33/49 Report of the Special Rapporteur on the human right to safe drinking water and sanitation

GE.16-13009(E)



Human Rights Council Thirty-third session

Agenda item 3

Promotion and protection of all human rights, civil,

political, economic, social and cultural rights,

including the right to development

Report of the Special Rapporteur on the human right to safe drinking water and sanitation

Note by the Secretariat

The Secretariat has the honour to transmit to the Human Rights Council the report of

the Special Rapporteur on the human right to safe drinking water and sanitation, prepared

pursuant to Council resolutions 16/2 and 21/2. In the report, the Special Rapporteur focuses

on gender equality in the realization of the human rights to water and sanitation.

Gender equality is a fundamental human rights principle, yet inequalities between

men and women, and on the basis of gender identity, are observed in all countries and often

translate into unequal opportunities and grave human rights violations. The Special

Rapporteur explains that a transformative approach is a prerequisite for ultimately

achieving gender equality in the enjoyment of the human rights to water and sanitation.

This approach requires challenging social norms, stereotypes and intra-household patterns,

while also promoting gender-responsive interventions that prioritize the implementation of

women’s specific needs. At the same time, the Special Rapporteur indicates that tackling

the material and structural determinants of gender inequalities in access to water, sanitation

and hygiene could serve as an entry point to address gender inequality more broadly.

The Special Rapporteur seeks to highlight areas that need particular attention in

order to prevent and respond to gender inequalities in access to water and sanitation, as well

as gender-based violence and barriers to the realization of the human rights to water and

sanitation.

Report of the Special Rapporteur on the human right to safe drinking water and sanitation

Contents

Page

I. Introduction ...................................................................................................................................... 3

II. Gender equality in law and policies ................................................................................................. 4

III. Intersectionality and multiple forms of discrimination .................................................................... 5

IV. Adopting gender-responsive measures ............................................................................................. 6

A. Redressing socioeconomic disadvantages ............................................................................... 6

B. Social norms and stereotyping ................................................................................................. 7

C. Gender-based violence and sanitation-related psychosocial stress .......................................... 9

D. Quality, health and safety issues .............................................................................................. 10

E. Affordability ............................................................................................................................ 11

F. Availability and accessibility ................................................................................................... 12

G. Participation and empowerment .............................................................................................. 15

H. Accountability.......................................................................................................................... 17

V. Conclusions and recommendations .................................................................................................. 20

I. Introduction

1. Inequalities based on gender exist in every country and in all aspects of social life,

and are echoed in the vast divides between men and women in their ability to access,

manage and benefit from water, sanitation and hygiene. A large and growing body of

studies suggests that women and men often have differentiated access, use, experiences and

knowledge of water, sanitation and hygiene. Cultural, social, economic and biological

differences between women and men consistently lead to unequal opportunities for women

in the enjoyment of the human rights to water and sanitation, with devastating

consequences for the enjoyment of other human rights and gender equality more generally.

2. Many of the challenges to achieving gender equality in access to water, sanitation

and hygiene are well documented: where water is not available in the home, women and

girls are primarily responsible for water and hygiene at the household level and bear the

greatest burden for collecting water. Other challenges related to inequality include access to

sanitation, menstrual hygiene and toilets for lesbian, gay, bisexual, transgender, intersex

and gender non-conforming people and an increased risk of gender-based violence.

3. Gender inequalities are pervasive at every stage of a women’s life: from infancy,

through to puberty, parenthood, illness and old age. In the present report, the Special

Rapporteur on the human right to safe drinking water and sanitation seeks to underscore the

importance of placing a strong focus on the needs of women and girls at all times,

throughout their whole lifecycle, and of not overlooking the needs of women and girls with

disabilities, living in poverty or suffering from other disadvantages. Gender inequality in

access to water and sanitation facilities affect a wide range of other human rights, including

women and girls’ rights to health, to adequate housing, to education and to food.

4. Gender-based violence infringes the right to life, personal safety and freedom of

movement. Gender non-conforming people often feel that they need to sign away their

freedom of expression since segregation by gender — including in public toilets, detention

centres, relief camps and school — poses a risk of exclusion, humiliation and violence.

5. Socioeconomic differences and sociocultural relationships, practices and stereotypes

may exacerbate gendered differences and result in discrimination in terms of the enjoyment

of rights. Since the root causes of those differences are complex and context-dependent,

progress towards substantive equality in access to water and sanitation requires public

action on different fronts. In tackling discrimination in the human rights to water and

sanitation, structural inequalities that inhibit the enjoyment of other human rights must also

be addressed. In the present report it is therefore suggested that concerted efforts in meeting

women’s material needs, such as access to affordable menstrual products, as well as their

strategic needs, such as tackling harmful gender stereotypes and structural determinants of

inequalities that affect access to water, sanitation and hygiene, may serve as entry points to

address gender inequalities more broadly.

6. The Special Rapporteur outlines several key points that require attention in order to

achieve substantive gender equality. Gender equality and non-discrimination must be

integrated in laws and policies and positive measures must be imposed to proactively

remedy injustices. Progress towards gender equality in practice requires the identification

of root causes of inequalities and the dismantling of structural barriers, taboos, stereotypes

and social norms that prevent the equal enjoyment of rights on the basis of gender. Policies

and special measures need to be adopted to tackle gender inequalities in practice and

strengthen women’s voice and participation. To ensure policies are implemented and

progress is made, strong accountability and monitoring frameworks must be put in place.

These will only be effective if women are systematically provided with opportunities for

meaningful participation, decision-making and access to and control of resources.

II. Gender equality in laws and policies

7. Non-discrimination and equality are interlinked and are fundamental principles of

international human rights law. Lack of access to adequate water, sanitation and hygiene

and the inability to participate in their management have in many instances, on a structural

basis, left many rights out of women and girls’ reach. Laws serve to give individuals a legal

claim, may create social expectations and may spur public action. Legal guarantees on

gender equality and non-discrimination can help to build political legitimacy to back the

enforcement of women’s and girls’ rights to access to water, sanitation and hygiene.

8. Gender equality refers to the equal rights, responsibilities and opportunities between

genders taking into consideration the different interests, needs and priorities and

recognizing the diversity of different groups of women and men.1 Gender equality means

that everyone must be able to enjoy the rights to water and sanitation equally. In order to

attain substantive equality, therefore, it is necessary to address the specific gendered

circumstances that act as barriers to the realization of those rights for women and girls in

practice. States must assess existing legislation, policies and strategies, and find out to what

extent the enjoyment of the rights to water and sanitation between men and women are

equally guaranteed. On the basis of that review, remedies should be provided and gender-

responsive strategies should be developed that guide policymaking and the corresponding

allocation of budgets. Temporary affirmative measures will in many cases be necessary.

9. Many legal constituencies, however, have laws in place that hinder the equal

enjoyment of the rights to water and sanitation. In many countries, land ownership, which is

a precondition for gaining access to water, is often denied to women by family laws that

also make it difficult for women to inherit land. Some countries criminalize open defecation

while at the same time closing down public sanitation facilities. 2 Public urination and

defecation is often criminalized and laws that aim to keep cities clean may discriminate

against homeless persons who have no other option but to relieve themselves in the open.

