101
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Fisher J, Cavill S, Reed B. Mainstreaming gender in the WASH sector: dilution or distillation? ACTA ACUST UNITED AC 2017. [DOI: 10.1080/13552074.2017.1331541] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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102
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103
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Ramirez-Ortiz D, Zolnikov TR. A Qualitative Study on the Interconnected Nature of HIV, Water, and Family. AIDS Behav 2017; 21:803-811. [PMID: 26874847 DOI: 10.1007/s10461-016-1334-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS) and poor access to water are two primary global health issues. Poor access to water may significantly affect families infected with HIV and result in adverse social and health consequences. A qualitative study used semi-structured interviews to understand health and social outcomes of families after the implementation of water interventions in rural Kenya. One major sub-theme emerged during this research, which included the effects of water on an HIV-affected family. Prior to the water interventions, common adverse health effects from lack of nutrition, water, and poor hygiene were experienced. After receiving access to water, nutrition and hygiene were improved and additional time was gained and used to reinforce relationships and spread awareness about HIV/AIDS. This study provides need-based evidence for access to safe drinking water in order to decrease adverse health outcomes and improve the quality of life for HIV-affected individuals.
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Affiliation(s)
- Daisy Ramirez-Ortiz
- Department of Public Health Sciences, University of Miami, Miami, FL, USA
- Kenya Red Cross, Red Cross Road, Bellevue, "South C", Nairobi, Kenya
| | - Tara Rava Zolnikov
- Department of Community Health, National University, San Diego, CA, USA.
- Kenya Red Cross, Red Cross Road, Bellevue, "South C", Nairobi, Kenya.
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104
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Workman CL, Ureksoy H. Water insecurity in a syndemic context: Understanding the psycho-emotional stress of water insecurity in Lesotho, Africa. Soc Sci Med 2017; 179:52-60. [PMID: 28254659 DOI: 10.1016/j.socscimed.2017.02.026] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 02/15/2017] [Accepted: 02/16/2017] [Indexed: 11/28/2022]
Abstract
Syndemics occur when populations experience synergistic and multiplicative effects of co-occurring epidemics. Proponents of syndemic theory highlight the importance of understanding the social context in which diseases spread and cogently argue that there are biocultural effects of external stresses such as food insecurity and water insecurity. Thus, a holistic understanding of disease or social vulnerability must incorporate an examination of the emotional and social effects of these phenomena. This paper is a response to the call for a renewed focus on measuring the psycho-emotional and psychosocial effects of food insecurity and water insecurity. Using a mixed-method approach of qualitative interviews and quantitative assessment, including a household demographic, illness, and water insecurity scale, the Household Food Insecurity Access Scale, and the Hopkins Symptoms Checklist-25, this research explored the psycho-emotional effects of water insecurity, food insecurity, and household illness on women and men residing in three low-land districts in Lesotho (n = 75). Conducted between February and November of 2011, this exploratory study first examined the complicated interaction of water insecurity, food insecurity and illness to understand and quantify the relationship between these co-occurring stresses in the context of HIV/AIDS. Second, it sought to separate the role of water insecurity in predicting psycho-emotional stress from other factors, such as food insecurity and household illness. When asked directly about water, qualitative research revealed water availability, access, usage amount, and perceived water cleanliness as important dimensions of water insecurity, creating stress in respondents' daily lives. Qualitative and quantitative data show that water insecurity, food insecurity and changing household demographics, likely resulting from the HIV/AIDS epidemic, are all associated with increased anxiety and depression, and support the conclusion that water insecurity is a critical syndemic dimension in Lesotho. Together, these data provide compelling evidence of the psycho-emotional burden of water insecurity.
