Article Text

Original research
Are the rights of people with disabilities included in international guidance on WASH during the COVID-19 pandemic? Content analysis using EquiFrame
  1. Nathaniel Scherer1,
  2. Islay Mactaggart1,
  3. Chelsea Huggett2,
  4. Pharozin Pheng3,
  5. Mahfuj-ur Rahman4,
  6. Jane Wilbur1
  1. 1Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
  2. 2WaterAid Australia, Melbourne, Victoria, Australia
  3. 3WaterAid Cambodia, Phnom Penh, Cambodia
  4. 4WaterAid Bangladesh, Dhaka, Bangladesh
  1. Correspondence to Mr Nathaniel Scherer; nathaniel.scherer{at}


Purpose People with disabilities are at increased risk from COVID-19. Access to water, sanitation and hygiene (WASH) services and facilities is a fundamental right for all, and is vital in stopping the transmission of COVID-19. However, people with disabilities often face difficulties accessing WASH. Various international organisations have published guidance and recommendations on WASH service provision during the COVID-19 pandemic, and this must include information of relevance to people with disabilities. This study aimed to investigate the inclusion of core concepts of rights for people with disabilities in guidance on WASH during the COVID-19 pandemic.

Method We used the EquiFrame content analysis tool to analyse the inclusion of 21 core concepts of rights for people with disabilities in international guidance documents on WASH during the pandemic. 29 documents were included from multilateral entities, international consortiums and non-governmental organisations. Key information from the included guidance documents was extracted for each of the 21 core concepts.

Results One-third of the WASH guidance did not include any reference to the rights of people with disabilities, and the majority of information was provided by just one guidance document. Most commonly referenced across all was access to WASH, including details on accessible infrastructure (eg, handwashing stations) and communication strategies. Information on many important rights and considerations, such as the affordability of services and caregiver support, was rarely included.

Conclusion Although some information is provided in international WASH guidance, this often has a narrow focus on access, rather than the full array of rights and considerations that are important for people with disabilities. International guidance should continue to be reviewed and updated to include further information of relevance to people with disabilities, informing a disability-inclusive approach to WASH during the remainder of the COVID-19 pandemic and future crises.

  • international health services
  • public health
  • COVID-19
  • Health policy

Data availability statement

Data are available upon reasonable request. Scoring of each individual WASH document is available from the lead author on request.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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Data availability statement

Data are available upon reasonable request. Scoring of each individual WASH document is available from the lead author on request.

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  • Twitter @Chelsea_Huggett, @janewilbur

  • Contributors NS was responsible for drafting the paper, conceptualising the study design, and conducting the data collection and analysis. JW provided supervision, and contributed to the study design, and data collection and analysis. IM supported the data analysis, interpretation and write-up. CH, PP and M-uR provided technical WASH expertise in study design and data analysis. All authors contributed to adapting the EquiFrame data collection tool to WASH and disability. All authors reviewed the final draft and provided comment to previous drafts.

  • Funding This study is funded by the Australian Government, Department of Foreign Affairs and Trade’s Water for Women Fund, under the project Translating disability inclusive WASH policies into practice: lessons learned from Cambodia and Bangladesh

  • Disclaimer The views expressed in this publication are those of the authors and not necessarily those of the Commonwealth of Australia. The Commonwealth of Australia accepts no responsibility for any loss, damage or injury resulting from reliance on any of the information or views contained in this publication.

  • Competing interests None declared

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.