Gender data gaps represent missed opportunities in WASH

Abstract

Amy Pickering and colleagues (September, 2019)1Pickering AJ Crider Y Sultana S et al.Effect of in-line drinking water chlorination at the point of collection on child diarrhoea in urban Bangladesh: a double-blind, cluster-randomised controlled trial.Lancet Glob Health. 2019; 7: e1247-e1256Summary Full Text Full Text PDF PubMed Scopus (41) Google Scholar found that a passive chlorination device at communal water points in urban Bangladesh reduced child diarrhoea, expenditures on and health-care seeking for child illnesses, and child antibiotic consumption.1Pickering AJ Crider Y Sultana S et al.Effect of in-line drinking water chlorination at the point of collection on child diarrhoea in urban Bangladesh: a double-blind, cluster-randomised controlled trial.Lancet Glob Health. 2019; 7: e1247-e1256Summary Full Text Full Text PDF PubMed Scopus (41) Google Scholar We suggest that additional data could have provided evidence of another potential benefit: reduced workload and time burden for women. A previous report2Luoto J Najnin N Mahmud M et al.What point-of-use water treatment products do consumers use? Evidence from a randomized controlled trial among the urban poor in Bangladesh.PLoS One. 2011; 6e26132Crossref PubMed Scopus (57) Google Scholar from the same study area observed that women ”typically have responsibility for water treatment” in this area. If the intervention evaluated by Pickering and colleagues enabled women to switch from active to passive methods of water treatment, it may have saved them time and effort while eliminating a gendered task. The intervention also might have reduced women's workload in relation to caregiving, if reductions in diarrhoea led to less labour managing faeces, cleaning, and seeking health care. Readers, like us, can surmise that women might have benefitted in these ways, but sex-disaggregated data and explicit discussion of women's roles in the outcomes reported would have allowed for both visibility and certainty. As reported in The Lancet, public health research is historically gender blind and there is a need to report sex-disaggregated data as a minimum first step.3Sugimoto CR Ahn Y-Y Smith E Macaluso B Larivière V Factors affecting sex-related reporting in medical research: a cross-disciplinary bibliometric analysis.Lancet. 2019; 393: 550-559Summary Full Text Full Text PDF PubMed Scopus (138) Google Scholar, 4Hawkes S Haseen F Aounallah-Skhiri H Measurement and meaning: reporting sex in health research.Lancet. 2019; 393: 497-499Summary Full Text Full Text PDF PubMed Scopus (9) Google Scholar That need also exists in water, sanitation, and hygiene (WASH) research. Sustainable Development Goal 6.2 calls for sanitation and hygiene to pay “special attention to the needs of women and girls”.5UNSustainable Development Goal 6: ensure availability and sustainable management of water and sanitation for all.https://sustainabledevelopment.un.org/sdg6Date: 2016Date accessed: August 30, 2019Google Scholar This call is not specific to women's and girls' own sanitation and hygiene needs, but also speaks to the behaviours that they are expected to perform for others due to their normative expectations, like the multiple behaviours involved in caring for a child with diarrhoea. Integrating a gender lens is crucial for the WASH sector as it might enable opportunities to identify additional evidence-based benefits (or even harms) of impactful interventions for women, who are chronically under-represented. We call for researchers to measure and critically assess the gendered impacts of WASH interventions. We declare no competing interests. Effect of in-line drinking water chlorination at the point of collection on child diarrhoea in urban Bangladesh: a double-blind, cluster-randomised controlled trialPassive chlorination at the point of collection could be an effective and scalable strategy in low-income urban settings for reducing child diarrhoea and for achieving global progress towards Sustainable Development Goal 6.1 to attain universal access to safe and affordable drinking water. Targeting a low chlorine residual (<0·5 ppm) in treated water can increase taste acceptability of chlorinated drinking water while still reducing the risk of diarrhoea. Full-Text PDF Open Access