Editorial: World Water Day 2022: importance of WASH, equal access opportunities, and WASH resilience - A social-inclusion perspective

Introduction

This Research Topic brings together research on inclusion in water, sanitation, and hygiene (WASH) services. The Research Topic includes 10 papers: six primarily focus on gender, two on disability, and encouragingly two on other groups (people experiencing homelessness, sanitation workers) and emerging issues (sextortion) that have been relatively absent from the current discourse.

The papers highlight the disconnect between those who design and deliver services and disadvantaged citizens who are too frequently excluded from provision. Five papers primarily focused on the need for WASH services to respond to the complexity and diversity of different needs, while another five papers viewed WASH as a potential entry point for broader changes in inequalities. The papers primarily employ qualitative methods with only one paper based on quantitative methods. In this editorial, we reflect on five cross-cutting themes arising from the papers, which also serve as areas for further work to reduce WASH and broader inequalities.

Tailoring WASH infrastructure and information to meet people's requirements

The primary emphasis in many of the papers is on how to improve access to WASH services for groups that may be vulnerable, whether through design, planning, management, implementation, financing, or monitoring and evaluation. Nine papers focus on improving access to WASH services for these various groups, including the need for accessible infrastructure for people with physical disabilities. As an example, Patrick et al. explore the importance of multiple (networked and non-networked) water sources when designing and monitoring water access as seasonality and climate change impact these, with implications for women's unpaid work collecting water for the household. In addition, two papers examine WASH services at home and in public settings during the COVID-19 pandemic, with Gonzalez et al. focusing on access to WASH for groups that may be marginalized and Liera et al. on the gaps in provision for people experiencing homelessness.

The affordability of WASH services is vital and is noted across multiple papers. Liera et al. note payment to use public toilets as a barrier for people experiencing homelessness. Wilbur, Pheng et al. also highlight the affordability of accessible WASH services as a barrier for people with disabilities and their carers. Several papers recommend that innovation in humanitarian programming (subsidies, cash transfers) must ensure they target the poorest and be accessible to people with disabilities.

The articles generally focus less on meeting hygiene requirements than on improving access to water and sanitation infrastructure for all groups. However, Wilbur, Clemens et al. focus exclusively on menstrual health in humanitarian settings and considers the disposal mechanisms for menstrual materials for women with and without disabilities.

Regarding gaps, Wilbur, Pheng et al. and Wilbur, Clemens et al. considered the accessibility of WASH information for people with different impairments. These authors highlighted that accessible information would benefit people with disabilities, people of lower literacy, including older women and other groups that may be. Bhakta et al.'s paper, raises another emerging issue relevant to tailored service provision: sanitation workers' rights and occupational safety to realize rights to decent work, including inclusive WASH infrastructure.

Participation and partnerships

Most authors in this Research Topic begin from the perspective that inclusive services require participation and partnerships to improve services and alter essential relationships and ongoing practices. Almost all papers mention the participation of groups that may be vulnerable and recognize the capabilities of these groups in furthering WASH by developing partnerships with organizations representing these populations (e.g., Organizations of Persons with Disabilities, women's groups, and worker's unions).

At the individual level, people with disabilities, women, and people experiencing homelessness face inequitable participation. MacArthur et al. point out how barriers are both informal and formal, with Wilbur, Pheng et al. noting this includes the ability of people with disabilities to attend meetings and Doma et al. highlighting barriers such as lack of women's confidence and women's voices not being respected at the community level. Mechanisms to improve people's participation included male support for women, as noted by Doma et al., transformative leaders who support diverse views and equitable participation in communities and workplaces, as described by Gonzalez et al., and collaboration amongst sanitation workers, human rights activists and allies in the WASH sector as put forward by Bhakta et al..

