Socioeconomic Factors Affecting Water Access in Rural Areas of Low and Middle Income Countries

The role of corruption in global food systems: a systematic scoping review

BACKGROUND

Corruption exists at all levels of our global society and is a potential threat to food security, food safety, equity, and social justice. However, there is a knowledge gap in the role and impact of corruption within the context of the global food system. We aimed to systematically review empirical literature focused on corruption in the global food system to examine how it is characterized, the actors involved, its potential impacts, and the solutions that have been proposed to address corruption in the food system.

METHODS

We used a systematic scoping review methodology. Terms combining corruption and the food system were searched in Scopus, PubMed, Web of Science, PsycInfo and Econlit, in October 2021. Two screeners applied a priori selection criteria to screen the articles at the title and abstract and full-text levels. Data was extracted into a charting form and thematically synthesized to describe the types of corruption in the food system, the actors involved, how corruption impacts the food system, and potential solutions. Sankey diagrams and narrative summaries were developed to summarize the included studies and findings.

RESULTS

From the 238 included records, five main types of corruption were identified in the global food system: bureaucratic corruption, fraud, bribery, organized crime, and corporate political activity. These different types of corruption spanned across various food system areas, from policy and governance structures to food environments, and involved a wide range of actors. More powerful actors like those in public and private sectors tended to instigate corruption in the food system, while community members and primary producers tended to be impacted by it. The impacts of corruption were mostly negative and corruption was found to undermine food system governance and regulatory structures; threaten health, safety, and food security; and lead or contribute to environmental degradation, economic loss, erosion of trust, social inequities, and decreased agricultural productivity. While solution-oriented literature was limited, the essential role of strong governance,  use of technology and predictive modelling methods to improve detection of corruption, and organizational approaches to problem solving were identified.

CONCLUSION

Our review findings provide researchers and policymakers with a comprehensive overview of corruption in the global food system, providing insights to inform a more holistic approach to addressing the issue. Addressing corruption in the food system is an essential element of supporting the transition to a more healthy, equitable and sustainable global food system.

Access to drinking safe water and its associated factors among households in East Africa: a mixed effect analysis using 12 East African countries recent national health survey

BACKGROUND

More than half of the population in Sub-Saharan Africa (SSA) faces limited access to safe drinking water. Unimproved water sources can pose risks to the health of entire households, particularly women and children. Despite the fact that East African countries have some of the poorest drinking water infrastructures globally, there is a lack of published data on this issue. Consequently, the objective of this study was to examine access to safe drinking water and its determinants among households in East Africa, utilizing recent nationally representative data.

METHODS

This study analyzed data from recent demographic and health surveys conducted in 12 East African nations between 2011 and 2022. Data were gathered from 204,275 households. A stratified two-stage cluster sampling method was employed, with enumeration areas serving as the main sampling units and households serving as the secondary sampling units. Binary and multiple multilevel logistic regression were used to examine the relevant factors associated with the use of different sources of drinking water in the region. In binary regression and multiple regression, P values of ≤ 0.2 and < 0.05, respectively, were used to determine the statistical significance of variables in the final model.

RESULTS

Approximately 72.62% (95% CI = 72.43, 72.83) of households have utilized improved sources of drinking water. Household heads aged 25-35 years (AOR = 1.09, 95% CI = 1.04, 1.14), 36-45 years (AOR = 1.09, 95% CI = 1.04, 1.14), and > 45 years (AOR = 1.08, 95% CI = 1.04, 1.14), those with secondary/higher education (AOR = 1.24, 95% CI = 1.20-1.29), and individuals in wealth index categories of poorest (AOR = 0.17, 95% CI = 0.16, 0.18), poorer (AOR = 0.21, 95% CI = 0.19, 0.22), middle (AOR = 0.25, 95% CI = 0.24, 0.27), and richer (AOR = 0.36, 95% CI = 0.34, 0.38) were associated with improved sources of drinking water. Additionally, female household leaders (AOR = 1.23, 95% CI = 1.20, 1.26), > 30 min of time taken to access the water source (AOR = 2.00, 95% CI = 1.95, 2.05), improved toilet facilities (AOR = 2.25, 95% CI = 2.19, 2.31), rural residence (AOR = 0.43, 95% CI = 0.42, 0.45), high community wealth (AOR = 1.31, 95% CI = 1.13-1.51), community media exposure (AOR = 1.32, 95% CI = 1.15, 1.51) were associated with improved sources of drinking water, respectively.

