A Systematic Review of Water and Gender Interlinkages: Assessing the Intersection With Health
Open accessAbstract
Background: Significant developmental challenges in low-resource settings limit access to sustainable water, sanitation, and hygiene (WASH). However, in addition to reducing human agency and dignity, gendered WASH inequities can also increase disease burden among women and girls. In this systematic review, a range of challenges experienced by women relating to inadequate WASH resources are described and their intersection with health are explored. We further assess the effectiveness of interventions in alleviating inequalities related to the Sustainable Development Goals (SDGs) 3 (health), 5 (gender), and 6 (water). Methods: We searched the MEDLINE database to identify research articles related to water (i.e., WASH), gender, and sustainability. An analysis of both observational and interventional studies was undertaken. For each study, content analysis was performed to identify the relevant WASH, gender, and health related outcomes, and the main conclusions of the study. Results: Key themes from our search included that women and girls face barriers towards accessing basic sanitation and hygiene resources, including a lack of secure and private sanitation and of Menstrual Hygiene Management (MHM) resources. In total, 71% of identified studies reported a health outcome, suggesting an intersection of water and gender with health. Half of the research studies that included a health component reflected on the relationship between WASH, gender, and infantile diseases, including under-5 mortality, waterborne parasites, and stunting. In addition, we found that women and girls, as a result of their role as water purveyors, were at risk of exposure to contaminated water and of sustaining musculoskeletal trauma. A limited number of studies directly compared gender differences in accessing WASH resources, and an even smaller fraction (N=5, 8.5%) reported sex-disaggregated outcomes. Educational, infrastructural, and programmatic interventions showed promise in reducing WASH and health outcomes. Indeed, infrastructural WASH interventions can be successful if long-term maintenance is ensured. Conclusions: Significant WASH inequities in women and girls further manifest as health burdens, providing strong evidence that the water-gender-nexus intersects with health. Thus, addressing gender and water inequities holds the potential to alleviate disease burden and have a significant impact on achieving the SDGs, including SDG 3, 5, and 6.
AI snapshot
Written from the paper’s full text.
TL;DR
This systematic review of 59 studies from 30 countries finds that gendered WASH inequities—especially women’s role as water purveyors, lack of safe/private sanitation, and inadequate menstrual hygiene management—intersect with health burdens. It concludes that addressing water-gender inequities could reduce disease burden and support SDGs 3, 5, and 6.
Key findings
- Women and girls were the primary water carriers, with prevalence estimates ranging from 61 to 79%; mean travel times for fetching water were as high as 54 min.
- Of 46 observational studies, 33 (72%) assessed a health component related to WASH; 16 (48%) assessed childhood health, mainly under-five mortality (15%), schistosomiasis/intestinal parasites (18%), and child stunting (12%).
- Only 5 publications (8.5%) reported sex-disaggregated outcomes, and close to half of studies (46%) focused exclusively on women and girls.
- Among 13 interventional studies, filtration systems were retained by 19–31% after 2–5 years; treated water reduced diarrhea in school children by 40%, and soap provision reduced child diarrhea by 90%.
Methods
- Systematic review using PRISMA and broad content analysis, searching MEDLINE via PubMed with terms for gender, water, and sustainability.
- Included observational studies and clinical trials with quantitative, qualitative, or mixed-methods designs; available in English; containing a WASH outcome; and explicitly considering a gendered outcome. Excluded non-human studies, non-primary data (commentaries, systematic reviews, literature reports), and case reports.
- Data extracted on study design, location, population, WASH outcomes, health outcomes, sex-disaggregation, and key highlights; risk of bias assessed with a validated adaptation of the Cochrane risk of bias instrument.
Limitations
- The paper states it cannot effectively describe the magnitude of WASH deficiencies, did not exclude studies with high bias, did not explicitly include health keywords in the search, used MEDLINE (likely biasing toward health outcomes), and was restricted to English.
- The text makes evident that only half of studies directly compared WASH outcomes between genders and fewer than 10% reported sex-disaggregated data, limiting understanding of how women’s access and health effects differ from men’s.
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Integrity signals
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Cites
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Claims the paper makes
0 of 110 cited sources checked · 0 supported · 0 flagged
- Findingcitation
Sanitation facilities were commonly cited to not be safe, clean, and accessible.
“Sanitation facilities were commonly cited to not be safe, clean, and accessible (Kwiringira et al., 2014;Sato et al., 2016;Khan et al., 2017;Aluko et al., 2018;Angoua et al., 2018;Dendup et al., 2018;Desalegn et al., 2018;Njuguna, 2019;Winter et al., 2019).”
Quote in the paperNot a substantial claim0 of 3 sources checked - Findingcitation
Within a household, there was substantial evidence that women as the primary carriers of water with prevalence estimates ranging from 61 to 79%.
“Moreover, within a household, there was substantial evidence that women as the primary carriers of water with prevalence estimates ranging from 61 to 79% (Hunter, 2006;Bornman et al., 2012;Holvoet et al., 2016;Geere et al., 2018).”
Quote in the paperSubstantial claim0 of 3 sources checked - Findingcitation
Mean travel times for fetching water were as high as 54 min.
“Mean travel times for fetching water were as high as 54 min (Holvoet et al., 2016).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Holvoet et al., 2016 source
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- Findingown data
Only five publications (8.5%) reported some sex-disaggregated outcomes.
“Only five publications (8.5%) reported some sex-disaggregated outcomes.”
Quote in the paperSubstantial claim - Findingcitation
The presence of a wife in the household significantly increased the likelihood of having access to clear water.
“Indeed, the presence of a wife in the household significantly increased the likelihood of having access to clear water (Angoua et al., 2018).”
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Close to half of studies (46%) focused exclusively on the experience of women and girls and did not consider impacts on men.
“As well, close to half of studies (46%) focused exclusively on the experience of women and girls and did not consider impacts on men.”
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Women are the primary water purveyors, particularly in the developing regions of the world.
“Women Are the Primary Water Purveyors, Particularly in the Developing Regions of the World”
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This analysis identified 59 research articles from 30 countries published between 1993 and 2019.
“This analysis identified 59 research articles from 30 countries published between 1993 and 2019.”
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In Kenya, in 2004 and 2008, but not 2014, female-headed households were more likely to openly defecate than male-headed households.
“In addition, Njuguna (2019) showed that in Kenya, in 2004 and 2008, but not 2014, female-headed households were more likely to openly defecate than male-headed households.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Njuguna, 2019 source
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- Findingnone given
The link between WASH resources in school and absenteeism was not definitive.
“However, the link between WASH resources in school and absenteeism was not definitive.”
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Women are at an increased risk of musculoskeletal disorders as a result of carrying water long-term and across long distances.
“Women are at an increased risk of musculoskeletal disorders as a result of carrying water long-term and across long distances (Geere et al., 2018).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Geere et al., 2018 source
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- Findingcitation
Exposure to open water near schools increases the risk of schistosomiasis.
“Outside of the home, exposure to open water near schools increases the risk of schistosomiasis (Kapito-Tembo et al., 2009).”
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- Findingcitation
Studies that compared access to sanitation between men and women found largely unremarkable gender differences.
“Generally, studies that compared access to sanitation between men and women found largely unremarkable gender differences (Ugbomoiko et al., 2009;Al-Delaimy et al., 2014;Alemu et al., 2017;Baker et al., 2018).”
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The majority of studies (N = 9) considered how WASH interventions could improve health impacts.
“The majority of studies (N = 9) considered how WASH interventions could improve health impacts.”
Quote in the paperNot a substantial claim - Findingcitation
Religious, new mothers who were fasting and did not have access to improved water or sanitation were more likely to be underweight.
“For example, religious, new mothers who were fasting and did not have access to improved water or sanitation were more likely to be underweight (Desalegn et al., 2018).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Desalegn et al., 2018 source
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- Findingcitation
Girls had reduced access to improved hygienic practices.
“There is further evidence that girls had reduced access to improved hygienic practices.”
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Infrastructural interventions that improved water accessibility demonstrated mixed results for long-term benefits.
“Infrastructural interventions that improved water accessibility demonstrated mixed results for long-term benefits.”
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Household piped water was one of the three stability factors needed to reduce HIV transmission for newborn infants.
“Household piped water was one of the three stability factors needed to reduce HIV transmission for newborn infants (Doherty et al., 2007).”
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- Findingcitation
A single study directly analyzed the effect of gender on the frequency of waterborne diseases in adults and found no gender differences.
“A single study directly analyzed the effect of gender on the frequency of waterborne diseases in adults, and found no gender differences (Al-Delaimy et al., 2014).”
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Interventions were equally split between providing WASH education (N = 8) or providing physical infrastructural improvements (N = 9).
“Interventions were equally split between providing WASH education (N = 8) or providing physical infrastructural improvements (N = 9).”
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Boys hand washed more frequently than girls.
“Nasr et al. (2013) comment that boys hand washed more frequently than girls”
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- Findingcitation
A small fraction (6%) of studies focused on the role of MHM, where women reported a lack of proper MHM products, such as clean pads, in addition to private areas and an absence of water provisioning for cleaning and sanitation needs.
“A small fraction (6%) of studies focused on the role of MHM, where women reported a lack of proper MHM products, such as clean pads, in addition to private areas and an absence of water provisioning for cleaning and sanitation needs (Khan et al., 2017;Budhathoki et al., 2018;Davis et al., 2018).”
Quote in the paperNot a substantial claim0 of 3 sources checked - Findingcitation
One study in rural Ethiopia found that male-headed households were ∼4-fold more likely to use household latrines than female-headed families.
“However, one study in rural Ethiopia found that male-headed households were ∼4-fold more likely to use household latrines than female-headed families (Aiemjoy et al., 2017).”
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- Findingreasoning
A lack of latrines that are safe, secure, and private represents a major engendered barrier.
“Additionally, a lack of latrines that are safe, secure, and private represents a major engendered barrier.”
Quote in the paperSubstantial claim - Findingcitation
Women may have less access to clean water.
“We found some indication that women may have less access to clean water (Bisung and Elliott, 2018); however, few studies have directly interrogated this question.”
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- Findingcitation
WASH infrastructural and educational interventions in general showed promise in reducing inequities in the water-gender and related health outcomes.
“WASH infrastructural and educational interventions in general showed promise in reducing inequities in the water-gender and related health outcome; however, issues surrounding long-term adoption reduced efficacy (Huq et al., 2010;Pickering et al., 2017).”
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Culture played a role in women preferring to openly defecate instead of using latrines.
“As well, culture played a role in women preferring to openly defecate instead of using latrines (Nyoka et al., 2017).”
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- Findingcitation
Poor WASH is linked to a multitude of health burdens, particularly childhood diseases including schistosomiasis, under-5 mortality, and stunting.
“Poor WASH, in general, was linked to a multitude of health burdens, and particularly childhood diseases, including schistosomiasis, under-5 mortality, and stunting (Ahmed et al., 2016;Atalabi et al., 2016;Acheampong et al., 2017Acheampong et al., , 2018;;Akombi et al., 2017;Donohue et al., 2017;Vos et al., 2017;Baker et al., 2018;Marinda et al., 2018).”
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There remained a significant depreciation in the long-term usage of the interventions.
“However, there remained a significant depreciation in the long-term usage of the interventions (Huq et al., 2010;Pickering et al., 2017).”
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All six included cohort studies exhibited lower levels of bias.
“all of the six included cohort studies likewise exhibited lower levels of bias (Supplemental Table 2).”
Quote in the paperNot a substantial claim - Findingcitation
Filtration systems provided to women were retained by 19 to 31% after a 2-5 years follow-up.
“Filtration systems provided to women were retained by 19 to 31% after a 2-5 years follow-up (Huq et al., 2010;Pickering et al., 2017).”
Quote in the paperNot a substantial claim0 of 2 sources checked - Findingcitation
The role of women and girls as main water purveyors increased their risk for musculoskeletal trauma.
“Regardless, women and girls typically served as the main water purveyors, a role which increased their risk for musculoskeletal trauma (Geere et al., 2018), and exposure to waterborne toxins (Gaspar et al., 2017;Guy et al., 2018).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Geere et al., 2018 source
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Across the 52 assessed cross-sectional studies, 41 (79%) were definitely or probably representative of the target population.
“Across the 52 assessed cross-sectional studies, 41 (79%) were definitely or probably representative of the target population (Supplemental Table 1).”
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Issues surrounding long-term adoption reduced the efficacy of WASH interventions.
“WASH infrastructural and educational interventions in general showed promise in reducing inequities in the water-gender and related health outcome; however, issues surrounding long-term adoption reduced efficacy (Huq et al., 2010;Pickering et al., 2017).”
