Dataset Information

Assessing Women's Negative Sanitation Experiences and Concerns: The Development of a Novel Sanitation Insecurity Measure.

ABSTRACT: Lack of access to acceptable sanitation facilities can expose individuals, particularly women, to physical, social, and mental health risks. While some of the challenges have been documented, standard metrics are needed to determine the extent to which women have urination- and defecation-related concerns and negative experiences. Such metrics also are needed to assess the effectiveness of interventions to mitigate them. We developed a sanitation insecurity measure to capture the range and frequency of women's sanitation-related concerns and negative experiences. Research was conducted in rural Odisha, India with women across various life course stages to reflect a range of perspectives. This paper documents the mixed data collection methods and the exploratory and confirmatory factor analyses we employed to arrive at a final measure. The final sanitation insecurity measure includes 50 items across seven factors that reflect the physical environment, the social environment, and individual-level constraints. Most factor scores were significantly higher for unmarried women and for women who lacked access to functional latrines, indicating social and environmental influence on experiences. This measure will enable researchers to evaluate how sanitation insecurity affects health and to determine if and how sanitation interventions ameliorate women's concerns and negative experiences associated with sanitation.

SUBMITTER: Caruso BA

PROVIDER: S-EPMC5551193 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

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Assessing Women's Negative Sanitation Experiences and Concerns: The Development of a Novel Sanitation Insecurity Measure.

Caruso Bethany A BA Clasen Thomas T Yount Kathryn M KM Cooper Hannah L F HLF Hadley Craig C Haardörfer Regine R

International journal of environmental research and public health 20170711 7

Lack of access to acceptable sanitation facilities can expose individuals, particularly women, to physical, social, and mental health risks. While some of the challenges have been documented, standard metrics are needed to determine the extent to which women have urination- and defecation-related concerns and negative experiences. Such metrics also are needed to assess the effectiveness of interventions to mitigate them. We developed a sanitation insecurity measure to capture the range and frequ ...[more]

PMID: 28696405

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Project description:BackgroundAs maternity services evolve and the population of women served also changes, there is a continuing need to effectively document the views of women with recent experience of care. A woman's maternity experience can have a positive or negative effect upon her emotional well-being and health, in the immediate and the long-term, which can also impact the infant and the wider family system. Measuring women's perceptions of maternity services is an important way of monitoring the quality of care provision, as well as providing key indicators to organisations of the services that they are providing. It follows that, without information identifying possible areas in need of improvement, it is not clear what changes should be made to improve the experiences of women during their journey through maternity services from pregnancy to the early weeks at home with a new baby . The objective is to describe the development process and psychometric properties of a measure of women's experience of maternity care covering the three distinctly different phases of maternity - pregnancy, labour and birth, and the early postnatal period.MethodsData from a national survey of women who had recently given birth (n = 504) were used. Exploratory and confirmatory factor analytic methods were employed. The measure was assessed for underlying latent factor structure, as well as for reliability, internal consistency, and validity (predictive, convergent and discriminant).ResultsThe models developed confirmed the use of three separate, but related scales about experience of maternity care during pregnancy, labour and birth and the postnatal period. Data reduction was effective, resulting in a measure with 36 items (12 per scale).ConclusionThe need for a psychometrically robust and qualitatively comprehensive measure of women's experience of maternity care has been addressed in the development and validation of this prototype measure. The whole measure can be used at one time point, or the three separate subscales used as individual measures of experience during particular phases of the maternity journey with identified factor structures in their own right.

Project description:Emerging qualitative research suggests women's sanitation experiences may impact mental health. However, specific associations remain unclear. We aimed to determine if sanitation access and sanitation experiences were associated with mental health among women in rural Odisha, India. Using a cross-sectional design, we evaluated the association between sanitation access and sanitation experiences and selected mental health outcomes. Data were collected from 1347 randomly selected women across four life course stages in 60 rural communities (December 2014-February 2015). Our four primary outcomes included: mental well-being, and symptoms of anxiety, depression, and distress. The primary exposures were (1) access to a functional latrine within the household compound and (2) sanitation insecurity (SI), evaluated using a seven domain measure assessing women's negative sanitation experiences and concerns. We used hierarchical linear modeling to determine associations between the exposures and mental health outcomes, adjusting for covariates (life stage, poverty, current health status, social support). Mean well-being scores were moderate and mean anxiety, depression, and distress scores were above a threshold indicating the potential presence of any of the three conditions. Access to a functional household latrine was associated with higher well-being scores, but not with anxiety, depression or distress. Women's SI domains were associated with all four outcomes: four domains were significantly associated with lower well-being scores, two were significantly associated with higher anxiety scores, three were significantly associated with higher depression scores, and three were significantly associated with higher distress scores, all independent of functional household latrine access. Women in rural Odisha, India may suffer assaults to their well-being and have higher symptoms of anxiety, depression, and distress when urinating and defecating, even if they have an available facility. These findings suggest that sanitation-related interventions should consider how to accommodate women's experiences beyond excreta management to comprehensively impact health.

