Prevailing social, economic and cultural constraints curtail women’s decision making on sanitation

Photo: Simon Williams, Ekta Parishad

Excerpts from the study, “Odisha Women’s role in sanitation decision making in rural coastal Odisha, India”*, by Parimita Routray, Belen Torondel, Thomas Clasen and Wolf-Peter Schmidt, scholars with the Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London:

Women and girls are the most affected by lack of access to sanitation facilities and safe water, as they have greater need for privacy during defecation and bathing compared to men. Absence of sanitation makes females vulnerable and exposes them to the risk of faecal-orally transmitted diseases, uro-genital tract infections, urinary incontinence and chronic constipation.

Females avoid being seen while defecating in the day light and wait till dark to use the open space for defecation, which may force them to eat less, resulting in malnutrition. Inadequate sanitation access leads to psychosocial stress, harassment and sexual violence, and increased work from water fetching, care-giving burdens and carrying out post defecation needs of old and ailing family members. Provision of adequate water, sanitation and hygiene facilities is thought to mitigate these adverse impacts, making their lives safer, easier and healthier.

The Indian government tried addressing the gender inequality in its country wide sanitation programmes—Total Sanitation Campaign (TSC), Nirmal Bharat Abhiyan (Clean India Campaign —NBA) and Swachh Bharat Abhiyan (Clean India Mission—SBA) by reserving 33% membership for women in institutions and bodies related to water and sanitation. However, in actual practice, women’s participation is seldom actively encouraged by the promoters at the field level. Studies have shown that attempts to include women as members in water and sanitation committees, does not guarantee their participation.

Similarly, women attending the community meetings for sanitation promotion and awareness, has not resulted in their participation in community level decision making. Societal and cultural barriers for females, their age, and position within the household are some of the factors, that determine their participation in the sanitation decision making.

Decision making regarding household matters in Odisha
Decision making regarding household matters in Odisha

Studies from India show male heads deciding for latrine acquisition, whereas, women were responsible for latrine’s maintenance, keeping the system functioning, fetching water for latrine flushing. There are examples of latrines being acquired by male heads only to secure the privacy and the perceived dignity of the newlywed daughters-in-law, but male heads themselves lacked motivation to use the facility. Further, men have been found to be less inconvenienced by the absence of a latrine, and tend to have a lower interest and willingness to install and use sanitary facilities. Thus, low priority among men for sanitation, may result in lower latrine adoption.

Results of the study

A total of 475 households were sampled out of which 217 had no latrine, 211 had a functional and 47 with a non-functional latrine. The mean number of households was 39.5 per village. Average age of the respondents was 51 years (range = 23 to 86). A total of 2740 individuals lived in the participating households, and the average number of persons per house was 5.8 (range 2 to 16 persons).All the surveyed households practised Hinduism, but belonging to different castes—61% were general caste, 25% were Other Backward Class (OBC) and 14% were Scheduled Castes (SC—lower caste). Seven percent of households were joint families. The majority of households had male heads. Only in 16% of households, women led after their husband’s death. Very few male heads had higher education in colleges or universities. Percentages of female heads attending senior secondary classes were low compared to male heads (40%).

A high percentage (38%) of female heads was illiterate and never went to school. Agriculture was the primary occupation of more than half of male heads. The majority of respondents (85%) were housewives, the rest worked either as agricultural labourers, construction and masonry helpers, had government or a private job, or ran some business. Compared to households without latrines, households with functional latrines had better educated male and female heads, a larger family size, and higher income.

Households belonging to SC tended to have fewer functional latrines than general and OBC families. Family income mostly comprised of the male head’s earnings but in 65% of households other family members such as grown up sons contributed to the income. Households with a functional latrine were more often in higher income categories than households with a nonfunctional latrine or no latrine, but the difference was only significant in the second group. lds with latrines more often owned agricultural land (85%) and a tubewell (83%) and were less often employed as share-croppers or labourer.

In contrast, households with non-functional or no latrines had more male heads with an occupation of lower perceived status (working as share cropper, mason or labour) and lower income. Latrine functionality status was associated with the education of the male and female heads. In 56% households that had no latrine and 50% households with a non-functional latrine, major additions to the house were made in the previous two years, suggesting financial capacity for other construction works.

The female head along with other females in the family were able to take decisions about their own health care in only 4.4% households. This proportion compares with 11.6% for decisions about visiting family and friends, 3.7% about upgrading the house (or make additions to their existing houses), 10% about tube-well installation, 5.4% about making large household purchases, 20.5% about purchase of farm animals or livestock, and 22.5% about making purchases for daily needs.

Decisionmaking related to sanitation at the household in Odisha
Decision making regarding sanitation among Odisha households

Females mostly decided what to cook for daily meals, and there was not much involvement of men. The data also shows that women’s non-involvement in the decision making of other important household activities had no strong association with latrine possession or latrine functionality. Even in the 16% households with female heads, males decided for latrine installation in 68% households and the site selection was again done by males in 66% households.

Females’ involvement in decisions regarding sanitation has been minimal. In 9% of households with male heads, females alone had the final say to build the latrine and in 10% households, women participated in the decision for latrine acquisition and installation. For the latrine site selection, in 11% households females exclusively decided, and in 9% households it was a joint decision. In other activities related to latrine installation, such as the purchase of raw materials, arranging masons and investing in latrine construction, female involvement was minimal.

The socio-economic conditions like caste, and education of male and female heads are not associated with female members inclusion in decision making directly. However, in families that had income less than 5000 Indian rupees per month, the female member’s participation in latrine installation decision making was found to be high (30%).

Prevailing socio-cultural practices, socio-economic constraints, and power hierarchies among household members curtail women’s autonomy regarding their preferences, choices and decision making power with respect to installation of sanitation facility. Women had less education, less exposure to the world beyond their home and village, and little control over resources and finances. This made them less confident, to make sanitation related decisions. Even if females were motivated to install a latrine, they relied on their spouse to take the decision and make arrangements for the construction.

*Click HERE to download full report

Photo, graphics courtesy


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