Quote in the paperSubstantial claim0 of 2 sources checked - Findingcitation
The absence of safe, secure, and private latrines forces women and girls to avoid practicing sustainable sanitation, hygiene, and MHM due to fear of violence or stigmatization.
“The absence of such facilities forces women and girls to avoid practicing sustainable sanitation, hygiene, and MHM due to a fear of violence, or as a result of stigmatization (Kwiringira et al., 2014;Khan et al., 2017;Budhathoki et al., 2018;Davis et al., 2018;Winter et al., 2019).”
Quote in the paperSubstantial claim0 of 3 sources checked - Findingcitation
The role of women and girls as main water purveyors increased their exposure to waterborne toxins.
“Regardless, women and girls typically served as the main water purveyors, a role which increased their risk for musculoskeletal trauma (Geere et al., 2018), and exposure to waterborne toxins (Gaspar et al., 2017;Guy et al., 2018).”
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Evidence that women were better than men at learning sustainable WASH practices through educational interventions has been reported.
“Evidence that women were better than men at learning sustainable WASH practices through educational interventions has also been reported (Cairncross et al., 2005;Williams et al., 2015).”
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The one included randomized controlled trial of a school intervention exhibited lower levels of bias except for evidence of blinding.
“one study deployed a randomized control trial to assess the effectiveness of a school intervention, which, with the exception of evidence of blinding, exhibited lower levels of bias (Supplemental Table 3).”
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Participant non-response rates were not reported by 15 of the assessed cross-sectional studies (29%).
“The largest issues surrounded the reporting of participant non-response rates which was not reported by 15 studies (29%).”
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Women affected by genital mutilations had issues using latrines.
“Furthermore, women affected by genital mutilations had issues using latrines (Nyoka et al., 2017).”
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- Findingcitation
Hand pumps were linked with overall healthier looking children.
“Hand pumps were linked with overall healthier looking children (Katsivo et al., 1993).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Katsivo et al., 1993
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- Findingcitation
Hygiene-related interventions were successful at alleviating disease.
“Hygiene-related interventions were likewise successful at alleviating disease.”
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Few studies have directly interrogated whether women have less access to clean water.
“We found some indication that women may have less access to clean water (Bisung and Elliott, 2018); however, few studies have directly interrogated this question.”
Quote in the paperNot a substantial claim - Findingcitation
Women and girls typically served as the main water purveyors.
“Regardless, women and girls typically served as the main water purveyors, a role which increased their risk for musculoskeletal trauma (Geere et al., 2018), and exposure to waterborne toxins (Gaspar et al., 2017;Guy et al., 2018).”
Quote in the paperSubstantial claim - Findingown data
The search uncovered a significant overlap between WASH inequities among women and health, linking the water-gender nexus with health.
“Without explicitly searching for health-related outcomes, our search uncovered a significant overlap between WASH inequities among women and health, thereby linking the water-gender nexus with health.”
Quote in the paperSubstantial claim - Findingcitation
Women occupy important WASH roles within households, including fetching, storing, and using water.
“From ours and other's work it is clear that women occupy important WASH roles within households, both with fetching, storing, and using water (e.g., cleaning, cooking, washing, etc.) (Morna, 2000).”
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Less than 10% of studies reported at least some gender-disaggregated data.
“However, only half of studies directly compared WASH outcomes between genders, and <10% reported at least some gender-disaggregated data.”
Quote in the paperSubstantial claim - Findingcitation
Stigma actively prevents women and girls from developing healthy habits, such as using soap and water or using latrines.
“Stigma actively prevents women and girls from developing healthy habits (e.g., using soap and water or from using latrines (O'Reilly and Louis, 2014; Yeasmin et al., 2017;Winter et al., 2019).”
Quote in the paperSubstantial claim0 of 3 sources checked - Findingcitation
Gender disparities largely have not been recognized in the SDG six synthesis report.
“Irrespective of gender, the SDG six synthesis report (2018) has recognized handwashing with soap and water as a top priority for reducing disease transmission; however, gender disparities largely have not been recognized (United Nations, 2018).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites United Nations, 2018
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- Findingown data
Only half of studies directly compared WASH outcomes between genders.
“However, only half of studies directly compared WASH outcomes between genders, and <10% reported at least some gender-disaggregated data.”
Quote in the paperSubstantial claim - Findingnone given
Poor WASH practices among mothers are strongly linked with childhood diseases.
“Moreover, poor WASH practices among mothers are strongly linked with childhood diseases.”
Quote in the paperNot a substantial claim - Findingown data
The analysis identified only a limited number of studies which addressed MHM.
“Surprisingly, our analysis identified only a limited number of studies which addressed MHM.”
Quote in the paperSubstantial claim - Premisecitation
Research assessing the intersection between gender and water is severely lacking.
“Despite these gender-related deficiencies, research assessing the intersection between gender and water is severely lacking and remediating gender-water inequities will require targeted resources to fill in the gaps.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Fletcher and Schonewille, 2015
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- cites Nagabhatla et al., 2019
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- Interpretationreasoning
Worsening WASH-inequities among women cause associated health burdens.
“There are further interlinkages existing between water, gender, and health-worsening WASH-inequities among women cause associated health burdens.”
Quote in the paperSubstantial claim - Study design and conductcitation
Risk of bias in individual studies was assessed using a previously validated adaptation of the Cochrane risk of bias instrument.
“We assessed the risk for bias in individual studies using a previously validated adaptation of the Cochrane risk of bias instrument (Akl et al., 2012).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Akl et al., 2012 source
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- Premisecitation
Poor WASH practices elevate the risk for waterborne diseases, including cholera.
“Among other burdens, poor WASH practices elevate the risk for waterborne diseases, including for example cholera, a bacterial infection and transmitted by contaminated water and poor sanitation and hygiene practices (Mahamud et al., 2011;Fletcher and Schonewille, 2015).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Mahamud et al., 2011 source
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- cites Fletcher and Schonewille, 2015
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- Interpretationreasoning
Poor access to water at a household level disproportionately impacts women and girls who are commonly responsible for securing water.
“Consequently, poor access to water at a household level disproportionately impacts women and girls who are commonly responsible for securing water.”
Quote in the paperSubstantial claim - Interpretationreasoning
Health burdens associated with poor WASH can disproportionately entangle women.
“Moreover, given that the health burdens associated with poor WASH can disproportionately entangle women, the water-gender interlinkages with health need to be carefully examined and, subsequently, integrated into policies.”
Quote in the paperSubstantial claim - Premisecitation
Given the role of women in water provisioning for households, they are at an increased risk of exposure to transmission and contraction of disease.
“Given the role of women in water provisioning for households, they are at an increased risk of exposure to transmission and contraction of disease (World Health Organization, 2011).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites World Health Organization, 2011
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- Premisecitation
Women and girls disproportionately serve as water purveyors, collecting water in eight of 10 households.
“Women and girls disproportionately serve as water purveyors, collecting water in eight of 10 households, and as such, often face the burdens of needing to transit long distances to retrieve water (WHO and UNICEF, 2017).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites WHO and UNICEF, 2017
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- Interpretationcitation
New mothers and pregnant women may represent a vulnerable population.
“New mothers and pregnant women, in particular may represent a vulnerable population.”
Quote in the paperNot a substantial claim - Interpretationreasoning
Infrastructural WASH interventions can be successful if long-term maintenance is ensured.
“Indeed, infrastructural WASH interventions can be successful if long-term maintenance is ensured.”
Quote in the paperNot a substantial claim - Interpretationnone given
Educational, infrastructural, and programmatic interventions showed promise in reducing WASH and health outcomes.
“Educational, infrastructural, and programmatic interventions showed promise in reducing WASH and health outcomes.”
Quote in the paperSubstantial claim - Interpretationcitation
MHM is not included clearly as an indicator within the SDGs portfolio.
“However, given that sustainability, and linkages with the SDGs was an explicit search term, the limited number of identified papers which assessed MHM practices perhaps reflects a more significant issue that MHM is not included clearly as an indicator within the SDGs portfolio (Anjum et al., 2019).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Anjum et al., 2019
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- Interpretationcitation
The impacts of disease and disability are likely to be further magnified in low-resource settings where women have reduced agency to make healthcare decisions.
“Considering that in low-resource settings women have reduced agency to make healthcare decisions, the impacts of disease and disability are likely to be further magnified (Osamor and Grady, 2016).”
Quote in the paperSubstantial claim - Interpretationnone given
Women are burdened as a result of their role as water purveyors.
“Major manifestations of the water-gender nexus include that women are burdened as a result of their role as water purveyors, a lack of private and secure latrines disproportionately impact women, and that women have less access to sustainable hygiene resources.”
Quote in the paperSubstantial claim - Interpretationreasoning
Addressing MHM needs is connected with women's access/capacity to gain education, employment, and financial capacity.
“Therefore, it is quite evident that addressing MHM needs is connected with women's access/capacity to gain education, employment, and financial capacity.”
Quote in the paperSubstantial claim- Rests on an assumption: In Bangladesh, more than two thirds of women factory workers lose 6 days of work per month because of a lack of safe places to change menstrual pads/cloths and the absence of disposal sites.
- Interpretationreasoning
It is difficult to understand how women's access to WASH services, and corresponding health effects, differ from similarly situated men.
“Consequently, while we report examples of gender and WASH deficiencies, it is difficult to understand how women's access to WASH services, and corresponding health effects, differ from similarly situated men.”
Quote in the paperSubstantial claim - Interpretationreasoning
There is a strong intersection between the water-gender nexus and health outcomes-the water-gender-health nexus.
“In general, we found a strong intersection between the water-gender nexus and health outcomes-the water-gender-health nexus.”
Quote in the paperSubstantial claim - Study design and conductreasoning
Not explicitly including keywords for health in the search strategy may limit the number of health-related studies identified.
“We did not explicitly include keywords for health in our search strategy, which serves as a kind of prevalence calculation in order to supports broad interlinkages within the literature between gender, water, and health may limit the number of healthrelated studies identified.”
Quote in the paperNot a substantial claim - Interpretationcitation
Empowering women with WASH-related education is a simple and feasible component for implementing successful interventions in health and sanitation-related challenges.
“This presents empowering women with WASH-related education as a simple, and feasible component for implementing successful interventions in the context of health and sanitationrelated challenges.”
Quote in the paperSubstantial claim - Premisecitation
In low-resource settings, women have reduced agency to make healthcare decisions.
“Considering that in low-resource settings women have reduced agency to make healthcare decisions, the impacts of disease and disability are likely to be further magnified (Osamor and Grady, 2016).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Osamor and Grady, 2016
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- Study design and conductreasoning
The review cannot effectively describe the magnitude of WASH deficiencies.
“While this afforded us a broad perspective on the array of WASH inequities faced by women and girls, we cannot effectively describe the magnitude of WASH deficiencies.”
Quote in the paperNot a substantial claim - Premisecitation
MHM has implications for promoting education and good health among adolescent girls.
“Likewise, other systematic reviews have concretely shown the implications of MHM on promoting education and good health among adolescent girls (Sommer et al., 2016).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Sommer et al., 2016 source
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- Study design and conductnone given
The analysis broadly combined qualitative investigation on the nuanced experiences of women with quantitative assessments on accessing sustainable WASH.
“This analysis broadly combined qualitative investigation on the nuanced experiences of women with quantitative assessments on accessing sustainable WASH.”
Quote in the paperSubstantial claim - Premisecitation
Access to safe drinking water and WASH in schools can improve school attendance by allowing girls to meet their MHM needs.
“The 2018 SDG 6 Synthesis Report more broadly describes how having access to safe drinking water and WASH in schools can improve school attendance by allowing girls to meet their MHM needs (United Nations, 2018).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites United Nations, 2018
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- Interpretationreasoning
Even when capacity is available, stigma can undermine development efforts.
“As a result, even when capacity is available, stigma can undermine development efforts, and must be actively addressed.”
Quote in the paperSubstantial claim- Rests on an assumption: Gender-inequity is in part facilitated by stigma, engendered cultural norms, and a societal power imbalance.
- Premisecitation
Women and girls experience occupational hazards for waterborne diseases as a result of exposure to contaminated water and soils.
“In support of our analysis, global reports have recognized that women and girls experience occupational hazards for waterborne diseases as a result of exposure to contaminated water and soils (World Health Organization, 2011).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites World Health Organization, 2011
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- Study design and conductnone given
Not excluding studies with high bias limits the generalizability of the findings.
“As well, we did not exclude studies with high bias, and this limits the generalizability of our findings.”
Quote in the paperNot a substantial claim - Interpretationnone given
Women have less access to sustainable hygiene resources.
