Desk-review on the hygiene needs of incontinence sufferers - and how WASH actors can better support them

[Chelsea Giles-Hansen]

Dear All

A desk-based review of how WASH actors can better address the hygiene needs of people living with urinary and/or faecal incontinence in developing countries was conducted in late 2015. This piece of work was supported by WaterAid UK/SHARE. Please find attached the report, in case it is of interest or use to you.

The report outlines what incontinence is and how people generally manage their incontinence, as well as relevant experiences and guidance from within the development and humanitarian spheres (related to incontinence as well as other areas such as MHM and inclusive WASH). The report also provides recommendations on how to better support the hygiene and WASH needs of those people suffering from incontinence.

Globally, it is estimated that incontinence affects 1 in 4 women over the age of 35 years, and 1 in 10 adult men. A global study in 2003 reported the average (median) prevalence of female urinary incontinence to be 27.6%.

Incontinence can affect:

• Elderly or older people
• Men, women and children with physical disabilities and/or learning difficulties
• Women and adolescent girls who have recently given birth
• Women and adolescent girls with fistula from prolonged and/or obstructed childbirth
• People who have had certain types of illness (e.g. stroke) or operation (e.g. such as removal of prostate)
• Stress or urge incontinence (see below) can also affect both men and women of all ages across their lifetime due to malfunctioning bladder and urinary systems

Risk factors for incontinence included parity (number of times a woman has given birth), obesity, chronic cough, depression, poor health, lower urinary tract symptoms, previous hysterectomy, and stroke. It is important to note that there are large variations in the severity, type and impacts of incontinence.

Many people living with incontinence suffer embarrassment and fear of leakage or smell. They may be ostracised, isolated or teased (due to their condition or the related smell). As well as being anxious about finding a place (sometimes at very short notice) to urinate and/or defecate, people living with incontinence may be concerned with how to protect themselves from leaking urine and/or faeces, how to clean themselves discretely and how to dispose of any materials they may have used to soak up the urine and/or faeces. All of these factors can have severe negative impacts on day-to-day activities, everyday life and personal confidence and dignity.

In low or middle income countries, people suffering from incontinence may not have access to products (e.g. not stocked in markets or pharmacies) or the financial means to purchase sanitary protection materials/cloths/mattresses, or extra soap and water, in order to be able to manage their incontinence (or care for a family member who has incontinence). Severe incontinence may prevent people from being able to work.

In emergency contexts, incontinence (similarly to menstruation in some places), may restrict people’s ability to access food and water distributions, and others may be unwilling to assist them due to smell or stigmatism.

Key recommendations for WASH actors include:

• Incorporate incontinence related questions into inclusive and sensitive needs assessment tools and checklists.
• Utilize existing resources (particularly the Minimum Standards for Age and Disability Inclusion in Humanitarian Action, and Inclusion Checklist) in field-based responses and programmes providing support to those living with incontinence.
• Document experiences and case studies, particularly around the type and management (e.g. washing/drying/disposal) of hygiene and personal protection items that people with incontinence need, and share this information with humanitarian and development agencies.
• Encourage the continued inclusion of references about and guidance for incontinence-related activities and support into hygiene promotion and WASH resources (including hygiene and dignity kit case studies and resources).
• Sensitise WASH and health staff to the issue of urine and faecal incontinence, and build their confidence and capacity to address incontinence in activities and programmes.
• Further research into the impact of incontinence on daily life, and the availability and preferences for protection material and hygiene items of incontinence sufferers in low and middle income countries. (The report provides a draft generic key information interview guide.)

Many thanks to Sue Cavill and Sarah House for their support and input to this piece of work.

Warm regards,
Chelsea

Chelsea Giles-Hansen
E: chels...@gmail.com
P: +46 729 066 574
S: chelsea_gh

[Raissa Azzalini]

Return Receipt

Your document:	Desk-review on the hygiene needs of incontinence sufferers - and how WASH actors can better support them
was received by:	RAzz...@oxfam.org.uk
at:	04/01/2016 09:37:53

Oxfam works with others to overcome poverty and suffering

Oxfam GB is a member of Oxfam International and a company limited by guarantee registered in England No. 612172.
Registered office: Oxfam House, John Smith Drive, Cowley, Oxford, OX4 2JY.
A registered charity in England and Wales (no 202918) and Scotland (SC 039042)

[Raissa Azzalini]

Return Receipt

Your document:	Desk-review on the hygiene needs of incontinence sufferers - and how WASH actors can better support them
was received by:	RAzz...@oxfam.org.uk

at:	04/01/2016 09:37:56

[Cor Dietvorst]

Dear Ms Giles-Hansen,

I have re-posted your text on Sanitation Updates.

Cor Dietvorst

Programme Officer | Information Specialist and News Editor | IRC

www.ircwash.org

Twitter @dietvorst

...

[Foyeke Tolani]

 

Dear All

Happy new year. A colleague of mine is trying to promote soap production among women in remote areas of South Sudan.

 

He has asked if anyone has technical notes available on local soap production by communities and any other documents related to this or lessons learnt from other countries where soap production has been promoted as either income generating activities or to boost soap availability for hygiene promotion. 

 

Any useful material would be appreciated.

 

Regards

 

Foye

 

Foyeke Tolani
Public Health Promotion Adviser and Handwashing Focal Point
Oxfam GB.
Tel:+441865473884
Skype: foyeketolani

[Brian Reed]

Rather old but may be useful…

 

http://www.bvsde.paho.org/eswww/tecapropiada/otratec/waterlin/tb8.pdf

 

 

 

 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Brian Reed BSc (Hons)(Dunelm), PGDip (Lond), MSc (N’cle), CEng, CEnv, C.WEM, MICE, MCIWEM, FHEA

Lecturer Water, Engineering and Development Centre (WEDC)

School of Civil and Building Engineering

The John Pickford Building

Loughborough University

Leicestershire  LE11 3TU  UK

 

Developing knowledge and capacity in water and sanitation

 

+ 44 (0) 1509 228307

http://wedc.lboro.ac.uk

https://twitter.com/wedcuk

https://www.facebook.com/wedc.lboro

 

Download free resources from the WEDC Knowledge Base: http://wedc.lboro.ac.uk/knowledge/know.html

 

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Save the date:

39th WEDC International Conference

To be held at Kumasi, Ghana

11 - 15 July 2016

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[Jeffrey Silverman]

Hi Foyeke,

Not sure if your colleague is from Oxfam South Sudan, buy FYI  Oxfam SS would like to conduct similar programming for soap production this year.  Please keep Zulfi and Tariro in the loop for any lesson learnt, resources, or other information that can be shared once you get any feedback. 

I think this is a great idea!

Regards,

Jeffrey Silverman, MPH
Public Health Coordinator
Juba, South Sudan
Humanitarian Department, Oxfam GB

Mobiles:
(+211) 092 892 66 08 MTN
(+211) 091 458 56 68 Zain

Email: jsilv...@oxfam.org.uk
Skype: jeff4784

-----hygienepro...@googlegroups.com wrote: -----

To: hygienepro...@googlegroups.com
From: Foyeke Tolani
Sent by: hygienepro...@googlegroups.com
Date: 01/04/2016 08:56AM

Subject: Soap production by women in remote areas

--