Abstract
BackgroundGlobally, one in ten individuals practice open defecation. Despite media speculation that it increases women’s risk of sexual violence, little empirical evidence supports the claims. We investigate the relationship between household sanitation facilities and women’s risk of non-partner sexual violence (NPSV) in India, where nearly half of the population lives without a pit or toilet.MethodsWe use the most recent NPSV data, from the National Family Health Survey-III, to estimate logistic regression models of the effects of household sanitation facilities (toilet, pit, or none) on NPSV in the last year among women who have resided in their current home for one year or more. These effects are estimated net of other socioeconomic factors, compared to effects of household sanitation facilities on child diarrhea, and, as a falsification test, compared to effects of household sanitation facilities on intimate partner sexual violence (IPSV) in the last year.ResultsNet of their socioeconomic status, women who use open defecation are twice as likely to face NPSV as women with a household toilet. This is twice the association between open defecation and child diarrhea. The results of our falsification test indicate that open defecation is not correlated with IPSV, thus disconfirming a simultaneous selection of women into open defecation and sexual violence.ConclusionsOur findings provide empirical evidence that lacking household sanitation is associated with higher risk of NPSV.
Highlights
One in ten individuals practice open defecation
We analyze data from the 2005–06 Indian National Family Health Survey- III (NFHS), a nationally representative dataset collected by ICF international and the Indian Ministry of Health using a stratified random sampling approach [14]. 68 % of women from the full sample were selected for the domestic violence module, with one woman between the ages of 15 and 49 randomly selected from each household to answer questions about their exposure within the past year to different types of violence, including non-partner sexual violence (NPSV)
To address whether the observed associations with NPSV reflect the selection of disadvantaged women into both households that lack sanitation facilities and higher risk of sexual violence, or are specific only to NPSV, we explore whether lack of sanitation facilities is associated with intimate partner sexual violence (IPSV)
Summary
We analyze data from the 2005–06 Indian National Family Health Survey- III (NFHS), a nationally representative dataset collected by ICF international and the Indian Ministry of Health using a stratified random sampling approach [14]. 68 % of women from the full sample were selected for the domestic violence module, with one woman between the ages of 15 and 49 randomly selected from each household to answer questions about their exposure within the past year to different types of violence, including NPSV. To put the magnitude of our estimated associations of the relationship between women’s access to sanitation facilities and NPSV in perspective, we test the relationship between household sanitation facilities and diarrhea among children This analysis is limited to mothers with a child younger than age five residing in their same household (N = 25,285; 33 % of the analytic sample). Though we account for socioeconomic factors in our main analyses, we recognize that other unobserved factors could drive a spurious association between household sanitation facilities and sexual violence. If this were the case, we would anticipate to observe an association between household sanitation facilities and IPSV. We present the results of all logistic regressions in terms of oddsratios (Tables 2, 3 and 4)
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