“Major manifestations of the water-gender nexus include that women are burdened as a result of their role as water purveyors, a lack of private and secure latrines disproportionately impact women, and that women have less access to sustainable hygiene resources.”
Quote in the paperSubstantial claim - Interpretationnone given
A lack of private and secure latrines disproportionately impacts women.
“Major manifestations of the water-gender nexus include that women are burdened as a result of their role as water purveyors, a lack of private and secure latrines disproportionately impact women, and that women have less access to sustainable hygiene resources.”
Quote in the paperSubstantial claim - Interpretationown data
There is a clear linkage between gender equitable access to WASH and SDG 3.2 targets for ending preventable deaths of newborns and children under 5.
“In addition, our analysis highlights a clear linkage between gender equitable access to WASH, and SDG 3.2 which aims to, by 2030, in all countries, end preventable deaths of newborns and children under 5 years of age, reduce neonatal mortality to at least as low as 12 per 1,000 live births, and to reduce under-5 mortality to at least as low as 25 per 1,000 live births.”
Quote in the paperSubstantial claim - Study design and conductnone given
The use of the MEDLINE database likely adds a bias toward journal articles which consider health outcomes.
“However, the use of the MEDLINE database likely adds a bias toward journal articles which consider health outcomes.”
Quote in the paperNot a substantial claim - Premisecitation
Health burdens can significantly reduce human agency, for example, by reducing income and employment.
“Health burdens can significantly reduce human agency, for example, by reducing income and employment (Alam and Mahal, 2014).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Alam and Mahal, 2014
Not checked in the free run.
- Premisecitation
31% of the village women continued to use the water filter 5 years after the intervention.
“31% of the village women continued to use the water filter 5 years after the intervention.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Huq et al. (2010) source
Not checked in the free run.
- May combine two claims. 47
- Classified as probably not a substantial claim. 17
May combine two claims.
FindingcitationA multitude of studies focused on women and girls and demonstrated that women practiced poor sanitation, hygiene, and MHM practices, largely due to lacking resources.
“A multitude of studies focused on women and girls and demonstrated that women practiced poor sanitation, hygiene, and MHM practices, largely due to lacking resources.”
Quote in the paperNot a substantial claimMay combine two claims.
FindingcitationWomen and girls face unique WASH and MHM challenges.
“Women Face Unique WASH and MHM Challenges”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataClose to half of the publications conducted analyses in Sub-Saharan Africa, with Kenya (N = 7) and Nigeria (N = 5) representing the most frequently studied countries.
“Close to half of the publications conducted analyses in Sub-Saharan Africa with Kenya (N = 7) and Nigeria (N = 5) representing the most frequently studied countries.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataPrimarily, WASH studies focused on measuring access to water (74%), followed by access to sanitation (54%), hygiene (10%), and MHM (7%).
“Primarily, WASH studies focused on measuring access to water (74%), followed by access to sanitation (54%), hygiene (10%), and MHM (7%).”
Quote in the paperNot a substantial claimMay combine two claims.
FindingcitationGirls less often changed their toothbrush and cited cost as a barrier.
“Oberoi et al. demonstrated that girls less often changed their toothbrush and cited cost as a barrier (Oberoi et al., 2014).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Oberoi et al., 2014 source
Not checked in the free run.
May combine two claims.
Findingown dataSignificant evidence of gender intersecting with WASH and health, with 33 of the 46 observational studies (72%) assessing a health component in relation to WASH.
“We found significant evidence of gender intersecting with WASH and health, with 33 of the 46 observational studies (72%) assessing a health component in relation to WASH (Figure 2).”
Quote in the paperSubstantial claimMay combine two claims.
FindingcitationMaternal or household access to clean water significantly reduced the risk of under-five mortality, child stunting, schistosomiasis, and hookworm infections.
“Concretely, studies showed that maternal, or household access to clean water significantly reduced the risk of under-five mortality (Ahmed et al., 2016;Acheampong et al., 2017Acheampong et al., , 2018)), child stunting (Akombi et al., 2017;Vos et al., 2017;Marinda et al., 2018), schistosomiasis (Atalabi et al., 2016;Donohue et al., 2017), and hookworm infections (Baker et al., 2018).”
Quote in the paperSubstantial claim0 of 3 sources checkedMay combine two claims.
FindingcitationBoys were at greater risk than girls for contracting schistosomiasis and hookworm infections as well as stunting.
“In assessing whether women and girls were at higher risk for health burdens, most studies focused on children determining that boys were at greater risk for contracting both schistosomiasis (Kapito-Tembo et al., 2009;Ugbomoiko et al., 2009;Atalabi et al., 2016;Donohue et al., 2017) and hookworm infections (Baker et al., 2018) as well as stunting (Akombi et al., 2017) which is in line with a well-d”
Quote in the paperNot a substantial claim0 of 3 sources checkedMay combine two claims.
FindingcitationPregnant women who experienced a natural disaster reported a lack of access to basic water and maternal care which added physical and psychological stress.
“Furthermore, pregnant women who experienced a natural disaster reported a lack of access to basic water and maternal care which added physical and psychological stress (Sato et al., 2016).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Sato et al., 2016 source
Not checked in the free run.
May combine two claims.
Findingown dataOf the 13 interventional studies included, eight examined water access, eight assessed sanitation, six assessed hygiene, and one assessed MHM.
“Of the 13 interventional studies included, eight examined water access, eight assessed sanitation, six assessed hygiene, and one assessed MHM.”
Quote in the paperNot a substantial claimMay combine two claims.
FindingcitationMaternal demographic factors, including mother's BMI, age, education level, and lack of employment, were all found to increase the risk of disease in children.
“Demographic factors, including the mother's BMI (Marinda et al., 2018;Prado et al., 2019), age (Dendup et al., 2018), education level (Nasr et al., 2013;Hasan and Richardson, 2017;Akachi et al., 2018;Prado et al., 2019), and lack of employment (Atalabi et al., 2016) were all found to increase the risk of disease in children.”
Quote in the paperNot a substantial claim0 of 3 sources checkedMay combine two claims.
FindingcitationOne in 10 students missed school due to menstruation, and this could in part be attributed to menstrual stigma.
“Davis et al. (2018) demonstrated how one in 10 students missed school due to menstruation, and this could, in part be attributed to menstrual stigma.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Davis et al., 2018 source
Not checked in the free run.
May combine two claims.
FindingcitationImproved sanitation and handwashing reduced under-five mortality, schistosomiasis, and acquiring other soil-transmitted helminths and parasites.
“Other aspects of WASH, including improved sanitation and handwashing, likewise reduced underfive mortality (Ahmed et al., 2016;Dendup et al., 2018), and schistosomiasis (Donohue et al., 2017), or acquiring other soiltransmitted helminths and parasites (Baker et al., 2018).”
Quote in the paperSubstantial claim0 of 3 sources checkedMay combine two claims.
FindingcitationWomen who fetched water from a drill pipe may be at increased exposure to lead, as the blood of first-trimester pregnant women was recorded to have elevated levels of lead.
“Women who fetched water from a drill pipe may also be at increased exposure to toxins, including lead as the blood of first-trimester pregnant women was recorded to have elevated levels of toxin lead (Guy et al., 2018).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Guy et al., 2018 source
Not checked in the free run.
May combine two claims.
Findingown dataIn total, 16 (48%) studies assessed childhood health and childhood infectious diseases, mainly centering on under-five mortality (15%), schistosomiasis/intestinal parasites (18%), and child stunting (12%).
“In total, 16 (48%) studies assessed childhood health and childhood infectious diseases, mainly centering on under-five mortality (15%), schistosomiasis/intestinal parasites (18%), and childstunting (12%).”
Quote in the paperNot a substantial claimMay combine two claims.
FindingcitationMales, but not females who fetched water >15 min, prioritized improving access to water over improving access to health services.
“Interestingly, males, but not females who fetched water >15 min, prioritized improving access to water over improving access to health services (Hunter, 2006).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Hunter, 2006 source
Not checked in the free run.
May combine two claims.
FindingreasoningWomen and girls, as a result of their role as water purveyors, were at risk of exposure to contaminated water and of sustaining musculoskeletal trauma.
“In addition, we found that women and girls, as a result of their role as water purveyors, were at risk of exposure to contaminated water and of sustaining musculoskeletal trauma.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataIn total, 71% of identified studies reported a health outcome, suggesting an intersection of water and gender with health.
“In total, 71% of identified studies reported a health outcome, suggesting an intersection of water and gender with health.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataA limited number of studies directly compared gender differences in accessing WASH resources, and an even smaller fraction (N = 5, 8.5%) reported sex-disaggregated outcomes.
“A limited number of studies directly compared gender differences in accessing WASH resources, and an even smaller fraction (N = 5, 8.5%) reported sex-disaggregated outcomes.”
Quote in the paperNot a substantial claimMay combine two claims.
FindingcitationAn intervention that provided mothers with treated water was successful in reducing diarrhea in school children by 40% and was considered a feasible solution by the participating mothers.
“An intervention that provided mothers with treated water was successful in reducing diarrhea in school children by 40% and was considered a feasible solution by the participating mothers (Rose et al., 2006).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Rose et al., 2006 source
Not checked in the free run.
May combine two claims.
FindingcitationA face washing intervention reduced the incidence of trachoma, which had a reported higher incidence in girls than boys.
“A face washing intervention reduced the incidence of trachoma (West et al., 1996), which had a reported higher incidence in girls than boys.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites West et al., 1996 source
Not checked in the free run.
May combine two claims.
FindingcitationProviding mothers with soap reduced diarrhea by 90% in children, as well as respiratory tract infections in school-children, and improved long-term hand hygienic practices.
“Providing mothers with soap reduced diarrhea by 90% in children, as well as respiratory tract infections in school-children (Alzaher et al., 2018), and improved longterm hand hygienic practices (Wilson and Chandler, 1993;Cairncross et al., 2005).”
Quote in the paperNot a substantial claim0 of 3 sources checkedMay combine two claims.
FindingcitationUse of filters corresponded to small improvements in water quality and a minor reduction in the incidence of cholera.
“Similarly, the use of filters corresponded to small improvements in water quality (Huq et al., 2010), and a minor reduction in the incidence of cholera (Pickering et al., 2017).”
Quote in the paperNot a substantial claim0 of 2 sources checkedMay combine two claims.
Findingown dataKey themes from our search included that women and girls face barriers toward accessing basic sanitation and hygiene resources, including a lack of secure and private sanitation and of Menstrual Hygiene Management (MHM) resources.
“Key themes from our search included that women and girls face barriers toward accessing basic sanitation and hygiene resources, including a lack of secure and private sanitation and of Menstrual Hygiene Management (MHM) resources.”
Quote in the paperSubstantial claimMay combine two claims.
FindingcitationEducation can reduce the incidence of diarrhea and improve overall health.
“Qualitative assessments of educational interventions suggest that education can reduce the incidence of diarrhea (Williams et al., 2015) and improve overall health (Magnin et al., 2018).”
Quote in the paperNot a substantial claim0 of 2 sources checkedMay combine two claims.
FindingcitationInterventions focused on construction of latrines and toilets were successful in reducing incidence of diarrhea, improving overall health, and providing more women with privacy and safety necessary to attend to menstrual health needs.
“Interventions that focused on the construction of latrines and toilets were successful in reducing the incidence of diarrhea (Chaudhuri, 2017), improving overall health (Katsivo et al., 1993), and providing more women with the privacy and safety necessary to attend to their menstrual health needs (Chaudhuri, 2017).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Chaudhuri, 2017 source
Not checked in the free run.
- cites Katsivo et al., 1993
Not checked in the free run.
May combine two claims.
FindingcitationA comprehensive intervention combining hand-pumps, latrines, and hygiene education demonstrated significant success after a 7-years follow-up, increasing households using improved WASH practices, reducing bacteria on hands of mothers, and reducing incidence of diarrhea in children.
“Furthermore, a comprehensive intervention which combined hand-pumps, latrines, and hygiene education demonstrated significant success after a 7-years follow-up, drastically increasing the number of households using improved WASH practices, reducing bacteria on the hands of mothers, and consequently the incidence of diarrhea in children (Hoque et al., 1996).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Hoque et al., 1996
Not checked in the free run.
May combine two claims.
Findingown dataA majority of studies exhibited a lower risk of bias, often deploying appropriate sampling strategies.
“In clarifying the reliability of our identified findings, a majority of studies exhibited a lower risk of bias, often deploying appropriate sampling strategies.”
Quote in the paperNot a substantial claimMay combine two claims.
FindingcitationGirls' emotions surrounding MHM can include sadness, stress/anxiety, physical discomfort, feeling dirty, and shame, and consequently, engendered needs are often silenced.
