Sanitation Services Designed with Inclusivity in Mind

Equitable access to water, sanitation, and hygiene is essential to achieving broader development goals, and supporting the health and dignity of all people. People with disabilities, LGBTQI+ persons, Indigenous Peoples, youth, women, and girls all face unique challenges when it comes to accessing water and sanitation services.

Universally accessible water, sanitation, and hygiene services can mitigate injuries, reduce poor health outcomes, and alleviate poverty risks faced disproportionately by marginalized groups.

At USAID, inclusive development is defined as an equitable development approach built on the understanding that every individual and community, of all diverse identities and experiences, is instrumental in the transformation of their own societies. Their engagement throughout the development process leads to better outcomes.

“We must offer people, not a vision merely of international development,” USAID Administrator Samantha Power stated, “but a vision of inclusive development.”

Under the U.S. Global Water Strategy, USAID is working to increase access to water, sanitation, and hygiene through programs grounded in inclusive approaches and designed to respond to specific experiences, traditional knowledge, and barriers to equity and inclusive outcomes.

Economic Empowerment and Sustainable Access to Period Products

When menstruators can access water and latrines anywhere and at any time, that contributes to a water-secure world. In Madagascar, USAID partnered with local organizations to create more inclusive environments for women, girls, and students in the community by increasing employment opportunities and simultaneously improving access to period products.

Vola is a professional seamstress with a physical disability that has affected her since she was in an accident as a child. When she was laid off after many years at a stable job as a pharmacy technician, she had a hard time finding work again.

“I am sure I have the experience, but people are still reluctant to work with disabled people,” said Vola.

She eventually found a training opportunity for people with disabilities to increase her level of expertise as a seamstress with the Ministry of Population, Social Protection and Promotion of Women (MPPSPF).

Vola was recognized for her leadership and quality of work during the training, and then recruited to participate in an additional USAID-supported training program where she learned to make reusable, washable sanitary pads. She also learned how to create an effective sales marketing strategy to sell her products to individuals who are sick and in the hospital or to people with reduced mobility.

When Vola first started her business, she sold about 100 menstrual products each month. Now, sales have reached about 600 menstrual products each month and Vola has been recruited by USAID to train other seamstresses to continue supporting menstruating individuals in her community with sustainable and affordable period products.

Equitable Access to Safe Sanitation

USAID also supports access to safe sanitation for persons with disabilities. Rasta, a father of four children and a construction worker, is working to eliminate barriers to safe sanitation for persons with disabilities in Madagascar.

Through USAID-supported training, he has become an expert in building latrines that are designed to improve access for persons with disabilities.

This year, Rasta and his team of construction workers built a latrine block at a local primary school and a college in Andonabe, Madagascar. Both are suitable for those with reduced mobility and include ramps instead of stairs and textured surfaces to help safely guide visually impaired people through the layout of the latrine block.

“I am happy to see that these students with disabilities can easily use this toilet block,” said Rasta.

In 2021, USAID supported over 205,000 people gain access to safe sanitation in Madagascar, including the students who benefitted from Rasta’s dedication to ensuring equitable access to sanitation services.

Partnering with LGBTQI+ Community in India

Transgender individuals all over the world are targets of discrimination and often lack legal recognition of their gender identity and access to essential services such as education, employment, as well as safe and stigma-free health care.

USAID partnered with the WASH Institute, the Odisha State Government, and the Odisha Water Academy to provide skills training for community self-help groups in over 1,000 cities to manage fecal sludge treatment plants. The program targeted marginalized groups that routinely encounter socio-economic exclusion — including the LGBTQI+ community here — with better opportunities for employment at the completion of their training.

The training helped participants to get jobs and earn a monthly salary of approximately 14,000 to 15,000 INR ($170-$183). Thanushree, a training graduate, said that fellow trainees stopped begging in public places after completing the training.

“We use this as an opportunity to educate ourselves and move on to better things,” shared Thanushree.

Inspired by the success of this initiative, other towns have now begun to adopt similar methods. As of June 2022, Odisha established 104 fecal sludge treatments, along with 32,000 existing self help groups for youth, LBGTQI+ persons, and others, across 111 towns and cities. Through the trainings provided by the self-help groups, community members will develop the skills to manage sanitation facilities, increasing their employability.

This model of inclusive development and locally-led work in Odisha has created a template for stronger approaches to sanitation elsewhere in the country.

In India, USAID’s partnership with communities like Thanushree’s resulted in over 1 million people gaining access to safe sanitation in 2021.

Paving the Way for Inclusive Development

In order to achieve our collective development goals, all individuals need to have equitable access to water and sanitation services, regardless of where they live or who they are.

USAID is committed to addressing these barriers through inclusive development practices, outlined in a new technical brief, which summarizes the Agency’s strategies to support effective, sustainable, and efficient water security, sanitation, and hygiene programming through inclusive approaches.

About the Author

Stephanie Mork is a Communications Analyst in USAID’s Bureau for Global Health.