Given the lack of consensus around how to measure empowerment in WASH, mapping existing indicators to two frameworks frequently used in the empowerment literature illustrates knowledge gaps. We identified 290 gender-sensitive indicators across nine WASH themes that were mapped to the Reach-Benefit-Empower and Resources-Agency-Achievements frameworks. Most indicators measure “Benefit” and/or “Resources.” Existing gender-sensitive indicators capturing empowerment and agency in WASH are lacking; only 10.3% of indicators capture “Empower” and 24.8% of indicators capture “Agency.”

There is a growing focus on gender-sensitive approaches and women’s empowerment in the water, sanitation, and hygiene sectors. At the same time, there is a lack of metrics to measure women’s empowerment in the WASH sector. Such metrics are important for understanding the types of programmatic interventions that are most needed for addressing women’s empowerment, as well as for assessing their impacts on women’s empowerment. In this report, we describe the development of a Women’s Empowerment metrics for Water, Sanitation, and Hygiene (WE-WASH). We collected data from individual women and men in 812 households in Malawi and 826 households in Nepal. Using the data, we develop 14 indicators and establish cutoff thresholds (i.e., whether the individual is empowered) in the areas of intrinsic, instrumental, and collective agency in WASH; instrumental and intrinsic agency in menstrual hygiene management; and the empowerment environment (or resources for empowerment). In each country, we observe differences in empowerment levels between women and men, that favor men on most outcomes. Notably, in both countries, we find that women are much less likely than men to contribute to WASH infrastructure decisions, and most women are spending an undue amount of time contributing to WASH-related labor. In Nepal especially, agency related to menstrual hygiene management is also a substantial area of disempowerment for women.

At birth and death, and each day in between, individual human need for water, sanitation and hygiene (WASH) is near constant. While WASH is intensely personal, it is also about power, inequality, development and social justice. Inadequate WASH provision both results from and causes continuing poverty, and serves to reinforce gender and other inequalities. Women and girls experience WASH needs differently from men, both as individuals, and as societies' carers. Gender and Water, Sanitation and Hygiene highlights the importance of WASH provision for women and girls in their own right, as carers for families and communities, and as key to women's empowerment.

Sustainable Development Goal 6 aims to ensure access to water and sanitation for all, and target 6.2 emphasizes “paying special attention to the needs of women and girls”. Research documenting how water, sanitation and hygiene (WASH) conditions impact women's and girls' lives is growing. However, no rigorously validated survey instruments exist for measuring empowerment within the WASH sector. The objective of our study was to develop and validate survey instruments to measure sub-domains of women's empowerment in relation to sanitation in urban areas of low- and middle-income countries. We followed a multi-phased, theory-informed approach that included factor analysis and item response theory methods, as well as reliability and validity testing, to analyze cross-sectional data collected from women in two cities: Tiruchirappalli, India (N=996) and Kampala, Uganda (N=1,024). Through rigorous evaluation of conceptually grounded question (item) sets, we identify a set of valid, comprehensive scales. The Agency, Resources, and Institutional Structures for Sanitation-related Empowerment (ARISE) scales represent 16 sub-domains of sanitation-related empowerment, each of which can be used alone or in combination with others, as needed. The ARISE scales are the only set of psychometrically validated metrics for the measurement of women's empowerment in WASH. In addition to the scales, we provide six indices to assess women's direct experiences with sub-domains of sanitation-related empowerment, as well as validated item sets related to menstruation, which are available as optional add-on measures for those who menstruate. The ARISE scales and associated survey modules respond to an established need for an increased focus on empowerment in WASH. We provide researchers and implementers with tools to measure sub-constructs of empowerment in a valid and reliable way, to generate data for better targeting, design, implementation, and evaluation of strategies to improve women's empowerment in the context of urban sanitation at the program and policy level.

There is growing acceptance that the progress delivered under the Millennium Development Goal target for drinking water and sanitation has been inequitable. As a result, the progressive reduction of inequalities is now an explicit focus of the Sustainable Development Goal (SDG) targets, adopted in 2015, for universal access to drinking water, sanitation and hygiene (WASH). This shift in focus has implications for the way in which the next generation of WASH policies and programmes will be conceived, designed, financed and monitored. This book provides an authoritative textbook for students, as well as a point of reference for policy-makers and practitioners interested in reducing inequalities in access to WASH services. Four key areas are addressed: background to the human right to water and development goals; dimensions of inequality; case studies in delivering water and sanitation equitably; and monitoring progress in reducing inequality.

Can women bring a fresh perspective to the provision of global sanitation services? The co-authors of this book, through their strong socio-political and scientific experiences, believe this to be the case. The book offers a critical look at the challenges and solutions needed to achieve Sanitation for All, including for vulnerable people, refugees, asylum seekers, stateless, or internally displaced persons, and especially women. We present sanitation policy and decision making from the perspective of women, providing conclusions to the prevailing debates. In 2022, 43% of the world’s population lacked access to safely managed sanitation. Poor sanitation is linked to the transmission of diarrhoeal diseases, exacerbates stunting, and contributes to the spread of antimicrobial resistance. In low-income countries, 5% of deaths are associated with unsafe sanitation. Poor sanitation affects mental well-being and safety, especially for women and children. Lack of sanitation costs around 2% of GDP (a figure that increases rapidly with epidemic outbreaks) because of income losses from trade and tourism and the impact on water quality. Besides being part of our human right to water, sanitation is essential to reach the United Nations’ Sustainable Development Goals on poverty, health, education, gender, water, equity, cities and the sustainable environment. Nevertheless, convincing politicians to invest in sanitation is a daunting challenge since, in contrast to drinking water, it is not an immediate vote-winner and is perceived as an unpleasant topic for public discussion. Despite this, to achieve the SDG target by 2030, a five-fold increase on current rates of progress will be required. The role of women in sanitation planning and implementation is key, due to their leadership in communities and their ability to organise and guarantee the sustainability of systems. Furthermore, women’s care-giving nature at home and in their communities has led them to understand the importance of sanitation and being open to discussing it publicly; women stand ready to raise the profile of this subject, putting it on a higher level on the political agenda. This book is vital reading not just for women but all stakeholders and partners in the water industry, especially those working in the sanitation and hygiene sectors.