Understanding user experiences of providing and utilizing washable absorbent continence products in India, Papua New Guinea and Romania.

Incontinence is a global health and social care challenge. Effectively containing bladder or bowel leakage is fundamental for people living with incontinence. Disposable absorbent products are widely used, but do not work well for everyone and are neither financially nor environmentally sustainable. Specifically designed washable absorbent products are not widely used. We aimed to understand people's experiences of using or providing washable products in different contexts. We undertook 57 interviews with product-users and/or carers and three focus groups with service providers in India, Papua New Guinea and Romania. Five themes were identified: 1) Usability variation, 2) Impact on lives, 3) Do no harm, 4) Future Use and 5) Scalability. We found that washable products have the potential to improve the lives of many people with long-term continence problems, but the designs tested do not work for everyone. Individual assessment and the opportunity to try out products are important. There is considerable scope for better designs and raising awareness of usage. Opinions on the products are partly shaped by the products used previously and individual financial considerations play a role. Overall, there is a clear demand for washable absorbent continence products, and innovation through co-design is urgently needed.