Six of the ten papers focused on the importance of partnering with rights-based organizations to improve the participation of groups that may be vulnerable. For instance, Grant et al. concentrate on women's rights groups, Wilbur, Pheng et al. on partnering with Organizations of Persons with Disabilities, Bhakta et al. details sanitation workers' unions and Liera et al. concentrates on a civil society organization that promotes the inclusion of people experiencing homelessness. Merkle et al., MacArthur et al., and Doma et al. highlight that gender transformative leadership can enable growth, inspire action, strengthen WASH services, and increase visibility and social inclusion. Grant et al. argue for a more collaborative stance and note the significance of finding synergies between women's rights groups and WASH-related organizations.

Do no harm

The significance of ‘do no harm' and how people were or could be harmed when using WASH services emerges clearly from seven of the 10 papers. Some highlight instances where challenges related to WASH services can be disempowering, with Patrick et al., Merkle et al., and MacArthur et al. focusing on women Liera et al. on people experiencing homelessness and Bhakta et al. on sanitation workers. Other authors note situations where additional responsibilities are passed to already vulnerable groups. Merkle et al. highlight potential harm at the intersection of corruption and violence that makes women vulnerable to sextortion in Bangladesh. This constitutes an emerging area of WASH-related harm and requires further research in other country contexts. MacArthur et al. discuss gender-insensitive approaches, which may be harmful, as well as potential backlash and resistance to more gender transformative approaches, recommending do no harm strategies in all efforts in gender integration. However, on a positive note, Gonzalez et al. highlight how women who experienced harm have been supported as leaders to mitigate that same experience for others.

Looking beyond WASH to transformative change

The potential for WASH interventions to also secure the radical changes needed for broader societal transformation remains a point of difference between these contributions. Is WASH an end in itself whereby people improve their access or can WASH catalyze equitable, inclusive development and dismantle inequalities? Seven papers considered WASH within the multidimensional nature of inequalities to suggest that transformative progress is possible but not guaranteed. Improved WASH services are essential to social transformation, a necessary even if not a sufficient condition. WASH actors can go only so far; coordination and deep engagement with others across different services, sectors and service providers are needed to achieve more far-reaching change, but such change is possible. For instance, Wilbur, Pheng et al. describe how assistive devices might be a pre-condition for people to leave home and access public WASH services. Similarly, Bhakta et al. highlight the importance of cross-sectoral action to ensure decent work in the WASH sector. Grant et al. describe the role of transformative leaders in enhancing those synergies in the context of Timor-Leste, addressing power differentials and creating the space for marginalized and excluded people to take their seats at the table, and Gonzalez et al. echoes these points based on transformative leaders across other parts of Asia. Together these papers point to an encouraging emerging trend and focus on transformative change, noting that addressing the much needed changes within WASH services should not be either forgotten or deprioritized and is required in tandem with broader transformation.

Conclusion

In summary, the papers represent diverse interventions emphasizing attention to gender equality, disability and social inclusion. While some initiatives aim to provide WASH services more efficiently and equitably, drawing on the capabilities of people who may be vulnerable together with their families and caregivers, others have emerged from rights-holder groups determined to advance their broader needs and interests. Whilst efforts increasingly aim for WASH services that include more population groups, the research covered in this Research Topic demonstrates that WASH services are rarely still accessible for all. Discrimination and exclusions remain, with limited research about WASH for population groups that may be vulnerable such as people with invisible disabilities, people of different gender identities, those in ethnic minorities, older adults and children and people experiencing homelessness. Although the evidence base is slowly growing, greater diversity in research methodology is needed (alongside greater diversity in population group), including mixed methods and quantitative research that can capture the scale and extent of issues to complement the welcome depth of qualitative research in this field. Such a strengthened evidence base can inform policy and practice toward greater inclusion within and beyond WASH services.

Author contributions

JWilb: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Writing—original draft, Writing—review and editing. SC: Conceptualization, Data curation, Formal analysis, Investigation, Writing—original draft, Writing—review and editing, Methodology. JWill: Conceptualization, Data curation, Formal analysis, Investigation, Writing—original draft, Writing—review and editing, Methodology.

Acknowledgments

The authors would like to thank all the authors who published papers in this Research Topic.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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