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The Sanitation Technology Platform GENDER IN SANITATION A resource for commercial partners Originally presented in March 2018 March 2019
The Sanitation Technology Platform
GENDER IN SANITATIONA resource for commercial partners
Originally presented in March 2018
March 2019
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Table of Contents
About the Partners:The Bill and Melinda Gates Foundation (BMGF) supports the development of novel
sanitation technologies poised for transformative impact through the Reinvent the Toilet Challenge (RTTC) and broad Water and Sanitation Sector support.
The Sanitation Technology Platform (STeP) serves as a platform to de-risk and bring to market novel sanitation technologies. STeP provides a full range of services including field testing, user insights, and commercialization support for technology developers
and commercial partners.
3 Background
4 Overview of gender and sanitation
11 Gender vocabulary 101
13 Gender influences the full sanitation value chain
15 What does this mean for Commercial Partners?
28 Appendix: Resources available to you
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Background on this ReportThis Gender in Sanitation resource aims to provide readers with a guide to integrating a gender lensinto sanitation solutions, including technology, policy, and others. Readers should come away with:
• An understanding of how gender influences sanitation and the resulting impacts of sanitation ongender-related outcomes
• Working knowledge of the language and terminology used in gender and sanitation• Gender-related elements to keep in mind when designing sanitation solutions and go-to-market
strategies• Examples of what can go wrong when gender is not considered in sanitation solutions• A path forward to integrating a gender lens into sanitation solutions
This resource is not a step-by-step guide to conducting a gender analysis. Rather, this resourceintroduces readers to the concepts and methods used when applying a gender lens to their workand outlines next steps to consider for gender integration. An appendix provides additionalresources that may be useful to readers who would like more information on gender in sanitation.
Note: All information provided in this report derives from The Bill and Melinda Gates Foundationteams supporting Gender and Water, Sanitation, and Hygiene initiatives unless specific in-textreferences are provided.
How gender influences sanitation
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Gender Differences: Evidence shows there are gender differences in sanitation decision making, facility use, construction and maintenance; yet there is little evidence on gender differences in participation and leadership.
Barriers: Failure to consider gender creates barriers across the value chain; current efforts are focused on increasing women’s participation, but rarely consider underlying gender norms that prevent them from doing so.
Relationships: Marriage and relationships within the household influence sanitation related decisions including access and use, as well as need for privacy.
Gender Based Violence: Sanitation is not a significant driver of gender based violence; however, fear of sexual assault, shaming and harassment influences women’s mobility and access to sanitation facilities outside the home. Sanitation is linked to women’s psychosocial stress.
How gender influences sanitation, cont’d
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Learning & Work: Boys and girls are both impacted by poor sanitation in school. Some, but not all, studies show the effect is larger for girls than for boys. There is limited research on gender differences in sanitation access and use in the workplace and its impact.
Technology: Gender differences are rarely considered in sanitation technology design and programming contributing to additional burden on female users and limitations in achieving sanitation outcomes for all. Menstrual hygiene product disposal is rarely considered.
Policy: Women's participation in sanitation policy making and decision-making is limited. There is some evidence that increasing women’s participation leads to better policies but we need more data.
Measurement & Evaluation (M&E): M&E typically is limited to sanitation access and use, with minimal consideration for empowerment outcomes.
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Health Outcomes
• Women and girls experience higher rates of
infection from poor sanitation conditions and
access.
• There is a causal link between mothers’
exposure to poor sanitation and infant
mortality. Emerging evidence from India links
adverse pregnancy outcomes to open
defecation.
• Fear of violence outside the home, including
for access to sanitation, leads to anxiety,
stress, and other psychosocial issues. Small
studies find evidence of women feeling
shame and humiliation around access to
sanitation.
Education Outcomes
• Poor sanitation in school impacts boys
and girls but reports show girls are
disproportionately impacted,
especially when managing
menstruation. Only 6.9% of girls in
Sierra Leone said that their schools
had water available in a private area
to wash during menstruation.
• There is some corroborating evidence
linking school sanitation to school
absences, though less on school
performance.
Economic Outcomes
• Both men and women seem to
experience a substantial loss of
productive time related to poor
sanitation. However, program-related
gender analyses suggest that women
experience more sanitation-related time
poverty than men.
• Studies suggest that, on average, women
invest more money than men in
nutrition, school fees, and other needs
of the family. Experts suggest they likely
do the same for sanitation facilities.
There is sufficient evidence to suggest that when women and girls have poor access to sanitation, they bear a greater burden and suffer worse outcomes than men.