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Affiliation(s)
- Cassandra L Workman
- Department of Anthropology, University of South Florida, 4202 E. Fowler Avenue, Tampa, FL 33620, USA.
| | - Heather Ureksoy
- Department of Psychology, University of South Florida, Tampa, FL, USA
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105
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Bisung E, Elliott SJ. Psychosocial impacts of the lack of access to water and sanitation in low- and middle-income countries: a scoping review. JOURNAL OF WATER AND HEALTH 2017; 15:17-30. [PMID: 28151436 DOI: 10.2166/wh.2016.158] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The lack of access to safe water and adequate sanitation has implications for the psychosocial well-being of individuals and households. To review the literature on psychosocial impacts, we completed a scoping review of the published literature using Medline, Embase, and Scopus. Fifteen studies met the inclusion criteria and were reviewed in detail. Of the included studies, six were conducted in India, one in Nepal, one in Mexico, one in Bolivia, two in Ethiopia, one in Zimbabwe, one in South Africa, and two in Kenya. Four interrelated groups of stressors emerged from the review: physical stressors, financial stressors, social stressors, and stressors related to (perceived) inequities. Further, gender differences were observed, with women carrying a disproportionate psychosocial burden. We argue that failure to incorporate psychosocial stressors when estimating the burden or benefits of safe water and sanitation may mask an important driver of health and well-being for many households in low- and middle-income countries. We propose further research on water-related stressors with particular attention to unique cultural norms around water and sanitation, short and long term psychosocial outcomes, and individual and collective coping strategies. These may help practitioners better understand cumulative impacts and mechanisms for addressing water and sanitation challenges.
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Affiliation(s)
- Elijah Bisung
- Department of Geography and Environmental Management, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada E-mail:
| | - Susan J Elliott
- Department of Geography and Environmental Management, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada E-mail:
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106
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Household water insecurity, missed schooling, and the mediating role of caregiver depression in rural Uganda. Glob Ment Health (Camb) 2017; 4:e15. [PMID: 29230311 PMCID: PMC5719478 DOI: 10.1017/gmh.2017.14] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 06/03/2017] [Accepted: 06/20/2017] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND School attendance rates in sub-Saharan Africa are among the lowest worldwide, placing children at heightened risk for poor educational and economic outcomes. One understudied risk factor for missed schooling is household water insecurity, which is linked to depression among women and may increase children's water-fetching burden at the expense of educational activities, particularly among children of depressed caregivers. In this study conducted in rural Uganda, we assessed the association between household water insecurity and child school participation and the mediating pathways behind these associations. METHOD We conducted a population-based, cross-sectional study of female household heads (N = 257) and their children ages 5-17 (N = 551) in the rural regions surrounding the town of Mbarara, in southwestern Uganda. We used multivariable linear regressions to estimate the association between water insecurity and missed schooling. We then assessed the extent to which the association was mediated by caregiver depression. RESULTS Among children, water insecurity had a statistically significant association with the number of missed school days (a standard deviation increase in water insecurity resulted in 0.30 more missed school days in the last week). The estimated association was partially mediated by caregiver depression. When stratified by sex, this mediating pathway remained significant for boys, but not among girls. CONCLUSIONS Water insecurity is a risk factor for missed schooling among children in rural Uganda. Caregiver depression partially mediated this relationship. Also addressing caregiver mental health in water insecure families may more fully address the needs of sub-Saharan African families and promote educational participation among youth.
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107
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Krumdieck NR, Collins SM, Wekesa P, Mbullo P, Boateng GO, Onono M, Young SL. Household water insecurity is associated with a range of negative consequences among pregnant Kenyan women of mixed HIV status. JOURNAL OF WATER AND HEALTH 2016; 14:1028-1031. [PMID: 27959881 PMCID: PMC5210218 DOI: 10.2166/wh.2016.079] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Water insecurity (WI) is a serious and worsening problem worldwide, but its role in health outcomes among people living with HIV or pregnant women is unknown. We assessed experiences of WI in a cohort of 323 pregnant Kenyan women of mixed HIV status. The majority (77.7%) had at least one experience of WI in the previous month; it was associated with negative economic, nutrition, disease, and psychosocial outcomes. A standardized cross-culturally valid household WI scale would facilitate assessment of the prevalence and consequences of WI, and increased attention to WI could reveal an overlooked, but modifiable, cause of adverse HIV outcomes.
