Experiences of inequalities in access to safe water and psycho-emotional distress in Ghana

"No peace in my heart": Exploring psychosocial problems experienced by women in relation to water insecurity and inadequate sanitation in an informal settlement, Kenya

BACKGROUND

Social determinants of mental health are recognized as significant contributors to the disproportionate burden of depression and anxiety experienced by women worldwide. This study aimed to explore psychosocial problems experienced by women in relation to water insecurity and inadequate sanitation in an informal settlement in Kenya.

METHODS

We conducted a qualitative study employing a phenomenological approach. The study setting was Kaptembwo, an informal settlement in Kenya. Data collection was conducted from March 28, 2023 to April 24, 2023. Twenty-one in-depth interviews were carried out in Swahili with women of reproductive age (18-49 years) selected through purposive sampling and snowballing. Women were approached as they accessed the common water point and sanitation facility at their households and invited to participate. Marrianne Hennik's thematic analysis approach was used to examine patterns, themes, and meanings of data.

RESULTS

The key themes that emerged were stresses and social tension; bodily concerns and relational impacts; emotional consequences; and coping strategies. Unreliable and inadequate water and sanitation brought myriad stresses, led to stigma, and threatened social harmony as women struggled to maintain the health and dignity of their families. Women experienced infections and expressed bodily concerns including backpain, urinary problems and vaginal discharge, that fueled discord within their intimate relationships. Emotional consequences included stress, anxiety, shame, discomfort, frustration, embarrassment, and depression. Coping strategies reported by women included attempts to restore social relationships or seek social solutions to gender-based violence, with limited uptake of formal psychosocial care. Women's accounts supported conceptualization of psychosocial problems as a syndemic arising from interconnections between infections, gender disadvantage and environment.

CONCLUSION

Future research should focus on longitudinal and ethnographic observational studies to track evolving experiences of women and investigate the hypothesis that psychosocial problems in women in this informal settlement are the best conceptualized as a syndemic.

Emotionality in Transboundary Water: A Case Study of Helmand River

While a substantial body of literature perceives rationality as the only path for negotiations over the use of the transboundary shared watercourse, recent scholarship has unveiled the role of emotion in decision-making processes over the use of the shared water. This research aims to challenge the conventional approach-rationality-by exploring affective dynamics of the riparian nations of the Helmand River (shared between upstream Afghanistan and downstream Iran) and how decisions over the use of the shared Helmand River are ingrained in the emotional dispositions of the riparian nations. Taking an integrated approach combining emotional political ecology and neoclassical realism, this research unravels the intricate emotional dynamics of the riparian nations to the flow of the Helmand River. The staggering increase in water withdrawal-both surface and groundwater resources- coupled with the population growth, and adverse effects of climate changes has stimulated the negative emotional dispositions of the borderland communities- the sufferings of farming communities due to lack of access to water-resulting in water conflict escalation in the Helmand River Basin. Finally, it is asserted that negotiations over the use of Helmand River are considered to be ill-equipped unless emotionality and rationality-a pluralistic approach- are equally weighed or gauged in water allocation and utilization by the co-riparian nations.

Exploring the experiences of the overburden of water collection responsibility of rural women in Ghana

Despite evidence emphasizing women's responsibility for collecting water in sub-Saharan Africa, more needs to be known about the gender-specific consequences of this obligation, especially in rural Ghana, where water inaccessibility is a persistent issue. Employing a community-based case study, this research aimed to explore the gendered consequences of women's water collection responsibility, using a coupled systems framework. Data were gathered from surveys and focus groups and analysed statistically and thematically, respectively. Key findings highlighted intersecting influences in women's water access and collection difficulties, including distance to water sources, poverty, and health issues. Results revealed that over 50% of women experienced multiple consequences, including physical and psychological injuries (>80%), animal attacks (≤12%), spousal violence (>40%), nutritional challenges (>30%), hygiene problems (>40%), and socioeconomic issues (>50%). Over half faced three to seven intersecting water-related consequences, which intensified their difficulty in accessing and collecting water. Differences were observed across sub-communities. Interestingly, not all men had knowledge of these consequences, highlighting the crucial need to broaden their understanding as part of the solution to ease women's burdens. Addressing sociocultural norms and the various factors influencing access through effective and gendered water management and planning is imperative to alleviate women's burdens and improve equitable access.

