Objective progress towards equitable and sufficient water, sanitation, and hygiene has primarily been measured by household-level data, e.g. from the Joint Monitoring Project (JMP) and the Wash Severity Classification (WSC.

These global indicators have been enormously helpful for many activities, but the limitations are very real. They rely on a very small number of indicators (eg, handwashing is typically the only indicator for hygiene). Further, they do not collect information on what is needed to be done to address observed issues. Finally, they are not able to determine differences in hygiene experiences by gender or other individual characteristics.

This research is developing experiential hygiene scales that will rectify many of these shortcomings, following the “playbook” used for the development of experiential measures of water insecurity. Briefly, there were many WASH indicators that focused on the physical availability of resources (e.g. m³ water per capita, and infrastructure for drinking water and/or sanitation facilities) (6). These were necessary, but not sufficient, to ensure that people experience secure access to water, sanitation, and hygiene (7).

Higher-resolution measures of water accessibility, adequacy, reliability, and safety were needed to understand how problems with water impact health and well-being, and they needed to do so from the user’s perspective.