“For instance, girls' emotions surrounding MHM can include sadness, stress/anxiety, physical discomfort, feeling dirty, and shame, and consequently, engendered needs are often silenced (McMahon et al., 2011;Naeem et al., 2015).”
Quote in the paperNot a substantial claim0 of 2 sources checkedMay combine two claims.
Findingnone givenInterventions were generally effective in reducing WASH inequities and poor health outcomes.
“Interventions were generally effective in reducing WASH inequities and poor health outcomes.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataWASH interventions can be successful in reducing both WASH inequities and disease.
“Our analysis of interventions to improve WASH can be successful in reducing both WASH inequities and disease; however, a focus is needed to ensure their long-term maintenance and usage.”
Quote in the paperSubstantial claimMay combine two claims.
FindingcitationStigma becomes an entrenched psyche, which actively promotes mental and physical distress, and its effects can be seen with regard to MHM.
“However, more than restricting access to WASH, stigma becomes an entrenched psyche, which actively promotes mental and physical distress and its pernicious effects can be readily seen with regard to MHM (Sommer et al., 2015a).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Sommer et al., 2015a
Not checked in the free run.
May combine two claims.
FindingcitationWomen and girls remain particularly disenfranchised due to their role as water purveyors and homemakers, gender roles which exacerbate the risk for health burdens and sexual assault.
“Women and girls remain particularly disenfranchised, for example, due to their role as water purveyors and homemakers, gender roles which exacerbate the risk for health burdens (Sommer et al., 2015b;Gaspar et al., 2017;Geere et al., 2018;Guy et al., 2018), and sexual assault.”
Quote in the paperSubstantial claim0 of 3 sources checkedMay combine two claims.
FindingcitationWomen had greater levels of WASH knowledge and were better at retaining WASH-related education.
“To this end, some reports indicated that women had greater levels of WASH knowledge and were better at retaining WASH-related education (Cairncross et al., 2005;Williams et al., 2015).”
Quote in the paperSubstantial claim0 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe systematic review was conducted using PRISMA guidelines.
“We conducted a systematic review using a broad-based content analysis through the PRISMA guidelines.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable), S4 (based).
Premisenone givenA detailed understanding of the interlinkages between water and gender is lacking.
“Despite this, a detailed understanding of the interlinkages between water and gender is lacking.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationUrinary tract infections as a result of poor MHM practices can result in school absences and an overall reduced education.
“Likewise, urinary tract infections (UTI's) as a result of poor MHM practices, can result in school absences and an overall reduced education (Sommer et al., 2016).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Sommer et al., 2016 source
Not checked in the free run.
May combine two claims.
PremisecitationMHM is instrumental in progressing women's and girls' ability to manage their menstrual periods safely and with dignity, thereby allowing them to participate in school, work, and other activities.
“MHM is instrumental in progressing women's and girls' ability to manage their menstrual periods safely and with dignity; thereby, allowing them to participate in school, work, and other activities (Sommer et al., 2016).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Sommer et al., 2016 source
Not checked in the free run.
May combine two claims.
InterpretationreasoningBoth infrastructural and educational interventions are successful in reducing WASH inequities and improving health outcomes.
“Both Infrastructural and Educational Interventions Are Successful in Reducing WASH Inequities and Improving Health Outcomes”
Quote in the paperSubstantial claimMay combine two claims.
InterpretationcitationA lack of privacy and security were related to women emptying bags and buckets at night, a behavior that can often increase the exposure of women to the threat of violence or sexual assault.
“In particular, a lack of privacy and security were related to women emptying bags and buckets at night, a behavior that can often increase the exposure of women to the threat of violence or sexual assault (Winter et al., 2019).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Winter et al., 2019 source
Not checked in the free run.
May combine two claims.
InterpretationreasoningSignificant WASH inequities in women and girls further manifest as health burdens, providing strong evidence that the water-gender-nexus intersects with health.
“Significant WASH inequities in women and girls further manifest as health burdens, providing strong evidence that the water-gender-nexus intersects with health.”
Quote in the paperSubstantial claimMay combine two claims.
InterpretationreasoningAddressing gender and water inequities holds the potential to alleviate disease burden and have a significant impact on achieving SDGs three, five, and six.
“Thus, addressing gender and water inequities holds the potential to alleviate disease burden and have a significant impact on achieving the SDGs, including SDG three, five, and six.”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationnone givenOccupational health risks result from chronically carrying water and being exposed to contaminated water, as well as risks for infection due to poor sanitation and hygiene.
“These include occupational health risks as a result of chronically carrying water and being exposed to contaminated water, as well as risks for infection due to poor sanitation and hygiene.”
Quote in the paperSubstantial claimMay combine two claims.
InterpretationreasoningAddressing the water-gender nexus will help manage disease burdens and have a more significant impact on achieving the targets of SDGs three, five, and six in tandem.
“This analysis supports the conjecture that addressing the water-gender nexus will help manage disease burdens and have a more significant impact on achieving the targets of SDGs three, five, and six in tandem.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).
Interpretationnone givenElevating women to leadership positions may aid in reducing cultural engendered power imbalances which actively suppress the human development of women and girls.
“Simultaneously, elevating women to leadership positions may aid in reducing cultural engendered power imbalances which actively suppress the human development of women and girls.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable).
Interpretationnone givenThere is a strong need for increasing MHM resources, which are instrumental in supporting women's health, education, and human development.
“In particular, there is a strong need for increasing MHM resources which are instrumental in supporting women's health, education, and human development.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim. May combine two claims.
PremisecitationModest progress has been made to meet the targets of the 2030 Agenda, but a specific focus on gender issues is lacking.
“The SDG 6 synthesis reports that modest progress has been made to meet the targets of the 2030 Agenda; however, a specific focus on gender issues is lacking.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites SDG 6 synthesis report
Not checked in the free run.
Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).
InterpretationcitationImproving the status of women through gender mainstreaming represents an important first step in reducing the impact of cultural norms.
“Improving the status of women through gender mainstreaming represents an important first step in reducing the impact of cultural norms (UN Women, 2017).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites UN Women, 2017
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe search method was restricted to English, which is a limitation.
“Finally, the search method was restricted to English, and thus, this is acknowledged as a limitation.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable).
InterpretationreasoningA focus is needed to ensure long-term maintenance and usage of WASH interventions.
“Our analysis of interventions to improve WASH can be successful in reducing both WASH inequities and disease; however, a focus is needed to ensure their long-term maintenance and usage.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).
Interpretationnone givenHazards in SDG target 3.9 represent occupational hazards for women and girls.
“Likewise, target 3.9 calls for substantial reduction of the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination, hazards which we contend represent occupational hazards for women and girls.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable). May combine two claims.
InterpretationcitationSustainability and the empowerment of women will necessarily require efforts to break engendered cultural norms and support the empowerment of women.
“While we recognize that behavioral change is a gradual process, sustainability and the empowerment of women will necessarily require efforts to break engendered cultural norms, and support the empowerment of women-critical steps to promote women's human development, and more broadly, sustainable development (Dery et al., 2019).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Dery et al., 2019 source
Not checked in the free run.
- Rests on an assumption: Behavioral change is a gradual process.
May combine two claims.
InterpretationreasoningAddressing inequities in the water-gender nexus will have wider-reaching network effects, including supporting women's health and by extension their empowerment.
“Thus, addressing inequities in the water-gender nexus will have wider-reaching network effects, including supporting women's health, and by extension their empowerment, as outlined in various SDG five targets, including 5.c (i.e., adopt and strengthen sound policies and enforceable legislation for the promotion of gender equality and the empowerment of all women and girls at all levels).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.
Premisenone givenAll 17 SDGs are explicitly and implicitly related to water, while only a fifth of SDG indicators refer to gender or sex.
“All 17 SDGs are explicitly and implicitly related to water, while only a fifth of SDG indicators refer to gender or sex.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable).
InterpretationreasoningEnsuring that a gendered perspective is included when developing capacity is essential to reducing engendered WASH inequities at scale.
“Thus, ensuring that a gendered perspective is included when developing capacity is essential to reducing engendered WASH inequities at scale.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing), S4 (based).
Interpretationnone givenThe interconnections among SDG three, five, and six also extend to other SDGs, including labor markets (SDG 8), political participation (SDG 10), poverty (SDG 1), peaceful and inclusive societies (SDG 16).
“It is also important to recognize that the interconnections that occur among SDG three, five, and six also extend to other SDGs, including; labor markets (SDG 8), political participation (SDG 10), poverty (SDG 1), peaceful and inclusive societies (SDG 16), among others.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
InterpretationcitationIncluding female perspectives may help elevate gender-based priorities, such as that when latrines are constructed, they include locks, are private, and are well-lit, in order to promote safety and increase access for women and girls.
“Including female perspectives may help elevate gender-based priorities (Dery et al., 2019), such as that when latrines are constructed, they include locks, are private, and are well-lit, in order to promote safety and therein increase access for women and girls.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Dery et al., 2019 source
Not checked in the free run.
Probably not a substantial claim: may not pass S2 (checkable).
InterpretationreasoningWomen and girls possess a particularly germane perspective which is needed to ensure that engendered WASH-related barriers are elevated and considered by policymakers and decisionmakers.
“Therefore, women and girls possess a particularly germane perspective which is needed to ensure that engendered WASHrelated barriers are elevated and considered by policymakers and decisionmakers.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationHandwashing with soap and water is a top priority for reducing disease transmission.
“Irrespective of gender, the SDG six synthesis report (2018) has recognized handwashing with soap and water as a top priority for reducing disease transmission; however, gender disparities largely have not been recognized (United Nations, 2018).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites United Nations, 2018
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataStatistics are not reported in the Alzaher et al. (2018) study.
“Statistics are not reported.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Alzaher et al. (2018) source
Not checked in the free run.
The paper relies on this without support.
The MEDLINE database search is sufficient to identify all relevant research articles on water, gender, and health.
“We searched the MEDLINE database to identify research articles related to water (i.e., WASH), gender, and sustainability.”
The paper relies on this without support.
The included studies' findings can be meaningfully synthesized despite differences in design, setting, and outcome definitions.
“An analysis of both observational and interventional studies was undertaken.”
The paper relies on this without support.
WASH-related challenges among women are often exacerbated by women's general reduced agency in low-resource settings.
“In general, WASH-related challenges among women are often exacerbated by women's general reduced agency in low-resource settings and need to be appropriately addressed to ensure gender equity objectives.”
The paper relies on this without support.
The promising effects of interventions observed in the included studies are generalizable to other low-resource settings.
“Educational, infrastructural, and programmatic interventions showed promise in reducing WASH and health outcomes.”
The paper relies on this without support.
In Bangladesh, more than two thirds of women factory workers lose 6 days of work per month because of a lack of safe places to change menstrual pads/cloths and the absence of disposal sites.
“In Bangladesh, where four out of five factory workers are women, more than two thirds loose 6 days of work in a month because of a lack of safe places to change their menstrual pads/cloths and the absence of disposal sites.”
The paper relies on this without support.
Gender-inequity is in part facilitated by stigma, engendered cultural norms, and a societal power imbalance.
“Gender-inequity is in part facilitated by stigma, engendered cultural norms, and a societal power imbalance.”
The paper relies on this without support.
Methods to address stigma remain in their infancy, especially in LMICs.
“While methods to address stigma remain in their infancy, especially in LMICs, interventions are needed to raise awareness on the importance of engendered WASH priorities, to ensure that the needs of women and girls are underscored.”
The paper relies on this without support.
Behavioral change is a gradual process.
“While we recognize that behavioral change is a gradual process, sustainability and the empowerment of women will necessarily require efforts to break engendered cultural norms, and support the empowerment of women-critical steps to promote women's human development, and more broadly, sustainable development (Dery et al., 2019).”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Girls and women experience a high burden of household water management including water-based chores and water collection, and may receive blame and/or violence when insufficient water access disrupts household expectations.
“Girls and women, in particular, experience a high burden of household water management including water-based chores (i.e., cooking and cleaning) and water collection (i.e., fetching household water), and may receive blame and/or violence when insuf fi cient water access disrupts household expectations (Geere et al. 2018; Brewis et al . 2019; Pouramin et al. 2020).”
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 Pouramin et al. 2020
The Introduction and Synthesized Findings say women and girls disproportionately collect household water and bear the burden of fetching it. The review does not establish the specified cooking and cleaning burden or blame or violence when insufficient water disrupts household expectations. Its discussion of violence concerns unsafe sanitation facilities, a different circumstance. (LLM, conf=0.87)
Experimental — accuracy not yet measuredWASH-GBV stressors are well articulated in non-humanitarian contexts.
