India's WASH policies unduly burden women

The COVID-19 pandemic has made hand hygiene crucial for disease prevention. This has led to water, sanitation and hygiene (WASH) gaining greater importance in households, schools, health facilities, and communities.

It is evident that inadequate WASH services disproportionately burden women, and hence, policy framing and implementation must recognise the experiences, needs, and barriers faced by women and girls.

Although India does not have an umbrella WASH policy, several policies for improved sanitation, clean drinking water, and menstrual hygiene, each focusing on different aspects of WASH have been undertaken.

We apply the 'Gender Responsive Assessment Scale' developed by the World Health Organisation (WHO) to evaluate those policies and programmes on a five-point scale: Gender-unequal: 1, Gender-blind: 2, Gender-sensitive: 3, Gender-specific: 4 and Gender-transformative

Jal Jeevan Mission (JJM)

The Government of India restructured and subsumed the National Rural Drinking Water Programme (NRDWP) into the Jal Jeevan Mission (JJM) in 2019. The policy aims to ensure affordable and adequate drinking water supply through Functional Household Tap Connections (FHTC) to every rural household by 2024.

The JJM guidelines released in 2019note that the provision of tap water connections to households will relieve women and girls of the struggle of walking miles to fetch water, alleviating 'time poverty'*.

It emphasises women's role in leading and participating in JJM activities, especially at the village level. Women are required to constitute 50 percent of the Village Water and Sanitation Committees. The 'Swajal' programme, under JJM, comprises a Women's Development Initiative (WDI) designed to upskill them, improve their income-earning capabilities, and connect them to the market, through help from Support Organisations.

However, habitations with less than 25 percent of the population having access to safe drinking water were granted lower priority in coverage than other categories. This indicates that water-stressed regions continue to suffer, and so do women and girls in those regions.

Nevertheless, the JJM presents a unique opportunity to undertake gender-transformation in rural India through promoting women's leadership.

Atal Bhujal Yojana

The gender strategy for the policy tracks the participation of women in the scheme. It requires 33 percent women members in Water Use Associations (WUA) at the Gram Panchayat level to allow holistic participation of women in water budgeting, water security planning, and monitoring implementation progress.

Apart from providing training, gender issues are also addressed in meetings of WUAs. Women members of Self-help Groups (SHGs) are also required to constitute a substantial number of Water Management Committees (WMC).

Although the on-ground gender transformation is yet to pan out, evidence indicates that women's participation in resource management improves their bargaining power and leadership skills while upholding more efficient water use.

Swachh Bharat Mission - Gramin (SBM-G)

Through its 'Gender Guidelines', the mission recognises the importance of adequate sanitation and menstrual hygiene management for women's health, privacy, safety, and socio-economic outcomes. It requires the active participation of women not only in campaigns but also as leaders constituting 50 percent of the Village Water and Sanitation Committees (VWSC).

The Information, Education, Communication (IEC) campaigns are targeted not only towards women but also men, to challenge gender stereotypes. It also encourages women to work as masons to help in toilet construction, adolescent girls to raise awareness of menstrual health management in their communities, and men to participate in maintaining toilets.

The programme has also incorporated trained foot soldiers, or swachhagrahis, mostly women, from self-help groups, ASHA workers, and other community-based organisations who motivate improved sanitation practices in their villages. In Jharkhand, 1.5 million women-led a hygiene campaign and constructed 1.7 lakh toilets in less than a month.

Although India was declared open-defecation-free (ODF) in 2019, several reports indicate the persistence of open-defecation in regions labelled ODF, defunct toilets, and discrepancies between the SBM administrative data and National Sample Survey data. There have also been reports of non-payment of wages to swachhagrahis. If such policy implementation gaps are not bridged, regions with poor sanitation and lack of adequate toilets will continue to fail their women.

Menstrual Hygiene Management (MHM)

The MHM guidelines, issued by the Ministry of Drinking Water and Sanitation, provide a well-defined MHM framework that incorporates IEC initiatives, better WASH infrastructure, availability and safe disposal of menstrual absorbents, and participation of communities and schools, to make adolescent girls capable of continuing their education and ending the taboo around menstruation. It also brings together various ministries to collectively act towards the cause.

However, MHM is still recognised as one of the least prioritised components of SBM-G. On the Lok Sabha question of allocation of funds to the MHM component of SBM-G, the Ministry of Drinking Water and Sanitation answered that they do not release component-wise funds and do not have any monitoring mechanism in place.

Ground reports show that knowledge of proper menstrual hygiene practices is still lacking. Girls have access to sanitary napkins as long as they are provided with the same from the school and later stop using them because of non-affordability or non-availability.

Even though ASHA workers continue to raise awareness, there are cases where 80 percent of women and girls in villages continue to practice unhygienic MHM.

Swachh Bharat Mission - Urban (SBM-U)

Although the SBM-Gramin has tried to be gender-transformative while recognising the burden of poor sanitation on women, SBM-U seems to have left that out entirely. The only gender sensitive point included in SBM-U's guidelines is that "adequate provision for separate toilets and bathing facilities for men, women and the physically-disabled" must be ensured.

This can be problematic. In 2018, 35.2 percent of India's urban population was living in slums, and with the ever-increasing urban population, this is only going to rise. Urban slums with poor sanitation, privacy, and infrastructure pose several challenges for women.

