How water, sanitation and hygiene can help accelerate progress on gender equality

Women and girls are disproportionately affected by inadequate water, sanitation and hygiene (WASH) yet their needs and voices are all too often excluded from the planning, delivery and monitoring of these services. In this blog, Sue Cavill sets out our recommendations to countries, donors and decision makers for advancing gender equality through WASH systems.

Women and girls represent half of the world’s population. Yet, according to the Human Development Report 2021–2022 there is almost nowhere in the world where women and girls are equal to boys and men. Women and people in gender minorities face social stigma and discrimination, more restrictions on mobility and are at greater risk of violence. They are often paid less, leave education earlier, and have limited agency and decision-making authority about things that affect them. This includes access to WASH.

Why WASH is a gender equality issue

Across the world, women and girls – especially those from rural, indigenous or other excluded groups – experience significant limitations when it comes to WASH. Women and girls aged 15 or older are responsible for water collection in 70% of households without a water supply, according to the latest data from the WHO/UNICEF Joint Monitoring Programme. Women and girls are also primarily responsible for other unpaid care and domestic work associated with WASH: treating water; ensuring everyone in the household has soap and other materials for personal hygiene; cleaning their homes; and caring for children and other family members. This affects the amount of time they have for education, paid work or other interests and reinforces gender-assigned roles.

At the same time, one in three women and girls live without a decent toilet, but social expectations around modesty often mean that women feel they should not be seen urinating, defecating or washing in public. This means that many women often associate menstrual hygiene management with emotional and psycho-social stress, resulting in feelings of shame, fear, anxiety and distraction.

It is estimated that 335 million girls go to a school that doesn’t have water and soap for them to wash their hands or clothes after changing their sanitary pads. Such inadequate toilet facilities are a contributory factor to girls missing school, failing classes or dropping out altogether.

Women also bear the brunt of unhygienic healthcare settings. Globally, seven in ten health workers are women, meaning they are disproportionately exposed to life-threatening infections and diseases in clinics and hospitals without adequate gender-inclusive WASH facilities.

Despite all this, women and girls are often excluded from the planning, delivery and monitoring of WASH activities and services. Globally, the World Bank estimates that 18% of water utility workers are women while UN Water estimates that women hold less than half of government roles associated with WASH; in a 2021–2022 survey (PDF) 23 countries reported that women held less than 10% of government WASH roles. This often means that those in power – usually men – often ‘speak for’ women and marginalised groups, undermining the voices and experiences of women and girls.

It is essential, then, that women and girls are no longer denied access to safe and sustainable WASH, and that they are included in decision-making forums about WASH services, to shift unequal power relations, tackle harmful social norms and ensure that all aspects of their human rights are truly fulfilled.

Our gender approach

Our mission to transform lives through safe and sustainable water, sanitation and hygiene enhances gender equality and women’s empowerment by:

• Promoting gender equality through universal WASH by enhancing the voices, leadership and representation of women and girls
• Improving quality of healthcare for women through WASH by demonstrating approaches that are gender responsive and promote women’s leadership and empowerment
• Strengthening climate-resilient WASH through adaptations and services that are gender responsive, socially inclusive and that promote women’s leadership
• Improving the quality of WASH financing so it is allocated and used in a more transparent and efficient way, prioritising gender and other inequality issues

Our policy recommendations

Our new policy paper makes recommendations for countries working to accelerate progress on gender equality through WASH systems. Recognising that decisions about WASH services are often made by men – and thus tend to result in male biases around technical and professional WASH roles, opportunities, services and resource allocation – the paper sets out gender-responsive WASH policies as an opportunity to:

• tackle harmful gender norms
• shift men's mindsets and attitudes
• elevate the status of women as decision makers
• bring visibility to the issue of redistributing women’s WASH-related burdens
• support women to be community leaders, claim their rights and participate in decision making

Our recommendations for developing country government ministers, policy makers and decision makers are to:

Promote gender-responsive and inclusive policies for WASH services

This can be achieved by setting standards for gender-responsive WASH in public spaces, workspaces, schools and healthcare facilities and establishing guidelines for the mandatory inclusion of women in decision-making structures. In this way, it is more likely that WASH policies and implementation plans are gender-responsive, for example, including menstrual health and hygiene in planning, design, capacity development, delivery, monitoring and regulations. Countries should also make menstrual health and hygiene in schools a key function of their education ministry, integrate it into monitoring systems and take measures to ensure menstrual products are affordable. We also recommend that governments support actors from women’s health, education and water institutions to design and implement policies together.

Integrate gender equality in WASH policies and workforce

This can be achieved by galvanising partners to challenge gender norms and provide funds to implement gender-responsive WASH policy commitments. Countries should support and invest in the participation of representatives from women’s organisations – including women with disabilities – in WASH consultations, decision making and accountability mechanisms. They should also monitor and review the impact of policies on gender equality in WASH and address the unintended consequences of WASH policies and services on women, girls and vulnerable groups under a "do no harm" principle.

Tackle gender inequality in the WASH workforce

This can be achieved by ensuring that occupations where the majority of workers are women are professionalised and given equal pay and safe working conditions. Stakeholders should also seek to understand and tackle the barriers women face in male-dominated WASH roles and institutions to ensure there is a better gender balance and staff retention, particularly in leadership positions. Employers, too, should be held responsible for undertaking gender pay audits and eradicating unfair pay practices.

At the Women Deliver conference and beyond, we will be advocating for WASH services to be provided in every healthcare facility and incorporated into health programmes and financing platforms. We will collaborate with gender and health stakeholders to strengthen institutional coordination to plan for, implement and monitor the integration of gender-responsive approaches to WASH in health system strengthening efforts.

Progress towards gender equality is essential to meet existing development goals. Ending all forms of discrimination against women and girls requires WASH efforts to intentionally address gender equity and empower women at all levels – individual, household, community and institutional.

This blog builds on the analysis and reflections captured in WaterAid’s policy paper 'Ending the water, sanitation and hygiene crisis together: policy priorities for accelerating progress', which analyses the blockages to progress for water, sanitation and hygiene and sets out policy recommendations for national governments, donors and decision makers to accelerate progress.

Sue Cavill is Senior Advisor – Equality, Inclusion and Rights, WaterAid

Top image: Shefali Rani Sardar is a Village Committee Worker and Caretaker of the pond sand filter in Purbo Durgabati village, Burigoalini, Bangladesh.