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‘When you have no water, it means you have no peace': a mixed-methods, whole-population study of water insecurity and depression in rural Uganda
Open accessAbstract
Background Lack of access to clean water has well known implications for communicable disease risks, but the broader construct of water insecurity is little studied, and its mental health impacts are even less well understood.Methods and findings We conducted a mixed-methods, whole-population study in rural Uganda to estimate the association between water insecurity and depression symptom severity, and to identify the mechanisms underlying the observed association. The whole-population sample included 1776 adults (response rate, 91.5%). Depression symptom severity was measured using a modified 15-item Hopkins Symptom Checklist for Depression. Water insecurity was measured with a locally validated 8-item Household Water Insecurity Access Scale. We fitted multivariable linear and Poisson regression models to the data to estimate the association between water insecurity and depression symptom severity, adjusting for age, marital status, self-reported overall health, household asset wealth, and educational attainment. These models showed that water insecurity was associated with depression symptom severity (b = 0.009; 95% confidence interval [CI], 0.004-0.15) and that the estimated association was larger among men (b = 0.012; 95% CI, 0.008-0.015) than among women (b = 0.008; 95% CI, 0.004-0.012. We conducted qualitative interviews with a sub-group of 30 participants, focusing on women given their traditional role in household water procurement in the Ugandan context. Qualitative analysis, following an inductive approach, showed that water insecurity led to "choice-less-ness" and undesirable social outcomes, which in turn led to emotional distress. These pathways were amplified by gender-unequal norms.Conclusions Among men and women in rural Uganda, the association between water insecurity and depression symptom severity is statistically significant, substantive in magnitude, and robust to potential confounding. Data from the qualitative interviews provide key narratives that reveal the mechanisms through which women's lived experiences with water insecurity may lead to emotional distress.
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“Furthermore, it appeared that the lack of proper maintenance of water systems and infrastructure by authorities in most places altered water availability in ways that increased bother and distress (Khatri and Vairavamoorthy, 2007; Mushavi et al., 2020; Pearson et al., 2015; Pamla et al., 2021).”
From Psychological effects of water scarcity on community members: a case study of Lephalale municipality, Limpopo province, South Africa (2025) · cites this paper as Mushavi et al., 2020
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
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“Prior studies (Mushavi et al., 2020; Goldin, 2010; Khodarahimi et al., 2014a; Stevenson et al., 2016) found that community members experience increased bother and emotional distress due to altered water availability, water shortages and insecurity.”
From Psychological effects of water scarcity on community members: a case study of Lephalale municipality, Limpopo province, South Africa (2025) · cites this paper as Mushavi et al., 2020
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“Fetching water from far water resources disrupted community members' daily activities, took over people's daily schedules and disorganized their chores (Mushavi et al., 2020; Hove et al., 2019; UNICEF (United Nations Children's Fund), 2021).”
From Psychological effects of water scarcity on community members: a case study of Lephalale municipality, Limpopo province, South Africa (2025) · cites this paper as Mushavi et al., 2020
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“Moreover, Mushavi et al. (2020) reported that water insecurity made it difficult for some women to maintain good hygiene, which potentially jeopardized their standing with others in the community.”
From Psychological effects of water scarcity on community members: a case study of Lephalale municipality, Limpopo province, South Africa (2025) · cites this paper as Mushavi et al. (2020)
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“Mushavi et al. (2020) further indicated that excess water demand at public water sources frequently caused verbal and physical disputes and conflicts among people in the queue.”
From Psychological effects of water scarcity on community members: a case study of Lephalale municipality, Limpopo province, South Africa (2025) · cites this paper as Mushavi et al. (2020)
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“In Uganda, outside of refugee contexts, water insecurity has been associated with increased risk of emotional distress (Mushavi et al. 2020), sexual violence (Pommells et al. 2018), and missed educational opportunities (Cooper-Vince et al. 2017).”
From Water insecurity and sexual and gender-based violence among refugee youth: qualitative insights from a humanitarian setting in Uganda (2022) · cites this paper as Mushavi et al. 2020
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In the citing paper
“As water insecurity and its impacts are ampli fi ed by gender-unequal norms”
From Water insecurity and sexual and gender-based violence among refugee youth: qualitative insights from a humanitarian setting in Uganda (2022) · cites this paper as Mushavi et al. 2020
In the citing paper
“Women's collective action has led to funding, demand, construction, repair, and maintenance of water services [56, 61, 73, 78, 89, 91, 125, 129, 163, 165, 168, 169, 193, 296] and latrines [129, 139, 147, 168, 170, 174, 175].”
From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [165]
In the citing paper
“Inadequate water provision and collection behaviors were reported to influence intimate partner violence [26,75,101,108,111,153,165,179,198,231,260,264,266].Women reported violence from husbands if they did not provide water for bathing needs (Kenya, [198] Ethiopia, [108] Vietnam, [111] Cameroon [231]), did not have water in the home (East Africa [179]), went to cleaner water sources considered”
From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [165]
In the citing paper
“Specifically, women limited bathing and washing hands, clothes, menstrual materials, and bathrooms; [76,86,98,100,123,144,165,197,198,200,202,229,232,281] restricted food and water to avoid defecation and urination; [135, 168, 174, 179, 184, 192, 212, 224] suppressed defecation and urination urges; [2,62,181,184,188,190,191, 214, 217, 229, 235, 236, 238, 241, 247, 248, 250, 270] delayed changing”
From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [165]
In the citing paper
“Women formed and maintained social connections when collecting water [57,78,110,115,153,279] and relied on social capital from family, friends, and community members for multiple water needs.They leveraged social capital to access water when queues were long or water was scarce, [61,110,114,164,165,179,198,279] jump water queues, [168, 179] get water from private wells, [279] haul water using”
From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [165]
In the citing paper
“Women reported spending money to access water sources with shorter wait times [61,198] or higher quality, [98,198] or to compensate male neighbors, laborers, or drivers for water collection [165,201].Water was a major expense for many women [65,86,111,198,200,292].”