Among them are many women and girls in desperate need of an adequate facility that offers

privacy. Some States allow individuals to use toilets in a manner consistent with that

person’s chosen gender identity while other States oblige persons to use only those toilets

that correspond with the biological sex listed on their birth certificate.3 Restrictive gender

recognition laws not only severely undermine transgender peoples’ ability to enjoy their

rights to basic services, it also prevents them from living safely, free from violence and

discrimination. Water and sanitation facilities must be safe, available, accessible,

affordable, socially and culturally acceptable, provide privacy and ensure dignity for all

individuals, including those who are transgender and gender non-conforming.

10. Under international human rights law, States have the obligation to identify and

rectify all laws that have direct or indirect discriminatory consequences on the enjoyment of

the human rights to water and sanitation. The legal framework should contain provisions on

non-discrimination and equality in access to water and sanitation. Such laws should aim to

1 Mayra Gómez and Inga Winkler, “Gender equality, water governance and food security with a focus

on the Near East and North Africa”, final draft (2015), p. 4. On file with the author.

2 See A/HRC/27/55, paras. 19 and 22.

3 See, for example, bill S. 1203, introduced to the Senate of South Carolina, United States of America,

on 6 April 2016.

eliminate both formal and substantive discrimination, and take into account both public and

private actors.

11. Laws, policies and strategies should not inadvertently reinforce gender stereotypes

but should seek to transform them.4 It is important that policies and strategies explicitly

mention the different experiences of men and women and marginalized groups, otherwise

documents that may seem gender-neutral will hide important differences between genders

and will in practice benefit some persons more than others with regard to water and

sanitation.

III. Intersectionality and multiple forms of discrimination

12. Although women — at every economic level, all over the world — may suffer

disproportionate disadvantages and discrimination, they cannot be seen as a homogenous

group. Different women are situated differently and face different challenges and barriers in

relationship to water, sanitation and hygiene. Gender-based inequalities are exacerbated

when they are coupled with other grounds for discrimination and disadvantages. Examples

include when women and girls lack adequate access to water and sanitation and at the same

time suffer from poverty, live with a disability, suffer from incontinence, live in remote

areas, lack security of tenure, are imprisoned or are homeless. In these cases, they will be

more likely to lack access to adequate facilities, to face exclusion or to experience

vulnerability and additional health risks. The effects of social factors such as caste, age,

marital status, profession, sexual orientation and gender identity are compounded when

they intersect with other grounds for discrimination. In some States, women sanitation

workers are particularly vulnerable, as they are exposed to an extremely dirty environment

and contamination, which have a far greater impact during pregnancy and menstruation.

Women belonging to certain minorities, including indigenous peoples and ethnic and

religious groups, may face exclusion and disadvantages on multiple grounds. Those factors

are not exhaustive and may change over time.

13. In humanitarian situations, including in times of conflict or natural disaster, when

water and sanitation sources are at a minimum, the specific needs of women and girls are

often not taken into account.5 It is vital to better understand and share experiences about the

kinds of responses that can be deployed across the diverse range of emergencies, including

the most adequate and effective adaptations and interventions. 6 It further requires an

integrated approach and ongoing coordination among all sectors concerned.7 Lesbian, gay,

bisexual, transgender, intersex and gender non-conforming people face additional

challenges in areas affected by disaster. A recent United Nations assessment found that, in

Europe, women and girls who are refugees are vulnerable to violence and lack services that

specifically meet their needs, such as private bathing and sanitation facilities. 8 Some

women have reported having stopped eating or drinking to avoid going to the toilet where

4 Office of the United Nations High Commissioner for Human Rights (OHCHR), “Gender stereotyping

as a human rights violation” (October 2013).

5 WaterAid Bangladesh, submission to the Special Rapporteur.

6 Marni Sommer and others, “What is the scope for addressing menstrual hygiene management in

complex humanitarian emergencies? A global review”, Waterlines (to be published in 2016).

7 Tajikistan, submission to the Special Rapporteur.

8 European Parliament, “Reception of female refugees and asylum seekers in the EU: case study

Germany” (2016), p. 13.

they felt unsafe.9 The reaction of Governments and others to these situations is considered

inadequate and there is an emphasis on the urgent need to scale up such response efforts.10

14. In line with international human rights law, States should therefore use an

“intersectionality lens” in all policy initiatives, to ensure that special attention is given to

those persons most disadvantaged in the enjoyment of their rights.

IV. Adopting gender-responsive measures

15. Substantive equality demands policy responses that address women’s material and

strategic needs. Therefore, next to women’s practical necessities (including, for example,

for menstrual hygiene management), gender-responsive measures by the State and

interventions by non-State actors should challenge customary relationships of unequal

power and control, as well as stereotypes, between genders.11 Owing to the disproportionate

role that they play in domestic and caregiving responsibilities, for example, women are

more affected by the absence of water, sanitation and hygiene. Meeting the material need

for water, sanitation and hygiene may make it easier in many respects for women to

perform the roles assigned to their gender, but it does not in and of itself lead to greater

gender equality in relation to unpaid care work.

A. Redressing socioeconomic disadvantages

16. Worldwide, women perform unpaid jobs — mostly domestic and caregiving

responsibilities — three times more than men do.12 Therefore, as caregivers, women are

also more affected when family members get ill as a result of inadequate water, sanitation

and hygiene. Women’s disproportionate share of unpaid work makes them financially

dependent on others and leaves them less time for education and paid work. This again

reinforces gender-assigned roles and women’s financial dependence on men, including in

terms of their ability to pay for water, sanitation and hygiene services. In addition, States do

not value or reflect unpaid domestic and care work in economic indicators. Any

governmental or civil society approach that seeks to address gender inequalities needs to

question existing social norms and develop measures to encourage men to share

responsibilities with women.

17. Social prejudices deny women equal opportunities in technical and managerial jobs

in the water and sanitation sector and general norms work against girls and women in terms

of enrolment in technical or engineering studies. 13 States can invest in reskilling and

retraining women for these jobs, and stimulate increased access to higher education.

Proactive recruitment efforts can reduce barriers that stop women from applying for jobs

9 See https://www.amnesty.org/en/latest/news/2016/01/female-refugees-face-physical-assault-

exploitation-and-sexual-harassment-on-their-journey-through-europe/.

10 Office of the United Nations High Commissioner for Refugees, United Nations Population Fund and

Women’s Refugee Commission, “Initial assessment report: protection risks for women and girls in

the European refugee and migrant crisis — Greece and the former Yugoslav Republic of

Macedonia”(2016), pp. 3-10.

11 See A/HRC/22/50, para. 42.

12 Human Development Report 2015: Work for Human Development (United Nations publication, Sales

No. E.15.III.B.1), p. 12.

13 Catherine Hill, Christianne Corbett and Andresse St. Rose, Why So Few? Women in Science,

Technology, Engineering and Mathematics (Washington, D.C., American Association of University

Women, 2010), p. xiv.

they would like to do, particularly in fields where women are either underrepresented or

where wage gaps persist. The presence of women in more publicly visible positions,

including in politics, management and decision-making, may influence stereotyping and

deeply rooted gender-assigned roles.

