prioritized. Community spaces must incorporate provisions that encourage women to share sanitation-related opinions in an environment that respects their engagement. WASH programming must engage with authority figures, leaders, and officials when seeking to increase women's agency and involvement with sanitation-related issues.

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“…The authors note that it can be used to analyze contexts, inform intervention design, and guide monitoring and measurement activities. Given that our systematic review was part of a BMGF-funded project to develop and validate measures to assess women's empowerment in urban sanitation, [50] we elected to use the same model for consistency. While van Eerdewijk et al also discuss the importance of engaging men and boys in…”

Section: Conceptual Foundationmentioning

confidence: 99%

Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis

et al. 2022

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Historically, water and sanitation programs have focused on women’s instrumental value in improving conditions and behaviors. No reviews have synthesized evidence on water and sanitation and women’s and girls’ empowerment. This review a) identified empirical water and sanitation research that engaged empowerment and/or empowerment-related domains; b) reported empowerment-related terminology used, research locations, methods leveraged, if water and/or sanitation was the focus; and c) synthesized evidence. A conceptual model of women’s and girls’ empowerment, which includes three interrelated domains (agency, resources, institutional structures), informed the search and analysis. We searched MEDLINE, EMBASE, CABI Global Health, PsycINFO, CINAHL and AGRICOLA for peer-reviewed sources presenting research on water and/or sanitation and either empowerment and/or related terms from the model (4 May 2020). We identified 12,616 publications; 257 were included, representing over 1,600,000 participants. We used the Mixed-Methods Appraisal Tool (MMAT) and followed the ‘best-fit framework synthesis’ analysis approach, using the model domains and sub-domains as codes. We inductively identified two additional sub-domains relevant to water and sanitation: privacy and freedom of movement. Thematic analysis guided synthesis of coded text. The majority of research took place in Asia (46%; 117) or Africa (40%; 102), engaged adults (69%; 177), and was published since 2010; (82%; 211). The greatest proportion of studies focused on water (45%; 115). Over half of studies used the term empowerment, yet only 7% (17) provided a clear definition or conceptualization. Agency was the least commonly engaged domain (47%; 122); the Resources domain was dominant (94%; 241). Measures for assessing empowerment are limited. Inclusion of only peer-reviewed sources in English is a main limitation. Well-conceptualized water and sanitation research that engages women’s and girls’ empowerment is limited. A more comprehensive ‘transformative WASH’ that includes gender-transformative approaches to challenge and reduce systemic constraints on women’s and girls’ resources and agency is long overdue.

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Protocol for development and validation of instruments to measure women’s empowerment in urban sanitation across countries in South Asia and Sub-Saharan Africa: the Agency, Resources and Institutional Structures for Sanitation-related Empowerment (ARISE) scales

Cited by 15 publications

References 25 publications

Systematic mapping of gender equality and social inclusion in WASH interventions: knowledge clusters and gaps

Systematic mapping of gender equality and social inclusion in WASH interventions: knowledge clusters and gaps

An exploration of sanitation-related decision-making, leadership, collective action, and freedom of movement among women in urban Tiruchirappalli, India

Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis

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