From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [165]
In the citing paper
“Men in Uganda who assisted with water collection were deemed emotionally unstable or bewitched, [165, 258]”
From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [165]
In the citing paper
“When men or boys do collect water, it has been more acceptable when they consider it 'helping' women [261] or use technology-like bicycles, wheelbarrows, or motorcycles-while women and girls are expected to carry water [123, 165, 229, 258, 261].”
From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [165]
In the citing paper
“When men or boys do collect water, it has been more acceptable when they consider it 'helping' women [261] or use technology-like bicycles, wheelbarrows, or motorcycles-while women and girls are expected to carry water [123, 165, 229, 258, 261].”
From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [165]
In the citing paper
“In Bangladesh, [110] India, [279] and Uganda [165] women relied on social networks to access water, but noted that relationships could be strained or unreliable when water was scarce.”
From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [165]
In the citing paper
“In Bangladesh, [110] India, [279] and Uganda [165] women relied on social networks to access water, but noted that relationships could be strained or unreliable when water was scarce.”
From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [165]
In the citing paper
“Water collection sites could be places of tension and danger, including sexual exploitation, for women and girls in Zimbabwe [123] and Uganda [165,179].”
From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [165]
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Citations
Cites
A Modified Poisson Regression Approach to Prospective Studies with Binary Data
Zou, G. (2004) · American Journal of Epidemiology · doi:10.1093/aje/kwh090 · Cited by 9,920
Sensitivity analysis in observational research: Introducing the E-value
VanderWeele, T. J., & Ding, P. (2017) · Annals of Internal Medicine · doi:10.7326/m16-2607 · Cited by 6,350
Whiteford, H. A., Degenhardt, L., Rehm, J., Baxter, A. J., Ferrari, A. J., Erskine, H. E., Charlson, F. J., Norman, R. E., Flaxman, A. D., Johns, N., et al. (2013) · The Lancet · doi:10.1016/s0140-6736(13)61611-6 · Cited by 6,006
Kawachi, I. I. (2001) · Journal of Heredity · doi:10.1093/jurban/78.3.458 · Cited by 3,565 · cited 1×
“Data consistent with the “buffering hypothesis” have been described in these contexts(47, 52, 53) and would be consistent with the sociological literature showing that women appear better able than men to mobilize social support to cope with psychosocial stressors(54, 55).”
ResultFerrari, A. J., Charlson, F. J., Norman, R. E., Patten, S. B., Freedman, G., Murray, C. J. L., Vos, T., & Whiteford, H. A. (2013) · PLoS Medicine · doi:10.1371/journal.pmed.1001547 · Cited by 3,115
Approaches to Qualitative-Quantitative Methodological Triangulation
Morse, J. M. (1991) · Nursing Research · doi:10.1097/00006199-199103000-00014 · Cited by 2,236 · cited 1×
“Following a “sequential” data collection approach (39), we used the quantitative findings to inform the design of the qualitative study.”
MethodBest Practices for Mixed Methods Research in Health Sciences
Creswell, J. W., Klassen, A. C., Clark, V. L. P., & Smith, K. C. (2011) · PsycEXTRA Dataset · doi:10.1037/e566732013-001 · Cited by 1,578
Poverty and common mental disorders in developing countries.
Patel, V., & Kleinman, A. M. (2003) · Europe PMC (PubMed Central) · Cited by 1,118
The Effect of Household Wealth on Educational Attainment: Evidence from 35 Countries
Filmer, D. P., & Pritchett, L. H. (1999) · Population and Development Review · doi:10.1111/j.1728-4457.1999.00085.x · Cited by 852 · cited 1×
“In addition to these two primary variables of interest, we also collected data on study participants’ ages, marital status, self-reported overall health, household asset wealth (34, 35), and educational attainment.”
BackgroundBARNETT, R. C., Biener, L., & Baruch, G. K. (1987) · Medical Entomology and Zoology · Cited by 488
Flagged first, then by citations
2 of the 67 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
- Hesbacher, 1980, Psychiatric illness in family practice, J. Clin. Psychiatry, 41, 6
Cited by
Sorted by citations
Lawrance, E. L., Thompson, R., Newberry Le Vay, J., Page, L., & Jennings, N. (2022) · International Review of Psychiatry · doi:10.1080/09540261.2022.2128725 · Cited by 500
Young, S. L., Frongillo, E. A., Jamaluddine, Z., Melgar-Quiñonez, H. R., Pérez‐Escamilla, R., Ringler, C., & Rosinger, A. Y. (2021) · Advances in Nutrition · doi:10.1093/advances/nmab003 · Cited by 206
“Water insecurity has since been linked with heightened worry, anger, frustration, and distress (19, 20, 33, 62, 110– 114) as well as increased depressive symptoms (101, 112, 113, 115, 116).”