B. Social norms and stereotyping

18. A gender stereotype is defined as “a generalized view or preconception about

attributes or characteristics that are ought to be possessed by, or the roles that are or should

be performed by women and men”. 14 A gender stereotype is harmful when it limits

women’s and men’s capacity to develop their personal abilities, pursue their careers and

make choices about their lives. Gender stereotyping is wrongful when it results in

violations of human rights and fundamental freedoms. States cannot dismiss stereotyping

and stigma as a social phenomenon over which States have no influence; instead, they must

actively combat practices that are based on harmful stereotypes of men and women,

including in the private sphere.15

19. Compounded gender stereotypes can have a disproportionately negative impact, in

particular on the enjoyment of the human rights to water and sanitation, on certain groups

of women, such as women with disabilities, women from minority or indigenous groups,

women from lower caste groups and women of lower economic status. They may moreover

become further compounded when they intersect with other forms of stigma or taboos, like

those linked to menstruation and perimenopause, incontinence or childbirth-related

complications, such as obstetric fistula. The power of stereotypes, stigmas, taboos and

gender-assigned roles is such that persons sometimes do not claim their legal rights for fear

or because of the pressure placed on them to conform to societal expectations. These deeply

entrenched issues call for approaches that go beyond formal protection in the law.

20. Practices and beliefs are different in every culture, but generally menstruation is

considered to be something unclean or impure and contact between men and women during

menstruation is viewed as something that should be avoided. 16 Girls and women are

sometimes not allowed to use the same toilets as men or are barred from certain locations.17

Girls all over the world grow up with the idea that menstruation is something they should

hide and not speak about — an embarrassing event associated with shame. This powerful

stigma and taboo surrounding menstruation translates into fear of leaking or staining

clothes. Worldwide, women and girls prefer to hide the fact that they are menstruating.18

Data collected in Senegal shows that, owing to shame, menstrual material, once washed, is

mainly dried in secluded, private and dark locations, such as tiled rooms or even under

pillows, instead of in direct sunlight, which would reduce the risk of infection by ensuring

that pathogens do not grow.19

21. In many cultures, girls are considered adults after their first menstruation and may

drop out of school, marry and start having children. Increased knowledge of menstruation

14 OHCHR, “Gender stereotyping as a human rights violation” (October 2013), p. 24.

15 See A/HRC/21/42, para. 58, and article 5 of the Convention on the Elimination of All Forms of

Discrimination against Women.

16 See www.wateraid.org/~/media/Files/Global/MHM%20files/Module1_HR.pdf.

17 Water Supply and Sanitation Collaborative Council and the United Nations Entity for Gender

Equality and the Empowerment of Women (UN-Women), Menstrual Hygiene Management:

Behaviour and Practices in the Louga Region, Senegal (2015), pp. 22-32.

18 See europe.newsweek.com/womens-periods-menstruation-tampons-pads-449833?rm=eu.

19 Water Supply and Sanitation Collaborative Council and UN-Women, Menstrual Hygiene

Management: Behaviour and Practices in the Louga Region, Senegal (2015), pp. 32.

by both men and women, combined with strategies to lift social taboos on menstruation,

may prevent girls from being considered as adults ready for marriage but, rather, as young

adolescents going through a normal phase of their development.20

22. Poor menstruation management has far-reaching consequences for society as a

whole and a lack of knowledge by both women and men reinforces the taboos on this topic.

Education, awareness-raising and training sessions are important ways to address this

problem. Moreover, it is not only girls and boys, but also teachers, government officials,

community-based health workers and development staff, who must be informed on

menstruation and its management. The Ministry of Drinking Water and Sanitation of India

has issued menstrual hygiene management guidelines containing various approaches to

creating an environment in which menstrual hygiene is considered acceptable and normal.21

Education on menstruation should focus on girls before menarche to ensure girls are aware

of what will happen to their bodies in time.

23. Bodily and hormonal changes, including menstruation, affect both boys and girls

and their attitudes towards each other. Men and boys must be involved in education and

empowerment initiatives, as they play a role in creating unequal power relations and

harmful stereotypes. Caution must be taken to not confirm or worsen stereotypes and

shame. Teachers in the Plurinational State of Bolivia have noted that simply introducing the

topic of menstruation embarrassed girls and increased teasing from boys.22 In India, the

campaign “No toilet, no bride” proved to be successful in terms of men investing more in

the construction of toilets, but some scholars have argued that it may have reinforced

stereotypes and gender roles within marriage.23 More evidence and evaluations are still

needed on the effectiveness of initiatives for health and schooling, as is the development of

country-level expertise.24

24. Sociocultural norms, notions of “female modesty” and masculinity and stereotypes

concerning gender-assigned roles, including of women as caretakers, translate into unequal

opportunities, unequal power and control over finances and resources, as well as unequal

household responsibilities. Where legislation and policies reflect stigmatizing attitudes,

thereby institutionalizing and formalizing stigma, they must be repealed. States may design

and implement, in collaboration with civil society, awareness-raising programmes to

enhance positive and non-stereotypical portrayals of women. Initiatives should aim to

reveal “invisible” social norms and power relations through a context-specific gender

analysis. WaterAid, for example, has undertaken qualitative research to explore how the

provision of water, sanitation and hygiene services has led to positive changes in gender

roles and social relations among men and women .25

25. The Committee on the Elimination of Discrimination against Women has

recommended using innovative measures targeting the media to enhance positive and non-

stereotypical portrayals of women. 26 Several attempts have been made to “break the

silence” on menstruation through the use of various forms of social media. A recent

Newsweek story highlighted the everyday struggle that women experience because of their

20 Ibid., p. 44.

21 India, Ministry of Drinking Water and Sanitation, Menstrual Hygiene Management (December 2015).

22 Jeanne Long and others, WASH in Schools Empowers Girls’ Education in Rural Cochabamba,

Bolivia: An Assessment of Menstrual Management in Schools (New York, United Nations Children’s

Fund, 2012), p. 10.

23 See https://sanitationupdates.wordpress.com/tag/no-toilet-no-bride-program/.

24 Marni Sommer and others, “A time for global action: addressing girls’ menstrual hygiene

management needs in schools”, 2016.

25 WaterAid Australia, submission to the Special Rapporteur.

26 See CEDAW/C/MNG/CO/8-9, para.15 (a).

menstrual cycle by showing a photograph of a tampon on the cover.27 A letter to the chief

executive officer of Facebook from a student in New Delhi asking him to introduce a “on

my period” button on the world’s largest social network has received significant online

attention.28 Awareness-raising campaigns to inform and change the mindsets and attitudes

of both men and women should be designed using all available means, including the media,

at the community level and in schools, with the participation of civil society.