CONCLUSION

Approximately three-quarters of the population in East Africa has access to improved drinking water, although the quality of water in the region is still considered poor. It is important for relevant organizations to collaborate in order to improve the quality of drinking water, with special attention given to high-risk groups such as communities with high poverty and low literacy rates, poor households, and rural residents. Strengthening women's empowerment and increasing mass media exposure can also play a crucial role in accelerating the adoption of improved drinking water sources in East Africa.

A review of the management of water resources in Malaysia facing climate change

This paper reviewed the impacts of climate change on the management of the water sector in Malaysia discussing the current status of water resources, water service, and water-related disasters. The implementation of engineering practices was discussed to provide the detailed assessment of climate change impacts, risks, and adaptation for sustainable development. The narrative methods of reviewing the literatures were used to get an understanding on the engineering practices of water infrastructures, implication of the government policies, and several models as the main motivation behind the concept of integrated water resource management to contribute as part of the sustainable development goals to achieve a better and more sustainable future for all. The findings of this review highlighted the impacts of climate change on the rivers, sea, lakes, dams, and groundwater affecting the availability of water for domestic and industrial water supplies, irrigation, hydropower, and fisheries. The impacts of climate change on the water-related disasters have been indicated affecting drought-flood abrupt alternation and water pollution. Challenges of water management practices facing climate change should be aware of the updated intensity-duration-frequency curves, alternative sources of water, effective water demand management, efficiency of irrigation water, inter-basin water transfer, and nonrevenue water. The transferability of this review findings contribute to an engagement with the society and policy makers to mobilize for climate change adaptation in the water sector.

Unimproved source of drinking water and its associated factors: a spatial and multilevel analysis of Ethiopian demographic and health survey

BACKGROUND

Drinking water quality has been a major public health concern in lower and middle income countries where access to improved water supplies is limited. Ethiopia is thought to have one of the worst drinking water infrastructures in the world. This study aimed to assess the spatial variation and determinants of using unimproved sources of drinking water in Ethiopia using recent nationally representative data.

METHODS

A population-based cross-sectional study was employed with the recent EDHS data of 2019. A total of 8663 households were sampled using a stratified two-stage cluster sampling method. Kuldorff's SaTScan version 9.6 software was used to generate spatial scan statistics. ArcGIS version 10.7 software was used to visualize the spatial patterns of unimproved drinking water sources. A multilevel multivariable mixed-effect logistic regression was used to identify factors associated with the use of an unimproved drinking water source. In the multivariable multilevel analysis, those variables with a p-value < 0.05 were considered to be significant predictors of using an unimproved source of drinking water.

RESULT

Around 31% (95% CI: 30%, 32%) of the population in Ethiopia uses unimproved sources of drinking water with significant spatial variation across the country. Households aged 41-60 [AOR = 0.69; 95%CI; 0.53, 0.89] as compared to the households aged 10-25, households having middle wealth index [AOR = 0.48; 95%CI; 0.40, 0.59], and households having a rich wealth index [AOR = 0.31; 95%CI; 0.25, 0.39] as compared to the poor households, living in high community literacy level [AOR = 0.36; 95%CI; 0.16, 0.80], living in high-level community poverty [AOR = 3.03; 95%CI; 1.32, 6.98], rural residence [AOR = 7.88; 95%CI; 2.74, 22.67] were significant predictors of use of unimproved source of drinking water. Hot spot areas of use of unimproved drinking water sources were observed in Amhara, Afar, and Somalia regions and some parts of SNNPR and Oromia regions in Ethiopia. The primary clusters were found in Ethiopia's Somalia and Oromia regions.

CONCLUSION

Around one third of the Ethiopian population utilizes unimproved source of drinking water and it was distributed non-randomly across regions of Ethiopia. The age of the household head, wealth status of the household, residence, community poverty level, and community literacy level were found to be significantly associated with utilizing unimproved drinking water source. State authorities, non-governmental organizations and local health administrators should work to improve the quality of drinking water particularly for high risk groups such as communities living in high poverty and low literacy, poor households, rural residents, and hot spot areas to decrease the adverse consequences of using unimproved drinking water source.