“While WASH-GBV stressors are well articulated in non-humanitarian contexts (Bisung & Elliott 2017; Pouramin et al . 2020; Wutich 2020; Nunbogu & Elliott 2022)”
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 Pouramin et al . 2020
Our review is more expansive and rigorous than recent WASH and gender or empowerment-focused reviews that restricted inclusion based on publication date, only extracted data from titles and abstracts, or focused more narrowly on the intersection of gender, water, and health or on identifying the dimensions of empowerment used in WASH research.
“Our review is more expansive and rigorous than recent WASH and gender or empowerment-focused reviews that restricted inclusion based on publication date, [39] only extracted data from titles and abstracts, [39] or focused more narrowly on the intersection of gender, water, and health [40] or on identifying the dimensions of empowerment used in WASH research [38].”
From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [40]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Adult disease comparison is attributed to a study of children
MajorThe text identifies Al-Delaimy et al. as the sole direct comparison of waterborne disease in adults. Table 1 describes its participants as schoolchildren aged 6-12, not adults.
“A single study directly analyzed the effect of gender on the frequency of waterborne diseases in adults, and found no gender differences (Al-Delaimy et al., 2014).”
“Al-Delaimy et al. (2014) Malaysia | Cross-sectional 498 school | Intestinal parasitic infections”
Donohue study country differs between table and citation
MinorThe study summary places Donohue et al. in Kenya, whereas its cited title says the schoolchildren were in Tanzania.
“Donohue et al. (2017) Kenya Cross-sectional 1,704 school children”
“Biosocial determinants of persistent schistosomiasis among schoolchildren in Tanzania despite repeated treatment.”
Review counts one randomized trial but lists two
MinorThe risk-of-bias section counts one randomized trial, the school intervention. Table 2 also describes the separate West et al. face-washing study as randomized.
“Finally, one study deployed a randomized control trial to assess the effectiveness of a school intervention”
“West et al. (1996) | Kongwa, | A randomized, | 240 households, a total”
Hoque follow-up is reported as both seven and five years
MinorThe results call the Hoque et al. follow-up seven years, while the cited paper's title calls it a five-year follow-up.
“a comprehensive intervention which combined hand-pumps, latrines, and hygiene education demonstrated significant success after a 7-years follow-up”
“Sustainability of a water, sanitation and hygiene education project in rural Bangladesh: a 5-year follow-up.”
Marinda study country differs between table and citation
MinorTable 1 places Marinda et al. in Namibia, whereas the cited paper's title identifies Zambia.
“Marinda et al. (2018) | Namibia”
“Dietary diversity determinants and contribution of fish to maternal and under-five nutritional status in Zambia.”
Cholera reduction is attributed to a study with no health component
MinorThe text attributes reduced cholera incidence to Pickering et al., but Table 2 lists that study's health component as N/A. The same table instead reports a 25% reduction in cholera-related hospital visits for Huq et al.
“a minor reduction in the incidence of cholera (Pickering et al., 2017).”
“Pickering et al. (2017) | Country Bunoma, Kakamega, Vihiga, and Busia, Kenya, (rural population, | Study design Cross-sectional | Sample size 499 households at 6 months, 531 households at 18 months, and 7,691 household at 24-36 months | Health component N/A”
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The Impact of Aerosols on Solar Ultraviolet Radiation and Photochemical Smog
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A Time for Global Action: Addressing Girls’ Menstrual Hygiene Management Needs in Schools
Sommer, M., Caruso, B. A., Sahin, M., Calderon, T., Cavill, S., Mahon, T., & Phillips-Howard, P. A. (2016) · PLOS Medicine · doi:10.1371/journal.pmed.1001962 · Cited by 435 · cited 2× · see citing works
“Likewise, urinary tract infections (UTI’s) as a result of poor MHM practices, can result in school absences and an overall reduced education (Sommer et al., 2016).”
BackgroundSommer, M., Hirsch, J. S., Nathanson, C., & Parker, R. G. (2015) · American Journal of Public Health · doi:10.2105/ajph.2014.302525 · Cited by 401 · see citing works
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“Considering that in low-resource settings women have reduced agency to make healthcare decisions, the impacts of disease and disability are likely to be further magnified (Osamor and Grady, 2016).”
BackgroundMason, L., Nyothach, E., Alexander, K., Odhiambo, F. O., Eleveld, A., Vulule, J., Rheingans, R., Laserson, K. F., Mohammed, A., & Phillips-Howard, P. A. (2013) · PLoS ONE · doi:10.1371/journal.pone.0079132 · Cited by 375 · see citing works
Stunting and severe stunting among children under-5 years in Nigeria: a multilevel analysis
Akombi, B. J., Agho, K. E., Hall, J. J., Merom, D., Astell-Burt, T., & Renzaho, A. M. N. (2017) · BMC Pediatrics · doi:10.1186/s12887-016-0770-z · Cited by 322 · cited 1× · see citing works
“Studies which considered gender likewise revealed a lack of access to improved water for both men and women alike (Ugbomoiko et al., 2009; Al-Delaimy et al., 2014; Atalabi et al., 2016; Holvoet et al., 2016; Akombi et al., 2017; Baker et al., 2018).”
BackgroundMcMahon, S. A., Winch, P. J., Caruso, B. A., Obure, A. F., Ogutu, E. A., Ochari, I. A., & Rheingans, R. D. (2011) · BMC International Health and Human Rights · doi:10.1186/1472-698x-11-7 · Cited by 316 · see citing works
Alam, K., & Mahal, A. S. (2014) · Globalization and Health · doi:10.1186/1744-8603-10-21 · Cited by 272 · see citing works
Violence, gender and WASH: spurring action on a complex, under-documented and sensitive topic
Sommer, M., Ferron, S., Cavill, S., & House, S. (2015) · Environment and Urbanization · doi:10.1177/0956247814564528 · Cited by 230 · see citing works
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“Assessing Risk of Bias We assessed the risk for bias in individual studies using a previously validated adaptation of the Cochrane risk of bias instrument (Akl et al., 2012).”
MethodThe toilet tripod: Understanding successful sanitation in rural India
O’Reilly, K., & Louis, E. (2014) · Health & Place · doi:10.1016/j.healthplace.2014.05.007 · Cited by 170 · see citing works
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Solar disinfection of water for diarrhoeal prevention in southern India
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Risk factors for constant, severe trachoma among preschool children in Kongwa, Tanzania
West, S. K., Munoz, B., Lynch, M., Kayongoya, A., Mmbaga, B. B. O., & Taylor, H. R. (1996) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a008659 · Cited by 114 · see citing works
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“T h e W a te r-G e n d e r N e xu s a n d H e a lth TABLE 1 | Continued References Country Study design Sample size Health component WASH outcome Gender outcome Sex disaggregated Conclusion Al-Delaimy et al. (2014) Malaysia Cross-sectional 498 school children aged 6–12 years old Intestinal parasitic infections Access…”
BackgroundInfluentialEpidemiology of intestinal polyparasitism among Orang Asli school children in rural Malaysia
Al-Delaimy, A. K., Al-Mekhlafi, H. M., Nasr, N. A., Sady, H., Atroosh, W. M., Nashiry, M., Anuar, T. S., Moktar, N., Lim, Y. A. L., & Mahmud, R. (2014) · PLoS neglected tropical diseases · doi:10.1371/journal.pntd.0003074 · Cited by 110 · cited 1× · see citing works
“Studies which considered gender likewise revealed a lack of access to improved water for both men and women alike (Ugbomoiko et al., 2009; Al-Delaimy et al., 2014; Atalabi et al., 2016; Holvoet et al., 2016; Akombi et al., 2017; Baker et al., 2018).”
BackgroundWhat causes sustainable changes in hygiene behaviour? A cross-sectional study from Kerala, India
Cairncross, S., Shordt, K., Zacharia, S., & Govindan, B. K. (2005) · Social Science & Medicine · doi:10.1016/j.socscimed.2005.04.019 · Cited by 108 · cited 4× · see citing works
“To this end, some reports indicated that women had greater levels of WASH knowledge and were better at retaining WASH-related education (Cairncross et al., 2005; Williams et al., 2015).”
BackgroundInfluentialKapito-Tembo, A. P., Mwapasa, V., Meshnick, S. R., Samanyika, Y., Banda, D., Bowie, C., & Radke, S. (2009) · PLoS neglected tropical diseases · doi:10.1371/journal.pntd.0000361 · Cited by 108 · see citing works
Descending the sanitation ladder in urban Uganda: evidence from Kampala Slums
Kwiringira, J., Atekyereza, P., Niwagaba, C., & Günther, I. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-624 · Cited by 96 · see citing works
Angoua, E. L. E., Dongo, K., Templeton, M. R., Zinsstag, J., & Bonfoh, B. (2018) · PLOS ONE · doi:10.1371/journal.pone.0202928 · Cited by 95 · cited 4× · see citing works
“Sanitation facilities were commonly cited to not be safe, clean, and accessible (Kwiringira et al., 2014; Sato et al., 2016; Khan et al., 2017; Aluko et al., 2018; Angoua et al., 2018; Dendup et al., 2018; Desalegn et al., 2018; Njuguna, 2019; Winter et al., 2019).”
BackgroundInfluentialEpidemic cholera in Kakuma Refugee Camp, Kenya, 2009: the importance of sanitation and soap
Mahamud, A. S., Ahmed, J. A., Nyoka, R., Auko, E., Kahi, V., Ndirangu, J., Nguhi, M., Burton, J. W., Muhindo, B. Z., Breiman, R. F., et al. (2011) · The Journal of Infection in Developing Countries · doi:10.3855/jidc.1966 · Cited by 89 · see citing works
Huq, A., Yunus, M., Sohel, S. S., Bhuiya, A., Emch, M., Luby, S. P., Russek-Cohen, E., Nair, G. B., Sack, R. B., & Colwell, R. R. (2010) · mBio · doi:10.1128/mbio.00034-10 · Cited by 87 · cited 18× · see citing works
“T h e W a te r-G e n d e r N e xu s a n d H e a lth TABLE 1 | Continued References Country Study design Sample size Health component WASH outcome Gender outcome Sex disaggregated Conclusion Al-Delaimy et al. (2014) Malaysia Cross-sectional 498 school children aged 6–12 years old Intestinal parasitic infections Access…”
BackgroundInfluentialMarinda, P. A., Genschick, S., Khayeka-Wandabwa, C., Kiwanuka-Lubinda, R., & Thilsted, S. H. (2018) · PLoS ONE · doi:10.1371/journal.pone.0204009 · Cited by 86 · see citing works
Nasr, N. A., Al-Mekhlafi, H. M., Ahmed, A., Roslan, M. A., & Bulgiba, A. (2013) · Parasites & Vectors · doi:10.1186/1756-3305-6-28 · Cited by 79 · see citing works
Listening to the community: Using formative research to strengthen maternity waiting homes in Zambia
Scott, N., Vian, T., Kaiser, J. L., Ngoma, T., Mataka, K., Henry, E. G., Biemba, G., Nambao, M., & Hamer, D. H. (2018) · PLoS ONE · doi:10.1371/journal.pone.0194535 · Cited by 79 · see citing works
Bisung, E., & Elliott, S. J. (2018) · Social Science & Medicine · doi:10.1016/j.socscimed.2018.01.001 · Cited by 76 · cited 1× · see citing works
“However, Bisung and Elliott (2018) showed that female-headed households had reduced access to water security (Bisung and Elliott, 2018).”
BackgroundUnderstanding empowerment in water, sanitation, and hygiene (WASH): a scoping review
Dery, F., Bisung, E., Dickin, S., & Dyer, M. (2020) · Journal of Water, Sanitation and Hygiene for Development · doi:10.2166/washdev.2019.077 · Cited by 74 · see citing works
Ahmed, S. M., Rawal, L. B., Chowdhury, S. A., Murray, J., Arscott-Mills, S., Jack, S., Hinton, R., Alam, P. M., & Kuruvilla, S. (2016) · Bulletin of the World Health Organization · doi:10.2471/blt.15.168450 · Cited by 71 · see citing works
Desalegn, B. B., Lambert, C., Riedel, S., Negese, T., & Biesalski, H. K. (2018) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph15081767 · Cited by 67 · cited 3× · see citing works
“For example, religious, new mothers who were fasting and did not have access to improved water or sanitation were more likely to be underweight (Desalegn et al., 2018).”
