Global Inadequacies in Access to Private Toilets for Women

 In Naturopathic News

Node Smith, ND

A recent article underlines a widespread form of gender discrimination – inadequate access to private toilets. This is a serious problem for girls and women around the world, and perhaps one of the most pervasive forms of gender discrimination. There has been an increase in advocacy and research in this area, however little has actually been done globally to improve designs, guidelines and placement of toilets for women and girls. This research has been conducted through Columbia Mailman School of Public Health and the International Rescue Committee, and published in a special issue on Water, Sanitation, and Hygiene in Humanitarian Contexts in Water, an open-access journal.1

Girls and women have different sanitation needs compared to their male counterparts

It is a fact that girls and women have different sanitation needs compared to their male counterparts. Roughly a quarter of all adult women, globally, are menstruating at any one time. This poses a significant obstacle for hygiene where private and safe facilities are not accessible, such as in urban slums and displacement camps.

“At the most basic level, adolescent girls and women around the world have increased and distinct water and sanitation-related needs, the product of their physiology, reproductive health processes linked to menstruation, and pregnancy, and safety concerns,” said senior author Marni Sommer, DrPH, MSN, associate professor of Sociomedical Sciences at Columbia Public Health. “This can be especially challenging for girls and women living in low-resource or over-crowded contexts, such as urban slums, displacement camps and informal settlements.”

An all too common stressor for women and girls

It is common for women and girls to experience stress, embarrassment, physical discomfort and even gender-based violence as a result of limited access to toilets with locking doors and rubbish containers for menstrual waste disposal.

Previous research highlighted that consultation with girls and women regarding hygiene and sanitation needs is relatively uncommon

Previous research has highlighted that consultation with girls and women regarding their hygiene and sanitation needs is relatively uncommon, such as in humanitarian relief contexts. Consultation with women and girls is often problematic by social and cultural taboos around menstruation, and expectations of female modesty, as well as a general discomfort discussing this topic.

In addition to menstruation considerations, girls and women commonly take on caretaker roles for young children or elderly which require them to assist family members into toilets. These roles can increase even further discrimination and stress levels.

Access to toilets at workplaces may impact productivity

Looking for, and actually finding a toilet, while away from home often affect activities girls and women participate in, such as attending school, visiting the market, or standing in long lines for their family’s daily water. Access to toilets at workplaces may impact productivity, attendance, well-being.

Research strives to cultivate awareness for the need of mainstreaming provisions for female friendly toilets

This research strives to bring awareness for the need for mainstreaming provisions for female friendly toilets, which would have significant implications for meeting the United Nations’ Sustainable Development Goals around health, education, sanitation, economic empowerment and gender.


  1.  Schmitt ML, Clatworthy D, Ogello T, et al.  Making the Case for a Female-Friendly Toilet. Water 2018, 10(9), 1193.

Photo by Tom Rogerson on Unsplash

Node Smith, ND, is a naturopathic physician in Portland, OR and associate editor for NDNR. He has been instrumental in maintaining a firm connection to the philosophy and heritage of naturopathic medicine among the next generation of docs. He helped found the first multi-generational experiential retreat, which brings elders, alumni, and students together for a weekend camp-out where naturopathic medicine and medical philosophy are experienced in nature. Four years ago he helped found the non-profit, Association for Naturopathic ReVitalization (ANR), for which he serves as the board chairman. ANR has a mission to inspire health practitioners to embody the naturopathic principles through experiential education. Node also has a firm belief that the next era of naturopathic medicine will see a resurgence of in-patient facilities which use fasting, earthing, hydrotherapy and homeopathy to bring people back from chronic diseases of modern living; he is involved in numerous conversations and projects to bring about this vision.

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