Poor access to sanitation is related to other outcome disparities for women and girls
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Gender relations within the household influence sanitation-related decisions
Decision: Should the household have a latrine?
• Studies found that men’s in-home
latrine preferences are driven by
prestige; women’s by concerns for
privacy. However, reported preferences
may not be a true reflection of
attitudes/needs and may be influenced
by agency and norms.
• Programs have leveraged patriarchal
norms to encourage men to build
household latrines. India’s ‘No Toilet, No
Bride’ program demanded that
potential marriage suitors construct a
toilet.
Decision: Who in the household can access or use the facility? When?
• Norms within the household restrict
certain family members from using toilets;
e.g.,
o Norms about sanitation practices
during menstruation can perpetuate
poor sanitation and increase risk of
sanitation-related illnesses;
o Women negotiate access to sanitation
with their husbands or in-laws and/or
taboos prevent men from using the
same toilet as their mothers in-law or
daughters.
Decision: What role does each household member play?
• Women carry the bulk of the day-to-
day sanitation burden (e.g., educating
children to managing hygiene and
cleaning the latrine). This can lead to
reinforced gender roles and time
poverty, and may limit roles within
and outside the home.
• Men take on the role of toilet
construction and financing; we know
less about the implications of this on
other sanitation decisions (e.g.,
where a toilet is constructed).
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While household latrines can improve privacy & safety, it could also restrict mobility for women. A study in Rajasthan
found that household latrines increased women's social isolation, as they no longer had a reason to leave the home
There are gendered differences in informal
sanitation roles …...and these roles can perpetuate gender inequities
Pit emptying is mostly done by men from low-
income communities.
For example, in Ghana, pit emptying is done manually by men.
The job is physically hazardous and causes stigma which
reduces opportunities to marry.
Latrine cleaning, even of public toilets, often
remains a woman’s role.
Low-caste women engaged in manual scavenging received little
or no income, perpetuating inequities and economic disparity.
Formal roles in the sanitation sector also
display gendered differences …
…however, the impact of gender imbalances on outcomes in these enterprises is unclear
Women are under-represented in formal, technical
roles in sanitation-related public and private
enterprises, e.g., a 2011 survey reported that
women comprise less than 10% of total
professional WASH staff.
Although there are some efforts to improve gender equality in
the sanitation sector, there is limited to no research on the
impact of women’s employment or leadership on the
effectiveness of sanitation programs.
There is limited participation of and leadership by women across the sanitation value chain
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Women typically are under-represented in formal, technical roles in sanitation-related public and private enterprises
Lack of gender considerations in policy
design can lead to unintended
consequences.
• India’s National Urban Sanitation Policy (2008) aims for universal
sanitation through behavioral change and integrated sanitary
installations. However, it does not provide ways to address the lack of
safety for women users, resulting in increased open defecation.
Even when gender is considered in
sanitation policies, budgets are
inadequate for implementation.
• “We’ve been asked to mainstream gender by our donor, it is part of our
strategic guidance, however, we have no line item budget for it.”
• “Sometimes, gender is seen as a ‘nice to have’ rather than a ‘need to do’
aspect; short time-frames and budget limitations add to this.”
Lack of gender disaggregated data
further inhibits sanitation policy
making and planning.
• None of the indicators for Sustainable Development Goal 6 on ‘water and
sanitation for all’ are disaggregated by gender. Even when indicators are
collected, the focus is on access, and not on outcomes that matter to
women, such as safety, privacy, and dignity.
• “Even household surveys may misrepresent views of women, particularly
in patriarchal communities where the man speaks for the family.”
Sanitation policies are designed as gender neutral, often overlooking the diverse needs of men and women
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Many sanitation policies have yet to integrate a gender lens and do not intentionally consider gender differences in the design of public sanitation systems and solutions
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Before
After
Gender in sanitation has progressed to a broader, systematic approach incorporating the full sanitation value chain
Despite the challenges still facing the sector, gender in sanitation has been moving from a very narrow view of how to incorporate gender – one that focuses mainly on how menstrual hygiene management (MHM) materials are disposed of – to a much broader, systematic approach that encompasses the full sanitation value chain.
Gender Unintentional
Gender Intentional
Gender Transformative
When thinking through gender issues, it is important to understand the vocabulary. This continuum of gender integration and mainstreaming spans three categories of how gender is incorporated, depending on whether the work has identified how gender affects a problem and is addressing it, and whether it seeks to reduce gender gaps in access to resources and / or transform gender power relations.