Assessing the social and economic implications on water security in the Nelson Mandela Bay Metropolitan Municipality, Eastern Cape of South Africa

Access to water is a universal human right for every individual and a key instrument in meeting the United Nations' sustainable development goal SDG 6, namely, to ensure safe drinking water and sanitation for all by 2030. Water is also intrinsically linked to any society or country's social, economic and political development. Nevertheless, many communities and households, predominantly rural and underprivileged in the Nelson Mandela Metropolitan Municipality, continue to experience persistent water shortages. This means entrenched poverty, ill health, hunger, stress, and social and economic challenges for the population. Using data collection tools inspired by traditional methods of qualitative and quantitative approaches, this paper scrutinised the social and economic factors contributing to severe inequality in water access in the municipality. Our findings established that water shortage is portrayed as a stand-alone issue without linking it to social and economic challenges. Furthermore, both government and municipalities fail to contextualise a multidimensional problem-solving approach to the water provision challenges in the municipality. This paper, therefore, recommends a multidimensional approach to tackling the problem of accessibility, taking into consideration the social and economic needs of the population.

Equity in access to safely managed sanitation and prevalence of diarrheal diseases in Bangladesh: a national and sub-national analysis

BACKGROUND

In Bangladesh, safely managed sanitation (SMS) coverage is low, and diarrheal disease is a significant health problem. This study estimated the inequality in access to SMS facilities at the national and sub-national levels and assessed the prevalence of diarrheal diseases in connection with these improved facilities.

METHODS

Data were extracted from the Bangladesh Demographic and Health Survey, conducted during 2017-2018. SMS was defined as using an improved sanitation facility, which designed to hygienically separate excreta from human contact and include the use of a flush toilet connected to piped sewer system, septic tank, ventilated improved pit latrine, pit latrine with a slab, and composting toilet. The slope index of inequality (SII) and multi-level regression models were used for inequality and risk factors of SMS respectively.

RESULTS

The national coverage of SMS was 44.0% (45.3% and 43.5% in urban and rural areas, respectively). At the sub-national level, the lowest and highest coverage of SMS was observed in Mymensingh (32.9%) and Chittagong (54.1%) divisions, respectively. The national level SII indicated that wealthy households had access to higher SMS by 60.8 percentage points than poor households. Additionally, greater inequality was observed in rural areas, which was 71.9 percentage points higher in the richest households than in the poorest households. The coverage gap between the rich and poor was highest in the Sylhet division (85.3 percentage points higher in rich than in poor) and lowest in Dhaka (34.9 percentage points). Old and highly educated household heads and richest households had better access to higher levels of adequate sanitation. After adjusting for confounding variables, the prevalence of diarrheal disease was 14.0% lower in the SMS user group than in their counterparts.

CONCLUSION

Substantial inequalities in access to SMS exist at both national and sub-national levels of Bangladesh, with the prevalence of diarrhea being lower among SMS users. These findings may help to prioritize resources for reducing inequality and expanding the coverage of improved sanitation in Bangladesh.

The Association Between Rainfall, Temperature, and Reported Drinking Water Source: A Multi-Country Analysis

Climate change may alter access to safe drinking water, with important implications for health. We assessed the relationship between temperature and rainfall and utilization of basic drinking water (BDW) in The Gambia, Mozambique, Pakistan, and Kenya. The outcomes of interest were (a) whether the reported drinking water source used in the past 2 weeks met the World Health Organization definition of BDW and (b) use of a BDW source that was always available. Temperature and precipitation data were compiled from weather stations and satellite data and summarized to account for long- and short-term weather patterns and lags. We utilized random forests and logistic regression to identify key weather variables that predicted outcomes by site and the association between important weather variables and BDW use. Higher temperatures were associated with decreased BDW use at three of four sites and decreased use of BDW that is always available at all four sites. Increasing rainfall, both in the long- and short-term, was associated with increased BDW use in three sites. We found evidence for interactions between household wealth and weather variables at two sites, suggesting lower wealth populations may be more sensitive to weather-driven changes in water access. Changes in temperature and precipitation can alter safe water use in low-resource settings-investigating drivers for these relationships can inform efforts to build climate resilience.

