Protocol for development and validation of instruments to measure women's empowerment in urban sanitation across countries in South Asia and Sub-Saharan Africa: the Agency, Resources and Institutional Structures for Sanitation-related Empowerment (ARISE) scales

Introduction Despite an increasing emphasis on gender and empowerment in water, sanitation and hygiene (WaSH) programmes, no rigorously validated survey instruments exist for measuring empowerment within the WaSH sector. Our objective is to develop and validate quantitative survey instruments to measure women's empowerment in relation to sanitation in urban areas of low-income and middle-income countries. Methods and analysis We are developing the Agency, Resources and Institutional Structures for Sanitation-related Empowerment scales through a process that involves three phases: item development; scale development and initial validation and scale evaluation and further validation. The first phase includes domain specification, item generation, face validity and content validity assessment and item refinement. The second phase involves a second round of face validity and content validity assessment, followed by survey implementation in two cities (Tiruchirappalli, India and Kampala, Uganda) and data analysis involving factor analysis and item response theory approaches as well as reliability and validity testing. The third phase involves a final round of face validity and content validity assessment, followed by survey implementation in three additional cities (Narsapur and Warangal, India and Lusaka, Zambia) and statistical analysis using similar approaches as in phase 2 for further validation. Ethics and dissemination Ethics approvals have been received from the Emory University Institutional Review Board (USA); Azim Premji University and Indian Institute of Health Management Research Institutional Review Boards (India); Makerere University School of Health Sciences Research and Ethics Committee (Uganda); and ERES Converge Institutional Review Board (Zambia). The study team will share findings with key stakeholders to inform programming activities and will publish results in peer-reviewed journals.

Automated summary

This study aims to develop and validate a scale to measure women's empowerment in relation to sanitation in urban areas of low-income and middle-income countries. The study involves three phases: item development, scale development and initial validation, and scale evaluation and further validation. The research team will implement surveys in multiple cities and conduct statistical analysis to assess the reliability and validity of the scale, with the goal of informing programming activities in the future.