Gender Vocabulary 101: Gender Integration
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Transforms Gender Power Relations and Norms
Recognizes Gender
▪ Investment does not recognize impact of gender on the problem;
▪ Investment does not integrate gender in the approach;
▪ Investment may result in unintended consequences to gender relations and to women and girls.
Investment seeks to reduce
gender gaps in access to
resources, for example by
improving the condition of
women and girls.
Investment seeks to transform gender power relations and norms
Investment seeks to increase women’s and girls’ empowerment
How can we support commercial partners in moving to here?
Source: BMGF Gender Integration Assessment Tool
Gender Vocabulary 101: Intersectionality
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Secondary school completion in Bolivia according to sex and language*
Gender analysis is more powerful when connected to other dimensions of exclusion because gender compounds discrimination – consider the intersection with race, geographic location, religion, and other factors.
Source of visual: World Bank. 2013. Inclusion Matters: The Foundation for Shared Prosperity. Washington, DC.
*Figure shows secondary school completion marginal effects, using men and Spanish mother tongue as reference group, for people 25 years and older, controlling for age, age-squared, and urban/rural residence.
Gender influences the full sanitation value chain – early learnings from the BMGF Gender Evidence Review
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The WSH team and Gender Equality teams at BMGF partnered to conduct an evidence review of the role that gender plays in sanitation. The review aimed specifically to:
Understand if, where, and how gender influences sanitation and to what extent sanitation is important for gender equality and women and girls
Understand the strength of the evidence base to show what the field knows and where there are gaps
Surface the most important challenges that emerge across the sanitation value chain related to gender
Highlight potential learning questions and knowledge gaps to inform the WSH team’s learning agenda
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4Read the Report in the STePResource Center here.
The BMGF Gender Evidence Review includes key findings from across the value chain that affect multiple stakeholders
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Household
Community
Public and
private
enterprises
Governance,
policy, and
financing
FACILITIES AND USE CONSTRUCTION MAINTENANCEDECISIONS/INFLUENCE Decision / Influence Facilities and Use Construction Maintenance Containment Emptying Transport Treatment Reuse / Disposal
Community sanitation efforts
encourage women’s participation,
but fail to address gendered roles
and relationships
“A study in Nigeria found that projects
led to equal representation of women
and men on the Water and Sanitation
Committees, but not equal decision-
making authority”
Discriminatory gendered social
norms within the household
influence men and women’s
sanitation purchase decisions, use,
maintenance, and accessibility
“In Zambia, rural men are prohibited
from sharing toilet with in-laws and
grown adolescent girls”
Number and placement of public sanitation
facilities favors men and is inadequate to meet
women’s needs “In Ahmedabad, public facilities for
men outnumber those for women by nearly 42%”
Sanitation design rarely considers women’s
preferences and/or need for privacy, convenience,
dignity and affordability “A cross-sectional study of
slum dwellers in Uganda and Tanzania found that
public latrines, though of good quality, were under-utilized due to user fees”
Fear of sexual assault, shaming, and harassment
influences women’s mobility and access to sanitation facilities outside the home
“56 % of women living in slums around Lagos, Nigeria
avoid using toilets at certain times of the day to avoid
putting themselves at risk of violence.”
Disposal of menstrual waste is rarely considered by public
and private sector actors “Menstrual waste disposal was not
prioritized in the planning of developing communal sanitation
blocks in informal settlements in Nairobi-. This led to women
throwing waste in toilets and blocking the pipes. “
Women perform low-level sanitation roles for little or no
income, perpetuating inequities and poor economic outcomes
“In India, up to 95% of the manual scavengers (people who
manually sweep household dry latrines and carry human excreta) are women”
Policies are designed as gender neutral, overlooking diverse needs of men and women across the life course; women have limited decision making role in setting
sanitation policies “India’s National Urban Sanitation Policy (2008) did not provide ways to address the lack of basic services and safety for women users, resulting in
increased open defecation from unsafe sanitary public infrastructure”
Sanitation enterprises are largely run by men; however, its
correlation to sanitation and gender outcomes is unclear
“Half of the countries surveyed reported that women comprise less
than 10% of total professional WASH staff “
Source: Gender and the Sanitation Value Chain: A Review of the Evidence, BMGF, December 2018. http://stepsforsanitation.org/resource-center/ft-all-resources/#gender-and-sanitation
What does this mean for Commercial Partners (CPs)?
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Build gender into your internal/external narratives
Measure it: Disaggregate data by sex
Look at your own team
Design products for the full market
Optimize go to market strategies
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Build gender into internal and external narratives
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Acknowledge how the experiences of women, men, girls and boys are different with respect to the targeted problems and proposed solutions• Are you building your case around women and girls’ development?