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Affiliation(s)
| | - Shalean M Collins
- Program in International Nutrition, Cornell University, Ithaca, NY 14853, USA and Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY 14853, USA E-mail:
| | - Pauline Wekesa
- Kenya Medical Research Institute, Centre for Microbiology Research, Mbagathi Road, Nairobi, Kenya
| | - Patrick Mbullo
- Kenya Medical Research Institute, Centre for Microbiology Research, Mbagathi Road, Nairobi, Kenya
| | - Godfred O Boateng
- Program in International Nutrition, Cornell University, Ithaca, NY 14853, USA and Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY 14853, USA E-mail:
| | - Maricianah Onono
- Kenya Medical Research Institute, Centre for Microbiology Research, Mbagathi Road, Nairobi, Kenya
| | - Sera L Young
- Program in International Nutrition, Cornell University, Ithaca, NY 14853, USA and Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY 14853, USA E-mail: ; Department of Anthropology, Northwestern University, Evanston, IL 60208, USA
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108
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Assessing reliability, change after intervention, and performance of a water insecurity scale in rural Ethiopia. Food Secur 2016. [DOI: 10.1007/s12571-016-0599-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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109
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Espinosa-Montero J, Monterrubio-Flores EA, Sanchez-Estrada M, Buendia-Jimenez I, Lieberman HR, Allaert FA, Barquera S. Development and Validation of an Instrument to Evaluate Perceived Wellbeing Associated with the Ingestion of Water: The Water Ingestion-Related Wellbeing Instrument (WIRWI). PLoS One 2016; 11:e0158567. [PMID: 27388902 PMCID: PMC4936734 DOI: 10.1371/journal.pone.0158567] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 06/19/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Ingestion of water has been associated with general wellbeing. When water intake is insufficient, symptoms such as thirst, fatigue and impaired memory result. Currently there are no instruments to assess water consumption associated with wellbeing. The objective of our study was to develop and validate such an instrument in urban, low socioeconomic, adult Mexican population. METHODS To construct the Water Ingestion-Related Wellbeing Instrument (WIRWI), a qualitative study in which wellbeing related to everyday practices and experiences in water consumption were investigated. To validate the WIRWI a formal, five-process procedure was used. Face and content validation were addressed, consistency was assessed by exploratory and confirmatory psychometric factor analyses, repeatability, reproducibility and concurrent validity were assessed by conducting correlation tests with other measures of wellbeing such as a quality of life instrument, the SF-36, and objective parameters such as urine osmolality, 24-hour urine total volume and others. RESULTS The final WIRWI is composed of 17 items assessing physical and mental dimensions. Items were selected based on their content and face validity. Exploratory and confirmatory factor analyses yielded Cronbach's alpha of 0.87 and 0.86, respectively. The final confirmatory factor analysis demonstrated that the model estimates were satisfactory for the constructs. Statistically significant correlations with the SF-36, total liquid consumption and simple water consumption were observed. CONCLUSION The resulting WIRWI is a reliable tool for assessing wellbeing associated with consumption of plain water in Mexican adults and could be useful for similar groups.
