Understanding empowerment in water, sanitation, and hygiene (WASH): a scoping review

Abstract

In low- and middle-income countries, a common component of water, sanitation, and hygiene (WASH) interventions is the goal of empowerment of beneficiaries, particularly poor households. Empowerment is viewed as an important development goal in itself, as well as a way to obtain improved WASH outcomes. However, empowerment is a complex and multi-dimensional concept, and it is often not clear how it is defined in WASH sector programming. This scoping review explores how concepts of empowerment have been used in the WASH sector and delineates relevant empowerment dimensions. Medline, Embase, and Global Health databases were searched for in the peer-reviewed literature published in English. A total of 13 studies were identified. Five major interrelated empowerment dimensions were identified: access to information, participation, capacity building, leadership and accountability, and decision-making. This review provides researchers and practitioners with a greater understanding of dimensions of empowerment that are relevant for strengthening WASH interventions, as well as tracking progress toward gender and social equality outcomes over time. This understanding can help ensure inclusive WASH service delivery to achieve gender-sensitive Sustainable Development Goal (SDG) targets for universal water and sanitation access.

A Systematic Review of Water and Gender Interlinkages: Assessing the Intersection With Health

“…Reducing gender inequities will also inevitably require women to have a more prominent platform to advocate for the remediation of nuanced gender-barriers (Morna, 2000). In this respect, like others [Kholif and Elfarouk, 2014;Leahy et al, 2017;Dery et al, 2019; World Water Assessment Programme (UNESCO WWAP), 2019], we advocate for gendermainstreaming efforts when addressing WASH inequities. From ours and other's work it is clear that women occupy important WASH roles within households, both with fetching, storing, and using water (e.g., cleaning, cooking, washing, etc.)…”

“…Therefore, women and girls possess a particularly germane perspective which is needed to ensure that engendered WASHrelated barriers are elevated and considered by policymakers and decisionmakers. Including female perspectives may help elevate gender-based priorities (Dery et al, 2019), such as that when latrines are constructed, they include locks, are private, and are well-lit, in order to promote safety and therein increase access for women and girls. Thus, ensuring that a gendered perspective is included when developing capacity is essential to reducing engendered WASH inequities at scale.…”

“…However, invariably, broader active efforts are needed to alter social behavior. While we recognize that behavioral change is a gradual process, sustainability and the empowerment of women will necessarily require efforts to break engendered cultural norms, and support the empowerment of women-critical steps to promote women's human development, and more broadly, sustainable development (Dery et al, 2019).…”

Building Resilient Health Systems: Patient Safety during COVID-19 and Lessons for the Future

“…Strengthen health infrastructure for good quality, safe and integrated services: Four articles emphasised scale up number of well-equipped health care facilities and laboratories, as well as institutionalising strong IPC measures with engineering controls such as adequate ventilation and access to water, sanitation and hygiene (WASH) services. (Chand et al, 2020; Dery & Bisung, 2020; Trevedi et al, 2020; WHO, 2020b). Effective referral and continuum of care mechanisms across the public and private sector, across levels of care and throughout the life course—from childhood to old age has the potential to improve responsiveness of health service delivery mechanisms and avert unnecessary patient harm (Barth et al, 2020).…”

Association of Women’s Empowerment With Water, Sanitation, and Hygiene (Wash) Services in Ethiopia: A Cross-sectional Analysis

“…Women's empowerment has been associated with other important public health services such as fertility preference ( 23), improved household nutrition (24,25), and agricultural productivity (26). In terms of WASHrelated services, studies showed that the connection between WASH and women is even more complex (1,27,28), and can be linked with women's reproductive health (29).…”