C. Gender-based violence and sanitation-related psychosocial stress

26. Gender-based violence can be defined as acts that “inflict physical, mental or sexual

harm or suffering, threats of such acts, coercion and other deprivations of liberty”.29 It is a

widespread issue rooted in power differences and structural inequality between men and

women, although men and boys can also suffer gender-based violence. As the Secretary-

General has pointed out: “Violence against women and girls makes its hideous imprint on

every continent, country and culture”.30

27. Women fear violence by men in public toilets and open defecation sites, and along

the routes leading to both. Some women and girls looking for a place to defecate have

reportedly been exposed to rude remarks, brick-throwing, stabbing and rape. Gender-based

violence also occurs at places to collect water, bathe and wash clothes. Abuse of boys is

reportedly a common and underrecognized phenomenon, and one that receives even less

attention, as shame and cultural restrictions or taboos concerning homosexuality deters

boys from reporting such abuse.31

28. In addition to risking physical violence, women and girls may also experience

sanitation-related psychosocial stress, including fear of sexual violence. Women and girls

who have limited access to sanitation facilities experience environmental barriers when

they engage in water, sanitation and hygiene practices, including carrying water, managing

menstruation, defecating and bathing, that contribute to that kind of stress. Examples

include the fear of encountering snakes and mosquitos when walking to a defecation site, or

the stress caused by social norms that view the fact of being seen by men while bathing as

negative, among other issues. A better understanding of the range of causes of stress and

adaptive behaviours is needed to inform context-specific, gender-sensitive water and

sanitation interventions.32

29. The fact that in many instances women and girls risk being harassed when they

relieve themselves in the open or in public facilities is partly due to the structural and

systematic use of stereotypes and stigma. The promotion of awareness-raising campaigns,

targeted education programmes and discussion groups, among other measures, to transform

both men’s and women’s perceptions of gender roles is therefore encouraged. Gender-

based violence must be prevented and investigated, and those responsible must be

prosecuted, in order to break patterns of societal acceptance of exclusion and violence

27 See www.vivala.com/womens-issues/newsweek-cover-period-stigma/4062.

28 See www.indiatimes.com/news/india/this-girl-s-open-letter-to-mark-zuckerberg-asking-for-an-on-

my-period-button-deserves-a-reply-252396.html.

29 Committee on the Elimination of Discrimination against Women, general recommendation No. 19

(1992) on violence against women.

30 See www.un.org/en/women/endviolence/pdf/pressmaterials/VAW%20Press%20Release.pdf.

31 Louisa Gosling and others, “Nowhere to go: how a lack of safe toilets threatens to increase violence

against women in slums” (WaterAid).

32 Krushna Chandra Sahoo and others, “Sanitation-related psychosocial stress: a grounded theory study

of women across the life-course in Odisha, India”, Social Science and Medecine, vol. 139 (August

2015), pp. 80-89.

based on gender norms. Recognizing that young people may grow up to be change makers,

curricula in all schools should challenge gender stereotypes and encourage critical thinking.

30. People who do not conform to a fixed idea of gender may experience violence and

abuse when using gender-segregated sanitation facilities. Gender non-conforming people

face harassment in or avoid gender-segregated public toilets altogether out of fear. For

example, transgender girls who use the boys’ toilets and transgender boys who use the girls’

toilet in schools are highly vulnerable to bullying, harassment and assault by other

students. 33 Research from India indicates that transgender persons face difficulties in

finding rental housing and are often forced to live in remote slum areas, where access to

water and sanitation facilities is poor.34

31. States must take all measures necessary to remove the barriers that deter people from

using sanitation facilities. A concerted approach is needed against violence based on gender

identity and initiatives must aim to increase respect and acceptance throughout society. A

basic level of recognition of rights is needed. Too many States have laws that punish people

on the basis of their sexual orientation and gender identity and expression. States should

attach considerable importance to training and supporting teachers and administrators on

non-violent learning environments. Malta, for example, has enacted guidelines35 for schools

to promote the learning of human diversity that is inclusive of trans, gender-variant and

intersex students, promoting social awareness, acceptance and respect.36

D. Quality, health and safety issues

32. Levels of access to water and sanitation services affect men and women unequally.

Because of their domestic roles and responsibilities, women are in greatest physical contact

with contaminated water and human waste.37 Women and girls who hold their urine for

long periods of time have a higher risk of bladder and kidney infections. In addition, they

tend to avoid consuming liquids to prevent having to use the toilet, as a result of which

many become dehydrated.

33. Quality standards must take into account the fact that the amount of toxic substances

to which a person can be safely exposed differs widely depending on the individual.

Pregnant women in particular can be at higher risk of waterborne diseases from an intake of

contaminated water. Standards on water, sanitation and hygiene quality must take into

account the fact that women, especially when pregnant, have a lower tolerance for toxic

substances.38

34. Soap and clean water for personal hygiene is of particular importance during

menstruation. Women and girls must be able to use clean materials to absorb or collect

menstrual fluid, and change them regularly and in privacy. They must have access to water

and soap to wash their hands and body and facilities to dispose safely and hygienically of

menstrual materials like pads, cups, cloths and tampons. Facilities must be easy to maintain

33 Human Rights Watch, submission to the Special Rapporteur.

34 Water Supply and Sanitation Collaborative Council and Freshwater Action Network South Asia,

Leave No One Behind: Voices of Women, Adolescent Girls, Elderly and Disabled People, and

Sanitation Workers (2016), p. 15.

35 Neela Ghoshal and Kyle Knight, Rights in Transition: Making Legal Recognition for Transgender

People a Global Priority (Human Rights Watch, 2016).

36 Malta, Ministry for Education and Employment, Trans, Gender-variant and Intersex Students in

School Policy (2015).

37 UN-Water, “Gender, water and sanitation: a policy brief” (2006), p. 4.

38 United States Human Rights Network and others, submission to the Special Rapporteur.

and to clean. Women and girls with disabilities face unique challenges in accessing

sanitation facilities. Their ability to properly manage their hygiene may be particularly

compromised and, when facilities do not provide for the space and materials they need,

they are especially prone to diseases. Service providers must ensure that facilities are

designed with the participation of women and girls in order to adapt them to their biological

and sociocultural needs. The specific needs of women and girls must be incorporated into

the design, implementation, monitoring and evaluation of sanitation facilities. Approaches

must go beyond advocacy to address policies, infrastructure, maintenance systems and

monitoring in order to ensure that services are adapted to the specific needs of users by, for

example, taking into account their bodies, including their physical abilities, and their age.

Formal independent regulators, as well as locally based participatory water and sanitation

committees, should monitor whether regulations are well interpreted, implemented and

effective.

35. Many women and girls risk their health using unhygienic sanitary methods, for

example by using dirty rags or newspapers to collect menstrual fluids, as other methods are

unaffordable, unavailable or unknown owing to stigma and taboos relating to menstruation.

Although women in western countries use, on average, at least 12,000 tampons during their

lifetime, there is no extensive and publicly available knowledge on the safety of tampon

usage. 39 States are required to enact regulations on the safety of industrially produced

menstrual products. Different women prefer different menstrual products, which include

cloths and menstrual cups. Information must be provided so women can use the product

they feel most comfortable with, with the knowledge and skills to manage their menses

hygienically. States must further ensure affordable health care for all women and girls,

including for menstrual issues and incontinence.

36. Water, sanitation and hygiene needs are critical to prevent high maternal and

newborn mortality rates. In its recently adopted general comment No. 22 (2016) on the

right to sexual and reproductive health, the Committee on Economic, Social and Cultural

Rights notes that access to safe and potable water and adequate sanitation, as well as access

to health-related education and information, are the underlying determinants to that right.

