Weight of Water: Who Carries the Burden of Water Interventions? Open Access

D'souza, Janice (Summer 2020)

Permanent URL: https://etd.library.emory.edu/concern/etds/b8515p618?locale=en


Background and Objective: Unsafe drinking water is associated with 9.1% of the global burden of all diseases and 6.3% of all deaths are due to unsafe water, inadequate sanitation, and poor hygiene. To address this burden of disease, water quality interventions implemented at the household level and designed to provide safe drinking water have been shown to reduce diarrhea frequency by 31%. Notably, these household point of use water interventions (chlorination, filtration etc.) typically rely on individuals to perform tasks associated with the intervention, such as water collection, treatment, and storage. As women are responsible for the majority of activities associated with carrying and managing water for households, there is a need to understand how water quality interventions engage and impact these individuals (women, girls, boys, and men) to achieve intervention goals.          

Methods: Water quality interventions aimed at reducing diarrheal disease were compiled as part of a systematic review by Clasen et al, (2015). Interventions that required a person to perform an intervention-related activity were eligible for inclusion for further review. We then determined who was identified to perform the intervention activity, and reviewed and evaluated interventions activities using the WHO Gender Responsiveness Assessment Scale (GRAS). The GRAS provides a framework, comprised of five designations: gender-unequal, gender-blind, gender-sensitive, gender-specific, and gender-transformative. Data from each included study, including intervention type, geography, household number of households engaged, etc., were extracted, compiled into an Excel database, and summarized (Microsoft, 2016).

Results: Forty-six out of 52 articles met our eligibility criteria and were included in our analysis. Overall, 100% of the interventions were classified as gender unequal (63%) or gender blind (37%) and none of the interventions were classified as gender-sensitive, or gender transformative. Among the 46 selected studies, the interventions targeted different members of the household to perform the required intervention actions or behaviors. Mothers were targeted by 44% of the interventions and caregivers by 37% of the interventions. Women (non-caregiver and non-mother) were targeted by 26% of the interventions. Overall, women were targeted by 91% of the interventions. Two percent of the interventions targeted the eldest daughter of the household specifically. Seven percent of the interventions targeted male members of the household.

Conclusion: Women and girls are disproportionately targeted when it comes to point-of-use water interventions and bear the burden of ensuring access to safe water, including those associated with water interventions. This study demonstrates public health practitioners and developmental agencies must critically examine gender roles, norms, and dynamics as part of formative research to inform intervention design. To build healthier, equal, and inclusive societies, there is a need to question gender roles, from the researchers all the way down to the manner in which programs are designed, in order to advance gender equality.  

Table of Contents

Chapter 1: Introduction.. 7

Definition of Terms. 10

Chapter 2: Literature Review.. 11

Access to Safe Drinking Water and Burden of Disease. 11

Gender and Water. 14

Gender Responsive Assessment Scale. 22

Water Interventions. 25

Conclusion.. 27

Objectives. 28

Chapter 3: Methods. 29

3.1 Research Design.. 29

3.2 Article Eligibility. 29

3.3 Analysis. 31

Chapter 4: Results. 34

4.1 Articles included in analysis. 34

4.2 Study and Intervention Characteristics. 34

4.3 Intervention Activities. 35

4.4 Research Activities. 36

4.5 Characterization of interventions and research activities according to the WHO Gender Assessment Scale. 37

Chapter 5: Discussion.. 64

Chapter 6: Implications and Recommendations. 69

Works Cited: 72

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