Gender and Other Vulnerabilities to Water–Energy Accessibility in Rural Households of Katsina State, Northern Nigeria

Water and energy are essential resources for all people. However, despite the availability of sufficient water and energy resources, men and women continue to be subject to unequal rights to both water and energy in terms of access, allocation, gathering, and quality of resources. Socio-economic parameters, which include gender, income, and location, are determinant factors of water and cooking energy accessibility in this study. The research aims to assess the accessibility of water and cooking fuels across female-headed households, and evaluate particular vulnerabilities and challenges faced by women and children in rural areas of Katsina State in circumstances of water and energy insecurities. A study involving a questionnaire covering 550 rural households across 11 areas in Katsina State, north-western Nigeria, was conducted. A Pearson product correlation analysis was performed to measure the strength of association between the respondents educational level and income. A chi-square test of independence was carried out to measure the degree of dependence of the households’ resources accessibility. The authors assessed the disproportionate threats and health risks linked to fetching water and gathering of fuel resources. The research findings indicate that water and energy uncertainty among women in rural households is due to unequal responsibilities associated with water- and energy-related household duties that are potentially linked to disadvantages for females, including violence, security threats, diseases, and disempowerment. To address these challenges, water and energy interventions, and important pathways for beneficial change, are proposed for rural regions in sub-Saharan Africa. This should lead to more gender equity associated with water and energy.

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

Research suggests that experiences of water insecurity may negatively impact the psycho-emotional wellbeing of water-insecure households. This paper examines how perceived inequalities in water access mediate the relationship between water insecurity and psycho-emotional distress. Data were collected among 1192 men and women in Ghana who are active water collectors within their households. We employed a binary logistics regression to identify the determinants of psycho-emotional distress. Sobel test was used to test the indirect effect of water insecurity and psycho-emotional distress through perceived inequalities. The results show that wealth (OR = 6.6, CI = 2.784-14.076), number of people in a household (OR = 1.07, CI = 1.002-1.145) and perceived inequalities (OR = 4.6, CI = 2.737-7.907) are significant predictors of psycho-emotional distress. Sobel test indicated that the point estimate (PE) of the indirect effect between water insecurity and psycho-emotional distress through perceived inequality is -0.136 (p = 0.000), meaning households were less likely to experience psycho-emotional distress if they felt that safe water facilities were equally distributed. The findings suggest that the distribution of water resources in cities with water challenges, no matter how scarce those resources are, has a profound effect on psycho-emotional distress. In resources constrained cities, there is a need for holistic water-related interventions that make inclusivity and fairness their primary focus.

Spatiotemporal Analysis of the Proportion of Unimproved Drinking Water Sources in Rural Ethiopia: Evidence from Ethiopian Socioeconomic Surveys (2011 to 2019)

Currently, around 36% of the rural Ethiopian population is accessing drinking water from unimproved sources and it is unevenly distributed through time and geographic regions. Therefore, this study aimed to analyze the spatiotemporal patterns of unimproved drinking water sources and identify hotspot areas in rural Ethiopia. Ethiopian Socioeconomic Survey (ESS) data obtained from the Central Statistical Agency were used. It was conducted in four waves from 2011 to 2019. A two-stage probability sampling design was applied. The sample of enumeration areas and households were taken as the first and second stages of sampling, respectively. A total of 3912, 3775, 3698, and 3115 sample households with complete information on drinking water sources were taken in each wave of ESS data, respectively. Weighted proportions, autocorrelation (Moran's “I”) statistic, and hotspot analyses were applied to estimate the prevalence, test the presence of clustering, and identify vulnerable areas with unimproved drinking water sources. The STATA version 14, Excel, and ArcGIS 10.6 were used to manage and analyze data. The proportions of households with unimproved drinking water sources were 0.497, 0.385, 0.298, and 0.363 in consecutive waves of ESS data. The results also revealed the existence of geographical and temporal variations of access to drinking water from unimproved sources, and the most recent vulnerable (hotspot) areas in the borders of the West and East Gojjam zones in the western Amhara region, Zone one in southern Afar region, and Liben, Afder, Shebelle, Korahe, and Nobob zones in Somali region were identified. In conclusion, this study reveals significant geographic inequalities in the use of improved drinking water sources. This may be necessary for policies and coverage targeting the most vulnerable regions. The presented map and analytical approaches can provide a mechanism to monitor future reductions in inequality within countries by reflecting resource allocation priorities.

