Water insecurity in 3 dimensions: An anthropological perspective on water and women's psychosocial distress in Ethiopia

• Type of Material: Article
• Authors: Edward Stevenson, Emory University; Leslie E. Greene, Emory University; Kenneth Maes, Brown University; Argaw Ambelu, Jimma University; Yihenew Alemu Tesfaye, Center for National Health Development in Ethiopia; Richard Rheingans, University of Florida; Craig Hadley, Emory University
• Language: English
• Date: 2012-07
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2012 Elsevier Ltd. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.socscimed.2012.03.022
• Title of Journal or Parent Work: Social Science and Medicine
• ISSN: 0277-9536
• Volume: 75
• Issue: 2
• Start Page: 392
• End Page: 400
• Grant/Funding Information: This study was funded by the Institute for Developing Nations at Emory University. EGJS was supported during analysis and writing in part by NIH/FIC grant #1R24TW008825-01.
• Keywords: Women; Africa; Mental Health; Water Insecurity; Psychosocial Stress; Ethiopia; Gender
• Research Categories: Environmental Sciences; Anthropology, Cultural; Health Sciences, Public Health

Abstract

Water insecurity is a primary underlying determinant of global health disparities. While public health research on water insecurity has focused mainly on two dimensions, water access and adequacy, an anthropological perspective highlights the cultural or lifestyle dimension of water insecurity, and its implications for access / adequacy and for the phenomenology of water insecurity. Recent work in Bolivia has shown that scores on a water insecurity scale derived from ethnographic observations are associated with emotional distress. We extend this line of research by assessing the utility of a locally developed water insecurity scale, compared with standard measures of water access and adequacy, in predicting women's psychosocial distress in Ethiopia. In 2009-2010 we conducted two phases of research. Phase I was mainly qualitative and designed to identify locally relevant experiences of water insecurity, and Phase II used a quantitative survey to test the association between women's reported water insecurity and the Falk Self-Reporting Questionnaire (SRQ-F), a measure of psychosocial distress. In multiple regression models controlling for food insecurity and reported quantity of water used, women's water insecurity scores were significantly associated with psychosocial distress. Including controls for time required to collect water and whether water sources were protected did not further predict psychosocial distress. This approach highlights the social dimension of water insecurity, and may be useful for informing and evaluating interventions to improve water supplies.