Wutich, A., Brewis, A., & Tsai, A. C. (2020) · Wiley Interdisciplinary Reviews Water · doi:10.1002/wat2.1461 · Cited by 201
“…Choudhary, & Wutich, 2019a, 2019b; Chindarkar, Chen, & Gurung, 2019; Cooper-Vince et al., 2017, 2018; Espinosa-Montero et al., 2016; Maxfield, 2020; Mushavi et al., 2020; Shrestha et al., 2018; Slekiene & Mosler, 2019; Snodgrass, Upadhyay, Debnath, & Lacy, 2016; Subbaraman et al., 2012, 2014;…”
InfluentialSelf-citationRosinger, A. Y., & Young, S. L. (2020) · Wiley Interdisciplinary Reviews Water · doi:10.1002/wat2.1468 · Cited by 152
Water insecurity and gender‐based violence: A global review of the evidence
Tallman, P. S., Collins, S. M., Salmón-Mulanovich, G., Rusyidi, B., Kothadia, A., & Cole, S. (2022) · Wiley Interdisciplinary Reviews Water · doi:10.1002/wat2.1619 · Cited by 131
“…2020; Chipeta, 2009; Choudhary et al., 2020; Collins et al., 2019; Epstein et al., 2020; Karim et al., 2012; Logie et al., 2021; Meyiwa et al., 2014; Mukuhlani & Nyamupingidza, 2014; Mushavi et al., 2020; Narang, 2014; Pommells et al., 2018; Shah, 2002; Sultana, 2011; Thompson et al., 2011).”
BackgroundInfluentialWater, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis
Caruso, B. A., Conrad, A., Patrick, M., Owens, A., Kviten, K., Zarella, O., Rogers, H., & Sinharoy, S. S. (2022) · PLOS Water · doi:10.1371/journal.pwat.0000026 · Cited by 94
Satinsky, E. N., Kakuhikire, B., Baguma, C., Rasmussen, J. D., Ashaba, S., Cooper‐Vince, C. E., Perkins, J. M., Kiconco, A., Namara, E. B., Bangsberg, D. R., et al. (2021) · PLoS Medicine · doi:10.1371/journal.pmed.1003642 · Cited by 97
“Local modifications involved dropping 1 item (“feeling trapped”) and adding 1 item (“don’t care what happens to your health”) [42,60].”
BackgroundSelf-citationStoler, J. B., Miller, J. D., Brewis, A., Freeman, M. C., Harris, L. M., Jepson, W. E., Pearson, A. L., Rosinger, A. Y., Shah, S. H., Staddon, C., et al. (2021) · International Journal of Hygiene and Environmental Health · doi:10.1016/j.ijheh.2021.113715 · Cited by 78
Kimutai, J. J., Lund, C., Moturi, W. N., Shewangizaw, S., Feyasa, M. B., & Hanlon, C. (2023) · PLoS ONE · doi:10.1371/journal.pone.0286146 · Cited by 79
“Twenty-five studies were included, with 23,103 participants from 16 countries in three conti- nents: Africa (Kenya, Ethiopia, Ghana, Uganda, South Africa, Malawi, Mozambique, and Lesotho), Asia (Nepal, Bangladesh, India, and Iran) and the Americas (Brazil, Haiti, Bolivia and Vietnam).”
BackgroundInfluentialKangmennaang, J., Bisung, E., & Elliott, S. J. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17030890 · Cited by 63
Nunbogu, A. M., & Elliott, S. J. (2022) · Water Security · doi:10.1016/j.wasec.2022.100113 · Cited by 59
Connecting the dots between climate change, household water insecurity, and migration
Stoler, J. B., Brewis, A., Kangmennaang, J., Keough, S. B., Pearson, A. L., Rosinger, A. Y., Stauber, C., & Stevenson, E. G. J. (2021) · Current Opinion in Environmental Sustainability · doi:10.1016/j.cosust.2021.02.008 · Cited by 65
The embodiment of water insecurity: Injuries and chronic stress in lowland Bolivia
Rosinger, A. Y., Bethancourt, H. J., Young, S. L., & Schultz, A. F. (2021) · Social Science & Medicine · doi:10.1016/j.socscimed.2021.114490 · Cited by 55
Thinking Too Much": A Systematic Review of the Idiom of Distress in Sub-Saharan Africa
Backe, E. L., Bosire, E. N., Kim, A. W., & Mendenhall, E. (2021) · Culture, Medicine, and Psychiatry · doi:10.1007/s11013-020-09697-z · Cited by 52
Socio‐environmental confounders of safe water interventions
Smiley, S. L., & Stoler, J. B. (2020) · Wiley Interdisciplinary Reviews Water · doi:10.1002/wat2.1438 · Cited by 52
“Psychosocial stress and anxiety have increasingly been appreciated as important individual-level components of water insecurity that shaped water seeking behavior (Collins et al., 2018; Hadley & Wutich, 2009; Mushavi et al., 2020; Workman & Ureksoy, 2017).”
BackgroundLocalizing resource insecurities: A biocultural perspective on water and wellbeing
Brewis, A., Piperata, B. A., Thompson, A. L., & Wutich, A. (2020) · Wiley Interdisciplinary Reviews Water · doi:10.1002/wat2.1440 · Cited by 50
Brewis, A., Roba, K. T., Wutich, A., Manning, M., & Hassen, J. Y. (2021) · SSM - Mental Health · doi:10.1016/j.ssmmh.2021.100008 · Cited by 53
Ediz, Ç., & YANIK, D. (2023) · International Journal of Social Psychiatry · doi:10.1177/00207640231206060 · Cited by 61
“…climate-related threats and inadequate climate action has been associated with many psychological and emotional responses such as anxiety, stress distress, hopelessness, fear, anger, grief, helplessness, frustration and guilt (Ingle & Mikulewicz, 2020; Mushavi et al., 2020; Ojala et al., 2021).”
BackgroundAinamani, H., Alele, P. E., Rukundo, G. Z., Maling, S., Wakida, E. K., Obua, C., & Tsai, A. C. (2020) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2020.7 · Cited by 45
“Food and water insecurity are common (Tsai et al., 2012, 2016; Mushavi et al., 2020).”