Collaboration among sectors makes it possible to exchange information on how to deliver

education on culturally taboo topics and to give greater priority to female-specific needs, in

a manner that the water, sanitation and hygiene sector alone cannot achieve.40

E. Affordability

37. Affordability is of special concern to women and girls, who often have less access to

financial resources than men. Women and girls need toilets for urination, defecation and

menstrual hygiene management as well as for assisting younger children. Combined with

women’s lower access to financial resources, pay-per-use toilets with the same user fee for

men and women are in practice often more expensive for women. Besides, public urinals

are often free for men but not for women. To tackle this, the municipal government of

Mumbai is currently constructing several toilet blocks the maintenance of which is financed

through family passes instead of by charging a fee for each use. Some public toilets can be

used free of charge by women and other groups that often lack access to economic

resources, such as children and older people.

39 Susan Dudley and others, “Tampon safety”, National Center for Health Research (2016). See also

http://www.europarl.europa.eu/sides/getDoc.do?pubRef=-//EP//TEXT+WQ+E-2015-

013116+0+DOC+XML+V0//EN.

40 WaterAid Australia, submission to the Special Rapporteur.

38. Water cut-offs may excessively affect women as family caretakers, in particular in

poor female-headed households. Human rights law prescribes that a person’s inability to

pay for reasons beyond their control must never result in the disconnection of services. In

Colombia, the Constitutional Court has stated that female-headed households may in some

cases be subjected to special protection should they not be able to pay their water bills, and

must be guaranteed special tariffs and a minimum amount of free water.41

39. Women and girls need to have materials to manage their menstruation, which can be

a particular burden for those living in poverty. The human rights to water and sanitation

include the right of all to affordable, safe and hygienic menstruation materials, which

should be subsidized or provided free of charge when necessary.

40. According to international human rights law, States must allocate their maximum

available resources to the progressive realization of human rights, paying particular

attention to the rights and needs of the most marginalized segments of the population.42

Progressive policies and plans will be rendered worthless, however, without a proper

budget. A gender analysis supports Governments in making better budget-related choices

by highlighting existing gender inequalities and the impact of public expenditures on

women and girls. States should promote gender mainstreaming in budgeting activities for

water sanitation and hygiene, and increase women’s participation in budgeting processes.

Specialized units throughout government can be tasked with oversight.43

41. While taxes are a key source of financing for such gender responsive initiatives, they

can have detrimental effects on the poorest women. Governments must therefore carefully

screen the effects of different tax mechanisms. For example, while value-added taxes may

appear gender-neutral, they may disproportionately affect those living in poverty. Certainly,

applying value-added tax to menstrual hygiene products disproportionately affects women

and girls.

42. External assistance from non-governmental organizations, development agencies or

the private sector should comply with human rights and may include measures to eliminate

gender inequalities in access. States should include such needs into their official financial

plans to ensure that they comply with the regulatory and policy framework developed to

decrease gender inequalities.

F. Availability and accessibility

1. Household- and community-level access

43. Private facilities in or close to the home provide for privacy and safety, which is

particularly relevant for women and girls, particularly the eldest, those living with

disabilities and those who are pregnant or menstruating. Moreover, it is estimated that one

in four women over the age of 35 experiences incontinence and that women

disproportionately suffer from a lack of adequate and private facilities.44 Having a water

supply on the premises reduces the time spent on fetching water, cleaning the household

and caring for family members. It eliminates the need for transportation and the risk of

unsafe storage, reducing the risk of health problems such as musculoskeletal disorders and

41 See www.corteconstitucional.gov.co/relatoria/2011/T-740-11.htm.

42 Committee on Economic, Social and Cultural Rights, general comment No. 3 (1990) on the nature of

States parties’ obligations.

43 Nigeria, Federal Ministry of Water Resources, submission to the Special Rapporteur, p. 5.

44 Benedicte Hafskjold and others, “Incompetent at incontinence: why are we ignoring the needs of

incontinence sufferers?”, Waterlines, vol. 35, No. 3 (to be published in July 2016).

water-related diseases. States must prioritize water and sanitation provision to households

not yet served and, in particular, those households where women and girls have the least

adequate alternatives.

44. Where it is not yet possible to have access to services on site, it is important to scale

up the construction of safe and nearby community toilets. As mentioned above, there is a

multitude of psychosocial stress factors that women face owing to unsafe, inadequate or

absent sanitation facilities. To reduce the risk of women and girls experiencing violence,

building codes for community water and sanitation facilities should include gender

considerations such as sex-segregated cubicles, closeness to the house and lighted pathways

to and at facilities. The location should also make it possible for a concierge to be present

and monitor the surroundings.45 It is important to note, however, that building safer latrines

in or close to households does not eliminate the risk of gender-based violence, as the

measure does not address the root causes of violence. As outlined by the Water Supply and

Sanitation Collaborative Council, adequate sanitation without attention to gendered

relations of power puts the burden of safety on women and does not address gender-based

patterns of violence against women, which require a far more structural approach. 46

Building safer facilities may sometimes, however, take away a burden for women and girls

to visit public toilets that provide for privacy and safety. In this context, WaterAid has

developed a toolkit for practitioners.47

2. Extra-household access

45. Human rights law requires that sanitation facilities be reliably accessible to satisfy

all needs throughout the day and the night, and meet the needs of their users. A lack of

adequate facilities in public spaces often leads women and girls to avoid the public and both

work and school life, particularly during menstruation, when they live with disabilities or

suffer from incontinence.

46. Worldwide, there are more possibilities for men than for women to relieve

themselves outside the house. Examples include the plenty free-to-use urinals for men in

the capital of the Netherlands.48 In India, public facilities for men outnumber those for

women by up to 42 per cent.49 The construction of public urinals to tackle open urination by

men is relatively easy, as such urinals do not need to have doors and locks, have no seat to

turn up, generally use less water and are therefore a relatively cheaper solution. States must

set targets to scale up adequate public sanitation facilities for women and girls.

47. Human rights law requires that a sufficient number of sanitation facilities be

available with associated services to ensure that waiting times are not unreasonably long.

Many public facilities have an identical number of stalls for men and women, although in

practice women and girls often have to wait in long lines to use the toilet, while men have

much quicker access. The clothes women tend to wear and have to take off using the toilet

require more time than for men, and women spend time assisting children using the toilet.

45 AquaFed and others and Germany, Federal Foreign Office, submissions to the Special Rapporteur.

46 Water Supply and Sanitation Collaborative Council, “Sanitation vulnerabilities: women’s stresses and

struggles for violence-free sanitation”, briefing note No. 2 (2015).

47 See http://violence-wash.lboro.ac.uk/.

48 See www.joostdevree.nl/bouwkunde2/jpgs/straatmeubilair_21_brochure_krullen_

in_amsterdam_urinoirs_www_cornelissenamsterdam_nl.pdf.

49 Miriam Hartmann and others, “Gender-responsive sanitation solutions in urban India”, (RTI Press,

2015).

Some States have adopted legislation in which equality requires a ratio of two women’s

cubicles for every cubicle provided for men.50

48. Standards in regulations and building codes should include special needs for women

and girls, and must be developed for schools, hospitals, the workplace, market places,

places of detention and public transport hubs and public institutions, among other places.

Standards should consider general menstrual hygiene needs, but also who the users are

likely to be. Standards must subsequently be implemented, put in practice and accordingly

be enforced at all levels. Everyone should be able to use the toilet corresponding to the

person’s gender identity and States must pay attention to the special needs of more

vulnerable persons, including those with disabilities and the elderly.

