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Int. J. Environ. Res. Public Health 2017, 14(7), 755; doi:10.3390/ijerph14070755

Assessing Women’s Negative Sanitation Experiences and Concerns: The Development of a Novel Sanitation Insecurity Measure

1
Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
2
Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
3
Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
4
Department of Sociology, Emory University, Atlanta, GA 30322, USA
5
Department of Anthropology, Emory University, Atlanta, GA 30322, USA
*
Author to whom correspondence should be addressed.
Received: 30 May 2017 / Revised: 3 July 2017 / Accepted: 5 July 2017 / Published: 11 July 2017
(This article belongs to the Section Global Health)
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Abstract

Lack of access to acceptable sanitation facilities can expose individuals, particularly women, to physical, social, and mental health risks. While some of the challenges have been documented, standard metrics are needed to determine the extent to which women have urination- and defecation-related concerns and negative experiences. Such metrics also are needed to assess the effectiveness of interventions to mitigate them. We developed a sanitation insecurity measure to capture the range and frequency of women’s sanitation-related concerns and negative experiences. Research was conducted in rural Odisha, India with women across various life course stages to reflect a range of perspectives. This paper documents the mixed data collection methods and the exploratory and confirmatory factor analyses we employed to arrive at a final measure. The final sanitation insecurity measure includes 50 items across seven factors that reflect the physical environment, the social environment, and individual-level constraints. Most factor scores were significantly higher for unmarried women and for women who lacked access to functional latrines, indicating social and environmental influence on experiences. This measure will enable researchers to evaluate how sanitation insecurity affects health and to determine if and how sanitation interventions ameliorate women’s concerns and negative experiences associated with sanitation. View Full-Text
Keywords: sanitation; water; gender; defecation; urination; security; factor analysis; differential item functioning sanitation; water; gender; defecation; urination; security; factor analysis; differential item functioning
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Caruso, B.A.; Clasen, T.; Yount, K.M.; Cooper, H.L.F.; Hadley, C.; Haardörfer, R. Assessing Women’s Negative Sanitation Experiences and Concerns: The Development of a Novel Sanitation Insecurity Measure. Int. J. Environ. Res. Public Health 2017, 14, 755.

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