Type of water and sanitation facilities and risk of-non-partner sexual violence: A multilevel analysis across 31 low-and middle-income countries

초록

Background: Disadvantaged access to water, sanitation, and hygiene (WASH) is acknowledged as a risk factor for non-partner sexual violence (NPSV), particularly in the context of low- and middle-income countries (LMICs). However, gaps in knowledge regarding the associations between inadequate WASH and NPSV persist. Methods: Demographic and Health Surveys from 31 low- and middle-income countries (2013-2021) were used for the analysis of 259,208 women aged 15-49 years. For the experience of NPSV in the last 12 months, its associations with source of drinking water (private [reference], public, open source) and type of toilet facilities (private [reference], shared, no facilities) were estimated using three-level logistic regressions. Results: Overall, 0.5 % had a recent experience of NPSV. After adjusting for sociodemographic characteristics, women who used public (Adjusted odds ratio [AOR] = 1.27, 95 % confidence interval [CI] = 1.06-1.52) or open source for drinking water (AOR = 1.37, 95 % CI = 1.02-1.84) were more likely to experience NPSV. Similarly, women who used shared toilet facilities (AOR = 1.16, 95 % CI = 1.01-1.34) and who had no facilities (AOR = 1.40, 95 % CI = 1.17-1.68) had greater risk for NPSV. The interaction was only marginally significant (p-value = 0.07). Conclusions: The findings support the need to expand WASH-related programs, which can contribute to the prevention of sexual violence and empowerment of women in LMICs. National and global advocacy is essential to resolve discriminatory climates that condone and facilitate violence against women in water-related contexts.

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