Are Nepal’s water, sanitation and hygiene and menstrual hygiene policies and supporting documents inclusive of disability? A policy analysis

Abstract Purpose This study assesses the inclusion of disability in Nepal’s policy and guidance relevant to water, sanitation and hygiene (WASH), and menstrual hygiene management (MHM) in comparison to gender. We investigated both policy formulation and implementation, using the Kavrepalanchok district as a case study. Materials and methods We used the EquiFrame framework, adapted for disability and gender, and focusing on WASH and MHM. Ten Nepali policies and guidance documents were reviewed and scored for quality against the framework, which included 21 core concepts of human rights. We also interviewed key informants to consider the inclusion of disability in the implementation of MHM interventions. We applied stratified purpose sampling to 12 government officials and service providers working in Kathmandu and the Kavrepalanchock district; conducted in-depth interviews and analysed data thematically using Nvivo 11. Results Disability was inadequately covered within the policy documents, and MHM policy commitments for disability were almost non-existent. Participation of people with disabilities in policy development was limited; within Kavrepalanchok, policy commitments were not implemented as intended and disability service providers were unable to allocate government resources. Inadequate data on disability and MHM resulted in limited professional understanding of the issues, as service providers had no training. A narrow WASH infrastructure approach to improving MHM for people with disabilities was prioritised. MHM interventions were delivered in schools; these failed to reach children with disabilities who are often out of school. Finally, there were indications that some caregivers seek sterilisation for people with disabilities who are unable to manage menstruation independently. Conclusion Though the Constitution of Nepal enshrines gender equality and disability inclusion, there are consistent gaps in attention to disability and MHM in policies and practice. These omit and exclude people with disabilities from MHM interventions. Investment is required to generate evidence on the MHM barriers faced by people with disabilities, which would then be drawn on to develop training on these issues for professionals to improve understanding. Subsequently, policy makers could include more concepts of human rights against disability in relevant policies and service providers could implement policy commitments as intended.

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The Inclusion of Rights of People with Disabilities and Women and Girls in Water, Sanitation, and Hygiene Policy Documents and Programs of Bangladesh and Cambodia: Content Analysis Using EquiFrame

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105087 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5087

Author(s):

Nathaniel Scherer ◽

Islay Mactaggart ◽

Chelsea Huggett ◽

Pharozin Pheng ◽

Mahfuj-ur Rahman ◽

...

Keyword(s):

Content Analysis ◽

People With Disabilities ◽

Analysis Tool ◽

Middle Income ◽

Policy Documents ◽

Sanitation And Hygiene ◽

Gender Inclusion ◽

Core Concepts ◽

Women And Girls ◽

And Gender

People with disabilities and as women and girls face barriers to accessing water, sanitation, and hygiene (WASH) services and facilities that fully meet their needs, especially in low- and middle-income countries. Women and girls with disabilities experience double discrimination. WASH policies should support and uphold the concepts of disability and gender inclusion, and they should also act as a guide to inform WASH programs and service delivery. Using a modified version of the EquiFrame content analysis tool, this study investigated the inclusion of 21 core concepts of human rights of people with disabilities and women and girls in 16 WASH policy documents and seven end-line program reports from Bangladesh and Cambodia. Included documents typically focused on issues of accessibility and neglected wider issues, including empowerment and support for caregivers. The rights of children and women with disabilities were scarcely focused on specifically, despite their individual needs, and there was a disconnect in the translation of certain rights from policy to practice. Qualitative research is needed with stakeholders in Bangladesh and Cambodia to investigate the inclusion and omission of core rights of people with disabilities, and women and girls, as well as the factors contributing to the translation of rights from policy to practice.

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Relationship among Human Rights Awareness, Social Support and Social Integration in Disability Service Providers

The Journal of the Korea Contents Association ◽

10.5392/jkca.2016.16.01.620 ◽

2016 ◽

Vol 16 (1) ◽

pp. 620-631

Author(s):

Jin-Youn Kim ◽

Young-Chun Kim

Keyword(s):

Social Support ◽

Human Rights ◽

Social Integration ◽

Service Providers ◽

Disability Service ◽

Disability Service Providers

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Human Rights and Neoliberalism in Australian Welfare to Work Policy: Experiences and Perceptions of People with Disabilities and Disability Stakeholders

Disability Studies Quarterly ◽

10.18061/dsq.v34i4.3992 ◽

2014 ◽

Vol 34 (4) ◽

Cited By ~ 1

Author(s):

Sarah Parker Harris ◽

Randall Owen ◽

Karen R Fisher ◽

Robert Gould

Keyword(s):

