Undoing Inequity

The Undoing Inequity research aims to understand and address the barriers that disabled, older and chronically ill people face when accessing water, sanitation and hygiene services in Zambia and Uganda.

‘Undoing Inequity: programmes that deliver for all in Uganda and Zambia’ is a collaborative action research project between WaterAid, Water Engineering Development Centre (WEDC), Leonard Cheshire Disability and implementing NGOs. The research investigated some of the barriers that prevent disabled, older and chronically ill people from accessing safe water, sanitation and hygiene (WASH). Using the findings, the project designed and tested an inclusive WASH approach to address those barriers in a number of districts in Uganda and Zambia. A mid-term review in 2015 assessed the early impacts of the intervention and tested and refined the baseline data collection tools.

The initial findings from this project, documented in two mid-term reviews and an accompanying process review, revealed that the inclusive WASH approach improved WASH access for people who are socially excluded. It also appeared to have increased marginalised people’s self-esteem and social inclusion and to have positively impacted on stigma and discrimination.

Overview of the project

This poster summarises the baseline findings, the inclusive WASH intervention and the mid-term review findings from the 'Undoing inequity' action research project

• Undoing Inequity research poster.

Barriers and solutions to improved WASH access

These resources summarise the Undoing Inequity baseline findings and provides an overview of the inclusive WASH approach developed.

• Briefing note: Undoing Inequity baseline findings
• Undoing Inequity: inclusive water, sanitation and hygiene programmes that deliver for all in Uganda and Zambia, J. Wilbur, H Jones, N Groce and E Challenger 
• Inclusive WASH infrastructure design: Ensuring everyone everywhere has access to safe water, sanitation and hygiene
• Undoing Inequity: inclusive water, sanitation and hygiene programmes that deliver for all in Zambia.

The outcomes of the intervention on people's lives

This mid-term review of the ‘Undoing Inequity’ action research project in Zambia was conducted to assess how the inclusive WASH approach impacted on the lives of disabled, older and chronically ill people and their families in the target areas. These documents capture the findings across both countries.

• Undoing Inequity: water, sanitation and hygiene programmes that deliver for all in Zambia – Mid-term review
• Undoing Inequity: inclusive water, sanitation and hygiene programmes that deliver for all in Uganda - Mid-term review
• Undoing Inequity: inclusive water, sanitation and hygiene programmes that deliver for all in Uganda and Zambia.

The process of developing an inclusive WASH approach

In 2014 WaterAid conducted a process review of the action research project. The purpose of this process review was to examine the strengths and weaknesses of the emerging approach to inclusive WASH that has been developed in Uganda and Zambia, and to make recommendations for how this might be scaled up across WaterAid.

• Undoing Inequity: process review.

Further resources

This study gives an overview of how disability and ageing issues have been incorporated into WASH programmes. It presents a ‘mainstreaming continuum’ as a conceptual framework to show the different stages organisations go through: from pilot studies and projects, through capacity building and guidelines, to a state in which disability and ageing are fully considered in all work. The different stages on the continuum can be used to acknowledge what has already been achieved, build on progress and help assess what needs to be done to move to the next stage. 

• Mainstreaming disability and ageing in water and sanitation programmes.

The publication outlines the reality of the experiences of people with disabilities and the varied nature of their needs, and concludes with practical recommendations for facilitators and everyone engaged in CLTS to make the whole process more inclusive.

• Frontiers of CLTS Issue 3: Disability – making CLTS fully inclusive.

This Compendium of accessible WASH technologies is designed for use by staff working directly with communities, such as health workers and community volunteers working with disabled and older people and their families in rural areas of Sub-Saharan Africa.

• Compendium of accessible WASH technologies
• Film: Making water and sanitation facilities accessible by all - lessons from Uganda, by Kiyimba James 
• Film: Information and guidance for inclusive water and sanitation designs in Uganda
• Film: Undoing Inequity - Investigating the cost of inclusive water, sanitation and hygiene service delivery. 

Mixed-method data collection tools that can measure inter- and intra-household inequalities in WASH access and use

These nine mixed-method data collection tools focus on WASH access and use, disability, ageing, chronic illness, menstrual hygiene management, safety and security. Analysis of data collected exposes intra- and inter-household inequalities in WASH access and use. Data collection methods include:

• Tool 1: A quantitative household survey for the household head
• Tool 2: A quantitative survey for disabled, older or chronically ill people living in the same household
• Tool 3: Ministry-level interviews
• Tool 4: Community focus group discussions
• Tool 5: Local officials/ community leaders key informant interviews
• Tool 6: School questionnaire and observation tool
• Tool 7: In-depth semi-structured individual interviews for disabled, older and chronically ill people
• Tool 8: A latrine observation checklist
• Tool 9: A water point observation checklist.

Process monitoring data collection tools for inclusive WASH programmes

These eight process monitoring tools are designed to collect data throughout an inclusive WASH programme to assess progress in capacity of implementing staff, levels of participation of different people at the community level, and the effectiveness of inputs and activities. These tools are designed to be administered by WASH implementers and INGO staff.

• Tool 1 captures inputs implementers make when carrying out inclusive WASH. 
• Tool 2 captures levels of participation and decision making in WASH group meetings. 
• Tool 3 is a participation ladder used to monitor meaningful participation in the programme cycle. 
• Tool 4 assesses the capacity of implementers to carry out inclusive WASH programming. 
• Tool 5 allows an organisation to reflect on their inputs and progress. 
• Tool 6, tool 7 and tool 8 captures the changes and challenges encountered by implementers and communities.