Open defecation and its impact on violence against women- A systematic review Público

Poudyal, Natasha (Fall 2023)

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Background: Open defecation is common worldwide, being practiced by 892 million people, and is of particular concern in rural and peri-urban communities. Open defecation and lack of sanitation affect women disproportionately and contribute to violence against women. The main goal of this study was to investigate the association between open defecation and violence against women.

Methods: A systematic review was conducted for articles on the Web of Science database. Using the search string created, 94 articles were screened for review. Based on the title review of the 94 articles, 51 articles were selected for further review of abstracts. Based on abstract review, 37 were selected for full-text review. The full-text review yielded 13 articles that were included in this systematic review, ensuring that they followed the inclusion and exclusion criteria. Endnote was used to organize all citations. 

Results: Most of the selected articles were based in low- and middle-income countries (LMICs). Open defecation was prevalent among young women living in peri-urban and rural settings. The prevalent forms of violence against women were sexual assault and rape because of open defecation. The practice of open defecation was feared by many at night (or in darkness). Furthermore, open defecation brought about shame and embarrassment, hence leading to discomfort discussing the topic among all women.

Discussion: Open defecation is a global concern affecting millions around the world. This systematic review can inform sanitation advocacy efforts that extend beyond mere access to gender sensitive perspectives. Using this systematic review, researchers, public health entities and government stakeholders can develop sustainable and targeted interventions to enhance the lives of women and their well-being, especially in communities where open defecation and violence against women are prevalent. 

Table of Contents

Chapter 1. Literature Review.. 1

1.1.     Introduction to importance of good WASH practice. 1

1.2.     Immediate health risks due to open defecation. 1

1.3.     Privacy, increased vulnerabilities and gender based violence. 2

1.4.     Loss of dignity and psychological concerns. 3

1.5.     Cultural norms and its consequences 4

1.6.     Impact on education and employment 6

1.7.     Challenges and barriers to promoting good WASH practices 7

1.8.     Goals and Aims. 8

1.9.     Significance. 9

Chapter 2. Methods. 10

2.1. Overview of the systematic review process. 10

2.2. Article screening. 11

2.3. Data extraction. 12

2.4. Data analysis 12

Chapter 3. Results. 14

3.1. Identification of the articles 14

3.3. Association between open defecation and violence against women. 17

3.4. Comparison of target population. 18

3.5. Women’s perceptions and concerns 19

Chapter 4. Discussion. 20

4.1. Main findings. 20

4.2. Strengths and Limitations 23

4.3. Implications. 23

4.4. Recommendations 24

4.5. Public health implications. 26

4.6. Conclusion. 27

Reference. 29


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