Are current approaches for measuring access to clean water and sanitation inclusive of people with disabilities? Comparison of individual- and household-level access between people with and without disabilities in the Tanahun district of Nepal
Are current approaches for measuring access to clean water and sanitation inclusive of people with disabilities? Comparison of individual- and household-level access between people with and without disabilities in the Tanahun district of Nepal
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DOI：
10.1371/journal.pone.0223557
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发表时间：
2019-10-11
期刊：
影响因子：
3.7
通讯作者：
Kuper, Hannah
中科院分区：
文献类型：
--
作者：
Banks, Lena Morgon;White, Sian;Kuper, Hannah
可持续发展目标的目标6强调了安全、负担得起地获得水、环境卫生和个人卫生（WASH）的至关重要性，该目标力求到2030年实现人人普遍和公平获得水、环境卫生和个人卫生。然而，占全球人口15%的残疾人在满足其讲卫生需求方面经常面临困难。目前追踪目标6进展情况的方法侧重于家庭而非个人层面的获取，可能无法捕捉到残疾人未得到满足的讲卫生运动需求。目的评估尼泊尔塔纳洪地区残疾人在个人和家庭层面获得安全饮用水、环境卫生和个人卫生（WASH）的情况。方法于2016年8月至10月进行了一项基于人口的残疾调查，以评估尼泊尔Tanahun地区有残疾人家庭（n = 198）和无残疾人家庭（n = 1265）获得改善的水和卫生设施的情况。然后使用新开发的21项“WASH access质量”问卷，对15岁及以上的残疾病例（n = 192）和年龄-性别-位置匹配的无残疾对照组（n = 189）进行巢式病例对照比较。多变量回归用于比较残疾人和非残疾人家庭和家庭之间的家庭和个人水平指标。对18名残疾人及其护理人员进行了深入访谈，以评估“WASH Access的质量”问卷的可接受性和适当性。调查结果：在有和没有残疾成员的家庭在获得改善的卫生设施或水源方面没有显著差异。然而，在个人层面上，与非残疾人相比，残疾人在获得水、环境卫生和个人卫生方面遇到的困难要大得多（第16页）
Background The critical importance of safe and affordable access to water, sanitation and hygiene (WASH) is highlighted in Goal 6 of the Sustainable Development Goals, which seeks to achieve universal and equitable access for all by 2030. However, people with disabilities-who comprise 15% of the global population-frequently face difficulties meeting their WASH needs. Unmet WASH needs amongst people with disabilities may not be captured through current approaches to tracking progress towards Goal 6, which focus on household- rather than individual-level access. Objective To evaluate access to safe water, sanitation and hygiene (WASH), at the individual- and household-level, amongst people with disabilities in the Tanahun district of Nepal. Methods A population-based survey of disability was conducted from August-October 2016 to evaluate access to improved water and sanitation facilities between households with members with disabilities (n = 198) and those without (n = 1,265) in the Tanahun district of Nepal. A nested case-control then compared individual-level access between cases aged 15 and above with disabilities (n = 192) and age-sex-location matched controls without disabilities (n = 189), using the newly developed 21-item "Quality of WASH Access" questionnaire. Multivariate regression was used to compare household- and individual-level indicators between people and households with and without disabilities. In-depth interviews with 18 people with disabilities and their caregivers was conducted to assess the acceptability and appropriateness of the "Quality of WASH Access" questionnaire. Findings There were no significant differences between households with and without members with disabilities in access to an improved sanitation facility or water source. However, at the individual-level, people with disabilities experienced significantly greater difficulties accessing water, sanitation and hygiene compared to people without disabilities (p