BackgroundSustained improvements in hygiene behaviour amongst village women in Lombok, Indonesia
Wilson, J. M., & Chandler, G. N. (1993) · Transactions of the Royal Society of Tropical Medicine and Hygiene · doi:10.1016/0035-9203(93)90260-w · Cited by 65 · see citing works
Inobaya, M. T., Chau, T. N. P., Ng, S., et al. (2018) · Parasites & Vectors · doi:10.1186/s13071-018-3022-2 · Cited by 62 · see citing works
Prado, E. L., Jimenez, E. Y., Vosti, S. A., Stewart, R. C., Stewart, C. P., Some, J. W., Pulakka, A., Ouédraogo, J., Okronipa, H., Ocansey, E., et al. (2019) · BMJ Global Health · doi:10.1136/bmjgh-2018-001155 · Cited by 59 · cited 1× · see citing works
“Synthesized Findings Women Are the Primary Water Purveyors, Particularly in the Developing Regions of the World Largely, the identified observational studies (Table 1) emphasized issues in accessing clean water among women and girls, and described that a lack of clean water and water resources negatively contributed t…”
BackgroundProgress in sanitation among poor households in Kenya: evidence from demographic and health surveys
Njuguna, J. (2019) · BMC Public Health · doi:10.1186/s12889-019-6459-0 · Cited by 50 · cited 3× · see citing works
“In addition, Njuguna (2019) showed that in Kenya, in 2004 and 2008, but not 2014, female-headed households were more likely to openly defecate than male-headed households.”
BackgroundOberoi, S., Mohanty, V., Mahajan, A., & Oberoi, A. (2014) · Journal of Indian Society of Periodontology · doi:10.4103/0972-124x.134580 · Cited by 49 · see citing works
Dendup, T., Zhao, Y., & Dema, D. (2018) · BMC Public Health · doi:10.1186/s12889-018-6308-6 · Cited by 47 · see citing works
Khan, S. M., Bain, R. E. S., Lunze, K., Unalan, T., Beshanski-Pedersen, B., Slaymaker, T., Johnston, R., & Hancioglu, A. (2017) · PLOS ONE · doi:10.1371/journal.pone.0189089 · Cited by 46 · see citing works
Leahy, C., Winterford, K., Nghiem, T., Kelleher, J., Leong, L., & Willetts, J. (2017) · Gender & Development · doi:10.1080/13552074.2017.1331530 · Cited by 46 · see citing works
Levels and determinants of DDT and DDE exposure in the VHEMBE cohort
Gaspar, F. W., Chevrier, J., Quirós-Alcalá, L., Lipsitt, J. M., Barr, D. B., Holland, N., Bornman, R., & Eskenazi, B. (2017) · Environmental Health Perspectives · doi:10.1289/ehp353 · Cited by 40 · see citing works
Odetola, T. D., & Fakorede, E. O. (2018) · Annals of Global Health · doi:10.29024/aogh.10 · Cited by 40 · cited 1× · see citing works
“Odetola and Fakorede (2018) Nigeria Cross-sectional 66 women Satisfaction with perinatal care Access to clean water Attitudes of postpartum women.”
BackgroundLubon, A., Erchick, D. J., Khatry, S. K., et al. (2018) · BMC Oral Health · doi:10.1186/s12903-018-0564-9 · Cited by 40 · see citing works
Immediate needs and concerns among pregnant women during and after Typhoon Haiyan (Yolanda)
Sato, M., Nakamura, Y., Atogami, F., Horiguchi, R., Tamaki, R., Yoshizawa, T., & Oshitani, H. (2016) · PLoS Currents · doi:10.1371/currents.dis.29e4c0c810db47d7fd8d0d1fb782892c · Cited by 39 · cited 2× · see citing works
“Synthesized Findings Women Are the Primary Water Purveyors, Particularly in the Developing Regions of the World Largely, the identified observational studies (Table 1) emphasized issues in accessing clean water among women and girls, and described that a lack of clean water and water resources negatively contributed t…”
BackgroundAtalabi, T. E., Lawal, U., & Ipinlaye, S. J. (2016) · Parasites & Vectors · doi:10.1186/s13071-016-1672-5 · Cited by 38 · cited 1× · see citing works
“Studies which considered gender likewise revealed a lack of access to improved water for both men and women alike (Ugbomoiko et al., 2009; Al-Delaimy et al., 2014; Atalabi et al., 2016; Holvoet et al., 2016; Akombi et al., 2017; Baker et al., 2018).”
BackgroundYeasmin, F., Luby, S. P., Saxton, R. E., Nizame, F. A., Alam, M.-U., Dutta, N. C., Masud, A.-A., Yeasmin, D., Layden, A., Rahman, H., et al. (2017) · BMC Public Health · doi:10.1186/s12889-017-4693-x · Cited by 34 · cited 5× · see citing works
“Yeasmin et al. (2017)Bangladesh Longitudinal 24 adults for post-interviews N/A A waste bin and informational signs to indicate how to use the latrine/waste bin Access to improved sanitation, MHM; Considered gender differences No In general, the waste bins were well-accepted and were reported to…”
BackgroundInfluentialInobaya, M. T., Chau, T. N. P., Ng, S., et al. (2017) · International Journal of Infectious Diseases · doi:10.1016/j.ijid.2017.10.023 · Cited by 33 · see citing works
Hasan, M. M., & Richardson, A. (2017) · BMJ Open · doi:10.1136/bmjopen-2016-015019 · Cited by 32 · see citing works
Guy, M., Accrombessi, M., Fievet, N., Yovo, E., Massougbodji, A., Le Bot, B., Glorennec, P., Bodeau-Livinec, F., & Briand, V. (2018) · Environmental Research · doi:10.1016/j.envres.2018.06.054 · Cited by 32 · see citing works
Aiemjoy, K., Stoller, N. E., Gebresillasie, S., Shiferaw, A., Tadesse, Z., Sewent, T., Ayele, B., Chanyalew, M., Aragie, S., Callahan, K., et al. (2017) · The American Society of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.16-0541 · Cited by 30 · see citing works
Nyoka, R., Foote, A. D., Woods, E., Lokey, H., O’Reilly, C. E., Magumba, F., Okello, P., Mintz, E. D., Marano, N., & Morris, J. F. (2017) · PLoS ONE · doi:10.1371/journal.pone.0180864 · Cited by 30 · see citing works
Pickering, A. J., Arnold, B. F., Dentz, H. N., Colford, J. M., & Null, C. (2017) · Environmental Health Perspectives · doi:10.1289/ehp342 · Cited by 29 · see citing works
Alemu, Z. A., Ahmed, A. A., Yalew, A. W., Birhanu, B. S., & Zaitchik, B. F. (2017) · Archives of Public Health · doi:10.1186/s13690-017-0193-9 · Cited by 28 · see citing works
Ugbomoiko, U. S., Dalumo, V., Ofoezie, I. E., & Obiezue, R. N. N. (2009) · Transactions of the Royal Society of Tropical Medicine and Hygiene · doi:10.1016/j.trstmh.2008.12.014 · Cited by 27 · cited 3× · see citing works
“…most studies focused on children determining that boys were at greater risk for contracting both schistosomiasis (Kapito-Tembo et al., 2009; Ugbomoiko et al., 2009; Atalabi et al., 2016; Donohue et al., 2017) and hookworm infections (Baker et al., 2018) as well as stunting (Akombi et al.,…”
BackgroundChaudhuri, I. N. (2017) · Frontiers in Public Health · doi:10.3389/fpubh.2017.00213 · Cited by 26 · cited 3× · see citing works
“…Nexus and Health Interventions that focused on the construction of latrines and toilets were successful in reducing the incidence of diarrhea (Chaudhuri, 2017), improving overall health (Katsivo et al., 1993), and providing more women with the privacy and safety necessary to attend to their…”
BackgroundInfluentialWinter, S., Dreibelbis, R., & Barchi, F. (2019) · Global Public Health · doi:10.1080/17441692.2018.1534256 · Cited by 24 · see citing works
Williams, H. A., Gaines, J., Patrick, M., Berendes, D., Fitter, D., & Handzel, T. (2015) · PLoS ONE · doi:10.1371/journal.pone.0142778 · Cited by 23 · see citing works
Acheampong, M., Ejiofor, C., & Salinas-Miranda, A. (2017) · Maternal and Child Health Journal · doi:10.1007/s10995-017-2260-9 · Cited by 22 · cited 16× · see citing works
“…studies showed that maternal, or household access to clean water significantly reduced the risk of under-five mortality (Ahmed et al., 2016; Acheampong et al., 2017, 2018), child stunting (Akombi et al., 2017; Vos et al., 2017; Marinda et al., 2018), schistosomiasis (Atalabi et al., 2016;…”
BackgroundInfluentialAkachi, Y., Steenland, M. W., & Fink, G. (2017) · International Journal of Epidemiology · doi:10.1093/ije/dyx262 · Cited by 21 · see citing works
Baker, J. M., Trinies, V., Bronzan, R. N., et al. (2018) · PLoS neglected tropical diseases · doi:10.1371/journal.pntd.0006374 · Cited by 19 · cited 1× · see citing works
“Studies which considered gender likewise revealed a lack of access to improved water for both men and women alike (Ugbomoiko et al., 2009; Al-Delaimy et al., 2014; Atalabi et al., 2016; Holvoet et al., 2016; Akombi et al., 2017; Baker et al., 2018).”
BackgroundDonohue, R., Mashoto, K., Mubyazi, G., Madon, S., Malecela, M., & Michael, E. (2017) · Tropical Medicine and Infectious Disease · doi:10.3390/tropicalmed2040061 · Cited by 17 · see citing works
Aluko, O. O., Oloruntoba, E. O., Chukwunenye, U. A., Henry, E. U., & Ojogun, E. (2018) · Public Health · doi:10.1016/j.puhe.2018.09.013 · Cited by 17 · cited 1× · see citing works
“Sanitation facilities were commonly cited to not be safe, clean, and accessible (Kwiringira et al., 2014; Sato et al., 2016; Khan et al., 2017; Aluko et al., 2018; Angoua et al., 2018; Dendup et al., 2018; Desalegn et al., 2018; Njuguna, 2019; Winter et al., 2019).”
BackgroundHolvoet, N., Dewachter, S., & Molenaers, N. (2016) · Environmental Management · doi:10.1007/s00267-016-0760-9 · Cited by 16 · see citing works
Hunter, L. M. (2006) · Population Research and Policy Review · doi:10.1007/s11113-006-9002-9 · Cited by 15 · cited 3× · see citing works
“Hunter (2006) Ghana Cross-sectional 700 households, 1,624 individuals Considered the relative importance of accessing health services.”
BackgroundAlzaher, A. A., Almudarra, S. S., Mustafa, M. H., & Gosadi, I. M. (2018) · Saudi Medical Journal · doi:10.15537/smj.2018.10.23344 · Cited by 15 · cited 14× · see citing works
“T h e W a te r-G e n d e r N e xu s a n d H e a lth TABLE 1 | Continued References Country Study design Sample size Health component WASH outcome Gender outcome Sex disaggregated Conclusion Al-Delaimy et al. (2014) Malaysia Cross-sectional 498 school children aged 6–12 years old Intestinal parasitic infections Access…”
BackgroundInfluentialAcheampong, M., Ejiofor, C. O., & Salinas‐Miranda, A. (2017) · Maternal and Child Health Journal · doi:10.1007/s10995-017-2293-0 · Cited by 12 · see citing works
Activating the role of women in water projects
Kholif, M. T., & Elfarouk, A. M. (2014) · Water Science · doi:10.1016/j.wsj.2014.10.002 · Cited by 11 · cited 1× · see citing works
“In this respect, like others [Kholif and Elfarouk, 2014; Leahy et al., 2017; Dery et al., 2019; World Water Assessment Programme (UNESCOWWAP), 2019], we advocate for gendermainstreaming efforts when addressing WASH inequities.”
BackgroundMurat Sahin, M. S., Kamran Naeem, K. N., Simone Klawitter, S. K., & Abida Aziz, A. A. (2015) · Waterlines · doi:10.3362/1756-3488.2015.010 · Cited by 11 · see citing works
Access to human rights for persons using prosthetic and orthotic assistive devices in Sierra Leone
Magnusson, L., & Bickenbach, J. (2019) · Disability and Rehabilitation · doi:10.1080/09638288.2018.1515267 · Cited by 11 · cited 1× · see citing works
“Magnusson and Bickenbach (2018) Sierra Leone Cross-sectional 139 lower-limb prosthetics patients Access to healthcare services, and holistic measures of health.”