Safety? Families? Empowerment?• Do you want to share your outcomes specific to the impact on different
genders?
Acknowledge
Think about how your organization views and values the role of gender intentionality in your activities• Intentional incorporation of gender perspectives will benefit your
product – expect a net benefit• Consider the additional internal benefits in increased employee
engagement
Self-assess
A gender analysis can be a great place to start to unearth the most important linkages between gender and the work CPs undertake (see slide 17).
What is a gender analysis in sanitation?
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A gender analysis is a critical, systematic examination of differences in the constraints and opportunities available to an individual or group with regards to sanitation based on their sex and gender identity
Gender analysis in sanitation explores social relationships in several domains, to determine:
• How gender determines the way people experience sanitation at all points of the value chain
• Gender differences in access to, use of, and agency over relevant sanitation resources
• Gender differences in who makes household decisions relevant to sanitation, e.g., where and how to spend resources, service utilization, transportation
• Relevant gender differences in time use (e.g., are women doing all the house work related to sanitation, while their husbands make decisions about sanitation)
• Prevalence of gender based violence and how it may be related to sanitation
• Analysis of laws, institutional policies and social practices that may reinforce or challenge relevant gender inequalities in sanitation, and how
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This approach to analyzing a situation can establish a more complete and less biased standpoint from which to understand the context of a project, allowing for improved outcomes/uptake.
It can also identify unintended consequences and potential risks to the welfare of beneficiaries that could result from the investment unless addressed, and allow them to be dealt with before any project is implemented.
What does this mean for Commercial Partners?
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Build gender into your internal/external narratives
Measure it: Disaggregate data by sex
Look at your own team
Design products for the full market
Optimize go to market strategies
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When researching market and field testing products, are the data collected disaggregated by sex? If not, you could be missing important insights.
If you are not including sex in your measurements, you risk unintended consequences, for example, if you don’t factor in household dynamics and control of resources at the individual level, product proliferation may suffer.
What does this mean for Commercial Partners?
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Build gender into your internal/external narratives
Measure it: Disaggregate data by sex
Look at your own team
Design products for the full market
Optimize go to market strategies
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Check your own gender assumptions.
• Are you gender balanced on your own team and in your partnerships?
• Do you have gender expertise on staff or can you build in this capacity?
2020
Look at your own team: are you gender balanced?3
BMGF partners conducted a survey targeting global BMGF RT technology grantees to understand team composition. Among surveyed teams, most have more men than women and are headed by men, but have wide representation from women.
Gender proportions related to the general team composition
Gender proportions related to the leadership composition
Source: https://biomasscontrols.com/elledge-sanitation-gender-lens-fsm5/
What does this mean for Commercial Partners?
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Build gender into your internal/external narratives
Measure it: Disaggregate data by sex
Look at your own team
Design products for the full market
Optimize go to market strategies
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Half of toilet users have menstrual hygiene needs. Product designs for women include
menstrual hygiene management (MHM) and go well beyond.
Design products for the full market to optimize potential4
Have you factored MHM needs into the use case for your product design and ecosystem?
Are you aware that MHM considerations are part of the emerging ISO standards?
Remember that other product design factors such as product placement or the design of the entrance may also be influenced by gender.
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Lack of gender-sensitive sanitation design … ..can create added burden for women users
For example, the septic tank, Aqua Privy, in South
Africa was designed to avoid the need for
consistent water supply and to reduce odors.
There was no consideration of gender differences
in use and facility maintenance.
Aqua Privy requires water to be poured into the toilet
bowl after use and the sludge needs to be emptied
periodically—being seen doing these activities
embarrassed female users. Additionally women could
not flush sanitary pads into the bowl and the toilets
were too small for pregnant women
Lack of up front gender analysis…..calls for product redesign once analysis is completed
For example, the Clean Toilet, is an off-grid
solution designed to be convenient, modern,
hygienic, user friendly and affordable for
households that failed to consider the physical
and cultural preferences of women.
As a result, women consistently stopped using their in
home toilet during menstruation. In the redesign
process engineers considered safety (including locks),
toilet placement and toilet appearance, among other
things, aimed at increasing use, especially among
women.
Design products for the full market so that women use them
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What does this mean for Commercial Partners?
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Build gender into your internal/external narratives
Measure it: Disaggregate data by sex
Look at your own team
Design products for the full market
Optimize go-to-market strategies
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3
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Optimize go-to-market strategies to reach women and girls
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Many times go-to-market strategies remain genderless. Factoring gender into a go-to-market strategy can lead to more effective strategies. Optimize go-to-market strategies with gender intentional models by considering the following:
Have household dynamics factored into your go-to-market strategy?• How might the norms influencing your target market affect how your
product is purchased and implemented?