Effects of water, energy, and food security on household well-being

Water, energy, and food insecurity are significant challenges that affect both economies and households, particularly in developing countries. These resources have an effect on households wellbeing, businesses, and all sectors of the economy, making them critical to ensuring household well-being, which is frequently measured by quintile welfare. As a result, there has been a significant increase in interest in securitizing these resources in order to mitigate their negative effects on household's wellbeing This study provides an empirical investigation of the determinants of water, energy, and food (WEF) security and the effect of water, energy, and food security on household well-being in Ghana. This study provides an empirical investigation of the determinants of water, energy, and food (WEF) security and the effect of water, energy, and food security on household well-being in Ghana. The study used a sample of 2,735 households from the Ghana Living Standard Survey (GLSS) Wave 7. We applied an instrumental variable probit, complementary log-log and ordered Probit estimation techniques for analysis. Empirical analysis reveals several important findings. Firstly, factors such as age, credit access, household location, employment status, and livestock ownership positively contribute to household water security, while remittances, water supply management, water bills, and water quantity have negative impacts. Secondly, age, marital status, household size, remittances, and livestock ownership significantly influence household energy security. Thirdly, marital status, household income, credit access, and household size are crucial determinants of household food security, with residence and region of household location exerting negative effects. Additionally, while water and energy security have a relatively lower impact on household well-being, food security emerges as a key driver in promoting household wellbeing. The study recommends that policymakers and stakeholders design and implement robust programs and interventions to sustain households' water, energy, and food supply.

Making waves: Mental health impacts of inadequate drinking water services - From sidenote to research focus

The paramount significance of the harmful impacts of poor drinking water services on physical health have been recognized for decades. Besides, over the past twenty years, an additional body of literature on their negative mental health impacts has emerged. With this brief review, we summarise the findings of the scholarship to advance addressing overall health (physical, mental, and social) in the water sector. We furthermore review the key policy documents of this field with a focus on mental health aspects and give recommendations for practitioners and decision-makers on addressing mental health in water service delivery. We reviewed the existing published works (42) assessing psychological impacts of deficient drinking water services in low-income settings. We then identified and compared the different mechanisms causing negative mental health outcomes described in them. For these purposes, we used a water insecurity experience -model and the vulnerability-stress model of clinical psychology. Next, we probed key international and national guiding documents of the water sector to analyse how mental health issues resulting from poor services are addressed today. We found that according to the literature, poor quality and quantity of water was predictably one of the most important psychosocial stressors to users. Surprisingly, however, various kinds of water-service-related inequalities (e.g. between genders, communities or socio-economic groups) showed up as equally significant stressors. Our analysis with the vulnerability-stress model furthermore indicates that insufficient drinking water services may predispose to common mental disorders particularly through external stress. Existing field guidelines have evolved to highlight the values of non-discrimination and participation, whilst mental health aspects remain ignored. This should not be the case. Therefore, practices for addressing mental health effectively in documentation and water service development should be further researched. But already in the light of the existing literature, we urge stakeholders to focus more on the negative mental health impacts of unequal service provision for users and nearby people left without improved services.

Do perceived inequalities in safe water access manifest in collective action? Evidence from urban Ghana

Access to safe drinking water is critical in improving health and well-being. It is estimated that >40% of urban households in Ghana do not have access to safe drinking water. Although the willingness and ability of community members to collectively take local initiatives are essential to curtailing inequities in water access in Ghana, the determinant of collective action is less explored. This paper explores determinants of collective action in water-insecure neighbourhoods and examines how perceived inequities in access to water and trust mediate the relationship between lack of access to water and collective action in urban Ghana. The results show that the urban poor OR = 12.047 (p = 0.000) were more likely to participate in water-related collective action compared to wealthy individuals. Primary decision-makers were 1.696 times more likely to participate in collective (p = 0.02). We also found that perceived inequities OR = 0.381 (p = 0.00) significantly predict participation in collective action to address water insecurity. Water service providers should be subjected to a rigid state-level framework that ensures inclusivity, fairness and justice in their distribution systems.