Psychosocial stress associated with sanitation practices: Experiences of women in a rural community in India.
Abstract
This study examined sources of psychosocial stress related to the use of toilet facilities or open defecation by women and adolescent girls at home, public places, workplaces and in schools in a rural community in Pune, India. The mixed methods approach included focus group discussions among women, key informant interviews, free listing and a community survey of 306 women. Nine per cent of the study households and most seasonal migrant women workers lacked access to toilets. Fear for personal safety, injury or accidents, lack of cleanliness, indignity, shame and embarrassment due to a lack of privacy were significant sources of stress related to open defecation. Seasonal migrant women workers perceived the lack of privacy as a significant source of psychosocial stress but did not fear for their personal safety or injuries, despite their general lack of access to toilet facilities. Women resorting to open defecation feel stressed and harassed by community leaders trying to enforce open defecation-free policies. Our study highlights the need for sanitation programs to consider the specific needs of women with regard to latrine maintenance, safety and privacy offered by sanitation installations. Specific strategies to address the sanitation and hygiene issues of seasonal migrant populations are also required.
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Fears or experiences of harm from domestic and wild animals and insects were reported for both water collection and sanitation activities; women and girls reported fear and actual experiences of injury at and when accessing sanitation locations, regardless of sanitation type.
“Fears or experiences of harm from domestic and wild animals and insects were reported for both water collection and sanitation activities [62, 135, 143, 170, 172-174, 177-179, 184, 187, 189-191, 198, 201, 214, 226, 229, 257, 258, 296].Women and girls reported fear and actual experiences of injury at and when accessing sanitation locations, regardless of sanitation type [135, 168, 172, 174, 184, 18”
From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [172]
Women reported myriad sanitation-related stressors, including fear of being attacked by men or ghosts, being shamed for using open defecation sites, suppressing urination or defecation, withholding food and water, needing help to meet sanitation needs, being hurried while using shared facilities, sanitation-related costs, and lacking privacy or being seen by others, especially men, while openly
“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,”
From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [172]
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.
“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].”
From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [172]
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- Authors
- Hirve, S., Lele, P., Sundaram, N., Chavan, U., Weiss, M., Steinmann, P., & Juvekar, S.
- Affiliations
- KEM Hospital Research Center, Pune, India
- Swiss Tropical and Public Health Institute (CH)
- Corresponding author
- Hirve, Siddhivinayak
- Venue
- Journal of Water Sanitation and Hygiene for Development
- Publisher
- IWA Publishing
- Published
- 2014-11-18
- Volume
- 5
- Issue
- 1
- Pages
- 115-126
- ISSN
- 2043-9083 (ISSN-L)
- 2408-9362
- OpenAlex
- W2133566364
- Cited by
- 99
- References
- 15
- Citations by year
- 2026: 4 · 2025: 12 · 2024: 4 · 2023: 10 · 2022: 11 · 2021: 10 · 2020: 9 · 2019: 11 · 2018: 5 · 2017: 14 · 2016: 6 · 2015: 2 · 2014: 1
- FWCI
- 7.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Water Sanitation and Hygiene for Development (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Social Sciences › Gender Studies › Gender Studies and Social Issues
- Physical Sciences › Environmental Science › Pollution › Energy and Environment Impacts
- Keywords
- psychosocial stress, open defecation, sanitation practices, women's health, adolescent girls, seasonal migrant workers, personal safety, sanitation programs, rural India, Pune
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