"We had to bring the water in pain": Water and sanitation challenges among pregnant and postpartum women in Odisha, India Público

Abstract

Globally, women and girls bear the burden of poor access to water and sanitation. While the challenges associated with water and sanitation among adolescent girls have been well documented, there is a dearth of research that examines similar concerns among pregnant and postpartum women. Secondary analysis was conducted on a subset of qualitative data sourced from sanitation insecurity research among women from across different life stages (adolescent, recently married, married over 3 years, older than 49) in rural Odisha, India. Transcripts from one-on-one interviews (69) and focus group discussions (8) were eligible for analysis if they contained data on women’s water and sanitation related challenges during pregnancy and up to 4 months postpartum. Data from 45 interviews and 4 focus group discussions were eligible for analysis. Analysis followed a thematic approach and yielded three key themes that represented pregnant and postpartum women’s sanitation and water related concerns: socio-cultural, environmental and individual challenges. It was found that social support, access to functioning latrine and water facilities served to ameliorate pregnant women’s challenges. Gender norms, the lack of social support and unfavorable seasonal weather events served to increase their burdens. Other studies should explore water and sanitation insecurities among pregnant and postpartum women in different contexts. Further research should examine the association between poor sanitation and water access and negative maternal and child health outcomes. 

Table of Contents

Chapter 1: Literature Review……….1

Women and Water Collection……….1

Women and Sanitation……….4

Maternal Health, Water and Sanitation……….6

Water and Sanitation in Rural India……….7

Chapter 2: Current Study……….10

Problem Statement……….10

Research Objective……….10

Chapter 3: Introduction……….12

Chapter 4: Methods……….16

Overview of Study Design……….16

Study Setting and Population……….17

Participant Recruitment and Eligibility……….18

Data Collection……….18

Data Analysis……….21

Chapter 5: Results……….23

Participant Characteristics……….23

The Scope of Women’s Challenges……….25

Individual Challenges Experienced by Pregnant and Postpartum Women ……….28

Environmental Challenges Experienced by Pregnant and Postpartum Women ……….36

Socio-Cultural Challenges Experienced by Pregnant and Postpartum Women……….39

Chapter 6: Discussion……….43

Strengths and Limitations……….46

Public Health Implications……….48

Chapter 7: Conclusion……….51

References……….52

About this Master's Thesis

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School	Rollins School of Public Health
Department	Environmental Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Palavra-chave	Pregnancy Postpartum Water Sanitation India Gender
Committee Chair / Thesis Advisor	Hennink, Monique, Emory University
Committee Members	Tolbert, Paige, Emory University Freeman, Matthew , Emory University Caruso, Bethany , Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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