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Affiliation(s)
- Juan Espinosa-Montero
- Nutritional Epidemiology, Nutrition and Health Research Center, Mexican National Institute of Public Health, Cuernavaca, Morelos, México
| | - Eric A. Monterrubio-Flores
- Nutritional Epidemiology, Nutrition and Health Research Center, Mexican National Institute of Public Health, Cuernavaca, Morelos, México
| | - Marcela Sanchez-Estrada
- Academic Operation, Academic Secretary, Mexican National Institute of Public Health, Cuernavaca, Morelos, México
| | | | | | | | - Simon Barquera
- Nutritional Epidemiology, Nutrition and Health Research Center, Mexican National Institute of Public Health, Cuernavaca, Morelos, México
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110
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Intermittent Domestic Water Supply: A Critical Review and Analysis of Causal-Consequential Pathways. WATER 2016. [DOI: 10.3390/w8070274] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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111
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Community Water Improvement, Household Water Insecurity, and Women's Psychological Distress: An Intervention and Control Study in Ethiopia. PLoS One 2016. [PMID: 27124391 DOI: 10.1371/journal.pone.0153432.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Over 650 million people worldwide lack access to safe water supplies, and even among those who have gained access to 'improved' sources, water may be seasonally unreliable, far from homes, expensive, and provide insufficient quantity. Measurement of water access at the level of communities and households remains crude, and better measures of household water insecurity are urgently needed to inform needs assessments and monitoring and evaluation. We set out to assess the validity of a quantitative scale of household water insecurity, and to investigate (1) whether improvements to community water supply reduce water insecurity, (2) whether water interventions affect women's psychological distress, and (3) the impacts of water insecurity on psychological distress, independent of socio-economic status, food security, and harvest quality. METHODS AND FINDINGS Measures were taken before and one to six months after a community water supply improvement in three villages in rural northern Ethiopia. Villages similar in size and access to water sources and other amenities did not receive interventions, and served as controls. Household water insecurity was assessed using a 21-item scale based on prior qualitative work in Ethiopia. Women's psychological distress was assessed using the WHO Self-Reporting Questionnaire (SRQ-20). Respondents were either female heads of household or wives of the heads of household (n = 247 at baseline, n = 223 at endline); 123 households provided data at both rounds. The intervention was associated with a decline of approximately 2 points on the water insecurity scale between baseline and endline compared to the control (beta -1.99; 95% CI's -3.15, -0.84). We did not find evidence of impact of the intervention on women's psychological distress. Water insecurity was, however, predictive of psychological distress (p <0.01), independent of household food security and the quality of the previous year's harvest. CONCLUSION These results contribute to the construct validity of our water insecurity scale, and establish our approach to measuring water insecurity as a plausible means of evaluating water interventions. Improvements to community water supplies were effective in reducing household water insecurity, but not psychological distress, in this population. Water insecurity was an important predictor of psychological distress. This study contributes to an emerging literature on quantitative assessment of household water insecurity, and draws attention to the potential impact of improved access to water on women's mental well-being.
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112
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Stevenson EGJ, Ambelu A, Caruso BA, Tesfaye Y, Freeman MC. Community Water Improvement, Household Water Insecurity, and Women's Psychological Distress: An Intervention and Control Study in Ethiopia. PLoS One 2016; 11:e0153432. [PMID: 27124391 PMCID: PMC4849673 DOI: 10.1371/journal.pone.0153432] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 03/29/2016] [Indexed: 01/28/2023] Open
Abstract
Background Over 650 million people worldwide lack access to safe water supplies, and even among those who have gained access to ‘improved’ sources, water may be seasonally unreliable, far from homes, expensive, and provide insufficient quantity. Measurement of water access at the level of communities and households remains crude, and better measures of household water insecurity are urgently needed to inform needs assessments and monitoring and evaluation. We set out to assess the validity of a quantitative scale of household water insecurity, and to investigate (1) whether improvements to community water supply reduce water insecurity, (2) whether water interventions affect women’s psychological distress, and (3) the impacts of water insecurity on psychological distress, independent of socio-economic status, food security, and harvest quality. Methods and Findings Measures were taken before and one to six months after a community water supply improvement in three villages in rural northern Ethiopia. Villages similar in size and access to water sources and other amenities did not receive interventions, and served as controls. Household water insecurity was assessed using a 21-item scale based on prior qualitative work in Ethiopia. Women’s psychological distress was assessed using the WHO Self-Reporting Questionnaire (SRQ-20). Respondents were either female heads of household or wives of the heads of household (n = 247 at baseline, n = 223 at endline); 123 households provided data at both rounds. The intervention was associated with a decline of approximately 2 points on the water insecurity scale between baseline and endline compared to the control (beta -1.99; 95% CI’s -3.15, -0.84). We did not find evidence of impact of the intervention on women’s psychological distress. Water insecurity was, however, predictive of psychological distress (p <0.01), independent of household food security and the quality of the previous year’s harvest. Conclusion These results contribute to the construct validity of our water insecurity scale, and establish our approach to measuring water insecurity as a plausible means of evaluating water interventions. Improvements to community water supplies were effective in reducing household water insecurity, but not psychological distress, in this population. Water insecurity was an important predictor of psychological distress. This study contributes to an emerging literature on quantitative assessment of household water insecurity, and draws attention to the potential impact of improved access to water on women’s mental well-being.
