Access to safe and adequate sanitation remains a critical public health challenge for women living in urban poor settlements in India. Despite national initiatives such as the Swachh Bharat Mission aimed at improving sanitation infrastructure, many women in low-income urban communities continue to face difficulties in accessing safe, hygienic, and gender-sensitive sanitation facilities. This study examines the relationship between public sanitation facilities and women’s health problems among the urban poor in Tamil Nadu.

The study adopts a mixed-method approach combining survey data and qualitative insights from women residing in selected urban low-income neighborhoods. Primary data were collected through structured questionnaires and focused discussions to understand patterns of public toilet usage, accessibility issues, safety concerns, hygiene conditions, and associated health outcomes. The findings indicate that inadequate sanitation infrastructure, overcrowded public toilets, poor maintenance, lack of privacy, and safety concerns significantly affect women’s health and wellbeing. Many respondents reported health problems such as urinary tract infections, reproductive health issues, and psychological stress due to delayed or restricted toilet use.

The study further highlights the intersection of gender, poverty, and urban infrastructure inequalities in shaping sanitation experiences. It argues that sanitation policies must move beyond infrastructure provision to include gender-sensitive design, regular maintenance, safety measures, and community participation. Strengthening public sanitation systems is essential not only for improving women’s health but also for advancing urban dignity, gender equity, and inclusive public health governance. The findings contribute to ongoing debates on urban sanitation policy and gender-responsive urban planning in the Global South.