Sinharoy Sheela S, McManus Shauna, Conrad Amelia, Patrick Madeleine, Caruso Bethany A
Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America.
Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America.
World Dev. 2023 Apr;164:106183. doi: 10.1016/j.worlddev.2023.106183.
Sustainable Development Goal 6 aims to ensure access to water and sanitation for all, and target 6.2 emphasizes "paying special attention to the needs of women and girls". Research documenting how water, sanitation and hygiene (WASH) conditions impact women's and girls' lives is growing. However, no rigorously validated survey instruments exist for measuring empowerment within the WASH sector. The objective of our study was to develop and validate survey instruments to measure sub-domains of women's empowerment in relation to sanitation in urban areas of low- and middle-income countries. We followed a multi-phased, theory-informed approach that included factor analysis and item response theory methods, as well as reliability and validity testing, to analyze cross-sectional data collected from women in two cities: Tiruchirappalli, India (N = 996) and Kampala, Uganda (N = 1,024). Through rigorous evaluation of conceptually grounded question (item) sets, we identify a set of valid, comprehensive scales. The Agency, Resources, and Institutional Structures for Sanitation-related Empowerment (ARISE) scales represent 16 sub-domains of sanitation-related empowerment, each of which can be used alone or in combination with others, as needed. The ARISE scales are the only set of psychometrically validated metrics for the measurement of women's empowerment in WASH. In addition to the scales, we provide six indices to assess women's direct experiences with sub-domains of sanitation-related empowerment, as well as validated item sets related to menstruation, which are available as optional add-on measures for those who menstruate. The ARISE scales and associated survey modules respond to an established need for an increased focus on empowerment in WASH. We provide researchers and implementers with tools to measure sub-constructs of empowerment in a valid and reliable way, to generate data for better targeting, design, implementation, and evaluation of strategies to improve women's empowerment in the context of urban sanitation at the program and policy level.
可持续发展目标6旨在确保人人都能获得水和卫生设施，具体目标6.2强调“特别关注妇女和女童的需求”。记录水、环境卫生和个人卫生（WASH）状况如何影响妇女和女童生活的研究越来越多。然而，目前还没有经过严格验证的调查工具来衡量WASH部门内的赋权情况。我们研究的目的是开发并验证调查工具，以衡量中低收入国家城市地区与卫生设施相关的妇女赋权子领域。我们采用了一种多阶段、基于理论的方法，包括因子分析和项目反应理论方法，以及信度和效度测试，来分析从印度蒂鲁吉拉伯利（N = 996）和乌干达坎帕拉（N = 1,024）两个城市的妇女那里收集到的横断面数据。通过对基于概念的问题（项目）集进行严格评估，我们确定了一组有效、全面的量表。卫生设施相关赋权的机构、资源和组织结构（ARISE）量表代表了与卫生设施相关赋权的16个子领域，每个子领域可根据需要单独使用或与其他子领域结合使用。ARISE量表是唯一一套经过心理测量学验证的用于衡量WASH中妇女赋权的指标。除了这些量表，我们还提供六个指数来评估妇女在与卫生设施相关赋权子领域的直接经历，以及与月经相关的经过验证的项目集，这些项目集可供 menstruate的女性作为可选的附加测量指标。ARISE量表和相关的调查模块满足了对WASH中增强赋权的关注度不断提高的既定需求。我们为研究人员和实施者提供工具，以有效且可靠的方式衡量赋权的子结构，生成数据，以便在项目和政策层面更好地确定目标、设计、实施和评估改善城市卫生设施背景下妇女赋权的战略。