49. The sanitation and menstrual hygiene needs of homeless women and girls are almost

universally unmet and the needs of that group are rarely reflected in water and sanitation

policies. Human rights law demands that States place a particular focus on the needs of the

most marginalized; hence, States should ensure that homeless women and girls have access

to facilities.

50. States must also ensure that schools have the necessary infrastructure for girls and

female teachers to manage their menstruation. Some Governments provide menstrual

hygiene products for free to girls in public schools.51 It is important that such products also

be provided for free in informal schools, as the students in those schools are among the

least able to afford them. Facilities must furthermore be acceptable to all users, and students

should be able to freely use the toilet with which they feel most comfortable.

51. Pregnant women and women that have recently given birth and are still recovering

from complications arising from labour are particularly vulnerable to the risk of infection

related to a lack of safe water, sanitation and hygiene.52 The Special Rapporteur’s recent

country visit to Tajikistan revealed the absence of a running water supply and adequate

sanitation facilities in hospitals in the country. 53 In addition, the Special Rappporteur

testified, during his visit to Botswana, that a clinic situated in an area facing serious drought

was still going through a procurement process to buy a water tank.54 In such critical places,

where the most vulnerable persons are treated, measures must be upheld in contingency

plans and implemented in advance. States must prioritize the provision to health centres of

adequate water, hygiene and sanitation facilities, with the necessary budget allocations.

52. Adequate water and sanitation services, including menstrual hygiene facilities, must

be accessible in the workplace, without hindrance, for all employees, in a manner that

corresponds with their gender identity. The Special Rapporteur has noted that there is an

urgent need to recognize and address the currently neglected lack of facilities that allow for

adequate sanitation and menstrual hygiene management for women and girls in the

workplace. Women and girls risk their health or miss out on workdays when such facilities

are lacking. For example, 60 per cent of all women working in sub-Saharan Africa and

South Asia work in the agriculture sector and their workplace often does not include

facilities that would allow them to manage their sanitation and menstruation, or those

50 See, for example, the “potty parity laws” in the United States mentioned in “Having to go: halting

stations for women” (12 April 2012), available from http://womenshistorynetwork.org/blog/?p=1140.

51 For example, the Kenya Environmental Sanitation and Hygiene Policy 2016-2030, pp. 39-40.

52 http://reliefweb.int/sites/reliefweb.int/files/resources/Briefing%20Note%203.pdf (accessed 14-7-

2016).

53 A/HRC/33/49/Add.2.

54 A/HRC/33/49/Add.3.

facilities are located far away from the place of work.55 Regulations often do not apply to

women working in the informal sector, and women working in public spaces such as

markets often have no access to facilities altogether. In the manufacturing industry and in

dense urban areas, women and girls sometimes work in overcrowded spaces where privacy

is limited and sanitation facilities and spaces are inadequate to manage their menstruation.

53. Employment codes and standards that explicitly require the inclusion of facilities for

menstrual hygiene management in the workplace are currently limited or do not exist. Such

regulations must be developed, promoted and enforced and must serve to hold businesses

and Governments to account. It is important that Governments determine these

responsibilities within their administrative structures, so they can be held to account. In

addition, private companies and employers have a responsibility to prioritize this issue and

take action. Trade unions too have the potential to encourage good practices and support

workers’ rights in this area.

G. Participation and empowerment

54. Participation is not only a right in itself, but also imperative for fulfilling other rights.

Participation encompasses women’s power to influence decisions, to voice their needs, to

make individual choices and to control their own lives. The lack of water, sanitation and

hygiene facilities that meet women’s and girls’ needs can be largely attributed to the

absence of women’s participation in decision-making and planning.

55. Water, sanitation and hygiene policies and laws must proactively and deliberately

enable the active, free and meaningful participation of women at all stages of planning,

decision-making, monitoring and evaluation. As a principle, the participation of women

must be fully integrated in both the legislative and the executive branches of government,

and in initiatives by implementing entities, such as non-governmental organizations and

service providers. Participation must take place at the micro, meso and macro levels. This

includes community-level initiatives, as well as initiatives and decision-making at the

national, regional and international levels.

56. At the national level, legal protections must be formulated to ensure the active

participation of key stakeholders, including women and marginalized groups, in the

formulation and implementation of policies. Governments must put in place mechanisms to

involve women in the formulation of regulations and policies on water and sanitation and in

decisions related to financing and budgeting, to influence the focus of monetary

investments.

57. Although the pivotal role of women as providers and users of water, as well as the

need to equip and empower women to participate at all levels in water resources

programmes, has long been recognized, it is mostly men who manage and control the water

services, resources, wastewater and solid waste industries at all levels.56 The integration of

women into these types of jobs can contribute to gender mainstreaming throughout the

sector and to services being managed from the perspective of women. Women’s

participation in the sector can be encouraged by developing policies and strategies,

including on education, with defined targets and timelines. As a good example, in the

National Drinking Water Policy of Pakistan it is outlined that special efforts will be made to

recruit and induct women in water supply-related institutions and other relevant agencies to

55 Marni Sommer and others, “Managing menstruation in the workplace: an overlooked issue in low-

and middle-income countries”, International Journal for Equity in Health, vol. 15, No. 86 (2016).

56 Finland, Italy, Lithuania, Nigeria, Tajikistan, State of Palestine, AquaFed, and Public Services

International, submissions to the Special Rapporteur.

ensure that the needs of women are adequately addressed in the design, operation and

maintenance of water supply systems.57 Aquafed and the Women for Water Partnership

have reported that they are working together with companies and water associations to

develop employment policies that aim to increase the representation of women in their staff

and to remove prejudices against female employees.58

58. Women’s and girls’ voices are indispensable to ensuring that their needs are

understood and prioritized, including on material and privacy requirements for menstrual

hygiene management. In many cases, they are not consulted about the placement of water

points and sanitation facilities, nor do they participate in designing the type of facility best

suited to their needs or easiest for them to use, even though women and girls most often use

these facilities and are primarily responsible for maintaining them. Including women and

girls in making decisions about the design and location of facilities is even more relevant

for those who have special needs because of a disability or their age or because they are

pregnant, live in remote areas or are homeless, for example. Trans or gender non-

conforming users of planned facilities must be given opportunities to participate. Some may

find it useful to have access to a gender-neutral facility, while in other communities it may

be acceptable for persons to simply use the toilet they feel most comfortable with.

59. Attempts to ensure women’s participation through laws or regulations, however,

may not correspond to local customary norms and their implementation subsequently fails.

Customary norms reflect cultural gender hierarchies and power relations within a

community and may have a much bigger influence in practice.59 This means that even when

women participate, their actual influence on the governance of water and sanitation may

still be very limited. States and development initiatives must actively identify, acknowledge

and remove barriers to meaningful participation. The right to information is inextricably

related to participation, since women are often not aware that they can participate.

Education on how to be part of a participatory process and how to voice needs is

indispensable. The non-governmental organization Armenian Women for Health and

Healthy Environment organizes seminars, workshops, training sessions and projects to

develop women’s leadership skills, for example.60

60. Women are sometimes unable to participate in meetings because of cultural norms

against women speaking on their own behalf or cannot talk about sanitation and menstrual

hygiene management needs because of taboos or social norms. For example, a recent study

on Myanmar revealed that leadership and politics were strongly associated with masculinity,

which is why women who do attend meetings rarely speak up.61 A gender analysis lowers

the risk of excluding women if special measures are taken accordingly, for example through

specially targeted consultations such as women-only spaces. In carefully determining the

location and meeting times and arranging transport, child care and translators, other barriers

may be overcome. Any initiative that seeks to ensure the participation of women must also

include a component of empowerment, including in economic terms, and address gender

stereotypes.

