🚺 Urban Sanitation & Women’s Health: Coping Mechanisms of Withholding and Suppression

✍️ Suryavanshi IAS – GS Paper I, II, III Current Affairs Focus

🧭 Context

A recent study published in Nature Water titled “Sanitation-related withholding and suppression among women in urban Uganda and India” reveals startling insights about how women intentionally avoid eating, drinking, urination, or defecation due to concerns over safety, privacy, and sanitation infrastructure in cities like Tiruchi (India) and Kampala (Uganda).

📘 UPSC GS Syllabus Relevance

GS Paper I:

Social Empowerment
Issues related to Women

GS Paper II:

Government policies and interventions for development
Issues relating to health, development and gender

GS Paper III:

Health and sanitation
Inclusive development and associated issues

🔎 Study Highlights

Element	Tiruchi (India)	Kampala (Uganda)
Withholding (food/water)	16.4%	38%
Suppression (urges)	96%	94.3%
Night-time suppression	92.9%	87.5%
Use of improved toilets	77.7%	100%
Water collection burden	31.1%	91%

Key Findings:

Most women withhold water, especially when away from home.
Suppression is most common at night, due to fear of violence or lack of safe access.
Perception of safety and privacy strongly correlates with the likelihood of these coping behaviours.
Women in Tiruchi experienced sanitation-related stress and fear, while in Kampala the leading concern was injury and risk of harm.

Key Issues

1. Health Hazards

Withholding food/water may lead to malnutrition, dehydration, and urinary tract infections.
Long-term suppression can result in bladder disorders, constipation, and psychological stress.

2. Gendered Impact of Urban Sanitation

Public sanitation is not designed with women’s safety and privacy in mind.
Night-time access is a major vulnerability.
Social norms discourage solo use of toilets by women in Tamil Nadu.

3. Structural Gaps

Kampala women often share toilets and fetch water, increasing burden.
Tiruchi women, despite having more private toilets, still face social and safety pressures.

Mains Value Addition – Analysis

Dimension	Observation
Social Empowerment	Poor sanitation limits women’s freedom of movement and bodily autonomy.
Gender Equity	Public policy often ignores the specific needs of women, reinforcing inequality.
Public Health	Coping mechanisms increase burden on healthcare and reduce quality of life.
SDGs	Impacts Goal 3 (Good Health) and Goal 6 (Clean Water & Sanitation).

Recommendations for Policy

✅ Gender-sensitive urban planning: Design toilets with privacy, lighting, locks, and access near homes.
✅ Community awareness: Address taboos and social stigma around sanitation.
✅ Sanitation mapping: Use data to target vulnerable localities.
✅ Safe public toilets: Separate, well-lit, female-only sanitation facilities.
✅ Water access reforms: Reduce the burden of manual water collection.

UPSC PYQs – Related Themes

📄 GS I – 2014: "Discuss the various social problems which originated out of the speedy process of urbanization in India."

📄 GS II – 2019: "Empowering women is the key to controlling population growth." Discuss.

📄 GS III – 2020: "What are the challenges of public health in India and how far can e-health solutions help?"

✍️ Practice Mains Question – Suryavanshi IAS Predicted Q

Q. Sanitation-related coping behaviours like withholding and suppression reflect deep-seated gendered inequalities in urban India. Discuss their implications on women’s health and empowerment and suggest policy measures. (250 words)

✅ Faculty Note

Sanitation is no longer just about infrastructure. It is about dignity, health, autonomy, and rights—especially for women. For aspirants, this is a converging topic relevant for GS I, II, and III, and can be connected with urbanisation, gender budgeting, and inclusive development in Essay as well.

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Suryavanshi IAS

Thursday, July 10, 2025