Human Rights ◽

Service Providers ◽

National Level ◽

People With Disabilities ◽

Welfare To Work ◽

Disability Rights ◽

Font Size ◽

Persons With Disabilities ◽

Accessible Information ◽

The Government

Recent policy approaches in Australia, influenced by neoliberalism, have constrained the implementation of international disability rights at the national level. Within the neoliberal and human rights approaches to social policy, what is the lived experience of people with disabilities? In focus groups with people with disabilities and interviews with disability stakeholders in Australia, participants were asked about their experiences and perspectives of welfare to work programs. We analyzed the data by drawing on the United Nations Convention on the Rights of Persons with Disabilities as a framework. The analysis revealed tensions between the rights and responsibilities of citizens and the government, and a disconnection between policy discourse and policy practice. The results suggest that disability rights are jeopardized unless governments take responsibility to create the policy environment for rights-based policy to be implemented; including the equalization of opportunities, providing accessible information and communication about employment, and addressing the administration and process practices that employment service providers follow.

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The Human Rights to Water and Sanitation in Policy Responses to the COVID-19 Pandemic: An Analysis of Brazilian States

Water ◽

10.3390/w13020228 ◽

2021 ◽

Vol 13 (2) ◽

pp. 228

Author(s):

Davi Madureira Victral ◽

Léo Heller

Keyword(s):

Human Rights ◽

Exploratory Study ◽

Service Providers ◽

Public Institutions ◽

Financial Sustainability ◽

Economic Sustainability ◽

Economic Sectors ◽

Water And Sanitation ◽

Policy Responses ◽

Sanitation And Hygiene

The outbreak of the new coronavirus disease (COVID-19) led to an unprecedented number of policy responses from public institutions involved in the health and economic sectors. Nonetheless, the water, sanitation, and hygiene (WASH) sector remained in the background of this decision-making arena. The objective of the study presented herein was to observe and discuss political responses to the new coronavirus pandemic in the context of WASH during the first 40 days of the outbreak, using as cases the five Brazilian states most affected by the pandemic. We addressed this issue with a quali-quantitative exploratory study using content analysis to discuss the direction (for whom and how?) of those policy responses, through the framework of the human rights to water and sanitation. The paper also introduces a timeline to map the reactivity and proactivity of the studied institutions. We identified two major priorities in policy responses to the coronavirus pandemic: population protection and financial and economic sustainability of service providers. In regard to population protection, the findings show that it often did not contemplate all of the population, and that equality and non-discriminations were partially ignored in the laws and regulations. In addition, institutions more attached to service providers were more committed to the provider’s economic and financial sustainability than to measures to directly protect the population.

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Qualitative study exploring the barriers to menstrual hygiene management faced by adolescents and young people with a disability, and their carers in the Kavrepalanchok district, Nepal

10.21203/rs.3.rs-25447/v2 ◽

2020 ◽

Author(s):

Jane Wilbur ◽

Shubha Kayastha ◽

Thérèse Mahon ◽

Belen Torondel ◽

Shaffa Hameed ◽

...

Keyword(s):

People With Disabilities ◽

User Preference ◽

Menstrual Hygiene ◽

Left Behind ◽

Menstrual Hygiene Management ◽

Hygiene Management ◽

Purposeful Sampling ◽

Educational Issue ◽

Sanitation And Hygiene ◽

Support Mechanisms

Abstract Background: Menstrual hygiene management (MHM) is a recognised public health, social and educational issue, which must be achieved to allow the realisation of human rights. People with disabilities are likely to experience layers of discrimination when they are menstruating, but little evidence exists.Methods: The study aims to investigate barriers to MHM that people with disabilities and their carers, face in the Kavrepalanchok, Nepal, using qualitative methods. Twenty people with disabilities, aged 15-24, who menstruate and experience ‘a lot of difficulty’ or more across one or more of the Washington Group functional domains were included, as well as 13 carers who provide menstrual support to these individuals. Purposeful sampling was applied to select participants. Different approaches were used to investigating barriers to MHM and triangulate data: in-depth interviews, PhotoVoice and ranking, market survey, product attribute assessment and user preference with ranking, observation of the water, sanitation and hygiene (WASH) facilities used. We analysed data thematically, using Nvivo 11.Results: Barriers to MHM experienced by people with disabilities differ according to the impairment. Inaccessible WASH facilities were a major challenge for people with mobility, self-care and visual impairments. People with intellectual impairments had difficulty accessing MHM information and their carers despaired when they showed their menstrual blood to others, which could result in abuse. No support mechanisms existed for carers for MHM, who overwhelmed and isolated. Menstrual discomfort was a major challenge; these were managed with home remedies, or not at all. Most participants followed menstrual restrictions, which were widespread and expected, for fear of being cursed if they did not. As disability is often viewed as a curse, this demonstrates the layers of discrimination faced.Conclusion: Issues related to MHM for people with disabilities is more complex than for others in the population due to the additional disability discrimination and impairment experienced. Research exploring these issues must be conducted in different settings, and MHM interventions, tailored for impairment type and carers requirements, must be developed. Attention to, and resourcing for disability inclusive MHM must be prioritised to ensure ‘no one is left behind’.

