Emergency sanitation for children with urinary incontinence

Children aged between five and 11 years old sometimes wet themselves. This could be due to them having the medical condition of urinary incontinence (UI, defined as the involuntary leakage of urine), or due to them not wanting to use, or not being able to use, the toilet facilities available (known as social incontinence). Little is known about how children aged five to 11 experience self-wetting (due to either UI or social incontinence) when displaced from their homes, and how they can be better supported. As a result, humanitarian programmes in sectors including health, protection, and water, sanitation and hygiene may not meet the needs of children that wet themselves. This research is the first known attempt to understand self-wetting in displaced children aged five to 11. It includes a systematic review of existing guidance for the provision of emergency sanitation for children aged five to 11, and the evaluation of two methodologies designed to address the operational and ethical challenges of conducting research with displaced children on personal and sensitive issues: the User-Centred Community Engagement (UCCE) methodology and the Story Book methodology. Improving sanitation facilities will improve the quality of life of children with social incontinence and their caregivers. The CHILD-SAN framework will support the better provision of sanitation facilities for such children, and the framework can be enhanced by using the UCCE methodology. Improving the quality of life for children with UI and their caregivers – and also for children that may never be comfortable using public latrines and subsequently self-wet – is more challenging. Communication to normalise UI is a critical first step, and the inclusion of products in standardised hygiene kits to support the management of self-wetting would also help. The provision of such communications and incontinence kits can be improved by using the Story Book methodology.