Development and validation protocol for an instrument to measure women's empowerment in urban sanitation across countries: The Agency, Resources, and Institutional Structures for Sanitation-related Empowerment (ARISE) Scales

IntroductionDespite an increasing emphasis on gender and empowerment in water, sanitation, and hygiene (WaSH) programs, 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 womens empowerment in relation to sanitation in urban areas of low-and middle-income countries. Methods and analysisWe are developing the Agency, Resources, and Institutional Structures for Sanitation-related Empowerment (ARISE) 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 disseminationEthics approvals have been received from ethics boards in all study locations. The study team will share findings with key stakeholders to inform programming activities and will publish results in peer-reviewed journals. Article SummaryO_ST_ABSStrengths and limitations of this studyC_ST_ABSO_LIWe employ rigorous methods to develop survey instruments, including testing and validating 15 scales, to assess domains of womens empowerment related to sanitation. C_LIO_LIPhased data collection is being carried out across five urban locations in South Asia and Africa to ensure that the survey instruments are valid and comparable across contexts. C_LIO_LIOur survey instruments are specific to women in urban settings; adaptation and further validity testing is needed to develop instruments that can be administered in other settings (e.g. rural, peri-urban) and with men. C_LIO_LIThe survey instruments are focused on empowerment at the individual, household, and community levels; they do not assess empowerment in markets (e.g. across the sanitation value chain) or in relation to policies and formal governance. C_LI