Understanding and defining sanitation insecurity: Women’s gendered experiences of urination, defecation and menstruation in rural Odisha, India.

In the citing paper

“In many settings, menstrual blood—and by extension, menstruating women—were considered ritually impure or polluting”

In the citing paper

“Rural Indian women reportedly suppressed urination and defecation urges when caregiving and household obligations were pressing [184]”

In the citing paper

“These findings seem inconsistent with high reports of stress associated with menstrual management in studies amongst school girls in sub-Saharan Africa [2,5,13,34], and among adult women in India [16,18,35].”

In the citing paper

“Movement restrictions influenced women and girls' access to water [101, 110, 178] and defecation, urination, and menstrual management locations, and are most widely reported in India [62, 135, 174, 181, 182, 184, 187], [101,110,187,[189][190][191].”

In the citing paper

“Women reported different health concerns, mostly negative, based on life stage and circumstance.Notably, pregnant women expressed health fears related to sanitationrelated superstitions (India [184, 189]), women with trouble controlling urination or defecation stressed about accessing sanitation sites (India [2]), women reliant on bags, buckets, or open defecation had substantially lower odds of”

In the citing paper

“Women reported challenges related to privacy and water, specifically concerning hygiene.Women and girls in Bangladesh, [199] India, [184, 189, 226] Indonesia, [115] and Mozambique [175, 261] described challenges obtaining privacy at water sources used for bathing, post-defecation cleansing, and washing, particularly during menstruation.”

In the citing paper

“Women in Nairobi, Kenya who rely on bags, buckets, or open defecation had lower odds of experiencing privacy [256].Household or shared toilets do not always prevent women from being seen or heard while defecating [123, 184, 186].”

In the citing paper

“Women coped with sanitation stressors by seeking social support, withholding food or drink, or changing the timing of sanitation behaviors, though adaptations could also cause stress [168, 177, 184, 189].”

In the citing paper

“Women who withheld food and water or suppressed urination and defecation when lacking access to safe, clean latrines reported experiencing urinary tract infections, headaches, stomach aches, constipation, diarrhea, and other illnesses [135, 168, 172-174, 184, 190, 214, 248].”

In the citing paper

“Women reported myriad sanitation-related stressors, including fear of being attacked by men or ghosts, [177, 181, 184, 189, 229, 238] being shamed for using open defecation sites, [172] suppressing urination or defecation, [184] withholding food and water, [184] needing help to meet sanitation needs, [184] being hurried while using shared facilities, [168, 185, 188] sanitation-related costs, [170,”

In the citing paper

“Privacy of household and shared latrines is compromised by broken [189] or missing doors, [184, 248] missing locks, [175,191,248,251] and poor construction [175,191,240,251].Furthermore, women worried about being seen walking to latrines; [189, 227] waiting in queues; [130] having others hear or smell their activity; [175] or the proximity of latrines to houses, main roads, or public spaces [69,1”

In the citing paper

“Social capital has facilitated sanitation access.Women and girls have formed and maintained social connections when accessing sanitation locations, [130, 182, 189] and sought social support to ensure privacy and safety and to protect reputations when urinating or defecating [173, 182, 184, 187-190, 223, 226].”

In the citing paper

“Studies in India, and Odisha specifically, have explored women’s MHM challenges beyond adolescence, but have focused primarily on issues related to water, sanitation, and hygiene (WASH) conditions, including sanitation insecurity, experiences with sanitation-related psychosocial stress, and reproductive tract infections [19, 28, 44–46].”

In the citing paper

“Wet seasons and weather presented challenges for thoroughly and discretely drying reusable menstrual materials [16, 79].”

In the citing paper

“Studies with greater interpretive depth noted that a lack of confidence to manage menses influenced how women and girls perceived themselves and their bodies, internalising a sense that ‘their bodies are beyond their control’ [5, 16, 47].”

In the citing paper

“Authors identified health impacts resulting from adherence to taboos such as dietary restrictions on the consumption of common foods, linked to fatigue, or withholding urination for fear of others observing menstrual blood in latrines [16, 41, 56, 57].”

In the citing paper

“Availability of a toilet still leaves an unmet need for addressing the women’s need for menstruation related privacy [38].”

In the citing paper

“In the south Asian context especially in India and Nepal, menstruation comes with many social restrictions including for religious rituals [9, 12, 38].”