BackgroundSelf-citationThe effects of household water insecurity on child health and well‐being
Rhue, S. J., Torrico, G., Amuzie, C., Collins, S. M., Lemaitre, A., Workman, C. L., Rosinger, A. Y., Pearson, A. L., Piperata, B. A., Wutich, A., et al. (2023) · Wiley Interdisciplinary Reviews Water · doi:10.1002/wat2.1666 · Cited by 61
“Ahmed et al., 2021 Wutich et al., 2020 Rizkalla et al., 2020 Mushavi et al., 2020 (Continues) evaluate the effects of water and integrated WASH interventions on children, and (3) supporting initiatives, policies, and legislation that guarantee all children the right to water.”
BackgroundInfluentialNexus between Water Security Framework and Public Health: A Comprehensive Scientific Review
Paudel, S., Kumar, P., Dasgupta, R., Johnson, B. A., Avtar, R., Shaw, R., Mishra, B. K., & Kanbara, S. (2021) · Water · doi:10.3390/w13101365 · Cited by 40
Nunbogu, A. M., & Elliott, S. J. (2021) · Health & Place · doi:10.1016/j.healthplace.2021.102651 · Cited by 40
Re-examining the effects of drought on intimate-partner violence
Cooper, M., Sandler, A., Vitellozzi, S., Lee, Y., Seymour, G., Haile, B., & Azzarri, C. (2021) · PLoS ONE · doi:10.1371/journal.pone.0254346 · Cited by 38
“While these studies have primarily focused on women’s mental health, an analysis from Uganda showed that water insecurity is more strongly associated with depression in men than in women, with implications for IPV [29].”
Drought and social conflict in rural Zimbabwe: Does the burden fall on women and girls?
Chigusiwa, L., Kembo, G., & Kairiza, T. (2022) · Review of Development Economics · doi:10.1111/rode.12944 · Cited by 39
Sohns, A., Ford, J. D., Adamowski, J., & Robinson, B. E. (2020) · Environmental Management · doi:10.1007/s00267-020-01387-1 · Cited by 36
Simiyu, S. N., Bagayoko, M., & Gyasi, R. M. (2021) · Aging & Mental Health · doi:10.1080/13607863.2021.1910796 · Cited by 36
Shupler, M. S., Baame, M., Nix, E., Tawiah, T. A. S., Lorenzetti, F., Saah, J., de Cuevas, R. A., Sang, E., Puzzolo, E., Mangeni, J. N., et al. (2022) · SSM - Mental Health · doi:10.1016/j.ssmmh.2022.100103 · Cited by 38
Brewis, A., DuBois, L. Z., Wutich, A., Adams, E. A., Dickin, S., Elliott, S. J., Empinotti, V. L., Harris, L. M., Nébié, E. K. I., & Korzenevica, M. (2023) · Wiley Interdisciplinary Reviews Water · doi:10.1002/wat2.1685 · Cited by 37
“In rural Uganda, Mushavi et al. (2020) found that an association between water insecurity and depression was especially strong for men.”
BackgroundAshaba, S., Cooper‐Vince, C. E., Maling, S., Satinsky, E. N., Baguma, C., Akena, D. H., Nansera, D., Bajunirwe, F., & Tsai, A. C. (2021) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2021.100094 · Cited by 37
“earn a living through subsistence agriculture, animal husbandry, and local trading where challenges of food and water insecurity are common (Mushavi et al., 2020; Tsai et al., 2011; Tsai et al., 2016a).”
BackgroundSelf-citationHo, E. W., Strohmeier-Breuning, S., Rossanese, M., Charron, D., Pennise, D. M., & Graham, J. P. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph181910355 · Cited by 33
“Mushavi et al. (2020) [17] Uganda: 1642 adults Water Mixed methods ND Women experienced severe emotional distress when water is unavailable; the association between water insecurity and depression was greater for men than women Nauges & Strand (2013) [18] Ghana: 405 clusters of HH Water Descriptive…”
Barnwell, G., & Wood, N. (2022) · South African Journal of Psychology · doi:10.1177/00812463211073384 · Cited by 35
“Moreover, Mushavi et al. (2020) report stigma, humiliation, and social alienation owing to the social dimensions of water insecurity, in particular.”
BackgroundFreeman, M. C., Delea, M. G., Snyder, J. S., Garn, J. V., Belew, M. L., Caruso, B. A., Clasen, T., Sclar, G. D., Tesfaye, Y. A., Woreta, M., et al. (2022) · PLOS Global Public Health · doi:10.1371/journal.pgph.0000056 · Cited by 33
Water insecurity is associated with gender-based violence: A mixed-methods study in Indonesia
Cole, S., Tallman, P. S., Salmón-Mulanovich, G., & Rusyidi, B. (2023) · Social Science & Medicine · doi:10.1016/j.socscimed.2023.116507 · Cited by 36
O’Laughlin, K. N., Greenwald, K. E., Rahman, S. K., Faustin, Z. M., Ashaba, S., Tsai, A. C., Ware, N. C., Kambugu, A. D., & Bassett, I. V. (2020) · AIDS and Behavior · doi:10.1007/s10461-020-03102-x · Cited by 26
Self-citationLinking water (in)security and wellbeing in low-and middle-income countries
Kangmennaang, J., & Elliott, S. J. (2021) · Water Security · doi:10.1016/j.wasec.2021.100089 · Cited by 28
Thomson, P., Pearson, A. L., Kumpel, E., Guzman, D. B., Workman, C. L., Fuente, D., Wutich, A., Stoler, J. B., & Household Water Insecurity Experiences Research Coordination Network (HWISE-RCN) (2024) · Environmental Science & Technology · doi:10.1021/acs.est.3c08443 · Cited by 29
Kakuhikire, B., Satinsky, E. N., Baguma, C., Rasmussen, J. D., Perkins, J. M., Gumisiriza, P., Juliet, M., Ayebare, P., Mushavi, R. C., Burns, B., et al. (2021) · PLoS Medicine · doi:10.1371/journal.pmed.1003705 · Cited by 24
“Economic variables included food insecurity (categorical; 9-item Household Food Insecurity Access Scale [55,63]), water insecurity (categorical; 8-item Household Water Insecurity Access Scale [57,58]), and household asset wealth (categorical; [64,65]).”