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Affiliation(s)
- E. G. J. Stevenson
- Department of Anthropology, University College London, London, United Kingdom
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States of America
- * E-mail:
| | - A. Ambelu
- Department of Environmental Health Sciences, Jimma University, Jimma, Ethiopia
| | - B. A. Caruso
- Department of Behavioral Science and Health Education, Emory University, Atlanta, GA, United States of America
| | - Y. Tesfaye
- Department of Anthropology, Oregon State University, Corvallis, OR, United States of America
| | - M. C. Freeman
- Department of Environmental Health, Emory University, Atlanta, GA, United States of America
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113
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Tsai AC, Kakuhikire B, Mushavi R, Vořechovská D, Perkins JM, McDonough AQ, Bangsberg DR. Population-based study of intra-household gender differences in water insecurity: reliability and validity of a survey instrument for use in rural Uganda. JOURNAL OF WATER AND HEALTH 2016; 14:280-92. [PMID: 27105413 PMCID: PMC4843843 DOI: 10.2166/wh.2015.165] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Hundreds of millions of people worldwide lack adequate access to water. Water insecurity, which is defined as having limited or uncertain availability of safe water or the ability to acquire safe water in socially acceptable ways, is typically overlooked by development organizations focusing on water availability. To address the urgent need in the literature for validated measures of water insecurity, we conducted a population-based study in rural Uganda with 327 reproductive-age women and 204 linked men from the same households. We used a novel method of photo identification so that we could accurately elicit study participants' primary household water sources, thereby enabling us to identify water sources for objective water quality testing and distance/elevation measurement. Our psychometric analyses provided strong evidence of the internal structure, reliability, and validity of a new eight-item Household Water Insecurity Access Scale (HWIAS). Important intra-household gender differences in perceptions of water insecurity were observed, with men generally perceiving household water insecurity as being less severe compared to women. In summary, the HWIAS represents a reliable and valid measure of water insecurity, particularly among women, and may be useful for informing and evaluating interventions to improve water access in resource-limited settings.
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Affiliation(s)
- Alexander C Tsai
- Massachusetts General Hospital Global Health, Boston, Massachusetts, USA E-mail: ; Harvard Medical School, Boston, Massachusetts, USA; Mbarara University of Science and Technology, Mbarara, Uganda
| | | | | | - Dagmar Vořechovská
- Massachusetts General Hospital Global Health, Boston, Massachusetts, USA E-mail:
| | - Jessica M Perkins
- Massachusetts General Hospital Global Health, Boston, Massachusetts, USA E-mail: ; Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Amy Q McDonough
- Massachusetts General Hospital Global Health, Boston, Massachusetts, USA E-mail:
| | - David R Bangsberg
- Massachusetts General Hospital Global Health, Boston, Massachusetts, USA E-mail: ; Harvard Medical School, Boston, Massachusetts, USA; Mbarara University of Science and Technology, Mbarara, Uganda; Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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114
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Gomes RDCM, Nogueira C, Toneli MJF. MULHERES EM CONTEXTOS RURAIS: UM MAPEAMENTO SOBRE GÊNERO E RURALIDADE. PSICOLOGIA & SOCIEDADE 2016. [DOI: 10.1590/1807-03102015v28n1p115] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo O artigo objetiva mapear a produção de conhecimento nas áreas das ciências da saúde, humanas e sociais sobre gênero e ruralidade, a partir de uma análise crítica. Para isso, foram realizadas buscas no sítio Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior com as palavras-chave: gênero e rural, gênero e ruralidade, mulher e rural, mulher e ruralidade, no período de 2000-2014. A seleção gerou um total de 108 artigos, dos quais 25, que apresentavam discussões acerca dos modos de vida das mulheres em contextos rurais, foram incluídos neste estudo. A análise abordou discussões sobre as relações de gênero em espaços rurais e gênero e novas ruralidades. As produções analisadas reconhecem os avanços na temática de gênero em espaços rurais, no entanto, demarcam a necessidade de uma maior presença das teorias feministas na constituição de abordagens teóricas e metodológicas junto a esses contextos.
