What barriers do disabled people face when accessing Water, Sanitation and Hygiene?
Sian White and Adam Biran from the Environmental Health Group have recently worked with others to publish an article in PLoS ONE which is entitled: A Qualitative Study of Barriers to Accessing Water, Sanitation and Hygiene for Disabled People in Malawi. We spoke to Sian White to understand more about the importance of the paper.
Why is the study important?
Although, globally, millions of people lack access to improved water, sanitation and hygiene (WASH), disabled people, disadvantaged both physically and socially, are likely to be among those facing the greatest inequities in WASH access. Most of us to not discuss our water use habits, the way we go to the toilet or they way we maintain our personal hygiene. However, for disabled people these most private and basic aspects of our day-to-day lives are highly challenging. This study used qualitative methods to explore the barriers faced by disabled people when accessing WASH. It sought to understand the prioritization of these issues in comparison to other challenges of daily living and map the diversity of barriers experienced. This study is timely because the new Sustainable Development Goals aim to provide access to improved sanitation and improved water sources to all by 2030. This will require services to be delivered to the hardest to reach, the poorest and those whose WASH needs are currently not addressed by mainstream programming. Achieving this goal necessitates that we think more deeply about the barriers faced by disabled people.
What are the key findings of the study?
Participants reported 50 barriers which related to water and sanitation access, personal and hand hygiene, social attitudes and participation in WASH programs. No two individuals reported facing the same set of barriers. This study found that being female, being from an urban area and having limited wealth and education were likely to increase the number and intensity of the barriers faced by an individual. This study found that body function limitations such as incontinence, pain and an inability to communicate WASH needs are in and of themselves significant barriers to adequate WASH access. Improved understanding of these barriers can assist governments, communities and non-government organisations to better support disabled people to ensure equitable access.
What are some of the things you learned personally while conducting the study?
This work was fascinating to undertake. Many of our respondents reported that they had never discussed these issues with anyone before. I felt privileged that they were able to speak so openly about these things with me and to hear their stories.
The diversity of our sample (e.g. many people with communication or cognitive impairments) and the sensitivity of the topics we were discussing meant that standard qualitative research methods were unlikely to work. It was an interesting process to pilot and use some more novel and innovative research methods. More about these research methods can be found here.
As part of this grant we have also had the opportunity to do a lot of public engagement work and think creatively about how we can disseminate results. For example we have now held five photo exhibitions relating to this work, we have translated the research into training workshops and we have invited research participants to be involved in sharing the findings with policy makers. This type of public engagement is something I think we would all like to do a lot more of as researchers so I hope it can inspire others to be equally innovative.