Advancing Equity: Principles for Climate-Resilient Disability Inclusive Water, Sanitation and Hygiene

Introduction: Access to water, sanitation and hygiene (WASH) is crucial for health, but billions lack access. People with disabilities face extra barriers, worsening health outcomes. Climate change heightens these challenges by disrupting water, sanitation, and hygiene, often leading to harmful coping strategies. Most climate action plans overlook disability needs, highlighting the need for guidance on disability inclusion in climate-resilient WASH. Our study: The ‘Inclusive Pathways Towards Climate-Resilient WASH’ study, led by the London School of Hygiene & Tropical Medicine in partnership with icddr,b and World Vision, investigated the effects of climate hazards on WASH access for people with disabilities in Bangladesh. Using mixed methods, a literature review, and participatory workshops, the team co-developed principles for climate-resilient disability inclusive WASH. Building the evidence: Our scoping review examined climate change impacts on WASH services in low- and middle-income countries, focusing on disability inclusion. WASH services are highly vulnerable to climate-related disruptions, yet evidence on impacts specific to people with disabilities is scarce. In Bangladesh, extreme weather severely disrupted WASH services, with 30% of water points and 13% of latrines damaged, leaving nearly half of affected people with disabilities unable to access alternatives. Many reduced toilet use due to safety, privacy, and physical challenges, while incontinence and mobility issues increased vulnerability. Hygiene was compromised as polluted floodwater replaced tube wells, heightening health risks. Inadequate disaster relief, inaccessible shelters, and poor preparedness worsened outcomes. Climate-resilient disability services and inclusive disaster relief are crucial for safety, dignity, and health. The Principles: Participatory workshops in Gaibandha, Satkhira, and Dhaka brought together people with disabilities, caregivers, Organisations of Persons with Disabilities, and sector experts to develop six principles collaboratively and suggested activities for climate-resilient, disability-inclusive WASH interventions. These principles, designed for practitioners, prioritise the meaningful inclusion of people with disabilities and their caregivers. They provide a blueprint for enhancing disability inclusion in existing climate-resilient WASH efforts. While the activities are not prescriptive, practitioners should select those relevant to their context and create additional ones as needed. This report provides research findings and presents the principles, explaining their purpose and how to use them.