From Research to Action: Learning from Older People with Incontinence Across 11 Humanitarian Contexts

WHAT HUMANITARIAN NEED WAS ADDRESSED?

Our project aimed to address gaps in knowledge and practice around incontinence in the humanitarian sector. Our primary learning objectives were to:  

• Discover how older people and their caregivers can be best supported to manage their incontinence within their household settings, in emergency contexts.

• Improve understanding of incontinence amongst humanitarian professionals, both in terms of recording the scale and severity of incontinence, and in terms of implementing support for people with incontinence.

• Understand from older people their preferences, challenges and suggestions for how incontinence products can be used in humanitarian contexts, to better inform selection of these products.  

HOW DID THE INNOVATIVE SOLUTION IMPACT HUMANITARIAN PRACTICE?

25 older people and 15 caregivers participated in the creation and testing of the toolkit, helping to guide and shape the finalised product.  

252 people attended training on incontinence – improving their knowledge about actions that can be taken to support those with incontinence.  

In Ukraine, the training was rolled out to humanitarian agencies, and questions about incontinence were submitted in a multi-sector needs assessment.  

In Somalia, the Oxfam WASH team has applied for funding to be able to continue work around incontinence products.  

Training for Oxfam staff has included the topic in country programmes that were not part of this study. There are wider conversations taking place on the topic in both country and global fora, indicating that incontinence is becoming more of a priority.  

102 people took part in testing incontinence products to assess their utility, and all kits contained re-useable items that participants can continue to use.  

WHAT PROGRESS WAS ACHIEVED AND WHAT WERE THE KEY LEARNINGS?

The Home Based Care Package (HBCP) was developed, tested, and refined based on feedback from older people living with incontinence, caregivers, and key stakeholders. Key themes such as incontinence management, caregiver support, and emotional wellbeing were integrated into the toolkit through data collection, consultations, and iterative revisions, to ensure the HBCP’s relevance, usability, and accessibility across diverse locations and settings.

Market assessments, product distribution and testing were conducted in Malawi, Venezuela, Tanzania, Lebanon, Somalia, Ukraine, DRC and Yemen. In total 102 people participated in product testing across 7 different countries, with a diversity of ages, genders and disabilities. The team disseminated the findings at the Emergency Environmental Health Forum in May 2025.

In total, 252 participants took part in the training across 10 different countries, from a mix of Government and UN agencies, international NGOs and national/local NGOs. Pre and post-tests for the training showed that 90% of participants increased their knowledge of incontinence.  

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FUTURE POTENTIAL AND LESSONS FOR INNOVATION

As a result of the action plans created in the training sessions, several opportunities have arisen for further impact and collaboration:  

• In Venezuela, FUNDANA staff conducted awareness sessions, and integrated incontinence education into World Handwashing Day activities. Humanity & Inclusion incorporated incontinence care into project proposals and needs assessments, and scheduled awareness sessions for 2025. FUNVAPE reported one community sensitisation session and had plans for further training and community awareness. Convite has integrated incontinence care into humanitarian proposals and advocated within the WASH Cluster.  

• In Tanzania, humanitarian actors have committed to identifying older people with incontinence and maintaining a database of individuals who need support. This will include hygiene kits and medical interventions. Simultaneously, participants at the training have committed to conduct community awareness campaigns. HelpAge in Tanzania will deliver specialised training for Caregivers and will monitor their progress monthly. UNHCR camp management have also pledged to include incontinence as an area of focus.  

• In Somalia, Oxfam staff have applied for funding to be able to continue research into product preferences, with the aim of influencing the WASH Cluster to adopt the products into an incontinence kit. In DRC, the survey testing prompted many people to come forward about their incontinence issues, and the team plan to work with Afripad to explore the idea of designing a reuseable pad for urinary incontinence.  

• As a result of this project, Reemi developed two prototypes of incontinence underwear for urinary incontinence. These prototypes are being tested in Ethiopia, to determine whether there is viability to mass produce them for humanitarian contexts.  

• In Malawi, the Ministry of Health were closely engaged in the creation and review of the HBCP. They are interested in incorporating the HBCP into training for community health workers and using this as a basis for training on incontinence care.  

More widely, we have seen the topic of incontinence gain momentum within the WASH sector, with more guidance, research and discussions taking place around the topic.

DISSEMINATION

The dissemination grant will allow us to pursue a pilot project with the Malawian Ministry of Health to trial the HBCP as a standard tool for use by Community Health Workers to support those with incontinence at home, and will allow us to continue increasing the numbers of humanitarian workers trained on incontinence as a topic, which will in turn lead to better visibility of the topic and more programme activities to support those with incontinence.

Our key objectives under this grant are:

• To increase the provision of Home-Based Incontinence Care for older people with incontinence living in the Blantyre area of Malawi: To achieve this objective, MANEPO will work with the Malawian Ministry of Health to adopt the Home-Based Care Package as a standard part of their Community Health Worker training and service provision in Blantyre.

• To increase the number of humanitarian practitioners able to train others on the topic: To achieve this objective, we will adapt the current Incontinence Training Package into a Training of Trainers (TOT) for Incontinence Package. After testing, this would then be rolled out to 3 online cohorts of trainers, plus ongoing support for the newly created trainer pool for them to deliver follow up trainings in their own countries.  

• To increase the number of humanitarian practitioners able to access information, training and resources on incontinence globally: we plan to use the Incontinence Training Package to create an online, self-directed course on incontinence that can be used as an induction for all humanitarian staff on the topic, and allows them to explore the support their sector can provide to older people with incontinence and their carers in humanitarian settings.  

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