57 Pakistan, National Drinking Water Policy (September 2009). Available from

http://epd.punjab.gov.pk/system/files/National_Drinking_Water_Policy.pdf.

58 AquaFed and others, submission to the Special Rapporteur.

59 Anne Hellum, Ingunn Ikdahl and Patricia Kameri-Mbote, “Turning the tide: engendering the human

right to water”, in Water is Life: Women’s Human Rights in National and Local Water Governance in

Southern and Eastern Africa, Anne Hellum and others, eds. (Harare, Weaver Press, 2015), p. 68.

60 Women for Water Partnership and UN-Women, Women as Agents of Change in Water: Reflections

on Experiences from the Field (Driebergen, De Hoop and Koonig, 2015), pp. 28-29.

61 Jasmine Burnley and others, “A case for gender-responsive budgeting in Myanmar”, Oxfam Briefing

Papers (Oxfam, ActionAid, Care and Women’s Organisations’ Network, 2016), p. 6.

61. Marginalized women and girls (including those with disabilities, those who are

elderly, uneducated or impoverished, and sex workers) face additional barriers to

participation. It is therefore important to consider who participates, since participation is

often extended only to certain women, in other words the wealthiest, more educated and

those who are relatively privileged owing to their caste or religion.

62. Civil society groups can play a role in empowering women to claim their rights. It is

moreover important for marginalized groups, including for example women and gender

non-conforming people, to be able to unite, to express themselves, to be heard and to gain

respect and recognition. Governments and donors should therefore invest in interest groups

at all levels and support their effective participation at all stages of decision-making and

planning, including in budgetary processes.

H. Accountability

63. Accountability refers to the relationship of duty bearers towards rights holders, as

the latter are affected by the decisions and actions of the former. It demands that individuals

and groups have access to courts and other mechanisms and that remedies be provided.

Accountability mechanisms also determine which aspects of a gender-sensitive policy or

service are functioning well or need to be adjusted. Monitoring is essential to track progress

and assess whether the State is meeting its goals and targets.

1. Monitoring compliance and access to justice

64. States must monitor the extent to which they and third parties comply with the legal

content of the human rights to water and sanitation and of human rights principles. States

must monitor decision-making processes and policy implementation, including on national

and local budgets, to track whether they serve to close existing gender-based inequalities.

The effectiveness of review and monitoring requires the allocation of sufficient resources,

transparency of government and State bodies that are independent of government

interference. It requires that those in positions of authority have clearly defined duties and

performance standards, enabling their actions to be assessed transparently and objectively.62

Courts, national human rights institutions, non-governmental organizations, independent

regulators and ombudspersons play an important role in identifying and addressing gender

inequalities in the enjoyment of the rights to water and sanitation and must be supported by

the State in doing so. Social movements play an important role in holding the State to

account as they can press public officials into being more answerable and request reasoned

justifications for actions and decisions. For example, thousands of women in slum areas in

Nairobi affected by a lack of toilets and bathing facilities signed a petition asking the

Ministry of Health to conduct a public inquiry in informal settlements, and succeeded.63

65. Persons must be made aware of the human rights to water and sanitation and the

enforceability of those rights. Women must be able to hold the State to account regarding

its obligations to provide adequate sanitation facilities in, for example, public spaces like

market places and transport hubs. Impunity for perpetrators of gender-based violence must

be eliminated and remedies must be provided. The Committee on the Elimination of

Discrimination against Women has recommended that all cases of violence and

62 OHCHR, Who Will Be Accountable? Human Rights and the Post-2015 Development Agenda (New

York and Geneva, 2013), p. 10.

63 See https://toopressed2wait.wordpress.com/2014/08/21/city-slum-women-petition-government-on-

sanitation/.

discrimination against women be brought under the jurisdiction of a criminal court rather

than be settled through mediation.

66. The ability to claim rights in front of the courts is important for changing social and

cultural attitudes. The courts play a role in condemning practices that reinforce gender

stereotypes and can require the State or third parties to adopt measures to address them.

Recently, a group of students asked the Supreme Court of India whether menstruation could

be a criterion for denying women of a certain age the right to enter a temple and worship in

it.64 The Supreme Court addressed the following questions to the administration of the

Sabarimala temple: “If men can go till a point (near the temple) without undertaking austere

activities, why can’t women go? … Are you associating menstruation with impurity? You

are making a classification. Can a biological phenomenon be a reason for discrimination?

All practices are acceptable till there is no distinction between genders.”65

2. Monitoring progress on the equal enjoyment of the human rights to water

and sanitation

67. Human rights-based monitoring can be built on a framework of structural, process

and outcome indicators that serve to monitor not only the commitments made by a State but

also the State’s ongoing efforts and whether progress is being made to achieve targets on

gender equality. Useful examples of indicators to monitor gender equality in access to

water, sanitation and hygiene can be found in the OHCHR framework on indicators66 and

by the World Health Organization-United Nations Children’s Fund Joint Monitoring

Programme Task Force on monitoring inequalities. Indicators on menstrual hygiene

facilities, for example, could be used to track gender equality and help to break related

taboos.

68. It is of crucial importance to monitor, in a rights- and gender-sensitive manner,

progress towards achieving the Sustainable Development Goals, and to make sure that

national and local mechanisms track compliance with and progress made to realize the

rights to water and sanitation, including in terms of gender equality. Gender equality is

central to the Goals (see Goal 5) and is reflected in several targets, including target 6.2.

Gender equality in access to water, sanitation and hygiene will have a positive impact on

other goals and targets, including those on ending poverty (Goal 1), on promoting decent

work and economic growth (Goal 8), on reducing inequality (Goal 10) and on making cities

and human settlements inclusive and sustainable (Goal 11). Since gender inequalities are so

profound in water and sanitation and, at the same time, manifest themselves in all human

rights and throughout the entire development agenda, a comprehensive approach would

allow for using similar indicators and information collected through the monitoring of

different human rights and development targets.

69. Filling the existing data gap should be a priority in order to support gender-sensitive

indicators. Systems need to be developed to improve the collection of data disaggregated by

sex and other relevant factors, which are necessary to assess the impact and effectiveness of

policies and programmes that aim to mainstream gender equality and enhance women’s

enjoyment of their human rights. Also, the collection process must take into account

stereotypes and social and cultural factors that may induce gender bias in the data and be

64 See www.thehindu.com/news/national/sabarimala-temple-entry-ban-can-menstruation-be-a-factor-

asks-supreme-court/article8472787.ece.

65 See www.firstpost.com/india/sabarimala-supreme-court-women-entry-trupti-desai-2748036.html.

66 See www.ohchr.org/Documents/Publications/Human_rights_indicators_en.pdf and A/HRC/27/55,

annex.

more inclusive, transparent and grounded in legally binding international human rights

commitments. OHCHR has developed a guidance note on data and disaggregation.67

70. The rapid development of technology has made it possible to leverage data from

new sources. There is a great opportunity to connect official statistics to citizen-generated

data. States must therefore support the crucial role played by civil society, women’s

organizations in particular. In addition to developing innovative ways of collecting data,

civil society also brings qualitative value in analysing and interpreting results to make sure

that gaps in monitoring are detected and that gender-specific needs are taken into account.