BackgroundBornman, M., Schlemmer, L., van der Walt, T., van Dyk, C., & Bouwman, H. (2012) · Transactions of the Royal Society of Tropical Medicine and Hygiene · doi:10.1016/j.trstmh.2012.04.007 · Cited by 10 · cited 2× · see citing works
“Synthesized Findings Women Are the Primary Water Purveyors, Particularly in the Developing Regions of the World Largely, the identified observational studies (Table 1) emphasized issues in accessing clean water among women and girls, and described that a lack of clean water and water resources negatively contributed t…”
BackgroundPerception of a schistosomiasis control project in rural Kenya by the beneficiaries.
Katsivo, M. N., Muthami, L. N., Karama, M., et al. (1993) · PubMed · Cited by 9 · see citing works
Acheampong, M., Ejiofor, C. O., Salinas‐Miranda, A., et al. (2018) · Annals of Global Health · doi:10.29024/aogh.9 · Cited by 6 · cited 3× · see citing works
“Acheampong et al. (2018) Africa Cross-sectional 43 countries Under-five mortality Access to an improved water source, improved sanitation Considered female employment and literacy rates.”
BackgroundMagnin, M., Jeannot, E., Voahangy, R., & Stoll, B. (2018) · Acta Paediatrica · doi:10.1111/apa.14267 · Cited by 5 · see citing works
Hall, D. C., & Le, Q. B. (2018) · Frontiers in Veterinary Science · doi:10.3389/fvets.2018.00154 · Cited by 5 · see citing works
In Sickness and Health: Views on Child Health From a Mayan Village
Braxton, M. E., & Larson, K. L. (2018) · Journal of Transcultural Nursing · doi:10.1177/1043659618794845 · Cited by 4 · see citing works
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2 of the 79 references couldn’t be matched to a known paper.
Research works printed but not linked: 4
- Mainstreaming gender in water and sanitation: literature review for the SA department of water and sanitation135 MornaC. Gend. Links2000
- Nagabhatla, 2019, UNESCO world water assessment programme (WWAP), 44
- 2017, Progress on Drinking Water, Sanitation, and Hygiene: 2017 Update and SDG Baselines
- 2019, Progress on Household Drinking Water, Sanitation, and Hygiene 2000–2017: Special Focus on Inequalities
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Adelodun, B., Ajibade, F. O., Ighalo, J. O., et al. (2020) · Environmental Research · doi:10.1016/j.envres.2020.110309 · Cited by 169 · see citing works
Water, 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 · see citing works
Roy, J., Prakash, A., Some, S., Singh, C., Kerr, R. B., Caretta, M. A., Conde, C., Rivera‐Ferre, M. G., Schuster‐Wallace, C. J., Tirado, C., et al. (2022) · Humanities and Social Sciences Communications · doi:10.1057/s41599-022-01266-6 · Cited by 81 · see citing works
Young, S. L., Bethancourt, H. J., Ritter, Z., & Frongillo, E. A. (2021) · BMJ Global Health · doi:10.1136/bmjgh-2021-006460 · Cited by 67 · see citing works
Community engagement in water, sanitation and hygiene in sub-Saharan Africa: does it WASH?
Tsekleves, E., Braga, M. F., Abonge, C. V., et al. (2022) · Journal of Water Sanitation and Hygiene for Development · doi:10.2166/washdev.2022.136 · Cited by 66 · see citing works
Modeling water inequality and water security: The role of water governance
Babuna, P., Yang, X., Tulcan, R. X. S., Bian, D., Takase, M., Guba, B. Y., Han, C., Awudi, D. A., & Li, M. (2022) · Journal of Environmental Management · doi:10.1016/j.jenvman.2022.116815 · Cited by 55 · see citing works
Inequality in infrastructure access and its association with health disparities
Tu, Y., Чэн, Б., Liao, C., Wu, S., An, J., Lin, C., Gong, P., Chen, B., Wei, H., & Xu, B. (2025) · Nature Human Behaviour · doi:10.1038/s41562-025-02208-3 · Cited by 55 · see citing works
“Please do not hesitate to contact me if you have any questions or would like to discuss these revisions further.”
Young, S. L., Bethancourt, H. J., Ritter, Z., & Frongillo, E. A. (2022) · The Lancet Planetary Health · doi:10.1016/s2542-5196(22)00241-8 · Cited by 48 · see citing works
Guzman, K. R. D., Stone, G., Yang, A. R., Schaffer, K. E., Lo, S., Kojok, R., Kirkpatrick, C. R., Pozo, A. G. D., Le, T., DePledge, L., et al. (2022) · International Journal of Hygiene and Environmental Health · doi:10.1016/j.ijheh.2022.114044 · Cited by 58 · see citing works
“…affected by inadequate water access because they are largely responsible for household water management (Graham et al., 2016; Kayser et al., 2019; Pouramin et al., 2020; Tomberge et al., 2021) When water sources are not readily accessible at the home, women and girls are responsible for…”
The impact of water pollution on the health of older people
Bochynska, S., Duszewska, A. M., Maciejewska-Jeske, M., Wrona, M., Szeliga, A., Budzik, M. P., Szczęsnowicz, A., Bala, G., Trzcinski, M., Męczekalski, B., et al. (2024) · Maturitas · doi:10.1016/j.maturitas.2024.107981 · Cited by 49 · see citing works
Scherer, N., Mactaggart, I., Huggett, C., Pheng, P., Rahman, M.-U., Biran, A., & Wilbur, J. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18105087 · Cited by 37 · see citing works
Garcia, C., Jiménez, P. A. L., Sánchez-Romero, F.-J., et al. (2023) · Sustainable Cities and Society · doi:10.1016/j.scs.2023.104704 · Cited by 39 · see citing works
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 31 · see citing works
Self-reported anticipated harm from drinking water across 141 countries
Miller, J. D., Staddon, C., Salzberg, A. A., Lucks, J. B., de Bruin, W. B., & Young, S. L. (2024) · Nature Communications · doi:10.1038/s41467-024-51528-x · Cited by 35 · see citing works
“For example, women reported similar or greater perceived future drinking water risk than men across income strata; this may be due to gendered disparities in access 60 or greater awareness about a household ’ s water risk situation, as women are typically the managers of domestic water 61 .”
Gender perspectives of the water, energy, land, and food security nexus in sub-Saharan Africa
Hlahla, S. (2022) · Frontiers in Sustainable Food Systems · doi:10.3389/fsufs.2022.719913 · Cited by 33 · see citing works
Tandon, I., Schuster‐Wallace, C. J., Caretta, M. A., Vij, S., & Irvine, A. (2022) · Climate and Development · doi:10.1080/17565529.2022.2051418 · Cited by 30 · see citing works
“For example, in Ban-gladesh, more than two thirds of women factory workers lose six days of work per month because of a lack of safe places to change and dispose of their menstrual pads (Pouramin et al., 2020).”
BackgroundWright, M. L., Drake, D., Link, D. G., et al. (2023) · Nursing Outlook · doi:10.1016/j.outlook.2023.101919 · Cited by 24 · see citing works
Systematic Review of the Microbiological Performance of Household Water Treatment Technologies
Rao, G., Wells, E. F., Reynolds, C., Yoo, R. S., Kowalsky, E., DeFrance, J., Linden, K. G., & Brown, J. M. (2025) · Environmental Science & Technology · doi:10.1021/acs.est.4c03494 · Cited by 24 · see citing works
Ten new insights in climate science 2020 – a horizon scan
Pihl, E., Alfredsson, E. C., Bengtsson, M., Bowen, K., Broto, V. C., Chou, K.-T., Cleugh, H., Ebi, K. L., Edwards, C. M., Fisher, E., et al. (2021) · Global Sustainability · doi:10.1017/sus.2021.2 · Cited by 22 · see citing works
“A review of water, sanitation and hygiene (WASH) and gender linkages shows that this highly unequal impact of inadequate water supply is the rule (Pouramin et al., 2020).”
Self-citationUtami, R. R., Geerling, G., Salami, I. R. S., et al. (2023) · International Journal of Environmental Health Research · doi:10.1080/09603123.2022.2163986 · Cited by 21 · see citing works
“It is a reality that women, in Ciwalengke and Indonesian context, hold a crucial role in domestic water demand and they are also more vulnerable to contaminant exposure from water sources due to their role (Singh and Mukherjee 2018; Pouramin 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 19 · see citing works
Sustainable Development Goals and Gender Equality: A Social Design Approach on Gender-Based Violence
Lima, R., & Guedes, G. (2024) · Sustainability · doi:10.3390/su16020914 · Cited by 17 · see citing works
“Women also struggle to access basic needs, such as water, soil and land, and health, which is reflected in the disease increase [10].”
Promoting global access to water and sanitation: A supply and demand perspective
Abellán, J., & Alonso, J. A. (2022) · Water Resources and Economics · doi:10.1016/j.wre.2022.100194 · Cited by 17 · see citing works
A sex and gender perspective for neglected zoonotic diseases
Fusco, D., Martínez‐Pérez, G. Z., Remkes, A., et al. (2022) · Frontiers in Microbiology · doi:10.3389/fmicb.2022.1031683 · Cited by 16 · see citing works
“However, the occupational risk also exists for women living in high-burdened schistosomiasis environments, as they come into contact with water for household-related activities and fishing practices not often associated to women (Standley et al., 2011; Munisi et al., 2016; Sevilimedu et al., 2017; Pouramin et al., 202…”
BackgroundRobinson, H. J., Barrington, D., Evans, B., Hutchings, P., & Narayanaswamy, L. (2023) · Development Policy Review · doi:10.1111/dpr.12741 · Cited by 17 · see citing works
Wu, D., Qu, C., Huang, P., Geng, X., Zhang, J., Shen, Y., Rao, Z., & Zhao, J. (2023) · Nutrients · doi:10.3390/nu15204477 · Cited by 14 · see citing works
“Based on the relevant literature and theories, gender may be an important factor affecting water intake and muscle function [57,58], as there are some biological and sociocultural differences between men and women.”
BackgroundChoudhary, N., SturtzSreetharan, C., Trainer, S. S., Brewis, A., Wutich, A., Clancy, K. B. H., Fatima, U. A., & Hossain, M. J. (2023) · Global Public Health · doi:10.1080/17441692.2023.2233996 · Cited by 16 · see citing works
“…under conditions of limited sanitation (defined in part by lack of access to adequate water) is also in itself very stressful (Alexander et al., 2018; Asumah et al., 2022a, 2022b; Behera et al., 2022; Caruso et al., 2017; Hussein et al., 2022; Pouramin et al., 2020; Torkan et al., 2021).”
BackgroundWater, Sanitation, and Women’s Empowerment: A systematic review and qualitative metasynthesisPreprint
Caruso, B. A., Conrad, A., Patrick, M., et al. (2021) · medRxiv · doi:10.1101/2021.10.26.21265535 · Cited by 14 · see citing works
“Our review is more expansive and rigorous than recent WASH and gender or empowerment-focused reviews that restricted inclusion based on publication date, [39] only extracted data from titles and abstracts, [39] or focused more narrowly on the intersection of gender, water, and health [40] or on identifying the dimensi…”
MethodGendered importance-performance perspective on sanitation resilience programs
Sofiyah, E. S., Suhardono, S., Lee, C., Ridhosari, B., & Suryawan, I. W. K. (2025) · Health & Place · doi:10.1016/j.healthplace.2025.103530 · Cited by 13 · see citing works
Equitable urban water security: beyond connections on premises
Grasham, C., Hoque, S., Korzenevica, M., Fuente, D., Goyol, K. B., Verstraete, L., Mueze, K., Tsadik, M., Zeleke, G., & Charles, K. (2022) · Environmental Research: Infrastructure and Sustainability · doi:10.1088/2634-4505/ac9c8d · Cited by 8 · see citing works
“Water supplies piped onto premises can mitigate the water safety risks from transporting water (Overbo et al 2016) and the time burden of sourcing and collecting water that, in many countries across the world, most often falls to women and girls (Geere and Cortobius 2017, Pouramin et al 2020).”
BackgroundWhen vulnerabilities are exploited—The role of sextortion in the WASH sector in Bangladesh
Merkle, O., Allakulov, U., Gonzalez, D., Sánchez, A. H., Rabbi, S. E., & Hasan, Z. (2023) · Frontiers in Water · doi:10.3389/frwa.2023.1048594 · Cited by 13 · see citing works
“It has been well-established that inequalities in accessing WASH services for women and girls lead to negative health consequences (Pouramin et al., 2020) and sextortion likely exacerbates these inequalities even further.”
