Abstract
Abstract Meeting the needs of an ageing population, particularly in the global South, is increasingly an issue for WASH service provision. An ageing-related issue for women, warranting specific attention from the WASH sector, is the perimenopause, but this is often not discussed publicly. Drawing on data from the UK and Ghana, this paper provides recommendations for meeting the additional WASH needs of women as they experience the perimenopause (the transition period to menopause). Finding these ‘hidden’ needs involved a UK-based phenomenological review and mixed feminist methods in two low-income urban communities in Accra and Kumasi, Ghana. The hidden WASH needs of perimenopausal women included understanding the perimenopause, menstrual hygiene management, urine incontinence management, bathing, and laundry. Community awareness, engagement and empowerment, and ensuring good perimenopausal health can begin to address these needs. Infrastructural measures for perimenopausal women include a continuous water supply, user-friendly bathing and laundry infrastructure, and gender-sensitive, accessible toilets with discrete sanitary disposal bins. High-absorbency sanitary products are important for managing heavy menstruation. A better understanding of the needs of perimenopausal women and training on how to meet these would benefit the WASH sector in ensuring that perimenopausal women are not left behind in efforts to meet the Sustainable Development Goals.
Highlights
People’s water and sanitation needs change throughout their lifespan, from those of an infant and toddler, to those of the elderly and infirm who may be unable to use standard facilities
Bathing and laundry are important hygiene practices that are under-discussed in the WASH sector
The data from the phenomenological review were used to formulate research questions to explore in the stage in Ghana, such as ‘What are the uses of water specific to perimenopausal women in low-income countries?’, ‘How are the bathing needs of women affected during the perimenopause?’, and ‘How are laundry needs affected during the perimenopause?’
Summary
People’s water and sanitation needs change throughout their lifespan, from those of an infant and toddler, to those of the elderly and infirm who may be unable to use standard facilities. Life expectancy in low-income countries is expected to increase (HelpAge International 2013). By 2050, almost 80% of the world’s population aged over 60 will be living in less-developed regions, with women projected to live for significantly longer than men in low- and middle-income countries (UN 2013). Ensuring that WASH services meet the needs of an ageing population is an increasing issue for equity and inclusion. The task of carrying water falls on women, who are prone to osteoporosis as life expectancy increases. Providing water and sanitation facilities closer to the home minimises the risk of injury and violence towards women (WSSCC and FANSA 2016). One in three men over 50 will have
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