A Qualitative Exploration in Causes of Water Insecurity Experiences, and Gender and Nutritional Consequences in South-Punjab, Pakistan.

Farooq Ahmed,Yang Cao,Jing Guo,Muhammad Shahid,Madeeha Gohar Qureshi,Sidra Zia,Saireen Fatima

doi:10.3390/ijerph182312534

Abstract

Although water insecurity has been discussed in general, its impacts on mothers’ physical and mental health, and infants’ and young children’s feeding (IYCF), has largely been ignored. This study explores household water insecurity experiences and their association with optimal health and nutrition of women and children in the Rajanpur district of Punjab Province. Using focus group discussions (FGDs) and key informants (KIIs) interviews from an area with high maternal-child malnutrition prevalence, a qualitative study was conducted to describe local experiences of water acquirement and arrangement, and of the consequences of water insecurity. The findings highlight that rural Western marginalized populations of the Rajanpur district rely on brackish, canal, or flood surface water as the water supply is absent, which intensifies mothers’ work burden and stress, and often makes them victims of violence, stigma, and sickness. Water fetching impacts women in unforeseen ways, impacting the psychosocial and physical health of mothers engaged in maternal breastfeeding. Water insecurity, originally rooted in regional disparities, compounds with gender inequities, which leads to maternal stress and child sickness. Justice in water resources is imperative and urgent in the deprived South of Punjab province for improving public health nutrition.

Highlights

Food insecurity, maternal poor health, suboptimal water, sanitation, and hygiene (WASH) and infants’ and young children’s feeding (IYCF) practices, which are considered to be important underlying determinants of malnutrition, have a close association with water insecurity
We argued that water insecurity is a syndemic and cross-cutting issue, associated with maternal-child malnutrition through multiple pathways: gender inequity, maternal stress, sub-optimal childcare, poor
Insecure and unsafe water at the community level in the Rajanpur district is a result of political indifference and regional inequities in Punjab province

Summary

Introduction

Maternal poor health, suboptimal water, sanitation, and hygiene (WASH) and IYCF practices, which are considered to be important underlying determinants of malnutrition, have a close association with water insecurity. In order to tackle poverty, ill health, inequality, and environmental degradation, the Sustainable Development Goals (SDGs) were established in 2012 at the United Nations Conference on Sustainable Development in Brazil. SDG-6 ensures “availability and sustainable management of water and sanitation for all” [1]. Almost 1.8 billion people drink water from contaminated sources worldwide [2]. Access to safe water is fundamental to health, nutrition, and development in low-and-middle-income countries [LMIC] [2]. The availability of safe drinking water is not possible without proper community development interventions, but in low-and-middle-income countries, the peripheries are deliberately ignored in terms of human development. Households and communities need a well-laid-out sanitation system

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