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115
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Bulled N. The Effects of Water Insecurity and Emotional Distress on Civic Action for Improved Water Infrastructure in Rural South Africa. Med Anthropol Q 2016; 31:133-154. [PMID: 26698378 DOI: 10.1111/maq.12270] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2015] [Indexed: 11/27/2022]
Abstract
The South African constitution ratifies water as a human right. Yet millions of citizens remain disconnected from the national water infrastructure. Drawing on data collected in 2013-2014 from women in northern South Africa, this study explores "water citizenship"-individual civic engagement related to improving water service provision. Literature indicates that water insecurity is associated with emotional distress and that water-related emotional distress influences citizen engagement. I extend these lines of research by assessing the connection that water insecurity and emotional distress may collectively have with civic engagement to improve access to water infrastructure.
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Affiliation(s)
- Nicola Bulled
- Interdisciplinary and Global Studies Division, Worcester Polytechnic Institute
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116
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Sanitation, Stress, and Life Stage: A Systematic Data Collection Study among Women in Odisha, India. PLoS One 2015; 10:e0141883. [PMID: 26551866 PMCID: PMC4638353 DOI: 10.1371/journal.pone.0141883] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 09/26/2015] [Indexed: 11/25/2022] Open
Abstract
Emerging evidence demonstrates how inadequate access to water and sanitation is linked to psychosocial stress, especially among women, forcing them to navigate social and physical barriers during their daily sanitation routines. We examine sanitation-related psychosocial stress (SRPS) across women’s reproductive lives in three distinct geographic sites (urban slums, rural villages, and rural tribal villages) in Odisha, India. We explored daily sanitation practices of adolescent, newly married, pregnant, and established adult women (n = 60) and identified stressors encountered during sanitation. Responding to structured data collection methods, women ranked seven sanitation activities (defecation, urination, menstruation, bathing, post-defecation cleaning, carrying water, and changing clothes) based on stress (high to low) and level of freedom (associated with greatest freedom to having the most restrictions). Women then identified common stressors they encountered when practicing sanitation and sorted stressors in constrained piles based on frequency and severity of each issue. The constellation of factors influencing SRPS varies by life stage and location. Overall, sanitation behaviors that were most restricted (i.e., menstruation) were the most stressful. Women in different sites encountered different stressors, and the level of perceived severity varied based on site and life stage. Understanding the influence of place and life stage on SRPS provides a nuanced understanding of sanitation, and may help identify areas for intervention.
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117
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Affiliation(s)
- Bethany A Caruso
- Center For Global Safe Water, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Varadan Sevilimedu
- Department of Biostatistics, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Isaac Chun-Hai Fung
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Archana Patkar
- Water Supply and Sanitation Collaborative Council, Geneva, Switzerland
| | - Kelly K Baker
- Department of Occupational and Environmental Health, College of Public Health, The University of Iowa, Iowa City, IA, USA.
