03016nas a2200337   4500000000100000008004100001260003700042653001500079653002900094653002000123653001600143653001800159653001000177653001200187653005100199100001600250700001300266700001500279700001300294700001600307700001200323700001500335700000600350700001300356245024400369856009600613300000900709490000600718520194000724022001402664       2024                            d  bPublic Library of Science (PLoS)10aSanitation10asexual and gender issues10aFactor Analysis10aMeasurement10aconsciousness10aNepal10aHygiene10aMental Health and Psychosocial Support (MHPSS)1 aMacArthur J1 aChase RP1 aGonzalez D1 aKozole T1 aNicoletti C1 aToeur V1 aWilletts J1 a 1 aTareq SM00aInvestigating impacts of gender-transformative interventions in water, sanitation, and hygiene: Structural validity, internal reliability and measurement invariance of the water, sanitation, and hygiene–Gender equality measure (WASH-GEM)  uhttps://journals.plos.org/water/article/file?id=10.1371/journal.pwat.0000233&type=printable  a1-240 v33 a<jats:p>Links between gender equality and water, sanitation, and hygiene (WASH) are well documented in qualitative studies, and emerging literature is recognizing the transformative potential of WASH interventions towards improvements in gender equality, of which empowerment is an important aspect. However, quantitative approaches to measure changing gender equality within WASH programs remain nascent. This study builds on previous work conducted in collaboration with the multi-country Water for Women Fund, establishing the theoretical development of the multi-dimensional WASH-gender equality measure (WASH-GEM) with five domains: resources, agency, critical consciousness, structures, and wellbeing. Starting from a strong conceptual foundation–this article demonstrates the WASH-GEM’s empirical rigor in balance with practical considerations. We present the measure’s staged development; examine its structural validity, internal consistency, and measurement invariance from an empirical basis; providing analysis from concurrent validation studies in Cambodia and Nepal (n = 3056). Twelve of the WASH-GEM’s 15 testable themes demonstrated high internal reliability and nine structural validity. Further refinement is recommended for the remaining four themes. Validation results from Cambodia and Nepal provide evidence of women and men’s differentiated experiences in relation to their WASH access, decision-making and roles, and in their lives more broadly. Results also reinforce the intersectional experiences of inequality and the importance of measurement beyond women’s empowerment. Overall, we provide evaluators and researchers with twelve curated and validated measures to examine changing gender dynamics within WASH-programs. These measures can be used as diagnostic or evaluation tools to support design and implementation of gender-transformative WASH interventions, programs, and policies.</jats:p>  a2767-3219