Here is a riddle for you: Asutifi North, a district in the Ahafo Region of Ghana, is home to 62,817 residents, 70% of whom live in rural areas. Only 16% of the population uses improved sanitation.

Diseases spread fast in the absence of water, sanitation and hygiene (WASH) services, compromising development efforts and trapping people in poverty.  How should Asutifi North go about fixing this problem?

Should the authorities build more toilets and dig more wells? Would this improve the situation for men and women equally? How should progress be monitored?

Increasingly, research indicates that infrastructure does not benefit everyone equally, and that the way we track the performance of WASH interventions doesn’t paint the full picture of who benefits and how.  In fact, water and sanitation services that should empower people to escape poverty may actually perpetuate inequality.

The Empowerment in WASH Index (EWI) was created to change that. This robust monitoring tool directly tracks empowerment, agency and participation in the context of WASH by using indicators to create empowerment profiles for male and female respondents. The outputs from the tool can be used to identify significant disempowering factors, all of which are disaggregated by gender.

For instance, our assessment in Asutifi North showed that only 63% of women and 76% of men felt they are empowered to make their own decisions, participate and have their voices heard in activities related to water, sanitation and hygiene. A similar assessment in Burkina Faso’s Banfora commune indicated a harsher disparity – only 26% of women and 63% of men felt empowered by WASH.

Challenging assumptions, highlighting blind spots

In many countries, women usually collect and manage water in their roles as cooks, cleaners and carers of young, old and sick family members. Women and girls also have particular biological needs for safe WASH services, such as during menstruation.

These gender-specific hygiene needs and gender norms increase women’s and girls’ vulnerability to poor water and sanitation; while the associated unpaid labor involved in hauling water takes away time from other activities.

So, it’s often thought that installing a water point or building a latrine will automatically benefit women. However, this idea is just an assumption.

Generally, we only measure the performance of water and sanitation infrastructure at the service level by looking at whether it is safely managed, basic or unimproved. Measures of infectious disease are also sometimes used to assess public health improvements.

But we have no idea how families use the infrastructure. In some cultures, it may not be acceptable for certain male and female family members to share the same toilet. Women may be barred from using a toilet during menstruation due to cultural taboos, and they may avoid it if it doesn’t meet their menstrual hygiene needs or if they feel unsafe.

Similar issues are manifested in water provision: People may continue to use unsafe water sources, even when a new water source is accessible. This may happen because the service is not reliable or not affordable, is located too far, or because the source isn’t culturally acceptable.

WASH interventions can’t consider these concerns if individuals have low level of agency in decision-making and little control over resources.

Furthermore, the WASH sector has a long tradition of emphasizing that water and sanitation services are critical for women and girls. But the SDG 6 indicators are effectively gender blind and do not collect data disaggregated by sex or age.

This data gap is a major challenge because prioritization and subsequent investment only occur if there is adequate, high quality, reliable data.

What can the EWI be used for? 

The Empowerment in WASH Index is made to bridge this gap and enable diagnostic assessments and the design of gender-integrated interventions that increase individual agency. Service providers, development partners and donors can use EWI to monitor empowerment and gender outcomes of WASH interventions.

With the help of this tool we can better understand how gender relations and power dynamics can generate exclusion from access to WASH services.

The application of EWI in Asutifi North revealed the lack of input into household decisions to participate in community WASH planning and implementation was the strongest disempowerment factor for women. The men also felt disempowered due to their low involvement in decisions about water collection and management at the household level. Evidently, we need to consider gender dynamics and norms when it comes to the provision of additional water or sanitation facilities.

The EWI tool will help us see why well-intended projects don’t work and why expected gender-equality outcomes aren’t achieved. We also will be able to build better accountability for gender commitments and to prioritize the factors contributing to disempowerment.

We have to move beyond popular assumptions about the potential benefits WASH programs can bring and move towards evidence-based, precise monitoring and practice, which will help make gender disparities in WASH a thing of the past.

This article was originally published by the World Bank Water Blog.