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      Systematic mapping of gender equality and social inclusion in WASH interventions: knowledge clusters and gaps

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          Abstract

          Introduction

          Poor access to water, sanitation and hygiene (WASH) services threatens population health and contributes to gender and social inequalities, especially in low-resource settings. Despite awareness in the WASH sector of the importance of promoting gender equality and social inclusion (GESI) to address these inequalities, evaluations of interventions focus largely on health outcomes, while gender equality and other social outcomes are rarely included. This review aimed to collate and describe available research evidence of GESI outcomes evaluated in WASH intervention studies.

          Methods

          We applied a systematic mapping methodology and searched for both academic and grey literature published between 2010 and 2020 in 16 bibliographic databases and 53 specialist websites. Eligibility screening (with consistency checking) was conducted according to predetermined criteria, followed by metadata coding and narrative synthesis.

          Results

          Our evidence base comprises 463 intervention studies. Only 42% of studies measured transformative GESI outcomes of WASH interventions, referring to those that seek to transform gender relations and power imbalances to promote equality. A majority of studies disaggregated outcome data by sex, but other forms of data disaggregation were limited. Most included studies (78%) lacked a specific GESI mainstreaming component in their intervention design. Of the interventions with GESI mainstreaming, the majority targeted women and girls, with very few focused on other social groups or intersectional considerations.

          Conclusion

          The review points to various areas for future primary and secondary research. Given the potential contribution of WASH to GESI, GESI considerations should be incorporated into the evaluation of WASH interventions. Regular collection of data and monitoring of GESI outcomes is needed as well as developing new and testing existing methods for monitoring and evaluation of such data.

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          Most cited references53

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          PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews

          The methods and results of systematic reviews should be reported in sufficient detail to allow users to assess the trustworthiness and applicability of the review findings. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement was developed to facilitate transparent and complete reporting of systematic reviews and has been updated (to PRISMA 2020) to reflect recent advances in systematic review methodology and terminology. Here, we present the explanation and elaboration paper for PRISMA 2020, where we explain why reporting of each item is recommended, present bullet points that detail the reporting recommendations, and present examples from published reviews. We hope that changes to the content and structure of PRISMA 2020 will facilitate uptake of the guideline and lead to more transparent, complete, and accurate reporting of systematic reviews.
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            PRISMA2020: An R package and Shiny app for producing PRISMA 2020‐compliant flow diagrams, with interactivity for optimised digital transparency and Open Synthesis

            Background Reporting standards, such as PRISMA aim to ensure that the methods and results of systematic reviews are described in sufficient detail to allow full transparency. Flow diagrams in evidence syntheses allow the reader to rapidly understand the core procedures used in a review and examine the attrition of irrelevant records throughout the review process. Recent research suggests that use of flow diagrams in systematic reviews is poor and of low quality and called for standardised templates to facilitate better reporting in flow diagrams. The increasing options for interactivity provided by the Internet gives us an opportunity to support easy‐to‐use evidence synthesis tools, and here we report on the development of a tool for the production of PRISMA 2020‐compliant systematic review flow diagrams. Methods and Findings We developed a free‐to‐use, Open Source R package and web‐based Shiny app to allow users to design PRISMA flow diagrams for their own systematic reviews. Our tool allows users to produce standardised visualisations that transparently document the methods and results of a systematic review process in a variety of formats. In addition, we provide the opportunity to produce interactive, web‐based flow diagrams (exported as HTML files), that allow readers to click on boxes of the diagram and navigate to further details on methods, results or data files. We provide an interactive example here; https://prisma-flowdiagram.github.io/ . Conclusions We have developed a user‐friendly tool for producing PRISMA 2020‐compliant flow diagrams for users with coding experience and, importantly, for users without prior experience in coding by making use of Shiny ( https://estech.shinyapps.io/prisma_flowdiagram/ ). This free‐to‐use tool will make it easier to produce clear and PRISMA 2020‐compliant systematic review flow diagrams. Significantly, users can also produce interactive flow diagrams for the first time, allowing readers of their reviews to smoothly and swiftly explore and navigate to further details of the methods and results of a review. We believe this tool will increase use of PRISMA flow diagrams, improve the compliance and quality of flow diagrams, and facilitate strong science communication of the methods and results of systematic reviews by making use of interactivity. We encourage the systematic review community to make use of the tool, and provide feedback to streamline and improve their usability and efficiency.
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              A methodology for systematic mapping in environmental sciences

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                Author and article information

                Journal
                BMJ Glob Health
                BMJ Glob Health
                bmjgh
                bmjgh
                BMJ Global Health
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2059-7908
                2023
                24 January 2023
                : 8
                : 1
                : e010850
                Affiliations
                [1 ]Stockholm Environment Institute , Stockholm, Sweden
                [2 ]departmentLancaster Environment Centre , Lancaster University , Lancaster, UK
                [3 ]departmentDepartment of Politics and Public Administration , University of Konstanz , Konstanz, Germany
                [4 ]departmentInstitute for Sustainable Futures , University of Technology Sydney , Broadway, Sydney, Australia
                [5 ]departmentResearch Group SoMeTHin’K, Faculty of Social Sciences , KU Leuven , Leuven, Belgium
                [6 ]departmentSociomedical Sciences , Mailman School of Public Health, Columbia University , New York, New York, USA
                [7 ]departmentDepartment of Women's and Children's Health , Uppsala University , Uppsala, Sweden
                Author notes
                [Correspondence to ] Dr Biljana Macura; biljana.macura@ 123456sei.org
                Author information
                http://orcid.org/0000-0002-4253-1390
                http://orcid.org/0000-0002-8564-6956
                http://orcid.org/0000-0002-5011-3615
                http://orcid.org/0000-0001-7442-9270
                http://orcid.org/0000-0003-0437-3755
                Article
                bmjgh-2022-010850
                10.1136/bmjgh-2022-010850
                9884933
                36693669
                f373e88c-4297-473c-a407-edc1115e2767
                © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 03 October 2022
                : 29 December 2022
                Funding
                Funded by: Centre of Excellence for Development Impact and Learning (CEDIL);
                Award ID: 38954
                Categories
                Original Research
                1506
                Custom metadata
                unlocked

                review,public health
                review, public health

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