Project description:BackgroundYoung female cancer survivors are at a disproportionate risk of suffering significant psychological distress following treatment, particularly fears of cancer recurrence (FCR). While previous research has established the robust relationship between FCR and family matters (e.g., family planning and motherhood), there is a paucity of information about how a history of cancer affects women's psychological functioning throughout the perinatal period. The present investigation sought to better understand women's experiences of pregnancy and the postpartum period following cancer treatment through a qualitative analysis.MethodsTen women participated in a semi-structured, one-on-one interview either over telephone or video conferencing (Zoom). Women were recruited from Sunnybrook Health Sciences Centre in Toronto, as well as through online cancer support platforms, and social media sites. Participants all had a past cancer diagnosis; no active disease; were 45-years of age or younger; currently in the perinatal period; and spoke English fluently. The study employed a grounded theory analysis by which verbatim interview data were analysed using a constant comparison method until data saturation was reached.ResultsThe qualitative analysis yielded I'm So Happy, But Also Terrified, as the core category, indicative of the duality of emotional experience that characterized the perinatal period for these women. Additionally, four higher-order categories emerged revealing how women go through a process of grief related to potential fertility loss; conditional joy during and after pregnancy due to the lingering weight of cancer; frustration with a lack of resources regarding perinatal health after cancer; and hope as they enter into motherhood.ConclusionThese results suggest that women in the perinatal period with a history of cancer may be at an increased risk for psychological distress and require additional fertility and reproductive resources both during and after cancer treatment. This research is an important step in further understanding women's experiences of pregnancy after cancer and may help to inform future research and healthcare practices, in addition to improving perinatal care after cancer.

Project description:BackgroundRaising awareness of the importance of fetal movements (FMs) and advising women on the appropriate action to take if they experience reduced FMs, is important for minimising or avoiding adverse perinatal outcomes. To gain insight and understanding of women's perspectives of assessing FMs in pregnancy, we conducted a qualitative evidence synthesis.MethodsA qualitative evidence synthesis using thematic synthesis was conducted. Studies were eligible if they included pregnant women who were at least 20 weeks gestation and reported qualitative data from women on assessing FMs in pregnancy. MEDLINE, CINAHL, EMBASE, PsycINFO and Social Science Citation Index, from inception to July 2020, were searched. The methodological quality of included studies was assessed by at least two reviewers using an Evidence for Policy and Practice Information (EPPI)-Centre quality assessment tool. Data synthesis, using the Thomas and Harden framework, involved line by line coding of extracted data, establishing descriptive themes, and determining analytical themes. Confidence in the findings was assessed using GRADE CER-Qual.ResultsNine studies, involving 2193 women, were included in the review. The methodological quality of the studies was overall generally high. The synthesis revealed three dominant themes, and seven sub-themes that reflected women's perspectives of assessing FMs in pregnancy. These were; 1) How women engage with FMs, with subthemes of informal engagement, formal engagement, and strategies to stimulate FMs; 2) ' … like a feather inside my belly' - articulating and describing FMs, with sub-themes of sensations associated with FMs and timing and frequency of FMs; and 3) FMs and help/health seeking, with sub-themes of information sources and interacting with healthcare professionals. Confidence in the findings was either high or moderate, although two findings were rated low confidence and one very low.ConclusionThis qualitative evidence synthesis reveals that women informally engage with FMs during pregnancy. Women commonly adopt strategies to stimulate FMs when concerned. The use of the internet was a common source of obtaining information regarding FMs. Women require better support when contacting healthcare professionals about FMs. As only three of the nine included studies were exclusively qualitative in design, further qualitative studies exploring women's perspective of assessing FMs in pregnancy are required.

Dataset Information

Assessing Women's Negative Sanitation Experiences and Concerns: The Development of a Novel Sanitation Insecurity Measure.

Publications

Assessing Women's Negative Sanitation Experiences and Concerns: The Development of a Novel Sanitation Insecurity Measure.

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