Water-Energy-Food Accessibility and Tracking Progress towards Achieving Sustainable Development Goals in the Savannah Region of Katsina State, Nigeria

Although remarkable progress has been achieved in reducing hunger and poverty and improving people’s health in the past couple of decades, humanity still faces considerable socio-economic and sustainability challenges. Ensuring sustainable access to safe and sufficient water, improved sanitation facilities, clean energy sources and healthy food is a necessary requirement for ending hunger and poverty, advancing health and achieving all the goals of the sustainable development agenda. Socio-economic variables are determinant factors of water, energy and food accessibility. Ecological region, income and education are measures used in this study, which aims to examine a pairwise comparison of water and energy sources, sanitation facilities and food accessibilities in six sampling communities and tracking progress towards achieving the sustainable development goals (SDG) at a local scale using nine specific SDG indicators. A study involving questionnaire administration covering 1785 households across the three ecological regions of Katsina state was performed. Two communities representing urban and rural households from each of the ecological regions were selected. An analysis of variance was used to test the equality of resource accessibility across the investigated communities followed up by a post hoc analysis to identify significant mean groups. The results showed that the overall access level to safely manage water and sanitation facilities were 16.5% and 28.1%, respectively. Access indices of 1.83 and 1.24 for electricity and cooking fuel, respectively, were calculated in the study area. The study revealed that location, education and income are the key drivers of water, energy and food access and choice.

Predicting factors of public awareness and perception about the quality, safety of drinking water, and pollution incidents

Public perception of drinking water quality and safety results from the interaction of multiple factors, including the public engagement, which requires sufficient knowledge and awareness. This issue has yet to be addressed in Algeria. This study investigated the residents' perception and awareness about the drinking water quality, safety, and water pollution events. A survey-based cross-sectional study was conducted amongst citizens living in the province of Biskra. Multinomial regression analysis was used to identify the predicted public perception factors about drinking water-related issues. Regardless of the degree of public trust in the drinking water sources, the main drinking water source reported by the participants was tank water (43.3%) followed by tap water (32%). Water quality standards are a measure of the condition of water relative to the contaminants. Water consumption profiles gave priority attention to taste (48.7%), odour (35%), appearance (34.7%), and colour (32%), reflecting a low level of knowledge about the water quality standards. Most of the residents (55.7%) reported a deficient communication about the preventive measures to protect public health. The higher level of education showed a statistically significant impact in discriminating between those who felt very satisfied and dissatisfied participants with the drinking water quality and those who felt between satisfied and dissatisfied (P = 0.023, P = 0.034, respectively). Additionally, education level had a statistically significant role in differentiating trust levels in drinking water quality between two groups, those belonging to either confident or relatively confident and the group of extremely worried respondents, with P = 0.000 and P = 0.000, respectively. Interviewed respondents with certain education levels showed higher trust in the safety of drinking water when compared to those with lower education levels. Gender had a significant role in differentiating the group of respondents who were relatively confident from those who were extremely worried (P = 0.016). The public knowledge about the standards of water quality, safety, and the pollution-related issues remains relatively low. This study is of interest to policy makers and public health authorities who implement actions for water contamination prevention and public health protection. These findings could have national implications and are also applicable, in general context, particularly in low and middle-income countries.

Mapping and situation analysis of basic WASH facilities at households in Bangladesh: Evidence from a nationally representative survey

BACKGROUND

Ensuring water, sanitation, and hygiene (WASH) facilities for households remains a major public health concern in low- and middle-income countries (LMICs). This study investigated the current situation of basic WASH facilities for households in Bangladesh and drew a national coverage map.

METHODS

We analyzed the publicly available nationally representative 2019 Multiple Indicator Cluster Survey (MICS) dataset that was carried out by the Bangladesh Bureau of Statistics (BBS) with support from the United Nations Children's Emergency Fund (UNICEF). A total of 61,209 households (weighted) were included in the analysis. Both bivariate and multivariate analyses were employed to examine the relationships between independent variables (socio-demographic and economic status) and their distributions over outcome variables (basic water, sanitation, and hygiene). Further, the spatial distribution of WASH facilities at the household level was depicted.

