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. 2021 May:234:113715.
doi: 10.1016/j.ijheh.2021.113715. Epub 2021 Feb 19.

Household water insecurity will complicate the ongoing COVID-19 response: Evidence from 29 sites in 23 low- and middle-income countries

Justin Stoler  1 , Joshua D Miller  2 , Alexandra Brewis  3 , Matthew C Freeman  4 , Leila M Harris  5 , Wendy Jepson  6 , Amber L Pearson  7 , Asher Y Rosinger  8 , Sameer H Shah  9 , Chad Staddon  10 , Cassandra Workman  11 , Amber Wutich  12 , Sera L Young  13 ; Household Water Insecurity Experiences Research Coordination Network (HWISE RCN)
Collaborators, Affiliations

Household water insecurity will complicate the ongoing COVID-19 response: Evidence from 29 sites in 23 low- and middle-income countries

Justin Stoler et al. Int J Hyg Environ Health. 2021 May.

Abstract

In March 2020, the World Health Organization (WHO) issued a set of public guidelines for Coronavirus Disease 2019 (COVID-19) prevention measures that highlighted handwashing, physical distancing, and household cleaning. These health behaviors are severely compromised in parts of the world that lack secure water supplies, particularly in low- and middle-income countries (LMICs). We used empirical data gathered in 2017-2018 from 8,297 households in 29 sites across 23 LMICs to address the potential implications of water insecurity for COVID-19 prevention and response. These data demonstrate how household water insecurity presents many pathways for limiting personal and environmental hygiene, impeding physical distancing and exacerbating existing social and health vulnerabilities that can lead to more severe COVID-19 outcomes. In the four weeks prior to survey implementation, 45.9% of households in our sample either were unable to wash their hands or reported borrowing water from others, which may undermine hygiene and physical distancing. Further, 70.9% of households experienced one or more water-related problems that potentially undermine COVID-19 control strategies or disease treatment, including insufficient water for bathing, laundering, or taking medication; drinking unsafe water; going to sleep thirsty; or having little-to-no drinking water. These findings help identify where water provision is most relevant to managing COVID-19 spread and outcomes.

Keywords: COVID-19; Global health; SARS-CoV-2; WASH; Water insecurity.

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Conflict of interest statement

Conflict of interest

This research does not contain any conflict of interests.

Figures

Figure 1.
Figure 1.
The 29 study sites showing the percent of households in each site that experienced one or more water problems in the prior four weeks that potentially undermine COVID-19 control strategies or disease treatment.
Figure 2.
Figure 2.
Distribution by study site of percent of households that experienced interruptions to hygiene behavior in the prior four weeks due to problems with water (with percent across all sites in bold).
Figure 3.
Figure 3.
Distribution by study site of percent of households that borrowed or loaned water in the prior four weeks, as well as those who considered moving due to problems with water (with percent across all sites in bold).
Figure 4.
Figure 4.
Distribution by study site of round trip time to primary water source and trips made to water source per week (with percent across all sites in bold).
Figure 5.
Figure 5.
Distribution by study site of percent of households that experienced livelihood or educational opportunity costs in the prior four weeks due to problems with water (with percent across all sites in bold).
Figure 6.
Figure 6.
Percent of households that worried about problems with water or experienced interruptions to hygiene in the prior four weeks by tertile of perceived socioeconomic status relative to others in their community.
Figure 7.
Figure 7.
Distribution by study site of percent of households that experienced water problems that could undermine physical or nutritional health in the prior four weeks (with percent across all sites in bold).
Figure 8.
Figure 8.
Distribution by study site of percent of households that experienced perceived stress or interpersonal conflict in the prior four weeks due to problems with water (with percent across all sites in bold).
See this image and copyright information in PMC

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