“The fear of violence is always there”: Gender-based violence, water and sanitation insecurity in Ghana

Soc Sci Med. 2026 Jun 19;404:119502. doi: 10.1016/j.socscimed.2026.119502. Online ahead of print.

ABSTRACT

Informed by feminist political ecologies of health, we explore gender-based violence related to water, sanitation, and hygiene (WASH) access in sub-Saharan Africa, using rural communities in the Upper West region of Ghana as a case study. In-depth interviews (n = 36) conducted with women in local languages were transcribed into English and underwent thematic analysis. Results reveal the physical, psychosocial, infrastructural, and sexual violence that women are exposed to at home, at water sources, and in transit to and from the water point or places of open defecation. These results highlight the impacts of the violence on women’s health and wellbeing and further underscore the role of social norms as they shape relationships of power and access to a fundamental life resource. The findings suggest that WASH interventions must move beyond essential infrastructure provision to enhance both water and WASH security and incorporate gender-transformative and gender-based violence (GBV)-sensitive approaches, including improving safety around water access points and provision of adequate sanitation facilities as well as addressing harmful social norms that shape water access and decision-making. Future research can enhance our understanding and direct us further toward change through gathering insights from men as well as women, thus enriching the gender discourse on WASH provision and GBV. In particular, such research should explore men’s voices and roles in household decision-making, control over resources, and the shaping of social norms that influence women’s safety and access to WASH services.

PMID:42341734 | DOI:10.1016/j.socscimed.2026.119502