RESULTS

Coverage of access to basic water facilities at the household level was 99.5% (95% CI 99.4% to 99.6%), sanitation 60.7% (95% CI 60.0% to 61.5%), and hygiene 56.3% (95% CI 55.6% to 57.0%). However, coverage of combined access to all three components was 40.2% (95% CI 39.4% to 40.9%). Among all 64 administrative districts of Bangladesh, we found comparatively lower coverage of WASH facilities in the South and South-East regions and relatively higher in the households of the North and North-Western regions. An adjusted regression model revealed that richest households [AOR = 29.64, 95% CI 26.31 to 33.39], households in the rural areas [AOR = 1.64, 95% CI 1.50 to 1.79], household heads with higher educational attainment [AOR = 2.28, 95% CI 2.09 to 2.49], and households with 5+ family members [AOR = 1.64, 95% CI 1.56 to 1.71] had the higher likelihood to have basic WASH facilities.

CONCLUSION

Less than half of the Bangladeshi households had access to all three major WASH components (basic water, sanitation, and hygiene facilities); however, variation exists at the individual parameter of basic water, sanitation, and hygiene facilities. A comprehensive WASH approach may reduce the gap and improve the quality of WASH facilities in Bangladesh.

Solar Seawater Distillation by Flexible and Fully Passive Multistage Membrane Distillation

Solar-assisted distillation is considered promising to solve the freshwater supply for off-grid communities. In this work, a passive and flexible multistage membrane distillation (F-MSMD) device is devised to produce freshwater via solar distillation with the latent heat of vapor condensation being recycled to enhance its energy efficiency. By designing a siphon effect, source water is continuously wicked into the evaporation layer and the concentrated brine flows out of the device before reaching saturation, which successfully solves the otherwise challenge of salt accumulation inside the device. To achieve such siphon flow, the recycled paper is prepared from spent copy paper and used as the evaporation layer for efficient water delivery owing to its large pore size and high hydrophilicity. An eight-stage F-MSMD device exhibits a stable clean water production rate at 3.61 kg m^-2 h^-1 in the newly designed siphon-flow mode. This work provides a green route for designing a solar-assisted distillation device.

WASH Financial and Social Investment Dynamics in a Conflict-Arid District of Jariban in Somalia

The paper investigated the social and financial resources’ interface in WASH programmes for vulnerable communities. Nineteen villages were randomly selected from the Jariban district in Somalia using the random number generator based on the village list. Data was collected in a sequential methodology that started with transect walks to observe and record the WASH infrastructure. Thirty-eight focus group discussions and desktop reviews triangulated transact walk recordings. The findings indicate minimum to zero investments towards WASH infrastructure in Jariban from the state government, with more dependency on the donor community. The study revealed that resources for the construction of latrines and water sources come from the following sources, NGOs (54.3%), diaspora community (34.5%) and community contributions (11.2%). The findings revealed a backlog in the WASH infrastructure, resulting in low access to water supply and sanitation services. The results demonstrate limited resource allocation by both the government and community, affecting the WASH infrastructure’s sustainability and further development. Due to the backlog in investments, particularly on improved latrines, it is concluded that their usage is low and a hindrance to having access to sanitation, hygiene and water as per the SDG goals, of leaving no one behind. While investment towards WASH in Jariban demonstrates multiple potential sources, there is a need to strengthen domestic resource mobilisation and explore governments’ role and capacity to secure WASH infrastructure investments. It is also recommended to explore how to tax the remittances to fund WASH infrastructure development and the private sector’s role in WASH infrastructure investment.

Assessment of socioeconomic inequality based on virus-contaminated water usage in developing countries: A review

Water is an essential resource required for various human activities such as drinking, cooking, and other recreational activities. While developed nations have made significant improvement in providing adequate quality water and sanitation devoid of virus contaminations to a significant percentage of the residences, many of the developing countries are still lacking in these regards, leading to many death cases among the vulnerable due to ingestion of virus-contaminated water and other waterborne pathogens. However, the recent global pandemic of COVID-19 seems to have changed the paradigm by reawakening the importance of water quality and sanitation, and focusing more attention on the pervasive effect of the use of virus-contaminated water as it can be a potential driver for the spread of the virus and other waterborne diseases, especially in developing nations that are characterized by low socioeconomic development. Therefore, this review assessed the socioeconomic inequalities related to the usage of virus-contaminated water and other waterborne pathogens in developing countries. The socioeconomic factors attributed to the various waterborne diseases due to the use of virus-contaminated water in many developing countries are poverty, the standard of living, access to health care facilities, age, gender, and level of education. Some mitigation strategies to address the viral contamination of water sources are therefore proposed, while future scope and recommendations on tackling the essential issues related to socioeconomic inequality in developing nations are highlighted.

