This interdisciplinary research project, combining social anthropology and gender studies with sanitary engineering, investigated water, sanitation and hygiene (WASH) infrastructure and users’ needs in selected public health care facilities in India and Uganda.

WASH in health care facilities in developing countries often fail to provide user friendly and gender sensitive services, putting the most vulnerable user groups (e.g. pregnant women, small children and disabled persons) at risk. In addition to health issues, women are confronted by social norms, which often hinder proper hygienic habits during menstruation, affecting their health and challenging their dignity. Through the application of our three assessment tools, our research provides data on the sanitary requirements of health care facilities to address the gendered realities of intimate needs in the face of inadequate or poorly designed WASH infrastructure.

A technical assessment of selected sanitary infrastructures was done with an adapted and refined tool which includes specific gender indicators and is one of the project outcomes. It will be further developed into an Open Data Kit based tool for mobile phone applications. It can be used to evaluate and monitor WASH services in health care facilities worldwide. The specific needs and priorities of the patients and attendants were also explored using a modified, gender sensitive focus group discussion method, the “Gender Action Learning System” (GALS), that was modified for this project. Lastly, health centre medical staff, facility managers and cleaning personnel were interviewed using a semi-structured interview technique.

The overall data from the three different assessment tools gives evidence of needs-based, gender sensitive, technically appropriate and socially acceptable solutions to the problems identified at the health care facilities. The results were shared with the corresponding stakeholders from the medical departments, management and health authorities and are the basis of two Policy Briefs for decision makers in India and Uganda. A video and an academic article are in production as further project outcomes. The publications will be relevant for health care managers, health authorities, and the local communities, and made accessible to relevant actors at local, regional and national levels.