Association of safety and security, privacy, and health with sanitation-related withholding and suppression among women in urban Uganda and India Público

Sinclair, Elaina (Spring 2022)

Permanent URL: https://etd.library.emory.edu/concern/etds/k643b236b?locale=pt-BR
Published

Abstract

Despite proximity to sanitation facilities, women may still face sanitation insecurity if the physical and sociocultural context prevents toilet access when needed. To cope with sanitation barriers, women may resort to withholding food and water or suppressing of the urge to urinate or defecate. Many qualitative studies have described the concerns of women regarding sanitation-related privacy, safety and security, and health; however, the quantitative association is lacking. This study is a secondary analysis of data collected in Kampala, Uganda, and Tiruchirappalli (Trichy), India. Withholding was found among 38% of women in Kampala and 16% of women in Trichy, and suppression was reported in more than 93% of women in both populations. To quantitatively capture privacy, safety and security, and health as exposures, the Agency, Resources, Institutional Structures for Empowerment (ARISE) Scales and factors were used to derive exposure scores. In addition to traditional demographic measures, several additional covariates were identified including the need to collect water, toilet type, facility sharing and numerous facility characteristics such as lockability and lighting. The privacy, safety and security, and health scores were all significantly associated with the odds of withholding among women in both Kampala and Trichy. Fewer significant results were found between privacy, safety and security and health scores and suppression, suggesting additional unaccounted variables at play. Nonetheless, the prevalence of withholding and suppression suggests concerning numbers of urban women who feel the need to avoid their sanitation facilities. In addition, this study successfully identifies several privacy, safety and security and health factors which programs may target to improve women’s sanitation situation and quality of life. 

Table of Contents

i. Distribution Agreement

ii. Approval Sheet

iii. Abstract Cover Sheet

iv. Abstract

v. Thesis Cover Page

vi. Acknowledgements

vii. Table of Contents

1. Introduction

3. Methods

3. Study Design

4. Primary Exposures

5. Primary Outcomes

7. Covariates

7. Analysis

8. Ethics

9. Results

10. Table 1

11. Table 2

12. Safety and security, privacy and health factors associated with withholding

14. Table 3

15. Figure 1

15. Figure 2

16. Safety and security, privacy and health factors associated with suppression

17. Table 4

17. Sensitivity analysis - safety and security

19. Table 5       

19. Table 6

19. Discussion

24. References

26. Appendix

26. Supplemental Figure 1

27. Supplemental Figure 2

28. Supplemental Figure 3

29. Supplemental Table 1

32. Supplemental Table 2

33. Supplemental Figure 4

34. Supplemental Figure 5

35. Supplemental Figure 6

36. Supplemental Text  1

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