Sinclair Elaina, Hüls Anke, Patrick Madeleine, Arun Srishty, Ramanarayanan Vinod, Sinharoy Sheela S, Caruso Bethany A
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA USA.
Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA USA.
Nat Water. 2025;3(7):782-792. doi: 10.1038/s44221-025-00452-5. Epub 2025 Jun 17.
Despite sanitation facility availability, perceived privacy, safety and security, and health status and risks may prevent toilet use, particularly for women. Women may withhold food and water (withholding) or suppress urination and defecation urges (suppression) to cope, though evidence on the prevalence and drivers of these behaviours is limited. This secondary analysis of data generated as part of the Measuring Urban Sanitation and Empowerment project ( = 2,173) assesses the prevalence of withholding and suppression among urban women in Kampala, Uganda and Tiruchirappalli, India, and associations with perceived sanitation-related privacy, safety and security, and health status and risks (withholding analytic sample, 1,308; suppression analytic sample, 862). Witholding was reported by 38% (265/697) of women in Kampala and 16% (100/611) in Tiruchirappalli; more than 93% of women in both populations (Kampala, 415/440; Tiruchirappalli, 336/350) reported suppression. Privacy, safety and security, and health scores were all significantly associated with the odds of withholding in both cities. Fewer significant results were found from linear regression analyses assessing privacy, safety and health scores and suppression, suggesting other, unaccounted-for influences. The results suggest that sanitation-related privacy, safety and health conditions should be addressed programmatically to improve women's sanitation-related circumstances and behaviours.
尽管有卫生设施，但对隐私、安全保障以及健康状况和风险的认知可能会阻碍人们使用厕所，尤其是对女性而言。女性可能会通过节食节水（节制）或抑制排尿和排便冲动（抑制）来应对这种情况，不过关于这些行为的发生率及其驱动因素的证据有限。这项对作为“衡量城市卫生与赋权”项目一部分所产生的数据进行的二次分析（样本量 = 2173），评估了乌干达坎帕拉和印度蒂鲁吉拉伯利的城市女性中节制和抑制行为的发生率，以及与对卫生相关隐私、安全保障、健康状况和风险的认知之间的关联（节制分析样本量为1308；抑制分析样本量为862）。坎帕拉38%（265/697）的女性和蒂鲁吉拉伯利16%（100/611）的女性报告有节制行为；这两个人口中超过93%的女性（坎帕拉，415/440；蒂鲁吉拉伯利，336/350）报告有抑制行为。在这两个城市中，隐私、安全保障和健康得分均与节制行为的几率显著相关。在评估隐私、安全保障和健康得分与抑制行为之间关系的线性回归分析中，发现的显著结果较少，这表明存在其他未得到解释的影响因素。研究结果表明，应通过制定相关计划来解决与卫生相关的隐私、安全保障和健康问题，以改善女性与卫生相关的处境和行为。
