Participants Panel

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Undoing inequity: inclusive WASH programmes that deliver for allJane Wilbur(Equity and Inclusion Advisor)WaterAid

Photo: WaterAid/Jane Wilbur

Project overview

The project aims to:

1. Understand the barriers that disabled, older and chronically ill people face when accessing WASH

2. Develop an approach to address barriers to WASH access and use

3. Understand how improved access to WASH impacts on the lives of vulnerable people and their families

Project areas

UGANDA, thirteen sub-counties in Amuria and Katakwi Districts

ZAMBIA, Mwanza West ward in Zambia’s Monze District

Baseline findings

Icons: Meeting by Scott Lewis from The Noun Project. Outhouse by Luis Prado from The Noun Project

People with physical impairments crawl on the floor to use a toilet or defecate in the open.

19% of disabled people were stopped from touching water because they were ‘dirty’ (Uganda). Disability is contagious, a curse (Zambia and Uganda).

Many vulnerable people had ‘never thought about’ adaptations to make toilets more accessible.Only 50% of vulnerable people were consulted where household toilets were made more accessible (Uganda).

Inclusive WASH intervention

Carrying out participatory barrier analysis at the district level (left) and in the community (right)

Aiming for full and meaningful participation in meetings and consultation

Accessibility and safety audits

“I don’t like leaving the toilet door open when I use the toilet, but the wheelchair blocks the door”

Developing low tech, low cost solutions

Providing information on low cost, low tech designs

Developing resources and materials

Mid-term review findingsWater access

• Fewer vulnerable people reported difficulties collecting water (Uganda: 70% to 55%; Zambia: 50% to 44%)

• Older and physically disabled people still face significant barriers: distance to the water point & carrying water containers

• Can rural WASH programmes address distance issues?

• Role of rainwater harvesting?WaterAid/Stephen Segawa

• Rates of open defecation have dropped by 20% in Zambia and 5% in Uganda. But…

Sanitation access

HHs including a vul-nerable member: 79%

HHs not including a vulnerable member:

21%

HHs not practic-ing OD81%

Uganda - Proportion of households (HHs) with a vulnerable member practicing open defecation (OD)

HHs not practicing OD94%

HHs practicing OD that include a vulnerable

member100%

Zambia - Proportion of households (HHs) with a vulnerable member prac-ticing open defecation (OD)

• Uptake of support structures inside the latrine was low in both countries (3 toilets in Zambia; 2 in Uganda)

• Older people face most challenges finding the toilet at night & balancing

Images: WaterAid/Layford Jere; WaterAid/Jane Wilbur

Sanitation access

Percentage of children with disabilities enrolled in schools.

Oaekere (Uganda) Awelu (Uganda) Nkaba Basic School (Zambia)0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

4%2%

1%

17%

4%5%

Baseline

Mid-term

Before they brought water, I could bathe once a month. Now I bathe two to three times a day. People never used to eat with me because I was dirty and smelling. Now everyone eats together as I am no longer dirty.

• Vulnerable people’s ability to bathe more frequently increased between the baseline and mid-term (by 31% in Zambia and 15% in Uganda).

• Potentially improving access to WASH may increase a vulnerable person’s self-esteem and social interactions.

Hygiene access

Baseline Mid-term

Disability is contagious, a curse.

Misconceptions seem to have reduced. At baseline, 19% of vulnerable people reported being told not to touch or handle water in Uganda. This dropped to 1% at mid-term (not a direct comparison).

Limited awareness about differing access requirements.

Partner staff and local government officials’ attitudes / perceptions have changed: disabled people were excluded from mainstream WASH activities and their needs were overlooked.

People still are socially excluded, especially older people (due to decreased mobility and ill health) within communities and households.

Stigma and discrimination

Everyone, everywhere forever by 2030• Vulnerable people face

common barriers to WASH access and use.

• We must address all three barriers. If not, people will still be excluded.

• We must mainstream inclusive WASH so everyone, everywhere has sustainable WASH by 2030.

Photo: WaterAid/Jane Wilbur

Thank you

Photo: WaterAid/Jane Wilbur