Assessment of socioeconomic inequality based on virus-contaminated water usage in developing countries: A review

Water is an essential resource required for various human activities such as drinking, cooking, and other recreational activities. While developed nations have made significant improvement in providing adequate quality water and sanitation devoid of virus contaminations to a significant percentage of the residences, many of the developing countries are still lacking in these regards, leading to many death cases among the vulnerable due to ingestion of virus-contaminated water and other waterborne pathogens. However, the recent global pandemic of COVID-19 seems to have changed the paradigm by reawakening the importance of water quality and sanitation, and focusing more attention on the pervasive effect of the use of virus-contaminated water as it can be a potential driver for the spread of the virus and other waterborne diseases, especially in developing nations that are characterized by low socioeconomic development. Therefore, this review assessed the socioeconomic inequalities related to the usage of virus-contaminated water and other waterborne pathogens in developing countries. The socioeconomic factors attributed to the various waterborne diseases due to the use of virus-contaminated water in many developing countries are poverty, the standard of living, access to health care facilities, age, gender, and level of education. Some mitigation strategies to address the viral contamination of water sources are therefore proposed, while future scope and recommendations on tackling the essential issues related to socioeconomic inequality in developing nations are highlighted.

Integrated Assessment—How Does It Help Unpack Water Access by Marginalized Farmers?

Water is critical to the lives and livelihoods of rural communities in developing countries; however, access to water can be inequitable within communities. This paper uses a generalized integrated assessment approach to explore the determinants of water access by marginalized farmers in two villages in coastal Bangladesh, before and after the setup of local water institutions. The study was part of a broader project aimed at promoting socially inclusive agricultural intensification. An integrative framework was developed in this study to capture and link the diverse range of factors that influence the distribution of water, including the often-overlooked role of social dynamics and governance arrangements. While interventions around improving water resource infrastructure can be critical for freshwater availability, the case studies show that a breakdown of asymmetric power structures may also be needed for water access to all individuals, especially marginalized groups. Establishing a community-based water institution on its own does not necessarily address power issues in a community. It is imperative that the agency and capacities of the marginalized members are developed and that the institutional arrangements foster an enabling environment for marginalized members to influence decision making. Integrated assessment allowed the case studies to be explored from multiple perspectives so as to gain a greater understanding of the barriers and levers to obtaining equitable outcomes from water interventions.

Socio-Economic Factors Related to Drinking Water Source and Sanitation in Malaysia

Access to improved water and sanitation is essential. We describe these practices in Malaysia using data from a nationwide community survey and used logistic regression to assess the determinants. Of the 7978 living quarters (LQs), 58.3% were in urban areas. About 2.4%, 0.5% and 27.4% of LQs had non-improved water sources, non-improved toilet types and improper domestic waste disposal, respectively. Open burning was practiced by 26.1%. Water source was a problem for long houses (10.5%), squatters (8.5%) and shared houses (4.0%). Non-improved toilet types were 11.9% for squatters and 4.8% for shared houses. Improper domestic waste disposal practices were higher for occupants of village houses (64.2%), long houses (54.4%), single houses (45.8%) and squatters (35.6%). An increase in education or income level was associated with a decrease in improper domestic waste disposal methods. House type significantly affected water and sanitation after adjusting for the effects of other variables. Lower household income was associated with non-improved toilet types and improper domestic waste disposal. Lower education and rural location influenced domestic waste disposal. The water and toilet facilities in Malaysia were generally good, while domestic waste management practices could be improved. There remain pockets of communities with environmental challenges for the nation.