BackgroundSelf-citationToivettula, A., Varis, O., Vahala, R., & Juvakoski, A. (2023) · Water Research · doi:10.1016/j.watres.2023.120335 · Cited by 25
Experiences of inequalities in access to safe water and psycho-emotional distress in Ghana
Achore, M., & Bisung, E. (2022) · Social Science & Medicine · doi:10.1016/j.socscimed.2022.114970 · Cited by 23
Health implications of coping with water insecurity at the household level
Azupogo, U. W., Achore, M., Dery, F., & Bisung, E. (2023) · Water Security · doi:10.1016/j.wasec.2023.100135 · Cited by 24
Hove, J., D’Ambruoso, L., Twine, R., Mabetha, D., van der Merwe, M., Mtungwa, I., Khoza, S., Kahn, K., & Witter, S. (2021) · Global Health Action · doi:10.1080/16549716.2021.1973715 · Cited by 22
“The local municipality in the Agincourt HDSS struggles to continuously supply safe water; a common phenomenon in rural municipalities across South Africa [41,42].”
BackgroundClimate and hydrological seasonal effects on household water insecurity: A systematic review
Broyles, L. M. T., Pakhtigian, E. L., Rosinger, A. Y., & Mejía, A. (2022) · Wiley Interdisciplinary Reviews Water · doi:10.1002/wat2.1593 · Cited by 22
“…Eichelberger, 2010, 2018, 2019; Hailu et al., 2020; Hamlet et al., 2020; Hanrahan & Mercer, 2019; Kelly et al., 2018; Lasage et al., 2008; Mukasa et al., 2020; Mushavi et al., 2020; Nyong & Kanaroglou, 1999; Pearson et al., 2015; Stevenson et al., 2012; Tucker et al., 2014; Uzomah & Scholz, 2002).”
BackgroundMethodInfluentialAshaba, S., Zanoni, B. C., Baguma, C., Tushemereirwe, P., Nuwagaba, G., Kirabira, J., Nansera, D., Maling, S., & Tsai, A. C. (2022) · AIDS and Behavior · doi:10.1007/s10461-022-03856-6 · Cited by 22
Self-citationAshaba, S., Kakuhikire, B., Baguma, C., Satinsky, E. N., Perkins, J. M., Rasmussen, J. D., Cooper‐Vince, C. E., Ahereza, P., Gumisiriza, P., Kananura, J., et al. (2022) · SSM - Mental Health · doi:10.1016/j.ssmmh.2022.100062 · Cited by 22
Self-citationJoshi, N., Lopus, S. E., Hannah, C., Ernst, K. C., Kilungo, A. P., Opiyo, R. O., Ng’ayu, M. M., Davies, J. M., & Evans, T. P. (2022) · Social Science & Medicine · doi:10.1016/j.socscimed.2022.115191 · Cited by 21
Perkins, J. M., Kakuhikire, B., Baguma, C., Jurinsky, J., Rasmussen, J. D., Satinsky, E. N., Namara, E. B., Ahereza, P., Kyokunda, V., Perkins, H. W., et al. (2021) · Addiction · doi:10.1111/add.15615 · Cited by 18
Self-citationLogie, C. H., Newman, P. A., Admassu, Z., Mackenzie, F., Chakrapani, V., Tepjan, S., Shunmugam, M., & Akkakanjanasupar, P. (2024) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2024.27 · Cited by 20
“Water insecurity is associated with poorer mental health across diverse global regions (Cooper-Vince et al., 2018; Maxfield, 2020; Mushavi et al., 2020; Stoler et al., 2020; Wutich et al., 2020).”
BackgroundLogie, C. H., Okumu, M., Coelho, M., Loutet, M. G., Narasimhan, M., Lukone, S. O., Kisubi, N., Musoke, D. K., Kyambadde, P., Dorea, C., et al. (2022) · Journal of Water Sanitation and Hygiene for Development · doi:10.2166/washdev.2022.236 · Cited by 22
Tsai, A. C., Kakuhikire, B., Perkins, J. M., Downey, J., Baguma, C., Satinsky, E. N., Gumisiriza, P., Kananura, J., & Bangsberg, D. R. (2021) · Journal of Global Health · doi:10.7189/jogh.11.04056 · Cited by 17
Self-citationStoler, J. B., Guzman, D. B., & Adams, E. A. (2023) · Wiley Interdisciplinary Reviews Water · doi:10.1002/wat2.1674 · Cited by 24
Nounkeu, C. D., & Dharod, J. M. (2021) · Health Care For Women International · doi:10.1080/07399332.2021.1931225 · Cited by 17
Apatinga, G. A., Schuster‐Wallace, C. J., & Dickson‐Anderson, S. E. (2022) · Wiley Interdisciplinary Reviews Water · doi:10.1002/wat2.1591 · Cited by 18
Impact of water insecurity amidst endemic and pandemic in Pakistan: Two tales unsolved
Ahmad, S., Zahra, J., Ali, M., Ali, S., Iqbal, S., Kamal, S., Tahir, M., & Aborode, A. T. (2022) · Annals of Medicine and Surgery · doi:10.1016/j.amsu.2022.104350 · Cited by 16
Rosinger, A. Y., Stoler, J. B., Ford, L. B., McGrosky, A., Sadhir, S., Ulrich, M., Todd, M., Bobbie, N., Nzunza, R., Braun, D. R., et al. (2024) · Social Science & Medicine · doi:10.1016/j.socscimed.2024.117280 · Cited by 16
Comfort, A. B., Asiimwe, S. B., Amanyire, G., Orrell, C., Moody, J. W., Musinguzi, N., Bwana, M., Bangsberg, D. R., Haberer, J. E., Tsai, A. C., et al. (2024) · SSM - Population Health · doi:10.1016/j.ssmph.2023.101593 · Cited by 15
“Food and water insecurity are prevalent in both settings (Mushavi et al., 2020; Perkins et al., 2018; Tsai et al., 2016).”