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Making the Case for a Female-Friendly Toilet

Water ◽

10.3390/w10091193 ◽

2018 ◽

Vol 10 (9) ◽

pp. 1193 ◽

Cited By ~ 9

Author(s):

Margaret Schmitt ◽

David Clatworthy ◽

Tom Ogello ◽

Marni Sommer

Keyword(s):

Personal Safety ◽

Gender Based Violence ◽

Specific Design ◽

Policy Makers ◽

Menstrual Hygiene ◽

Sanitation And Hygiene ◽

The World ◽

Gender Based ◽

And Gender ◽

Critical Challenge

Inadequate access to a private, comfortable, and well-located toilet remains a critical challenge for many girls and women around the world. This issue is especially acute for girls and women living in densely populated urban slums, displacement camps, and informal settlements, often resulting in anxiety, embarrassment, discomfort, and gender-based violence. The unique sanitation needs of girls and women are rarely accounted for during the design and construction of toilet facilities, including needs related to their physiology, reproductive health processes, prevalent social norms, and their heightened vulnerability to violence. It is critical that a new norm be developed regarding the design of female-friendly toilets which better enables girls and women to feel confident, safe, and dignified while managing their daily sanitation needs. This includes adopting specific design measures which account for their menstrual hygiene, personal safety, and dignity-related needs. Ultimately, an enhanced dialogue must take place among designers, policy makers, water, sanitation, and hygiene (WASH) practitioners, and other relevant actors, in addition to the target female users themselves, about how to adapt toilets in a range of development and emergency contexts and operations to better address these critical needs of girls and women.

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Are the rights of people with disabilities included in international guidance on WASH during the COVID-19 pandemic? Content analysis using EquiFrame

BMJ Open ◽

10.1136/bmjopen-2020-046112 ◽

2021 ◽

Vol 11 (7) ◽

pp. e046112

Author(s):

Nathaniel Scherer ◽

Islay Mactaggart ◽

Chelsea Huggett ◽

Pharozin Pheng ◽

Mahfuj-ur Rahman ◽

...

Keyword(s):

Content Analysis ◽

People With Disabilities ◽

Analysis Tool ◽

Guidance Document ◽

Caregiver Support ◽

Sanitation And Hygiene ◽

Increased Risk ◽

Inclusive Approach ◽

Core Concepts ◽

Guidance Documents

PurposePeople with disabilities are at increased risk from COVID-19. Access to water, sanitation and hygiene (WASH) services and facilities is a fundamental right for all, and is vital in stopping the transmission of COVID-19. However, people with disabilities often face difficulties accessing WASH. Various international organisations have published guidance and recommendations on WASH service provision during the COVID-19 pandemic, and this must include information of relevance to people with disabilities. This study aimed to investigate the inclusion of core concepts of rights for people with disabilities in guidance on WASH during the COVID-19 pandemic.MethodWe used the EquiFrame content analysis tool to analyse the inclusion of 21 core concepts of rights for people with disabilities in international guidance documents on WASH during the pandemic. 29 documents were included from multilateral entities, international consortiums and non-governmental organisations. Key information from the included guidance documents was extracted for each of the 21 core concepts.ResultsOne-third of the WASH guidance did not include any reference to the rights of people with disabilities, and the majority of information was provided by just one guidance document. Most commonly referenced across all was access to WASH, including details on accessible infrastructure (eg, handwashing stations) and communication strategies. Information on many important rights and considerations, such as the affordability of services and caregiver support, was rarely included.ConclusionAlthough some information is provided in international WASH guidance, this often has a narrow focus on access, rather than the full array of rights and considerations that are important for people with disabilities. International guidance should continue to be reviewed and updated to include further information of relevance to people with disabilities, informing a disability-inclusive approach to WASH during the remainder of the COVID-19 pandemic and future crises.

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