Are current approaches for measuring access to clean water and sanitation inclusive of people with disabilities? Comparison of individual- and household-level access between people with and without disabilities in the Tanahun district of Nepal

摘要: Background The critical importance of safe and affordable access to water, sanitation hygiene (WASH) is highlighted in Goal 6 the Sustainable Development Goals, which seeks achieve universal equitable for all by 2030. However, people with disabilities–who comprise 15% global population–frequently face difficulties meeting their WASH needs. Unmet needs amongst disabilities may not be captured through current approaches tracking progress towards 6, focus on household- rather than individual-level access. Objective To evaluate (WASH), at individual- household-level, Tanahun district Nepal. Methods A population-based survey disability was conducted from August-October 2016 improved water facilities between households members (n = 198) those without 1,265) nested case-control then compared cases aged 15 above 192) age-sex-location matched controls 189), using newly developed 21-item “Quality Access” questionnaire. Multivariate regression used compare indicators disabilities. In-depth interviews 18 caregivers assess acceptability appropriateness Findings There were no significant differences an facility or source. individual-level, experienced significantly greater accessing (p<0.001 three scores). Amongst disabilities, difficulty scores associated having a physical impairment severity; lower socioeconomic status self-care limitations; positively limitations status, inversely hearing impairments. Qualitative research found questionnaire well understood participants many challenges they faced. Additional covered tool included: (1) time spent WASH, (2) consistency access, (3) sufficiency (4) dignity Conclusion People substantial needs, particularly services autonomously, consistently, hygienically, privacy, pain fear abuse. These are household-level data, so needed monitor Quality Access provide useful data collection tool.