Sanitation, Stress, and Life Stage: A Systematic Data Collection Study among Women in Odisha, India

Abstract

Emerging evidence demonstrates how inadequate access to water and sanitation is linked to psychosocial stress, especially among women, forcing them to navigate social and physical barriers during their daily sanitation routines. We examine sanitation-related psychosocial stress (SRPS) across women’s reproductive lives in three distinct geographic sites (urban slums, rural villages, and rural tribal villages) in Odisha, India. We explored daily sanitation practices of adolescent, newly married, pregnant, and established adult women (n = 60) and identified stressors encountered during sanitation. Responding to structured data collection methods, women ranked seven sanitation activities (defecation, urination, menstruation, bathing, post-defecation cleaning, carrying water, and changing clothes) based on stress (high to low) and level of freedom (associated with greatest freedom to having the most restrictions). Women then identified common stressors they encountered when practicing sanitation and sorted stressors in constrained piles based on frequency and severity of each issue. The constellation of factors influencing SRPS varies by life stage and location. Overall, sanitation behaviors that were most restricted (i.e., menstruation) were the most stressful. Women in different sites encountered different stressors, and the level of perceived severity varied based on site and life stage. Understanding the influence of place and life stage on SRPS provides a nuanced understanding of sanitation, and may help identify areas for intervention.

Water insecurity and urban poverty in the Global South: Implications for health and human biology

“…Water rationing and uncertainties over water supply times may engender feelings of anxiety. Women's inability to perform these tasks leads to feelings of inadequacy, shame, fear, worry, and anxiety that ultimately leads to poor mental health (Hulland et al, ; Workman & Ureksoy, ). When women are incapable of performing duties that are traditionally important and expected, such as keeping houses clean for visitors, helping their families to maintain proper hygiene, and ensuring that their families are clean and able to participate in public functions, feelings of anxiety and mental illnesses may develop (Stevenson et al, ).…”

“…When women are incapable of performing duties that are traditionally important and expected, such as keeping houses clean for visitors, helping their families to maintain proper hygiene, and ensuring that their families are clean and able to participate in public functions, feelings of anxiety and mental illnesses may develop (Stevenson et al, ). For example, women in urban areas of Odisha, noted that the most stressful aspect of their sanitation experiences was the need to carry water every day, sometimes getting wet on rainy days and walking through mud (Hulland et al, ). The same study found that defecation, menstruation, and cleaning duties were constant sources of stress related to water and sanitation and insecurity (Hulland et al, ).…”

A ruralidade como condicionante da adoção de soluções de saneamento básico

“…Alguns autores defendem que o conceito de rural, além de aspectos demográficos, é definido também por condições socioeconômicas e territoriais relacionadas com os modos de reprodução social (WANDERLEY;FAVARETO, 2013;ABRAMOVAY, 2000). Nas três comunidades em estudo, a associação comunitária representa uma forte organização social que promove a união dos moradores e cumpre o papel de buscar direitos e benefícios para a localidade que A ausência de instalação sanitária é apontada por alguns estudos como um dos fatores que impactam, sobremaneira, a vida das mulheres (HULLAND et al, 2015;KWIRINGIRA et al, 2014). Além disso, devido às divisões de trabalho usualmente adotadas nas áreas rurais -onde o homem é responsável pelo trabalho agrícola e o sustento da casa, e a mulher é a responsável pelo trabalho doméstico -, as mulheres se envolvem mais com as ações sanitárias, sendo as responsáveis pelo acesso à água e sua gestão cotidiana no nível domiciliar e pela queima dos resíduos sólidos.…”

Design and rationale of a matched cohort study to assess the effectiveness of a combined household-level piped water and sanitation intervention in rural Odisha, India

“…22 30 31 Poor water and sanitation access can also affect the social, physical and mental well-being of women, acting through pathways ranging from unsafe menstrual hygiene management practices and increased risk of violence. [32][33][34] Description of the intervention Over the past few decades, there has been a global commitment to determine water and sanitation interventions with demonstrated effectiveness, not just efficacy. 35 Gram Vikas, a non-governmental organisation based in Odisha, India (http://www.gramvikas.org/), has responded by implementing its MANTRA (Movement and Action Network for Transformation of Rural Areas) water and sanitation programme in more than 1000 villages since 2002.…”