TY - JOUR
T1 - Sanitation-related psychosocial stress
T2 - A grounded theory study of women across the life-course in Odisha, India
AU - Sahoo, Krushna Chandra
AU - Hulland, Kristyna R S
AU - Caruso, Bethany A.
AU - Swain, Rojalin
AU - Freeman, Matthew C.
AU - Panigrahi, Pinaki
AU - Dreibelbis, Robert
N1 - Funding Information:
All participants provided written consent or assent prior to data collection. For children under the age of 18, both written assent from the participant and written consent from the participant's parent were obtained. Participants were informed of their rights to terminate the interview at any time and to skip questions or topics they were uncomfortable discussing. Names and other identifiers collected during the interview were redacted during the transcription process and the original audio files destroyed. Ethical approval for this study was provided by the Ethical Review Committee at AIPH (ERC Protocol No. 2013-03) and the Institutional Review Board at Emory University (Protocol 00069418).
Funding Information:
This work was made possible with UK aid from the Department for International Development (DfID), as part of the SHARE research programme, and support from the Water Supply and Sanitation Council (WSSCC). However the views expressed do not necessarily reflect DfID's official policies or the policies of WSSCC. The funding agencies had no involvement in study design, data collection, data analysis, and data interpretation.
Publisher Copyright:
© 2015 The Authors.
PY - 2015/8/1
Y1 - 2015/8/1
N2 - While sanitation interventions have focused primarily on child health, women's unique health risks from inadequate sanitation are gaining recognition as a priority issue. This study examines the range of sanitation-related psychosocial stressors during routine sanitation practices in Odisha, India. Between August 2013 and March 2014, we conducted in-depth interviews with 56 women in four life stages: adolescent, newly married, pregnant and established adult women in three settings: urban slums, rural villages and indigenous villages. Using a grounded theory approach, the study team transcribed, translated, coded and discussed interviews using detailed analytic memos to identify and characterize stressors at each life stage and study site. We found that sanitation practices encompassed more than defecation and urination and included carrying water, washing, bathing, menstrual management, and changing clothes. During the course of these activities, women encountered three broad types of stressors-environmental, social, and sexual-the intensity of which were modified by the woman's life stage, living environment, and access to sanitation facilities. Environmental barriers, social factors and fears of sexual violence all contributed to sanitation-related psychosocial stress. Though women responded with small changes to sanitation practices, they were unable to significantly modify their circumstances, notably by achieving adequate privacy for sanitation-related behaviors. A better understanding of the range of causes of stress and adaptive behaviors is needed to inform context-specific, gender-sensitive sanitation interventions.
AB - While sanitation interventions have focused primarily on child health, women's unique health risks from inadequate sanitation are gaining recognition as a priority issue. This study examines the range of sanitation-related psychosocial stressors during routine sanitation practices in Odisha, India. Between August 2013 and March 2014, we conducted in-depth interviews with 56 women in four life stages: adolescent, newly married, pregnant and established adult women in three settings: urban slums, rural villages and indigenous villages. Using a grounded theory approach, the study team transcribed, translated, coded and discussed interviews using detailed analytic memos to identify and characterize stressors at each life stage and study site. We found that sanitation practices encompassed more than defecation and urination and included carrying water, washing, bathing, menstrual management, and changing clothes. During the course of these activities, women encountered three broad types of stressors-environmental, social, and sexual-the intensity of which were modified by the woman's life stage, living environment, and access to sanitation facilities. Environmental barriers, social factors and fears of sexual violence all contributed to sanitation-related psychosocial stress. Though women responded with small changes to sanitation practices, they were unable to significantly modify their circumstances, notably by achieving adequate privacy for sanitation-related behaviors. A better understanding of the range of causes of stress and adaptive behaviors is needed to inform context-specific, gender-sensitive sanitation interventions.
KW - Gender
KW - India
KW - Open defecation
KW - Psychosocial stress
KW - Sanitation
KW - Sexual violence
KW - Women
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U2 - 10.1016/j.socscimed.2015.06.031
DO - 10.1016/j.socscimed.2015.06.031
M3 - Article
C2 - 26164119
AN - SCOPUS:84936859714
VL - 139
SP - 80
EP - 89
JO - Ethics in Science and Medicine
JF - Ethics in Science and Medicine
SN - 0277-9536
ER -