Sub-optimal household water access is associated with greater risk of intimate partner violence against women: evidence from Nepal

Household water management is often women's responsibility, as related to the gendered nature of household roles. Ethnographic data suggest that household water insecurity could increase women's exposure to emotional and physical forms of intimate partner violence (IPV), as punishments for failures to complete socially expected household tasks that rely on water (like cooking and cleaning) and the generally elevated emotional state of household members dealing with resource scarcity. Here, we test the associations between sub-optimal household water access and women's exposure to IPV, using the nationally-representative data from Nepal Demographic and Health Survey, 2016. Drawing upon the intra-household bargaining model as the theoretical framework, we run instrumental variable probit regression, to test the association between household water access and prevalence of IPV against women. After controlling for other known covariates of IPV such as women's empowerment and education, the findings substantiate that worse household water access consistently elevates women's exposures to all forms of IPV. This suggests that improvements in household water access may have additional ramifications for reducing women's risk of IPV, beyond currently recognized socioeconomic benefits. While both household water access and IPV have known health consequences, linking them provides another pathway through which water could affect women's health.

A review on the potential sources and health implications of fluoride in groundwater of Sub-Saharan Africa

Groundwater is a major source of drinking water for millions of people around the world. Over 400 million people in Africa depend solely on it as their main source of water supply. Fluoride is a common contaminant in groundwater. In low concentration (0.5-1.0 mg/L), fluoride is needed by humans for healthy development of bones and teeth, however, a concentration >1.5 mg/L has been linked with several fluorosis and non-fluorosis diseases. Dental and skeletal fluorosis are the major fluorosis diseases commonly reported with the consumption of fluoride-rich water. Although fluoride intake through other pathways such as the drinking of tea and eating of vegetables have been reported, the drinking of fluoride-rich water remains the major pathway of fluoride into humans. Cases of high fluoride levels in groundwater have been reported in almost all the sub-Saharan Africa region but it is more prevalent in East African countries, Sudan and South Africa. Although fluoride is present in surface water mostly in the East African Rift Valley across different countries in East Africa, its significant or high levels are usually associated with groundwater. Geogenic sources such as fluorite, apatite, biotite, amphibole, micas, topaz, cryolite, muscovite and fluorspar have been identified as the major sources of fluoride in groundwater. High fluoride levels have been reported across sub Saharan Africa, with generally higher levels in East Africa resulting from the volcanic activities in the rift system. Dental fluorosis has been reported in many sub-Saharan African countries including South Africa, Tanzania, Uganda, Ethiopia, Kenya, Sudan, Niger, Nigeria, Benin, Ghana and Malawi. Geothermal temperature has been regarded as one of the driving forces for high fluoride levels recorded in groundwater from deep aquifers and geothermal springs. The most affected people with the consumption of fluoride-rich water are the poor with low socioeconomic status who live in rural areas. Some of the proposed alternative sources include rainwater and fog water harvesting and blending of water from various sources. Low-cost and sustainable deflouridation technique remains one of the best ways to treat fluoride contaminated water either at communal level or at the point-of-use.

Rural Piped-Water Enterprises in Cambodia: A Pathway to Women’s Empowerment?

This research examined the extent to which women’s ownership and management of water supply schemes led to their empowerment, including their economic empowerment, in rural Cambodia. Privately managed water supply schemes in rural Cambodia serve over one million people. This study is the first of its kind to systematically investigate the experiences and needs of female water supply scheme owners, using well-established theoretical frameworks for women’s empowerment, namely Longwe’s stages of empowerment, and Rowlands, VeneKlasen and Miller’s elaboration on different types of power. Business management frameworks relevant to the water, sanitation and hygiene (WASH) sector were also drawn on to assess operational constraints and enablers. Fifteen structured interviews were conducted with female water entrepreneurs in rural Cambodia. Female entrepreneurs reported encountering four key barriers to establishing and managing water supply schemes. The first were operational, and government and regulatory related issues, followed by financial issues and limited demand for water services. Three important enablers were reported by entrepreneurs: social enablers, economic enablers and program support from government, associations and non-government organisations (NGOs). This study found that, whilst there was evidence of empowerment reported by female water enterprise owners, the complexity of the ongoing empowerment process, challenges and limitations were also observed. Women’s empowerment can be advanced through leadership of, and involvement in water enterprises, as evidenced by this study, however, gender norms constrained women, especially with respect to mobility (leaving the home for extended periods), and household and family duties impacting on income-generating work or vice versa. As such, targeted strategies are needed by a range of actors to address such constraints. The findings of this study can assist NGOs, donors and governments incentivizing entrepreneurship in water services, to ensure that these interventions are not gender blind, and to draw on evidence of the barriers and enablers for female entrepreneurs and how these are influenced by contextualized gender norms.