BackgroundSelf-citationUnlocking water sustainability: The role of knowledge, attitudes, and practices among women
Haddid, O. A., Ahmad, A. M. K., & AbedRabbo, M. (2024) · Journal of Cleaner Production · doi:10.1016/j.jclepro.2024.143697 · Cited by 19
Osinuga, A., Janssen, B., Fethke, N. B., Story, W. T., Imaledo, J. A., & Baker, K. K. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182111043 · Cited by 16
“Timely management and performance of daily domestic work responsibilities, such as manual laundry, cooking, and childcare, depended on women’s access to water, which is supported by prior research [70].”
BackgroundResultTallman, P. S., Salmón-Mulanovich, G., Archdeacon, N., Kothadia, A., Flórez, L. L., Castañeda, K., Collins, S. M., Rusyidi, B., & Cole, S. (2024) · Violence Against Women · doi:10.1177/10778012241230323 · Cited by 18
“Failure to meet prescribed gender roles around water collection, or water-related domestic tasks, is linked to physical and psychological intimate partner violence (Mushavi et al., 2020).”
Kisliuk, N., LaPointe, S., Young, S. L., Prencipe, L., Luchemba, P., Lukongo, T. M., & Palermo, T. (2024) · Global Public Health · doi:10.1080/17441692.2024.2409369 · Cited by 14
“…associated with psychosocial and psychological distress, especially among women (Mushavi et al., 2020; Stevenson et al., 2016; 2012; Stoler et al., 2020; Workman & Ureksoy, 2017; Wutich & Ragsdale, 2008), as WI impedes quality of life and mental health (Aihara et al., 2016; Mushavi et al., 2020).”
InfluentialLee, Y. J., Christ, R., Mbabazi, R., Dabagia, J., Prendergast, A., Wykoff, J. A., Dasari, S., Safai, D., Nakaweesi, S., Aturinde, S. R., et al. (2024) · PLOS mental health. · doi:10.1371/journal.pmen.0000069 · Cited by 14
Self-citationMgwele, A., Bhanye, J. I., & Mocwagae, K. (2024) · Sustainable development goals series · doi:10.1007/978-3-031-68734-1_4 · Cited by 13
Wallach, E. S., Lam, N. L., Nuwagira, E., Muyanja, D., Tayebwa, M., Valeri, L., Tsai, A. C., Vallarino, J., Allen, J. G., & Lai, P. S. (2022) · Indoor Air · doi:10.1111/ina.12986 · Cited by 13
Self-citationSeretlo-Rangata, M. L., Sodi, T., & Govender, S. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1537992 · Cited by 15
Water Challenges in Rural Sub-Saharan Africa
Nyika, J. M., & Dinka, M. O. (2023) · SpringerBriefs in water science and technology · doi:10.1007/978-3-031-26271-5_3 · Cited by 11
Bachwenkizi, J., Mohamed, H., Funsan, P., Rweyemamu, D. R., Nelson, W., Shao, M., Kaijage, H., Muyumbana, N., Salehe, S. S., Mwelange, L. P., et al. (2023) · Hygiene and Environmental Health Advances · doi:10.1016/j.heha.2023.100063 · Cited by 11
Dinko, D. H., & Nyantakyi‐Frimpong, H. (2023) · Annals of the American Association of Geographers · doi:10.1080/24694452.2023.2231528 · Cited by 13
“…constructed at the intersection of ecological and social systems (e.g., Dyck et al. 2005; Winchester and King 2018; Kangmennaang and Elliott 2019; Mushavi et al. 2020; Dinko 2022) and find that unequal gender norms intersect with geographic and topographic characteristics to frustrate women into…”
BackgroundLeahy, W., Achore, M., & Dery, F. (2024) · PLOS Water · doi:10.1371/journal.pwat.0000265 · Cited by 11
Interacting Water Insecurity and Food Insecurity: Recent Advances in Theory and Application
Brewis, A., Jepson, W. E., Rosinger, A. Y., Stoler, J. B., Workman, C. L., Wutich, A., & Young, S. L. (2025) · American Journal of Human Biology · doi:10.1002/ajhb.70052 · Cited by 13
“Examples include concerns of spousal violence from serving less-palatable meals made with too little or low-quality water in Uganda (Mushavi et al. 2020), distress of changed cooking plans in Cameroon (Nounkeu et al. 2022), and complex issues around lactation and infant feeding in Pakistan (Ahmed et al. 2021).”
