Investigating WASH (Water, Sanitation, and Hygiene) Practices and Related Health Risks Among Women in Communities of Dharavi, Mumbai

Abstract

Access to sufficient water, sanitation, and hygiene (WASH) remains a persistent challenge in urban slum settlements thus, affecting women’s health and well-being. This pilot study investigates WASH practices among women aged 15–45 in Dharavi, Mumbai—one of Asia’s largest informal settlements—with a keen focus on menstrual hygiene management and the associated risk of Urinary Tract Infections (UTIs). A cross-sectional survey was conducted among 50 women aged 15–45 years using structured questionnaires. Data were analysed using descriptive statistics, Chi-square, and Fisher’s Exact Test to evaluate associations between menstrual hygiene practices and UTI symptoms. Most women (78%) are still depended on overcrowded community toilets, which lack basic facilities such as water and soap. Disposable sanitary pads were used by 74% of respondents, while 26% still relied on cloth. A significant association was observed between frequency of changing menstrual products and UTI symptoms (χ² = 14.3, p = 0.027; Fisher’s p = 0.011). Avoiding eating to reduce toilet visits was also associated with UTI symptoms (χ² = 4.37, p = 0.037). Choice of menstrual product was linked to age (p = 0.022) and education level (p = 0.006) of the women. However, reduced water intake showed no significant association (p = 0.155). The study highlights the urgent need for raising awareness programs in managing reproductive infections in Dharavi. Affordable sanitary products, safe disposal facilities, and gender-sensitive sanitation policies are critical to reducing health risks and promoting dignity in menstrual hygiene management.