Inadequate WASH access and risk for non-partner sexual violence in low- and middle-income countries

BACKGROUND: Globally, 6% of women and girls have ever experienced non-partner sexual violence (NPSV) at least once in their lifetime. Prior literature suggests that inadequate access to water, sanitation and hygiene (WASH) facilities can exacerbate the vulnerability to NPSV against women and girls, especially in low- and middle-income countries (LMICs). Nevertheless, quantitative evidence on the association between NPSV and inadequate WASH access is still limited. METHODS: Demographic and Health Surveys from 27 LMICs were used for the analysis of 237,324 women aged 15-49 years. Experience of NPSV was defined as an event within 12 months preceding the survey. Explanatory variables included type of sources for drinking water (private, public, and open source) and toilet facilities (private, shared, and open type). Multivariable three-level random effects logistic regressions were conducted. RESULTS: Overall, 6.6% of women were getting water from open sources such as river and 19.9% were openly defecating. 0.5% of the study sample had recent experience of NPSV. After adjusting for demographic and socioeconomic covariates, having to use public or open source for drinking water was associated with 26% and 37% greater likelihood of experiencing NPSV, respectively (OR: 1.26, 95% CI: 1.04-1.51 for public; OR: 1.37, 95% CI: 1.01-1.84). Using shared toilets and practicing open defecation were also associated with 16% and 39% greater risk for NPSV (OR: 1.16, 95% CI: 1.00-1.34 for shared; OR: 1.39, 95% CI: 1.16-1.68 for open). CONCLUSIONS: To prevent the victimization of women with disadvantaged WASH infrastructures and achieve Target 5 from the Sustainable Development Goals, which envisions to eliminate all forms of violence against all women and girls by 2030, it is essential to secure private water sources and toilet facilities via multinational official development assistance as well as country-level policies alongside with ensuring gender equality. KEY MESSAGES: • One out of 200 women in low- and middle-income countries has experienced non-partner sexual violence within a year. • Risk for such non-partner sexual violence was positively associated with inadequate access to water and sanitation facilities, particularly in low-resource settings.