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118
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Siziya S, Mazaba ML. Prevalence and Correlates for Psychosocial Distress Among In-School Adolescents in Zambia. Front Public Health 2015; 3:180. [PMID: 26236704 PMCID: PMC4503886 DOI: 10.3389/fpubh.2015.00180] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 06/29/2015] [Indexed: 11/23/2022] Open
Abstract
There is scanty information on correlates for psychosocial distress in Zambia. Secondary analysis was conducted using the data collected in 2004 in Zambia during the global school-based health survey to determine the prevalence and correlates for psychosocial distress. Logistic regression analyses were used to estimate magnitudes of associations between exposure factors and the outcome, while the Yates' corrected Chi-squared test was used to compare proportions at the 5% significance level. A total of 2257 students participated in the survey of which 54.2% were males. Males were generally older than females (p < 0.001). Significantly, more females than males were bullied (p = 0.036), involved in a fight (p = 0.019), and consumed alcohol (p = 0.012). Psychosocial distress was detected in 15.7% of the participants (14.4% of males and 16.8% of females). Age <14 years, male gender, parental support for males, and having close friends were protective factors against psychosocial distress. Risk factors for psychosocial distress were being bullied, involvement in a fight, alcohol consumption, being physically active, and parental support. The prevalence of psychosocial distress among adolescents in Zambia appears to be common. There is a need to validate the psychosocial distress indicators that were used in the current study.
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Affiliation(s)
- Seter Siziya
- Department of Clinical Sciences, School of Medicine, Copperbelt University, Ndola, Zambia
- Department of Public Health, School of Health Sciences, University of Lusaka, Lusaka, Zambia
| | - Mazyanga Lucy Mazaba
- Immune and Vaccine Preventable Diseases, World Health Organization, Lusaka, Zambia
- Virology Unit, University Teaching Hospital, Ministry of Health, Lusaka, Zambia
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119
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Sahoo KC, Hulland KRS, Caruso BA, Swain R, Freeman MC, Panigrahi P, Dreibelbis R. Sanitation-related psychosocial stress: A grounded theory study of women across the life-course in Odisha, India. Soc Sci Med 2015; 139:80-9. [PMID: 26164119 DOI: 10.1016/j.socscimed.2015.06.031] [Citation(s) in RCA: 125] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 06/17/2015] [Accepted: 06/22/2015] [Indexed: 10/23/2022]
Abstract
While sanitation interventions have focused primarily on child health, women's unique health risks from inadequate sanitation are gaining recognition as a priority issue. This study examines the range of sanitation-related psychosocial stressors during routine sanitation practices in Odisha, India. Between August 2013 and March 2014, we conducted in-depth interviews with 56 women in four life stages: adolescent, newly married, pregnant and established adult women in three settings: urban slums, rural villages and indigenous villages. Using a grounded theory approach, the study team transcribed, translated, coded and discussed interviews using detailed analytic memos to identify and characterize stressors at each life stage and study site. We found that sanitation practices encompassed more than defecation and urination and included carrying water, washing, bathing, menstrual management, and changing clothes. During the course of these activities, women encountered three broad types of stressors-environmental, social, and sexual-the intensity of which were modified by the woman's life stage, living environment, and access to sanitation facilities. Environmental barriers, social factors and fears of sexual violence all contributed to sanitation-related psychosocial stress. Though women responded with small changes to sanitation practices, they were unable to significantly modify their circumstances, notably by achieving adequate privacy for sanitation-related behaviors. A better understanding of the range of causes of stress and adaptive behaviors is needed to inform context-specific, gender-sensitive sanitation interventions.
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Affiliation(s)
| | | | - Bethany A Caruso
- Department of Behavioral Science and Health Education and Center for Global Safe Water/Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Rojalin Swain
- Asian Institute of Public Health, Bhubaneswar, India
| | - Matthew C Freeman
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Pinaki Panigrahi
- Epidemiology and Pediatrics and Center for Global Health and Development, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Robert Dreibelbis
- Center for Applied Social Research, Civil Engineering and Environmental Science, and Department of Anthropology, University of Oklahoma, Norman, OK, USA.
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Hadley C, Stevenson EGJ, Tadesse Y, Belachew T. Rapidly rising food prices and the experience of food insecurity in urban Ethiopia: Impacts on health and well-being. Soc Sci Med 2012; 75:2412-9. [DOI: 10.1016/j.socscimed.2012.09.018] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Revised: 09/14/2012] [Accepted: 09/15/2012] [Indexed: 11/29/2022]
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