Since girls and women mostly use community toilet complexes or public toilets — often located on the outskirts of the slum within 1-2 km radius — they are prone to harassment and violence. These privacy and safety concerns are magnified in the evenings and late nights.

The paucity of clean and separate toilets for women in the urban working landscape can discourage and restrict women from joining the workforce, in addition to several factors that already hinder their labour force participation. The toilets are also poorly maintained and lack of water connection and proper waste disposal methods. To arrange water for household use, women and girls need to stand in long queues to collect it from the water tankers.

Swachh Vidyalaya Abhiyan

The Clean India: Clean Schools campaign under SBM has recognised separate toilets and clean water in schools is crucial to a girl's education. It provides for barrier-free access to clean toilets and clean drinking water for all children.

The programme also includes education on menstrual hygiene management, sanitation, and handwashing. However, while there have been significant improvements in sanitation and clean water availability post this campaign, some problems remain.

In 15 percent of schools assessed by WaterAid, drinking water was not safe, and half of them lacked a water storage facility. While 95 percent of the schools had functional toilets, these toilets were locked in 39 percent schools and some students were still defecating in the open. A third of the schools had no running water for handwashing, and only about 20 percent of schools assessed had "some facility for girls to manage their menses".

Kayakalp initiative

Launched by the Ministry of Health and Family Welfare to supplement the efforts of SBM, this initiative aims to promote cleanliness, hygiene and infection control in public health facilities, encourages regular performance assessment, and develops sustainable cleanliness practices to improve health outcomes.

The scheme also recognises and awards the best-performing public health facilities. However, although the guidelines mention toilets and labour rooms' cleaning, the gender dimension is not considered.

Policy recommendations

Evidence from across the globe finds that involving women in designing, planning, and implementing WASH programmes helps in decreasing dropout rates from school, increasing school attendance, improving literacy rates and health outcomes, ensuring greater privacy and dignity, and reducing child mortality and the risk of harassment and violence.

Hence, women's participation in WASH services benefits not only them but also their families and entire communities.

1. Integrate existing policies into a single WASH policy for India

While it's notable that policies such as the Jal Jeevan Mission and Kayakalp scheme are recognised as being in tandem with the Swachh Bharat Mission, the convergence of these policies under the umbrella of WASH would provide the synergy and holistic implementation that India's WASH sector needs.

2. Train swachhagrahis for wider communication and ensure timely wage payments

The network and reach of swachhagrahis must be utilised beyond the basic sanitation and toilet construction concerns. They must be trained to propagate gender-sensitive IEC, promote women's access to toilets, and build more gender-friendly toilets, to challenge certain social norms in practice.

It must be ensured that due wages are paid to them on time as per the swachhagrahi guidelines.

3. WASH in schools: Amplify the policy focus on Menstrual Hygiene Management

The availability of separate functional toilets for girls and boys and adequate handwashing stations needs to increase. The schools must have adequate MHM infrastructure, which includes private spaces, clean water supply, and waste disposal facilities. The school management committees (SMC) must ensure that WASH services and awareness are maintained.

The local self-governments and authorities must ensure women's leadership to eliminate the taboo around menstruation and gender-inclusive decision making. The use of cheaper and sustainable options for MHM must be encouraged.

The government can incentivise and support grassroots entrepreneurs to scale production and distribution of their biodegradable menstrual hygiene products, to maintain a stable supply even for last-mile populations.

4. Swachh Bharat Mission (Urban) needs to be sensitive towards women in urban slums

It is crucial that designers of public toilets or community toilet complexes are cognisant of factors such as privacy, hours of availability, distance from the residential areas, design of toilets that can impact women and girls, and employ innovation in building gender-sensitive structures. This will require sufficient initiative from the government's end.

To ensure the right to hygiene and sanitation, licenses for setting up shops, factories or workspaces must be issued only if women-friendly toilets are available, irrespective of whether women are employed or not. The government must pursue urban sanitary infrastructure with due rigour and monitor compliance efficiently.

5. WASH in health facilities must be gender-sensitive

WASH policies in health facilities must integrate the special needs of women and children, which includes safe, hygienic and accessible health centres and functional toilets. The Kayakalp Awards must include 'gender-inclusive infrastructure' as a metric in assessing health facilities for their health environment.

Monitoring systems must be set up to track WASH performance of health facilities and its impact on health outcomes of women and girls.

6. Develop a 'Gender Tracking' system and favourable ecosystem for change

Even while WASH policies are gender-sensitive or gender-transformative in their design and planning, they fail to measure the gendered impact of the policy. Most evidence available is anecdotal, and there is no quantitative data or monitoring to depict where the policy stands on bridging the gender gap.

Policies must employ gender analysis tools to develop a framework for such measurement and integrate it with the Management Information System (MIS) or mobile apps to track progress on gendered outcomes.

To create an ecosystem for gender transformation, it's crucial for WASH policies to go beyond gender sensitivity and address the causes of gender inequality and bring forth positive changes in the power dynamics between women and men.

*Time poverty refers to the lack of time for personal recreation or leisure due to long working hours. In the case of women, it indicates the shortage of time due to domestic chores or care activities that take up most of their hours.

( Courtesy: Firstpost)