Water, sanitation, and hygiene challenges for menstruating women in an South African correctional facility

Abstract

ABSTRACT Graphic abstract, Rasweswe et al., 2026. Incarcerated women in low- and middle-income countries often face significant challenges in accessing water, sanitation, and hygiene services, which are fundamental human rights. To explore incarcerated women's experiences of Water, Sanitation, and Hygiene in a South African correctional facility using naive sketching and narrative discussions. The study was qualitative, following a descriptive phenomenological approach guided by Colaizzi's method. Data were collected through naive sketches (participant-produced drawings) and follow-up narrative discussions with 32 purposively sampled incarcerated women. Visual and textual data were integrated during analysis. The sketches were interpreted in light of the participants' descriptions and clustered into thematic units of meaning. To organize and contextualize the analysis more clearly, the Availability, Accessibility, Acceptability, and Quality framework was utilized. Two major themes emerged: limited water access and sanitation under Strain, each supported by subthemes. Water, sanitation, and hygiene conditions in correctional facilities position incarcerated women's health and dignity at risk. Urgent reforms are needed to align carceral environments with human rights standards and improve gender-sensitive services.