"I know how stressful it is to lack water!’ Exploring the lived experiences of household water insecurity among pregnant and postpartum women in western Kenya.
Open accessAbstract
There is rapidly evolving literature on water insecurity in the general adult population, but the role of water insecurity during the vulnerable periods of pregnancy and postpartum, or in the context of HIV, has been largely overlooked. Therefore, we conducted an exploratory study, using Go Along interviews, photo-elicitation interviews, and pile sorts with 40 pregnant and postpartum Kenyan women living in an area of high HIV prevalence. We sought to (1) describe their lived experiences of water acquisition, prioritisation, and use and (2) explore the consequences of water insecurity. The results suggest that water insecurity is particularly acute in this period, and impacts women in far-reaching and unexpected ways. We propose a broader conceptualisation of water insecurity to include consideration of the consequences of water insecurity for maternal and infant psychosocial and physical health, nutrition, and economic well-being.
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Women's and girls' bodily integrity has been constrained due to water and sanitation conditions, including limiting bathing and washing, restricting food and water, suppressing defecation and urination urges, delaying changing menstrual materials, and taking anti-diarrheal medicines when lacking sufficient, safe or clean water and sanitation.
“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 [198]
Almost all articles documenting physical violence from interpersonal conflicts focused on water, including intrahousehold conflicts and beatings due to participation in water supply projects, abuse from mothers-in-law over water collection, quarrels while waiting in water queues, and beatings by school janitors over unclean toilets.
“Almost all articles documenting physical violence from interpersonal conflicts focused on water [89,110,198,243,258]. Women in India experienced intrahousehold conflicts and beatings due to participation in a water supply project; [89] young women in Bangladesh, especially new brides, suffered verbal and physical abuse from mothers-in-law when they failed to collect water quickly or did not”
From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [198]
Inadequate water provision and collection behaviors were reported to influence intimate partner violence, including violence from husbands for not providing water for bathing, not having water in the home, going to cleaner water sources considered too far, not preparing food on time, or attending water-focused community meetings.
“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 [198]
Women in Kenya consumed poorer quality foods and a less diverse diet as a result of water insecurity.
“Women in Kenya consumed poorer quality foods and a less diverse diet as a result of water insecurity [198].”
From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [198]
Women reported spending money to access water sources with shorter wait times or higher quality, or to compensate male neighbors, laborers, or drivers for water collection; water was a major expense for many women.
“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 [198]
Norms have influenced the extent that men engage in water collection and how they are perceived.
“Norms have influenced the extent that men engage in water collection and how they are perceived [110,198,258,279,296].”
From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [198]
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Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis
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- Authors
- Collins, S. M., Mbullo Owuor, P., Miller, J. D., Boateng, G. O., Wekesa, P., Onono, M., & Young, S. L.
- Affiliations
- Northwestern University (US)
- Department of Anthropology, Northwestern University, Evanston, IL, USA
- Kenya Medical Research Institute (KE)
- Corresponding author
- Young, Sera L.
- ORCID
- Venue
- Global Public Health
- Publisher
- Informa UK Limited
- Published
- 2018-09-20
- Volume
- 14
- Issue
- 5
- Pages
- 649-662
- ISSN
- 1744-1692 (ISSN-L)
- 1744-1706
- PMC
- PMC6414268
- OpenAlex
- W2890930155
- Cited by
- 170
- References
- 48
- Citations by year
- 2026: 22 · 2025: 18 · 2024: 20 · 2023: 28 · 2022: 30 · 2021: 27 · 2020: 13 · 2019: 10 · 2018: 2
- FWCI
- 10.75
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Global Public Health (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (NIH/NIMH K01MH098902, NIH/NIMH R21MH10844403)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Physical Sciences › Environmental Science › Water Science and Technology › Water Resource Management and Quality
- Health Sciences › Health Professions › General Health Professions › Food Security and Health in Diverse Populations
- Keywords
- household water insecurity, pregnancy, postpartum period, women's experiences, water acquisition, water consumption, HIV, maternal health, infant health, psychosocial health, nutrition, economic well-being, Western Kenya
- MeSH terms
- Child Health, Maternal Health, Adult, Female, Humans, Interviews as Topic, Kenya, Pregnancy, Stress, Psychological, Water Supply, Qualitative Research, Postpartum Period, Young Adult
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