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Structured interviews remain a key approach to collect information from community members, particularly in development contexts. Such enumerated surveys often focus on potentially distressing topics including gender equality, social inclusion, wellbeing, and even socio-demographics. Researchers have an obligation to consider the ethics of survey processes and mitigate potential distress for participants. However, approaches to quantify and evaluate participant distress remain nascent outside of clinical practice. To support ethical considerations in quantitative survey deployment, we introduce a four-item formative measure to analyze interview ease, stress, privacy, and comprehension. We present the measure's conceptual and empirical development and examine the validity of the measure through data from Cambodia and Nepal (n = 4,674) using Partial Least Squares Structural Equation Modeling (PLS-SEM) for formative measurement model assessment. The measure is shown to have content and face validity, anticipated divergence with two reflective constructs, low collinearity, structural validity, and construct validity through known groups testing. As ethical considerations are increasingly recognized as important in research in both development and other research and evaluation contexts, tools to diagnose and analyze distress can support in mitigating negative impacts.

Growing evidence highlights the gender-transformative potential of water, sanitation, and hygiene (WASH) interventions, which can shape gender equality and social inclusion alongside and through improvements in WASH practices, service delivery, and governance. This paper presents results from a quasi-experimental evaluation of the gender-transformative impacts of WASH interventions in the districts of Dailekh and Sarlahi in Nepal between 2020 and 2022. This timeframe also overlapped with the COVID-19 pandemic. The evaluation utilized propensity-score-matching and difference-in-difference techniques with the 16-theme water, sanitation, and hygiene - gender equality measure (WASH-GEM) to differentiate results between women and men of varying levels of program involvement. Average scores increased in 10 of the 16 themes for men, while decreasing in 10 themes for women; suggesting that men experienced greater improvements in gendered outcomes. Nonetheless, active participation in the program led to higher benefits or mitigated negative impacts in 15 themes, and women had better outcomes than men in 13 of these. These results suggest that active participation in the program had a positive net benefit for women participants, mitigating the negative gender impacts of the pandemic. This study illustrates the value of gender-transformative WASH programming as a pathway not only to improved WASH but also advancing equality.

Transformative change in how local governments support rural water services is required to accommodate the increasingly extreme effects of climate change on water service systems. This study explores the potential for contextualised soft systems thinking activities to prepare local government officials with responsibilities pertaining to rural water services in Nepal to shift towards more transformative thinking. First, the study presents the findings of focus group discussions in two rural districts of Nepal that identified common climate-related problems for rural water access including water shortages, contamination, and unequal burden of impacts. Second, we facilitated workshops with local government and non-government stakeholders, drawing on the focus group findings to frame the challenges for rural water linked to climate change that require local government response. We designed the workshops drawing on ‘transformative spaces’ concepts and included soft systems thinking activities to foster systemic perspectives. Participants learned about worldviews, leverage points, rich pictures, root cause analysis, and theory-of-change based action planning. Following the workshops, the study team participated in reflective sensemaking in which they deliberated on their experiences and notes from facilitating the workshops to assess the extent to which the participants demonstrated transformative thinking about rural water systems. The workshop approach showed promise in shifting how local government participants think about rural water services beyond technical fixes towards addressing deep-seated issues. However, further work is required to foster new relationships necessary to support transformation and grapple with ethical dilemmas pertaining to power dynamics at community and government levels. Nevertheless, the approach presented here is a replicable, low-cost way to prepare local government stakeholders in Nepal for transforming their thinking and systems to ways that enable sustainable rural water service delivery under threats of climate change.

The connections between WASH and gender equality have been extensively explored and documented using qualitative approaches, but not yet through quantitative means in ways that can strengthen WASH programming. The Water, Sanitation and Hygiene Gender Equality Measure (WASH-GEM) is a novel quantitative multidimensional tool co-produced in partnership between researchers and practitioners. This article explores three dimensions of the WASH-GEM co-production and implementation: (i) the role of partnerships in co-production processes for bringing contextual and practitioner knowledge into measure development; (ii) selected results from the validation pilot in Cambodia and Nepal (n = 3,056) that demonstrate ways in which the measure can inform WASH programming through analysis at different levels and with different co-variants; and (iii) the collaborative process of translating research into programming. The study illustrates that strong partnership and co-production processes were foundational for the development of a conceptually rigorous quantitative measure that has practical relevance. The findings presented in this article have implications for future measure development and WASH programming that aims to influence gender equality in rural communities.