Laddering up? A research framework in sanitation for people with disabilities in low-income settings
With a motivation to make progress towards the United Nations Sustainable Development Goal of sanitation for all by 2030, this paper proposes a framework to guide future research and evaluation of sanitation-for-all initiatives. The proposed framework builds upon the social model of disability, emphasizes a human rights perspective regarding sanitation access and use, leverages existing research and case examples, and is based on the need to extend the Joint Monitoring Programme (JMP) sanitation ladder to include ‘equitable sanitation’. The framework includes three mediating factors that influence sanitation access (personal/individual, social, and environmental factors) and one moderating factor (institutional structures), and provides a planning structure for achieving equitable sanitation. The sanitation-for-all framework contributes to previous efforts to broaden and deepen the impacts of the JMP, particularly from a human rights perspective, and holds potential regarding other marginalized populations, such as adolescent girls and older adults.
Taking Stock: Incompetent at incontinence – why are we ignoring the needs of incontinence sufferers?
How would you cope if you had no control over how you urinated or defecated and regularly or constantly leaked urine or faeces? How would this make you feel? How would you deal with the smell, with the indignity? What if you were a young teenager, traumatized by very stressful events and returned to bed-wetting as a result? And what would you do if you didn’t have the money to buy spare underwear or incontinence protection products or those are simply not available to you? Could you manage if you were suddenly displaced in an emergency and did not have access to a toilet, shower or bathing facilities, or your usual materials and coping mechanisms? What if you lived in a camp and your toilet or bathing shelter was a 5 minute walk away and had a long line in front of it? Would you be able to stand in line at food distribution or water collection points, go to school, or look for or undertake work?
The Bishesta campaign: a menstrual hygiene management intervention for people with intellectual impairments and their carers
This paper describes the components of the Bishesta campaign: a behaviour change intervention for menstrual hygiene management (MHM), targeting young people with intellectual impairments, and their carers in Nepal. The campaign uses two fictitious characters: Bishesta (a young person with an intellectual impairment) and Perana (her carer), and consists of three group training modules. ‘Period packs’, designed to make MHM behaviours attractive and easy to adopt, are given to the young people. Packs include storage bags, a bin, and stories about Bishesta menstruating and learning to manage as independently as possible, with Perana’s support. Carers receive a calendar to track the young person’s menstrual cycle. A Bishesta doll, with removable clothes, underwear, and a miniature ‘period pack’ is used in training to demonstrate MHM. Evaluation findings show the intervention is feasible at small scale, so further research on how to scale up the intervention in an evidence-based way is required.