Perkins, J. M., Kakuhikire, B., Baguma, C., Rasmussen, J. D., Satinsky, E. N., Kiconco, A., Kananura, J., Audet, C. M., Siedner, M. J., Haberer, J. E., et al. (2022) · AIDS and Behavior · doi:10.1007/s10461-021-03540-1 · Cited by 10
Self-citationInfluences on water source selection and use among women in rural Odisha, India
Patrick, M., Hennink, M. M., Dasmohapatra, M., Rout, M., Clasen, T., & Caruso, B. A. (2023) · Frontiers in Water · doi:10.3389/frwa.2023.1040981 · Cited by 13
Mngadi, L. C., Cuadros, D. F., Tanser, F. C., Burns, J. K., Slotow, R., & Tomita, A. M. (2023) · Psychology Health & Medicine · doi:10.1080/13548506.2023.2179643 · Cited by 10
“Only a few studies (Mushavi et al., 2020; Simiyu et al., 2022) have investigated their relationship with mental health, particularly depression in sub-Saharan Africa, including South Africa.”
BackgroundGüler, K. G., & Albayrak, E. (2024) · Public Health Nursing · doi:10.1111/phn.13388 · Cited by 12
Ashaba, S., Zanoni, B. C., Baguma, C., Tushemereirwe, P., Nuwagaba, G., Nansera, D., Maling, S., & Tsai, A. C. (2022) · Journal of the Association of Nurses in AIDS Care · doi:10.1097/jnc.0000000000000342 · Cited by 10
Self-citationAshaba, S., Baguma, C., Tushemereirwe, P., Nansera, D., Maling, S., Zanon, B. C., & Tsai, A. C. (2024) · PLOS Global Public Health · doi:10.1371/journal.pgph.0003600 · Cited by 9
“Most of the people who attend the HIV clinic reside in nearby communities and earn their livelihood through subsistence farming, animal husbandry, and small scale trading despite acknowledged challenges of water and food insecurity [36, 37].”
BackgroundSelf-citationWaSH insecurity and anxiety among people who inject drugs in the Tijuana-San Diego border region
Portillo, L. J. A., Calderón-Villarreal, A., Abramovitz, D. A., Vera, A., Cassels, S. L., Vera, C. F., Muñoz, S., Tornez, A., Rangel, G., Strathdee, S. A., et al. (2024) · BMC Public Health · doi:10.1186/s12889-023-17341-9 · Cited by 10
Kim, A. W., Kakuhikire, B., Baguma, C., North, C. M., Satinsky, E. N., Perkins, J. M., Ayebare, P., Kiconco, A., Namara, E. B., Bangsberg, D. R., et al. (2021) · Journal of Global Health · doi:10.7189/jogh.11.04035 · Cited by 9
Self-citationPerceived and misperceived norms about khat and/or cannabis use among adults in southwest Uganda
Perkins, J. M., Kakuhikire, B., Baguma, C., Meadows, M. L., Evans, C. Q., Jurinsky, J., Rasmussen, J. D., Satinsky, E. N., Ayebare, P., Kyokunda, V., et al. (2021) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2021.103527 · Cited by 9
Self-citationMpondo, F., Kim, A. W., Tsai, A. C., & Mendenhall, E. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.02.035 · Cited by 8
Self-citationCaregiver preferences for physically harsh discipline of children in rural Uganda
Satinsky, E. N., Kakuhikire, B., Baguma, C., Cooper‐Vince, C. E., Rasmussen, J. D., Ashaba, S., Perkins, J. M., Ahereza, P., Ayebare, P., Kim, A. W., et al. (2023) · Journal of Family Violence · doi:10.1007/s10896-023-00536-4 · Cited by 8
“Additionally, since this study was conducted in a rural setting characterized by considerable food and water insecurity (Mushavi et al. 2020; Perkins et al. 2018; Tsai et al. 2011), associations between economic insecurity and harsh discipline may extend throughout the entire study setting.”
InfluentialSelf-citationRoss, A., Mack, E. A., Marcantonio, R. A., Miller‐Graff, L. E., Pearson, A. L., Smith, A. C., Bunting, E., & Zimmer, A. (2023) · Climate and Development · doi:10.1080/17565529.2023.2186746 · Cited by 10
“A more recent study by Mushavi et al. (2020) in rural Uganda highlights several aspects of violence linked to water.”
BackgroundKar, S., JibanbandhuGayak, Khan, K. R., Satpati, L., & Mukherjee, S. (2023) · Disaster risk reduction · doi:10.1007/978-3-031-26143-5_16 · Cited by 8
Yang, I. T., Hemphill, L., Kim, J., Bibangambah, P., Sentongo, R. N., Kakuhire, B., Plutzky, J., Boum, Y., Tsai, A. C., Okello, S., et al. (2020) · Journal of Global Health · doi:10.7189/jogh.10.010407 · Cited by 11
Self-citationPerkins, J. M., Kakuhikire, B., Baguma, C., Jeon, S., Walker, S. F., Dongre, R., Kyokunda, V., Juliet, M., Satinsky, E. N., Comfort, A. B., et al. (2023) · Journal of Global Health · doi:10.7189/jogh.13.04149 · Cited by 7
Self-citationMutanda, G. W., & Nhamo, G. (2024) · Frontiers in Water · doi:10.3389/frwa.2024.1399415 · Cited by 7
Tufail, M., Nasir, M. J., Rahman, A., Kakakhel, S. I., Ashraf, M., & Tariq, A. (2025) · World Development Perspectives · doi:10.1016/j.wdp.2025.100679 · Cited by 8
Silva, B. B., & Rezende, S. C. (2022) · Environmental Science & Policy · doi:10.1016/j.envsci.2022.04.014 · Cited by 7
Olivieri‐Mui, B. L., Hoeppner, S. S., Tong, Y., Kohrt, E., Quach, L., Saylor, D. R., Seeley, J., Tsai, A. C., Reynolds, Z., Okello, S., et al. (2023) · Journal of Global Health · doi:10.7189/jogh.13.06003 · Cited by 7
Self-citationAhiabli, P., Adatara, P., & Cross, R. (2023) · Journal of Water Sanitation and Hygiene for Development · doi:10.2166/washdev.2023.142 · Cited by 7
Logie, C. H., Okumu, M., Admassu, Z., Mackenzie, F., Kortenaar, J., Perez‐Brumer, A., Gittings, L., Khan, N., Hakiza, R., Musoke, D. K., et al. (2024) · SSM - Mental Health · doi:10.1016/j.ssmmh.2024.100306 · Cited by 7
Ashaba, S., Baguma, C., Tushemereirwe, P., Nansera, D., Maling, S., Tsai, A. C., & Zanoni, B. C. (2024) · PLOS Global Public Health · doi:10.1371/journal.pgph.0003037 · Cited by 6
Self-citationSabuhoro, E., Wright, B. A., Munanura, I. E., Powell, R. B., Hallo, J. C., & Layton, P. A. (2021) · Human Dimensions of Wildlife · doi:10.1080/10871209.2021.2015487 · Cited by 6
“In particular, poor residents are less able to afford clean water than other residents (Mushavi et al., 2020; Osei et al., 2015).”
