Sanitation-related empowerment resources are associated with women’s well-being, anxiety, and depression: findings from Bangladesh, India, Senegal, and Uganda
Thea Mink, Madeleine Patrick, Amelia Conrad, Tanvir Ahmed, Srishty Arun, Vinod Ramanarayanan, Niladri Chakraborti, Y. Malini Reddy , Abhilaasha Nagarajan, Tanushree Bhan, Sheela S. Sinharoy, Bethany A. Caruso | June 2026
Abstract
Recent research has identified linkages between women’s sanitation experiences, like safety and privacy, and their mental health. Our study examined associations between sanitation-related empowerment resources (Bodily Integrity, Safety and Security, Privacy, and Time) and mental health outcomes (well-being, depression, and anxiety). We conducted a secondary analysis of cross-sectional data collected in 2021–2022 from household surveys of women in Bangladesh, India, Senegal, and Uganda (n = 2285). Primary exposures were sanitation-related empowerment resources measured using the Agency, Resources, and Institutional Structures for Sanitation-related Empowerment (ARISE) Scales. Three outcomes were assessed: subjective well-being (World Health Organization Well-being Index, WHO-5), anxiety (General Anxiety Disorder measure, GAD-2), and depression (Patient Health Questionnaire, PHQ-2). Linear regressions of WHO-5 scores and negative binomial regressions of PHQ-2 and GAD-2 scores on the four sanitation-related empowerment resources were conducted.

