Understanding and defining sanitation insecurity: women's gendered experiences of urination, defecation and menstruation in rural Odisha, India.
Understanding and defining sanitation insecurity: women's gendered experiences of urination, defecation and menstruation in rural Odisha, India.
复制标题
DOI：
10.1136/bmjgh-2017-000414
复制
发表时间：
2017
影响因子：
8.1
通讯作者：
Cooper HL
中科院分区：
文献类型：
--
作者：
Caruso BA;Clasen TF;Hadley C;Yount KM;Haardörfer R;Rout M;Dasmohapatra M;Cooper HL
研究表明，卫生设施不足的生活经历可能会导致除病原体暴露之外的不良健康结果，特别是在妇女中。这项研究的目标是通过记录妇女与小便、排便和大小便有关的关切，了解妇女在卫生方面的生活经历，利用研究结果制定低收入环境中妇女卫生无保障的定义，并制定一个概念模型，解释造成其经历的因素，包括潜在的行为和健康后果。我们在印度奥里萨邦的农村人口中进行了69次自由名单访谈和8次焦点小组讨论，以确定妇女的卫生问题，并建立对卫生不安全的理解。我们发现，印度奥里萨邦农村不同生命阶段的妇女有许多未解决的排尿、排便和月经问题。关注的问题分为四个领域：社会文化背景、物质环境、社会环境和个人限制。这些因季节、一天中的时间、生命阶段和厕所所有权而异，并与一系列适应（即压制、不给食物和水）和后果（即责骂、羞耻、恐惧）有关。我们得出的定义和卫生不安全的概念模型反映了这四个领域。我们的调查结果表明，要真正满足妇女的卫生需求，需要的不仅仅是改变物质环境的设施。要使妇女能够独立、舒适、安全、卫生、私密、健康、有尊严地按需排尿、排便和管理月经，就需要采取变革性的办法，这些办法还应解决尽管有设施，但仍影响妇女的性别、社会文化和社会环境。这项研究为今后的环境卫生研究奠定了基础，以验证或完善拟议的定义，并评估妇女的环境卫生无保障状况，甚至在那些有厕所的妇女中，以确定可能需要采取哪些措施来改善妇女的环境卫生状况。
Research suggests that the lived experience of inadequate sanitation may contribute to poor health outcomes above and beyond pathogen exposure, particularly among women. The goal of this research was to understand women’s lived experiences of sanitation by documenting their urination-related, defecation-related and menstruation-related concerns, to use findings to develop a definition of sanitation insecurity among women in low-income settings and to develop a conceptual model to explain the factors that contribute to their experiences, including potential behavioural and health consequences. We conducted 69 Free-List Interviews and eight focus group discussions in a rural population in Odisha, India to identify women’s sanitation concerns and to build an understanding of sanitation insecurity. We found that women at different life stages in rural Odisha, India have a multitude of unaddressed urination, defecation and menstruation concerns. Concerns fell into four domains: the sociocultural context, the physical environment, the social environment and personal constraints. These varied by season, time of day, life stage and toilet ownership, and were linked with an array of adaptations (ie, suppression, withholding food and water) and consequences (ie, scolding, shame, fear). Our derived definition and conceptual model of sanitation insecurity reflect these four domains. To sincerely address women’s sanitation needs, our findings indicate that more is needed than facilities that change the physical environment alone. Efforts to enable urinating, defecating and managing menstruation independently, comfortably, safely, hygienically, privately, healthily, with dignity and as needed require transformative approaches that also address the gendered, sociocultural and social environments that impact women despite facility access. This research lays the groundwork for future sanitation studies to validate or refine the proposed definition and to assess women’s sanitation insecurity, even among those who have latrines, to determine what may be needed to improve women’s sanitation circumstances.
登录
查看更多内容
影响因子：
3.7
作者：
Barnard, Sharmani;Routray, Parimita;Clasen, Thomas
通讯作者：
Clasen, Thomas
DOI：
10.2166/washdev.2014.110
发表时间：
2015-01-01
影响因子：
1.7
作者：
Hirve, Siddhivinayak;Lele, Pallavi;Juvekar, Sanjay
通讯作者：
Juvekar, Sanjay
DOI：
10.1073/pnas.1008944107
发表时间：
2010-12-28
影响因子：
11.1
作者：
Arnold, Benjamin F.;Khush, Ranjiv S.;Colford, John M., Jr.
通讯作者：
Colford, John M., Jr.
DOI：
10.1186/1476-069x-11-4
发表时间：
2012-01-27
期刊：
Environmental health : a global access science source
影响因子：
--
作者：
Cheng JJ;Schuster-Wallace CJ;Watt S;Newbold BK;Mente A
通讯作者：
Mente A
DOI：
10.3390/ijerph14070755
发表时间：
2017-07-01
影响因子：
--
作者：
Caruso, Bethany A.;Clasen, Thomas;Haardorfer, Regine
通讯作者：
Haardorfer, Regine