BackgroundKirabira, J., Ashaba, S., Favina, A., Maling, S., Nansera, D., & Zanoni, B. C. (2023) · Psychology Health & Medicine · doi:10.1080/13548506.2023.2198244 · Cited by 6
“The majority of people who seek care at MRRH HIV clinic reside in rural areas outside of the city where they are engaged in retail trading, subsistence farming and animal rearing to make a living amid challenges of water and food scarcity (Mushavi et al., 2020; Tsai et al., 2016).”
BackgroundKim, A. W., Rieder, A. D., Cooper‐Vince, C. E., Kakuhikire, B., Baguma, C., Satinsky, E. N., Perkins, J. M., Kiconco, A., Namara, E. B., Rasmussen, J. D., et al. (2023) · American Journal of Biological Anthropology · doi:10.1002/ajpa.24758 · Cited by 7
Self-citationSeasonal variation in household water insecurity in rural Bangladesh: A longitudinal analysis
Broyles, L. M. T., Pakhtigian, E. L., Aziz, S., Akanda, A. S., & Mejía, A. (2023) · PLOS Water · doi:10.1371/journal.pwat.0000157 · Cited by 6
Money Down the Drain: Corruption and Access to Water in AfricaPreprint
Breen, M., & Gillanders, R. (2021) · SSRN Electronic Journal · doi:10.2139/ssrn.3866657 · Cited by 6
Water, economic systems, and mental health: A review of theorized relationships
Choudhary, N., Brewis, A., Beresford, M., Workman, C. L., & Wutich, A. (2022) · CABI Reviews · doi:10.1079/cabireviews202217042 · Cited by 4
Ponticiello, M. N., Nuwagira, E., Tayebwa, M., Mugerwa, J., Nahabwe, H., Nakasita, C., Tumuhimbise, J. B., Lam, N. L., Wiens, M. O., Vallarino, J., et al. (2023) · Journal of Global Health · doi:10.7189/jogh.13.04026 · Cited by 4
Self-citationO’Brien, L. A., Snyder, J. S., Garn, J. V., Kann, R. S., Júnior, A., McGunegill, S., Muneme, B., Manuel, J. L., Nalá, R., Lévy, K., et al. (2024) · PLOS Water · doi:10.1371/journal.pwat.0000219 · Cited by 5
Who is more water insecure? Gendered evidence from urban Pakistan
Khalid, S., Hafeez, M., & Aqib, S. (2024) · Frontiers in Water · doi:10.3389/frwa.2024.1423237 · Cited by 4
Brugger, C., Owen, B. N., Hamad, B. A. A., van Gastel, T., Sittaro, F., Rossi, R., Probst-Hensch, N. M., & Winkler, M. S. (2025) · Environmental Health · doi:10.1186/s12940-025-01191-6 · Cited by 5
“Water access insecurity, concerns about quality and high costs can contribute to stress and mental health issues [46–48].”
Metadata
- Authors
- Mushavi, R. C., Burns, B. F. O., Kakuhikire, B., Owembabazi, M., Vořechovská, D., McDonough, A. Q., Cooper-Vince, C. E., Baguma, C., Rasmussen, J. D., Bangsberg, D. R., & Tsai, A. C.
- Affiliations
- Brigham and Women's Hospital (US)
- Massachusetts General Hospital (US)
- Mbarara University of Science and Technology (UG)
- Duke University (US)
- Portland State University (US)
- Harvard University (US)
- Corresponding author
- Mushavi, Rumbidzai C.
- ORCID
- Venue
- Social Science & Medicine
- Publisher
- Elsevier BV
- Published
- 2020-01
- Volume
- 245
- Pages
- 112561
- ISSN
- 0277-9536 (ISSN-L)
- PMC
- PMC6936324
- OpenAlex
- W2978384331
- Cited by
- 164
- References
- 67
- Citations by year
- 2026: 21 · 2025: 22 · 2024: 28 · 2023: 31 · 2022: 24 · 2021: 29 · 2020: 9
- FWCI
- 5.61
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Social Science & Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- PDXScholar (Portland State University) (submittedVersion)
- Funders
- Doris Duke Charitable Foundation
- National Institutes of Health
- Topics
- Physical Sciences › Environmental Science › Water Science and Technology › Water Resource Management and Quality
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Keywords
- water insecurity, depression, mental health, rural Uganda, household water access, gender norms, emotional distress, social outcomes
- MeSH terms
- Water Insecurity, Adult, Depression, Female, Humans, Male, Middle Aged, Psychometrics, Surveys and Questionnaires, Rural Population, Socioeconomic Factors, Uganda
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