Are the rights of people with disabilities included in international guidance on WASH during the COVID-19 pandemic? Content analysis using EquiFrame

Abstract

PurposePeople with disabilities are at increased risk from COVID-19. Access to water, sanitation and hygiene (WASH) services and facilities is a fundamental right for all, and is vital in stopping the transmission of COVID-19. However, people with disabilities often face difficulties accessing WASH. Various international organisations have published guidance and recommendations on WASH service provision during the COVID-19 pandemic, and this must include information of relevance to people with disabilities. This study aimed to investigate the inclusion of core concepts of rights for people with disabilities in guidance on WASH during the COVID-19 pandemic.MethodWe used the EquiFrame content analysis tool to analyse the inclusion of 21 core concepts of rights for people with disabilities in international guidance documents on WASH during the pandemic. 29 documents were included from multilateral entities, international consortiums and non-governmental organisations. Key information from the included guidance documents was extracted for each of the 21 core concepts.ResultsOne-third of the WASH guidance did not include any reference to the rights of people with disabilities, and the majority of information was provided by just one guidance document. Most commonly referenced across all was access to WASH, including details on accessible infrastructure (eg, handwashing stations) and communication strategies. Information on many important rights and considerations, such as the affordability of services and caregiver support, was rarely included.ConclusionAlthough some information is provided in international WASH guidance, this often has a narrow focus on access, rather than the full array of rights and considerations that are important for people with disabilities. International guidance should continue to be reviewed and updated to include further information of relevance to people with disabilities, informing a disability-inclusive approach to WASH during the remainder of the COVID-19 pandemic and future crises.

The inclusion of disability and aging in COVID-19 hygiene behavior change interventions across low-and middle-income countries: A review using the COVID-19 Inclusive WASH Checklist

“…A consistent finding across studies which explore inclusive WASH is that caregivers are not recognized for the critical support roles they often play in supporting people with disabilities and older adults with WASH and maintaining personal hygiene (21,26,30,(49)(50)(51). Our study found a greater emphasis on caregivers (Family resource) than in other studies (37,39,48). As noted above, though this indicates an awareness of caregivers' importance, this attention did not translate into clearly articulated actions for this group, meaning they were also unlikely to benefit extensively from these efforts.…”

“…However, the total number of references made to individual core concepts was limited, particularly about aging, which was woefully low. Across this and other similar studies, Individualized services and Access are referenced consistently highly, whilst Participation, Capability based services, and Accountability receive little attention (37,39,48). Some may think this unsurprising because many governments, organizations, and institutions aim to increase access to WASH services, particularly in an emergency setting.…”

The inclusion of disability within efforts to address menstrual health during humanitarian emergencies: A systematized review

“…Inadequate effective and meaningful participation of people with disabilities in WASH programs, from design to evaluation, has been widely documented in development settings (Groce et al, 2011;UN Water, 2015;Scherer et al, 2021b;Wilbur et al, 2021b). Evidence also exists from humanitarian settings, including two papers which explore the extent to which the rights of persons with disabilities are included in international guidance on WASH responses to prevent the transmission of COVID-19 (Scherer et al, 2021a) and interventions (Wilbur, in press). Both found that participation was referenced significantly less than ensuring access to WASH infrastructure in guidance documents (Scherer et al, 2021a) and interventions (Wilbur, in press).…”

“…Evidence also exists from humanitarian settings, including two papers which explore the extent to which the rights of persons with disabilities are included in international guidance on WASH responses to prevent the transmission of COVID-19 (Scherer et al, 2021a) and interventions (Wilbur, in press). Both found that participation was referenced significantly less than ensuring access to WASH infrastructure in guidance documents (Scherer et al, 2021a) and interventions (Wilbur, in press). These patterns are apparent in our study.…”

“…Yet efforts to ensure the inclusion of people with disabilities in humanitarian efforts are limited (Robinson et al, 2020). A recent review of international guidance on water, sanitation and hygiene (WASH) responses during the COVID-19 found that one-third did not include any references to the rights of people with disabilities, and the majority of references were made in one guidance document (Scherer et al, 2021a).…”