A qualitative study of barriers to accessing water, sanitation and hygiene for disabled people in Malawi.
Open accessAbstract
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. This study explores the WASH priorities of disabled people and uses the social model of disability and the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework to look at the relationships between impairments, contextual factors and barriers to WASH access. 36 disabled people and 15 carers from urban and rural Malawi were purposively selected through key informants. The study employed a range of qualitative methods including interviews, emotion mapping, free-listing of priorities, ranking, photo voice, observation and WASH demonstrations. A thematic analysis was conducted using nVivo 10. WASH access affected all participants and comprised almost a third of the challenges of daily living identified by disabled people. 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. The social model proved useful for classifying the majority of barriers. However, this model was weaker when applied to individuals who were more seriously disabled by their body function. 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. Understanding these access barriers is important for the WASH sector at a time when there is a global push for equitable access.
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In Malawi, women with disabilities experienced difficulty collecting water, though they are often still expected to fulfill this role.
“In Malawi, women with disabilities experienced difficulty collecting water, though they are often still expected to fulfill this role [282].”
From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [282]
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Cites
Using thematic analysis in psychology
Braun, V., & Clarke, V. (2006) · Qualitative Research in Psychology · doi:10.1191/1478088706qp063oa · Cited by 194,414 · see citing works
Shakespeare, T., & Officer, A. (2011) · Disability and Rehabilitation · doi:10.3109/09638288.2011.590392 · Cited by 1,792 · see citing works
Davis, L. J. (2013) · Routledge eBooks · doi:10.4324/9780203077887 · Cited by 1,486 · see citing works
Global challenges in water, sanitation and health
Moe, C. L., & Rheingans, R. (2006) · Journal of Water and Health · doi:10.2166/wh.2006.0043 · Cited by 429 · see citing works
Doing qualitative analysis in psychology.
Andersson, G. (1998) · Clinical Psychology & Psychotherapy · Cited by 335 · see citing works
The Use and Abuse of Models of Disability
Llewellyn, A., & Hogan, K. (2000) · Disability & Society · doi:10.1080/09687590025829 · Cited by 267 · see citing works
Theory-led thematic analysis: Social identification in small companies.
Hayes, N. (1997) · doi:10.4324/9781315804552-13 · Cited by 150 · see citing works
Definitions, concepts, and measures of disability
Altman, B. M. (2013) · Annals of Epidemiology · doi:10.1016/j.annepidem.2013.05.018 · Cited by 125 · see citing works
Köhler, B. (2016) · Zürcher Hochschule für Angewandte Wissenschaften digital collection (Zurich University of Applied Sciences) · Cited by 75 · see citing works
Groce, N., Bailey, N., Lang, R., et al. (2011) · Journal of Water and Health · doi:10.2166/wh.2011.198 · Cited by 74 · see citing works
Beyond the Millennium Development Goals: Public health challenges in water and sanitation
Rheingans, R., Dreibelbis, R., & Freeman, M. C. (2006) · Global Public Health · doi:10.1080/17441690500443139 · Cited by 42 · see citing works
Jones, H., & Reed, B. (2005) · Loughborough University Research Repository (Loughborough University) · Cited by 41 · see citing works
Measuring disparities in sanitation access: does the measure matter?
Rheingans, R., Anderson, J. D., Luyendijk, R., & Cumming, O. (2013) · Tropical Medicine & International Health · doi:10.1111/tmi.12220 · Cited by 36 · see citing works
MacLeod, M., Pann, M., Cantwell, R., et al. (2014) · Journal of Water and Health · doi:10.2166/wh.2014.009 · Cited by 13 · see citing works
Why should the water and sanitation sector consider disabled people?
Fisher, J. (2005) · Loughborough University Institutional Repository (Loughborough University) · Cited by 7 · see citing works
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Research works printed but not linked: 2
- [3]WHO and World Bank, "World Report on Disability," ed, 2011. 26131540
- [12]H. Jones, K. Parker, and R. Reed, "Water supply and sanitation access and use by physically disabled people—a literature review," 2002.
Cited by
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Sclar, G. D., Penakalapati, G., Caruso, B. A., Rehfuess, E. A., Garn, J. V., Alexander, K. T., Freeman, M. C., Boisson, S., Medlicott, K., & Clasen, T. (2018) · Social Science & Medicine · doi:10.1016/j.socscimed.2018.09.016 · Cited by 113 · see citing works
Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis
Caruso, B. A., Conrad, A., Patrick, M., Owens, A., Kviten, K., Zarella, O., Rogers, H., & Sinharoy, S. S. (2022) · PLOS Water · doi:10.1371/journal.pwat.0000026 · Cited by 94 · see citing works
- Authors
- White, S., Kuper, H., Itimu-Phiri, A., Holm, R., & Biran, A.
- Affiliations
- London School of Hygiene & Tropical Medicine (GB)
- Mzuzu University (MW)
- Corresponding author
- White, Sian
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2016-05-12
- Volume
- 11
- Issue
- 5
- Pages
- e0155043
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4865162
- OpenAlex
- W2372791790
- Cited by
- 100
- References
- 15
- Citations by year
- 2026: 9 · 2025: 11 · 2024: 15 · 2023: 6 · 2022: 12 · 2021: 12 · 2020: 15 · 2019: 5 · 2018: 11 · 2017: 3 · 2016: 1
- FWCI
- 16.29
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- ThinkIR: The University of Louisville's Institutional Repository (University of Louisville) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Department of Foreign Affairs and Trade, Australian Government (66469)
- Topics
- Social Sciences › Safety Research › Disability Rights and Representation
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Physical Sciences › Environmental Science › Water Science and Technology › Water Resource Management and Quality
- Keywords
- water, sanitation and hygiene, people with disabilities, social model of disability, International Classification of Functioning, Disability and Health, hand hygiene, personal hygiene, incontinence, caregivers, gender inequality, urban-rural differences, socioeconomic status, Malawi
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Education, Female, Persons with Disabilities, Disabled Persons, Humans, Hygiene, Malawi, Male, Middle Aged, Rural Population, Sanitation, Socioeconomic Factors, Urban Population, Water, Caregivers, Qualitative Research, Young Adult, Research Report
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