A qualitative study of barriers to accessing water, sanitation and hygiene for disabled people in Malawi.

The study took place in 10 Traditional Authorities (TAs) and townships in Malawi (See Table 1). These were purposively selected from across the Northern, Central and Southern regions. Data collection was done through local languages and with the support of three field assistants from the Federation for Disabled People in Malawi (all of them disabled people). Data collection took place between July and October 2014. Respondents were purposively sampled to reflect a range of impairments as well as variety in location and socio-demographic characteristics. The sample was not intended to be statistically representative. Respondents in each TA were identified through a two-step process beginning with consultation of ‘key informants’ who included village chiefs, representatives of Disabled Persons Organisations (DPOs), local social welfare officers and other service providers. Following the Washington Group short list of screening questions (18), key informants were asked to identify individuals in their community who they thought would experience ‘some difficulty’, ‘a lot of difficulty’ or be ‘unable  to do’ any of six specified activities: seeing, hearing, walking, remembering/understanding, communicating and self-care. Lists of up to 20 names, along with descriptions of each individual’s impairment type, were generated by key informants in each region. Based on these lists the research team purposively selected participants based on impairment type, gender, age and geographical location. The second step in the process involved the research team confirming the eligibility (determined by having at least ‘some difficulty’ in doing at least one of the six activities) of each of the purposively selected participants using the same short set of questions with the participant and/or the caregiver.