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Sanitation Insecurity: Definition, Measurement, and Associations with Women's Mental Health in Rural Orissa, India

Caruso, Bethany (2015)
Dissertation (189 pages)
Committee Chair / Thesis Adviser: Cooper, Hannah
Committee Members: Clasen, Thomas ; Haardoerfer, Regine ; Hadley, Craig ; Yount, Kathryn
Research Fields: Health Sciences, Public Health; Health Sciences, Mental Health
Keywords: Sanitation; Gender; Mental Health; India
Program: Laney Graduate School, Behavioral Sciences and Health Education
Permanent url: http://pid.emory.edu/ark:/25593/rfhnt

Abstract

Water, sanitation, and hygiene (WASH) are critical for human health. Research on WASH and health to date has predominantly focused on infectious agents and resultant diseases, leaving other facets of health--such as mental health--underexplored. Qualitative investigations suggest that women experience assaults to their mental health due to poor sanitation conditions and the gendered sanitation behaviors they are expected to perform. No research has aimed to determine the association between women's sanitation-related experiences and their mental-health outcomes. The primary aims of this research were to (1) understand women's lived experiences of sanitation beyond access to a sanitation facility--their sanitation insecurity, (2) create a measure of sanitation insecurity, and (3) determine the association between sanitation insecurity and mental health among women at different life stages in rural Orissa, India. This mixed-methods investigation found that women have a myriad of concerns related to their urination, defecation, and menstrual management behaviors that vary by life stage; women face challenges performing sanitation-related behaviors despite access to a sanitation facility; and associations between women's sanitation insecurity and well-being, anxiety, depression, and distress exist.

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