71. Under the framework of the Millennium Development Goals, data disaggregated by

gender was not reported in a standardized fashion. There is not much data available on

intra-household inequalities in terms of access to and use of sanitation and menstrual

hygiene facilities or in terms of intersecting factors such as disability and age. The

household cannot be considered as a homogeneous unit: its members have different roles,

opinions and experiences. Finding ways to monitor intra-household inequalities may be

pivotal in order to reveal gender inequalities and root causes of inequality that often remain

invisible in household-level analyses. There might be a stark divide in terms of perspectives

in household monitoring. A household member could respond differently to a household

survey depending on whether that person is a man or a woman or has a disability.

72. In addition, it would be important to monitor how gender inequalities, including

among lesbian, gay, bisexual, transgender, intersex and gender non-conforming persons,

manifest themselves in extra-household settings, including in facilities in public institutions.

This would reveal gender inequalities in the realm of many other human rights, since a lack

of access to facilities outside the home severely impedes women and girls from attending

school and participating in work, among other opportunities.

73. A project on gender-sensitive water monitoring, assessment and reporting that

included several toolkits was initiated in the context of the World Water Assessment

Programme.68 The toolkits show the difficulties inherent in using quantitative methods to

capture the nuances of gendered power relations and the socioeconomic processes that

create or sustain gender inequalities in access to water and sanitation. They also underscore

that some women may attend meetings because regulations on participation tell them to do

so but that cultural norms may keep them from speaking up or being listened to. It may

therefore be useful to integrate quantitative data with qualitative methods, for meaning and

interpretation. On the basis of the findings of qualitative surveys, other quantitative

indicators can be developed to fill the gap left by previous indicators. Counting the number

of heads at meetings may then be accompanied with indicators that include the number of

contributions made in meetings by women and men and the percentage of decisions on

water and sanitation adopted on the basis of those contributions.

74. A recent study underscored that gender-differentiated patterns are not the same

everywhere and reinforced the importance of context for understanding the gender

dimensions of access and experience.69 The quantity and quality of sex-disaggregated data

at the micro level are considered to be better than those of data at the global level. It is

therefore important that measuring progress in the rights to water and sanitation and gender

equality is not based on global monitoring and on the use of quantitative data only.

Context-specific studies and monitoring that capture the intersection of gender inequalities

67 See www.ohchr.org/Documents/Issues/HRIndicators/GuidanceNoteonApproachtoData.pdf.

68 See www.unesco.org/new/en/natural-sciences/environment/water/wwap/indicators/.

69 Leila Harris and others, “Intersections of gender and water: comparative approaches to everyday

gendered negotiations of water access in underserved areas of Accra, Ghana, and Cape Town, South

Africa”, Journal of Gender Studies (2016), p. 13.

in the enjoyment of other human rights are key to understanding and developing improved

policy responses.

V. Conclusions and recommendations

75. Safe, adequate and affordable access to water, sanitation and hygiene, as well

as the promotion of women’s empowerment, can serve as an entry point to ensure that

women and girls can enjoy their right to have and make choices, their right to have

access to opportunities and resources, and their right to control their own lives, both

inside and outside the home. Gender equality in respect of the human rights to water

and sanitation will not only empower women individually but will also help women

overcome poverty and empower their children, families and communities.

76. Likewise, structural gender inequalities have an inevitable impact on the

enjoyment of the rights to water and sanitation. Any approach to overcoming gender

inequalities in respect of the rights to water and sanitation must therefore address

women’s strategic needs, including the eradication of harmful gender stereotypes,

alongside interventions that focus on the implementation of women’s material needs,

such as adequate menstrual hygiene facilities. Although such a transformative

approach that challenges social norms, stereotypes and intra-household patterns may

take time, it is required in order to ultimately achieve gender equality in the

enjoyment of the rights to water and sanitation.

77. In line with the above, the Special Rapporteur recommends that States:

(a) Identify, repeal and reform all laws that have both direct and indirect

discriminatory consequences with regard to the equal enjoyment of the human rights

to water and sanitation, as well as with regard to gender-based violence;

(b) Go beyond enacting formal provisions and implement targeted policies

and budgets, among other measures, in order to tackle structural gender inequalities

for the enjoyment of the rights to water and sanitation;

(c) Make a legitimate effort to prevent and combat the root causes of gender

inequalities, including the impacts of social norms, stereotypes, roles and taboos with

regard to both women and men, through public campaigns, education and the media,

among other measures;

(d) Create an enabling environment for women and girls to safely use water

and sanitation facilities. Discrimination and violence based on gender identity must be

prevented, investigated and remedied, and those responsible must be prosecuted;

(e) Promote gender equality, through intersectional policies, considering

that gender-based inequalities related to water and sanitation are exacerbated when

they are coupled with other grounds of discrimination and disadvantages;

(f) Increase collaboration between entities operating in the water, sanitation

and hygiene sector and those operating in other sectors, including the health sector, to

address gender inequalities and culturally taboo topics more effectively and in a

comprehensive manner;

(g) Apply a gender analysis and increase women’s participation in the

formulation of government budgets to water, sanitation and hygiene;

(h) Ensure that regulations require that the specific needs of women and

girls are incorporated into the design, implementation, monitoring and evaluation of

water and sanitation facilities, taking into consideration the special needs of women

and girls made more vulnerable by disability and age. Regulators should monitor

whether such regulations are well interpreted, implemented and effective;

(i) Ensure the gender-responsive water, sanitation and hygiene facilities are

available in schools, hospitals, the workplace, market places, places of detention and

public spaces like public transport hubs and public institutions, among other places.

Laws and regulations must be developed, promoted and enforced and must serve to

hold Governments and non-State actors to account;

(j) Develop water, sanitation and hygiene approaches, programmes and

policies that proactively and deliberately enable the meaningful participation of

women at all stages of planning, decision-making, implementation, monitoring and

evaluation. States and development partners must identify, acknowledge and remove

barriers to participation in decision-making in respect of water, sanitation and

hygiene initiatives and ensure that women are aware of their ability to participate;

(k) Develop a gender indicator system to improve the collection of data

disaggregated by sex and other relevant factors, which are necessary to assess the

impact and effectiveness of policies aimed at mainstreaming gender equality and

enhancing women’s enjoyment of their human rights to water and sanitation;

(l) Monitor intra-household inequalities and the way in which inequalities

based on gender become manifest in extra-household settings, including in facilities in

public institutions;

(m) Ensure that comprehensive data is collected on access to water,

sanitation and hygiene management in respect of women and girls belonging to

marginalized groups and living in marginalized areas, and support civil society in

collecting data and in analysing, interpreting and monitoring results;

(n) Complement quantitative data on water, sanitation and hygiene with

qualitative methods, to improve understanding and interpretation of gender-related

issues and to inform and validate survey methods and techniques.

78. In addition, the Special Rapporteur recommends that development cooperation

entities ensure that external assistance from non-governmental organizations,

development agencies and the private sector comply with human rights standards and

include measures to eliminate gender inequalities in access.