Have you evaluated consumer preferences by gender, acknowledging the interhousehold dynamics in decision making? This can lead to:• More effective go-to-market strategies• Opportunities that others may have missed (e.g., female sani-preneurs)
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Access to resources and need for privacy influence women’s use of public sanitation
Pay-per-use public toilets can discriminate against women.
• Women need more frequent access to facilities during
menstruation and pregnancy – so the cost of public
toilets affects them more.
• Women who have no income, women who earn less
than men or have little to no control over household
financial resources, can find paying for public toilets as
a significant barrier to use.
Need for privacy may affect willingness to use public toilets.
• Public toilet designs often do not protect privacy, causing
stress, particularly for women.
• Since defecating is associated with shame, both men
and women also desire privacy while walking or waiting
to use facilities.
“The toilet was made out of wood planks. I could see someone
from inside and the person outside could also see me. It was
really stressful as I would feel eyes watching me.” - Female
user in an informal slum, Kenya
A study in Zambia found that men are concerned about the
anonymity of public latrine use—since urinating in the open is
easy for a man, using a public latrine may clearly indicate to
others that he needs to defecate.
A cross-sectional study of slum dwellers in Uganda and
Tanzania found that public latrines, though of good quality,
were under-utilized due to user fees.
Optimize go-to-market strategies – examples from the field
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Appendix: Additional Resources
The BMGF Gender Integration Guide outlines how the Foundation is thinking about investing in gender
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Step Three: Context
What is the gendered context in which theproblem exists?
Step Five: Solution
How does the proposed solution integrate agender lens?
Step One: Problem
What problem does this investment target?
Step Two: Population
Who is affected by this problem?
Step Four: Gaps
What are the relevantgender gaps affectingthis problem?
Look for:
▪ Primary and secondary data supporting the problem statement;
▪ An analysis of the root causes and social context of the problem.
Look for:
▪ An analysis of who is most affected by this problem:▪ Which
population(s) specifically, which women, men, girls and boys?
▪ How the problem differentially affects people based on their social and demographic characteristics.
Look for:
▪ Whether a gender analysis was conducted:▪ Context analysis
identifying the different barriers, challenges and opportunities that women, men, girls and boys face with regard to the problem.
Look for:
▪ A clear articulation of gender gaps and gender-related barriers;
▪ Data supporting the identification of gender gaps;
▪ Explanation of how these gaps were prioritized in determining the proposed solution(s).
Look for:
▪ Whether the proposed solution addresses prioritized gender gaps/barriers;
▪ Potential risks/ unintended consequences;
▪ A plan to measure changes in gender gaps and barriers;
▪ Opportunities for gender transformative work;
▪ Gender expertise on implementation team.
The BMGF Review of the Evidence provides key learnings to help advance research and understanding
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This report provides a review of the current evidence available on gender in sanitation and concludes with key learnings to help advance research and understanding
• Understand if, where, and how gender influences sanitation and to what extent sanitation is important for gender equality and women and girls
• Understand the strength of the evidence base to show what the field knows and where there are gaps
• Surface the most important challenges that emerge across the sanitation value chain related to gender
• Highlight potential learning questions and knowledge gaps to inform the WSH team’s learning agenda Click here to view report in the STeP Resource Center
The BMGF Case Studies in Gender Integration illustrate how gender impacts sanitation outcomes
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These case studies in gender and sanitation are intended to offer readers an opportunity to unpack and understand the role of gender differences in driving sanitation outcomes, how programs identify and seek to address these differences, and whether the program also promotes gender equality and women’s empowerment. Each of the three sanitation sector case studies focuses on different parts of the value chain to illustrate the many ways that gender impacts sanitation outcomes for men and women.
Click here to view reports in the STeP Resource Center
The BMGF Women and Girls’ Empowerment Conceptual Model draws on decades of evidence and practice
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Many programs that aim to benefit women and girls do not ultimately empower them, and may in fact reinforce their lack of power. A focus on empowerment requires a shift away from seeing women and girls as beneficiaries of programs to viewing them as agents of change. The aim of this conceptual model is not to reinvent the concept of women and girls’ empowerment, but rather to draw on decades of thought, program work, evidence, and learning to ensure that we approach our work on women and girls’ empowerment with clarity and consistency. This brief presents the BMGF model of women and girls’ empowerment, developed in partnership with the Gender Team at the Royal Tropical Institute of the Netherlands (KIT).
Click here to view the report in the STeP Resource Center
