Access to water and sanitation among people with disabilities: results from cross-sectional surveys in Bangladesh, Cameroon, India and Malawi
Objectives To assess access to adequate water, sanitation and hygiene (WASH) among people with disabilities at the household and individual level.Design Cross-sectional surveys.Setting Data were included from five district-level or regional-level surveys: two in Bangladesh (Bangladesh-1, Bangladesh-...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2018-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/8/6/e020077.full |
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| author | Islay Mactaggart Hannah Kuper Sarah Polack Mahfuzar Rahman Wolf-Peter Schmidt Kristof Bostoen Joseph Chunga Lisa Danquah Amal Krishna Halder Saira Parveen Jolly Marielle Snel Adam Biran |
| author_facet | Islay Mactaggart Hannah Kuper Sarah Polack Mahfuzar Rahman Wolf-Peter Schmidt Kristof Bostoen Joseph Chunga Lisa Danquah Amal Krishna Halder Saira Parveen Jolly Marielle Snel Adam Biran |
| author_sort | Islay Mactaggart |
| collection | DOAJ |
| description | Objectives To assess access to adequate water, sanitation and hygiene (WASH) among people with disabilities at the household and individual level.Design Cross-sectional surveys.Setting Data were included from five district-level or regional-level surveys: two in Bangladesh (Bangladesh-1, Bangladesh-2), and one each in Cameroon, Malawi and India.Participants 99 252 participants were sampled across the datasets (range: 3567–75 767), including 2494 with disabilities (93–1374).Outcome Prevalence of access to WASH at household and individual level.Data analysis Age/sex disaggregated disability prevalence estimates were calculated accounting for survey design. The Unicef/WHO Joint Monitoring Programme definitions were used to classify facilities as improved/unimproved. Multivariable logistic regression was undertaken to compare between households with/without a person with a disability, and to identify predictors of access among people with disabilities.Results There were no differences in access to improved sanitation or water sources between households with/without members with disabilities across the datasets. In Bangladesh-2, households including a person with a disability were more likely to share facilities with other households (OR 1.3, 95% CI 1.1 to 1.5). Households with people with disabilities were more likely to spend >30 min (round-trip) collecting drinking water than households without in both Cameroon (OR 1.8, 95% CI 1.0 to 3.4) and India (OR 2.3, 95% CI 1.2 to 4.7). Within households, people with disabilities reported difficulties collecting water themselves (23%–80% unable to) and accessing the same sanitation facilities as other household members, particularly without coming into contact with faeces (up to 47% in Bangladesh-2). These difficulties were most marked for people with more severe impairments.Conclusions People with disabilities may not have poorer access to WASH at the household level, but may have poorer quality of access within their households. Further programmatic work is needed to ensure WASH facilities are inclusive of people with disabilities. |
| format | Article |
| id | doaj-art-1161c82d35a84cb589f7d5e88e138424 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2018-06-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-1161c82d35a84cb589f7d5e88e1384242025-02-07T01:30:14ZengBMJ Publishing GroupBMJ Open2044-60552018-06-018610.1136/bmjopen-2017-020077Access to water and sanitation among people with disabilities: results from cross-sectional surveys in Bangladesh, Cameroon, India and MalawiIslay Mactaggart0Hannah Kuper1Sarah Polack2Mahfuzar Rahman3Wolf-Peter Schmidt4Kristof Bostoen5Joseph Chunga6Lisa Danquah7Amal Krishna Halder8Saira Parveen Jolly9Marielle Snel10Adam Biran11Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK2 International Center for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UKInternational Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK7 Resarch and Evaluation Division, Bangladesh Rural Advancement Committee, Dhaka, Bangladesh2 Environmental Health Group, London School of Hygiene & Tropical Medicine, London, UK3 Monitoring[4] ch∆nge and IRC-Associate, The Hague, The Netherlands4 Centre for Social Research, University of Malawi, Zomba, Malawi5 Centre for Tropical Medicine and Global Health, Oxford University, Oxford, UK6 International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh7 Resarch and Evaluation Division, Bangladesh Rural Advancement Committee, Dhaka, Bangladesh8 World Vision International, Geneva, Switzerland2 Environmental Health Group, London School of Hygiene & Tropical Medicine, London, UKObjectives To assess access to adequate water, sanitation and hygiene (WASH) among people with disabilities at the household and individual level.Design Cross-sectional surveys.Setting Data were included from five district-level or regional-level surveys: two in Bangladesh (Bangladesh-1, Bangladesh-2), and one each in Cameroon, Malawi and India.Participants 99 252 participants were sampled across the datasets (range: 3567–75 767), including 2494 with disabilities (93–1374).Outcome Prevalence of access to WASH at household and individual level.Data analysis Age/sex disaggregated disability prevalence estimates were calculated accounting for survey design. The Unicef/WHO Joint Monitoring Programme definitions were used to classify facilities as improved/unimproved. Multivariable logistic regression was undertaken to compare between households with/without a person with a disability, and to identify predictors of access among people with disabilities.Results There were no differences in access to improved sanitation or water sources between households with/without members with disabilities across the datasets. In Bangladesh-2, households including a person with a disability were more likely to share facilities with other households (OR 1.3, 95% CI 1.1 to 1.5). Households with people with disabilities were more likely to spend >30 min (round-trip) collecting drinking water than households without in both Cameroon (OR 1.8, 95% CI 1.0 to 3.4) and India (OR 2.3, 95% CI 1.2 to 4.7). Within households, people with disabilities reported difficulties collecting water themselves (23%–80% unable to) and accessing the same sanitation facilities as other household members, particularly without coming into contact with faeces (up to 47% in Bangladesh-2). These difficulties were most marked for people with more severe impairments.Conclusions People with disabilities may not have poorer access to WASH at the household level, but may have poorer quality of access within their households. Further programmatic work is needed to ensure WASH facilities are inclusive of people with disabilities.https://bmjopen.bmj.com/content/8/6/e020077.full |
| spellingShingle | Islay Mactaggart Hannah Kuper Sarah Polack Mahfuzar Rahman Wolf-Peter Schmidt Kristof Bostoen Joseph Chunga Lisa Danquah Amal Krishna Halder Saira Parveen Jolly Marielle Snel Adam Biran Access to water and sanitation among people with disabilities: results from cross-sectional surveys in Bangladesh, Cameroon, India and Malawi BMJ Open |
| title | Access to water and sanitation among people with disabilities: results from cross-sectional surveys in Bangladesh, Cameroon, India and Malawi |
| title_full | Access to water and sanitation among people with disabilities: results from cross-sectional surveys in Bangladesh, Cameroon, India and Malawi |
| title_fullStr | Access to water and sanitation among people with disabilities: results from cross-sectional surveys in Bangladesh, Cameroon, India and Malawi |
| title_full_unstemmed | Access to water and sanitation among people with disabilities: results from cross-sectional surveys in Bangladesh, Cameroon, India and Malawi |
| title_short | Access to water and sanitation among people with disabilities: results from cross-sectional surveys in Bangladesh, Cameroon, India and Malawi |
| title_sort | access to water and sanitation among people with disabilities results from cross sectional surveys in bangladesh cameroon india and malawi |
| url | https://bmjopen.bmj.com/content/8/6/e020077.full |
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