Abstract
Many women in low-income countries carry heavy loads of drinking water for their families in difficult terrain. This can adversely affect their health and well-being. The present study is the first to investigate the physical burden of water carrying and women’s psychosocial well-being, and how this relationship is moderated by environmental and health conditions. Trained local interviewers conducted interviews with 1001 women across five rural communities in Nepal. In addition, objective measurement was used to assess the weight carried and distance from the water source. The physical burden of water carrying was calculated from weight, distance, and frequency of trips. Its association with psychosocial well-being was modeled using generalized estimating equations. Two additional models included the terrain and uterine prolapse as moderators. The physical burden of water carrying is directly related to higher emotional distress and reduced daily functioning. This correlation was exacerbated for women carrying in hilly versus flat terrain, and for those who had uterine prolapse. Our results underline the importance of adequate water access for women’s psychosocial well-being, especially for vulnerable populations such as women with impaired health (e.g., uterine prolapse) or those living in hilly terrain. The results further highlight the interconnectedness of the Sustainable Development Goal (SDG) 6: water access, SDG 3: health and well-being, and SDG 5: gender equality.
Highlights
Introduction iationsWater is needed in many areas of life, such as drinking water, food production, care of domestic animals, hygiene, cleaning, and waste disposal [1]
Women reported low-to-moderate emotional distress, moderate quality of life, and moderate-to-high daily functioning related to water carrying
The physical burden of water carrying was not related to quality of life
Summary
Water is needed in many areas of life, such as drinking water, food production, care of domestic animals, hygiene, cleaning, and waste disposal [1]. Previous research on the health consequences of sub-optimal water access has described adverse impacts of low water quality [3,4], the transport of water [5,6,7] water insecurity [8,9], and poor menstrual hygiene management [10,11]. In water poor areas, the time required to retrieve water can pose barriers to other activities, such as education, paid work, and healthcare, which results in impairment of women’s quality of life [14]. The responsibility of water collection can further pose a serious threat to women’s psychosocial well-being [15,16,17]
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