A qualitative study on gendered wash insecurity and health outcomes among internally displaced populations in conflict-affected context

Internally displaced populations (IDPs) in conflict-affected settings face severe challenges related to water, sanitation, and hygiene (WASH) insecurity. Gender plays a critical role in shaping these experiences and their consequent health outcomes. This study explores the gendered dimensions of WASH insecurity among IDPs living in makeshift shelters in the Gaza Strip and examines associated health impacts. A qualitative study was conducted between March 28 and May 8, 2025, involving in-depth interviews with 26 female participants, including adult women and adolescent girls, residing in Gaza’s displacement shelters. Descriptive themes were developed to explore: (1) access to clean water and sanitation facilities; (2) menstrual hygiene practices and challenges; (3) personal safety and dignity in WASH settings; (4) mental and physical health impacts; (5) gender roles and responsibilities related to WASH; and (6) coping mechanisms and support networks. Data were analyzed thematically to capture the lived experiences, coping strategies, and health consequences of WASH insecurity through a gender-sensitive lens. Findings reveal that WASH insecurity disproportionately affects women and girls by exacerbating risks to physical and mental health, including recurrent infections, menstrual hygiene challenges, and psychosocial distress. Social norms and displacement conditions restrict women’s access to safe, private sanitation, increasing vulnerability to harassment and undermining dignity. Despite these hardships, participants demonstrated resilience through adaptive coping strategies, though these often reinforced gendered burdens. Addressing WASH insecurity in Gaza’s displacement settings requires gender-responsive humanitarian interventions that prioritize privacy, safety, and menstrual hygiene management. Integrating WASH services with protection and health programs is vital to improving health outcomes and upholding the dignity of displaced women and girls. Enhanced participation of women in WASH planning and decision-making is crucial to achieving equitable and sustainable solutions.