BackgroundWater as a social determinant of health: bringing policies into action
Sheel, V., Kotwal, A., Dumka, N., Sharma, V., Kumar, R., & Tyagi, V. (2024) · Journal of Global Health Reports · doi:10.29392/001c.92160 · Cited by 14 · see citing works
Circular and Transformative Economy
Nhamo, L., Mpandeli, S., Liphadzi, S., & Mabhaudhi, T. (2024) · CRC Press eBooks · doi:10.1201/9781003327615 · Cited by 12 · see citing works
Sofiyah, E. S., Sianipar, I. M. J., Rahman, A., et al. (2025) · Sustainable Futures · doi:10.1016/j.sftr.2025.100633 · Cited by 10 · see citing works
Sani, Y., & Scholz, M. (2022) · Sustainability · doi:10.3390/su14127499 · Cited by 10 · see citing works
Assessment of Water-Migration-Gender Interconnections in Ethiopia
Färber, L., Nagabhatla, N., & Ruyssen, I. (2022) · Frontiers in Human Dynamics · doi:10.3389/fhumd.2022.858229 · Cited by 9 · see citing works
“Note that accounting gender disaggregated approach in migration and gender assessments is flagged as a key priority by international experts and development agencies (International Organisation for Migration, 2014; Pouramin et al., 2020).”
BackgroundSelf-citationJupiter, S. D., Jenkins, A., Negin, J., Anthony, S., Baleinamau, P., Devi, R. R., Gavidi, S., Latinne, A., Mailautoka, K. K., Mangubhai, S., et al. (2024) · PLOS Water · doi:10.1371/journal.pwat.0000102 · Cited by 10 · see citing works
Assessing the Impact of Water Insecurity on Maternal Mental Health at Six Nations of the Grand River
Sultana, A., Wilson, J. M., Martin‐Hill, D., Davis-Hill, L., & Homer, J. (2022) · Frontiers in Water · doi:10.3389/frwa.2022.834080 · Cited by 10 · see citing works
“Research has confirmed that women are most vulnerable to water insecurity (Fleifel et al., 2019; Pouramin et al., 2020; Dickin et al., 2021; Duignan et al., in press).”
BackgroundLogie, C. H., Okumu, M., Tailor, L. S., Taing, L., Dorea, C. C., Mbuagbaw, L. C. E., Hakiza, R., Musoke, D. K., Katisi, B., Nakitende, A., et al. (2024) · Journal of Water Sanitation and Hygiene for Development · doi:10.2166/washdev.2024.298 · Cited by 9 · see citing works
Oluwasanya, G., Omoniyi, A., Perera, D., Layi-Adigun, B. O., Thuy, L., & Qadir, M. (2023) · Environmental Monitoring and Assessment · doi:10.1007/s10661-023-11833-2 · Cited by 7 · see citing works
“Some other studies reviewed the intersections of health on the water and gender interlinkages (Pouramin et al., 2020), emphasizing that addressing gender and water inequities holds the potential to alleviate disease burden.”
BackgroundInfluentialSharma, M. D., Gupta, P., Chauhan, S., et al. (2023) · Environmental Monitoring and Assessment · doi:10.1007/s10661-023-11510-4 · Cited by 7 · see citing works
“Water, cleanliness, and health are interconnected (Pouramin et al., 2020).”
Dako‐Gyeke, M., Hervie, V. M., Abekah‐Carter, K., & Darkwa, A. A. (2024) · Environment Development and Sustainability · doi:10.1007/s10668-024-05477-6 · Cited by 7 · see citing works
“This is because it contributes to human dignity, reduces the burden of collecting water, improves education and health outcomes, reduces water pollution, and prevents violence (Assefa et al., 2021; Pouramin et al., 2020; United Nations, 2023).”
Unmasking the Unseen: The Gendered Impacts of Water Quality, Sanitation and Hygiene
Oluwasanya, G., Omoniyi, A., Perera, D., et al. (2024) · doi:10.53328/inr24gar011 · Cited by 5 · see citing works
Water footprint for sustainable practices
Bhat, M. A., Dar, T. A., Ahmed, R., Khurshid, Z., & Nisa, F. U. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-30054-7.00013-6 · Cited by 4 · see citing works
Khan, S., Kumar, V., Gawde, N. C., & Dash, A. (2022) · International Journal of Community Medicine and Public Health · doi:10.18203/2394-6040.ijcmph20223223 · Cited by 4 · see citing works
Dery, F., Bisung, E., Dickin, S., & Soliku, O. (2023) · Social Science & Medicine (1967) · doi:10.1016/j.socscimed.2023.116490 · Cited by 4 · see citing works
Utami, R. R., Yoga, G. P., Geerling, G., et al. (2023) · IOP Conference Series Earth and Environmental Science · doi:10.1088/1755-1315/1263/1/012036 · Cited by 4 · see citing works
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 · see citing works
Water-related sustainable development goal accelerators: A rapid review
Taing, L., Dang, N., Agarwal, M., & Glickman, T. (2021) · Water Security · doi:10.1016/j.wasec.2021.100100 · Cited by 4 · see citing works
Jupiter, S. D., Jenkins, A., Negin, J., et al. (2023) · doi:10.31223/x56s9m · Cited by 4 · see citing works
Gender, Mental Health, and Climate Change: Impacts on Women and Gender Minorities
Chekuri, B., Sood, N., Campbell, H., Vurgeç, B. A., Isom, J., Ojiaku, N., & Sorensen, C. J. (2024) · Springer eBooks · doi:10.1007/978-3-031-56736-0_5 · Cited by 5 · see citing works
Arsenic health risks and interaction with salinity in coastal areas of Bangladesh
Islam, M. T., Asma, K. M., Islam, M., & Kotani, K. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1610311 · Cited by 3 · see citing works
Malik, A. S., & Mahmood, A. (2021) · Journal of Humanities Social and Management Sciences (JHSMS) · doi:10.47264/idea.jhsms/2.2.7 · Cited by 3 · see citing works
Haar, R. J., Abdelrahman, S., Muzzall, E., et al. (2023) · PLOS Global Public Health · doi:10.1371/journal.pgph.0002696 · Cited by 2 · see citing works
Exploring the Interwoven Pathways of Water Sustainability and Poverty: Insights From a 2SLS Analysis
Redhu, S., & Jain, P. (2025) · World Water Policy · doi:10.1002/wwp2.70006 · Cited by 2 · see citing works
Detchaptche, S. P. N., Jain, S., Mahdi, A., Gandra, S., & Sulis, G. (2026) · Expert Review of Anti-infective Therapy · doi:10.1080/14787210.2026.2625376 · Cited by 2 · see citing works
“However, evidence of gender-specific infection burdens from water-borne pathogens remains limited [115,116].”
Ecologies of sustainable development goals: a mid-term perspective
Mustafa, D., Matson, P., Roberts, E., & Sharpe, J. (2023) · International Development Planning Review · doi:10.3828/idpr.2023.12 · Cited by 2 · see citing works
Panhwar, S., Keerio, H. A., Ali, A., et al. (2023) · Applied Biochemistry and Microbiology · doi:10.1134/s0003683823060261 · Cited by 2 · see citing works
Mier, A. R., Tiangco, P. M. P., Mier-Alpaño, J. D., Tongson, E. C., Muego, P. E. N., & Labarda, M. D. P. (2025) · BMJ Innovations · doi:10.1136/bmjinnov-2024-001280 · Cited by 3 · see citing works
The Economics of Household Water Access: A Review and Research Roadmap for “Water for All”
Choumert, J., & Phélinas, P. (2025) · Annual Review of Resource Economics · doi:10.1146/annurev-resource-121223-014639 · Cited by 4 · see citing works
Sanitation-related withholding and suppression among women in urban Uganda and India
Sinclair, E., Hüls, A., Patrick, M., Arun, S., Ramanarayanan, V., Sinharoy, S. S., & Caruso, B. A. (2025) · Nature Water · doi:10.1038/s44221-025-00452-5 · Cited by 2 · see citing works
“Specifically, by withholding food or water or suppressing urges, women can potentially limit the frequency with which they need to access unsupportive sanitation environments 8,11,12,17,24,26–28 .”
Love the Food that Loves you Back: A Planetary Health and Women's Heart Health Partnership
Drake, D., Hayden, A. M., & Delkoski, S. L. (2021) · Creative Nursing · doi:10.1891/cn-2021-0016 · Cited by 2 · see citing works
Scales, S. E., Park, J. W., Nixon, R., et al. (2024) · Scientific Reports · doi:10.1038/s41598-024-65696-9 · Cited by 1 · see citing works
“Given the underlying disease prevalences within our study population, we would not expect to see clear benefits from WASH implementation; the benefits of WASH are best measured and understood in the context of controlling pathogens that spread via water-borne and fecal–oral routes 38,39 .”
BackgroundGender dimensions of water vending in LMICs: A scoping review
Weißenberger, L., & Elliott, S. J. (2024) · Water Security · doi:10.1016/j.wasec.2024.100186 · Cited by 1 · see citing works
Characterizing the gendered health burdens of poor water quality in the Global South
Oluwasanya, G., Omoniyi, A., Qadir, M., & Madani, K. M. (2025) · Human and Ecological Risk Assessment An International Journal · doi:10.1080/10807039.2025.2535630 · Cited by 1 · see citing works
“In the Global South, research on the health impact of poor water quality disaggregated by gender or age group is sparse (Nagabhatla et al. 2020).”
Manolakos, D., & Leder, S. (2025) · Development in Practice · doi:10.1080/09614524.2025.2540582 · Cited by 1 · see citing works
“…gender is crucial to ensure that gender equality is seriously considered across stakeholders and activities (Hunting and Hankivsky 2020; Pouramin, Nagabhatla, and Miletto 2020), applying an intersectional lens could further advance participatory and transformative governance, as well…”
Chandra, R. K., Dutta, A., Srivastava, S., Mukherjee, S., & Singh, A. (2025) · Violence Against Women · doi:10.1177/10778012251363593 · Cited by 1 · see citing works
“In the age of climate change, where the risk of water insecurities is predicted to grow exponentially, the effect of poor access to WASH would be more pronounced on women (Huynh & Resurreccion, 2014; Pouramin et al., 2020).”
Unplanned urbanisation and drinking water insecurity in Faridpur City, Bangladesh
Mia, M. S., Parvin, M., & Islam, M. J. (2025) · Development in Practice · doi:10.1080/09614524.2025.2558754 · Cited by 1 · see citing works
“We enhance the discussion by connecting these experiences to intersectional disadvantages faced by older women, female-headed families, and migratory workers, who encounter increased exclusion due to socioeconomic and patriarchal limitations (Pouramin, Nagabhatla, and Miletto 2020).”
Unpacking the water-wealth-gender nexus: an integrated vulnerability approach
Oluwasanya, G., Omoniyi, A., Matin, M. A., Bankole, A. R., Qadir, M., & Madani, K. (2026) · Sustainability Nexus Forum · doi:10.1007/s00550-026-00586-4 · Cited by 1 · see citing works
“This impact is especially pronounced in developing countries, where women often bear the burden of water collection and household management (Pouramin et al. 2020; Oluwasanya et al. 2023 ).”
Feminist Political Ecology ( FPE ) Research on Irrigation: A Systematic Literature Review
Leder, S., Clément, F., & Shrestha, G. (2026) · Wiley Interdisciplinary Reviews Water · doi:10.1002/wat2.70073 · Cited by 1 · see citing works
“Systematic literature reviews on the literature of gender and water are numerous, with foci on migration (Irbık 2022), health (Pouramin et al. 2020), drinking water (De Guzman et al. 2023), water, sanitation and hygiene (Caruso et al. 2022; MacArthur et al. 2020; Macura et al. 2023; Nunbogu and…”
Saad, D. (2024) · CRC Press eBooks · doi:10.1201/9781003327615-9 · Cited by 1 · see citing works
Widespread global concern over harm from drinking waterPreprint
Young, S. L., Miller, J. D., Staddon, C., et al. (2021) · Research Square · doi:10.21203/rs.3.rs-916693/v1
Welfare impacts of water security in Kenya: Evidence from the Upper Ewaso Ngiro North Catchment Area
Mwaura, S. N., Kariuki, I. M., Kiprop, S., et al. (2022) · Watershed Ecology and the Environment · doi:10.1016/j.wsee.2022.01.001
Water and Sanitation Infrastructure Access in Selected Rural Communities
Medayese, S., Ali, B. A., Popoola, A. A., et al. (2022) · Advances in environmental engineering and green technologies book series · doi:10.4018/978-1-7998-7356-3.ch030
Narratives for Water, Gender, and Human Development
Singh, P., Nagabhatla, N., & Naeem, N. (2021) · Encyclopedia of the UN sustainable development goals · doi:10.1007/978-3-319-70061-8_177-1
Self-citationGendered Water, Sanitation, and Hygiene (WASH) Equality: Challenges and Opportunities
Donkor, F. K. (2021) · Encyclopedia of the UN sustainable development goals · doi:10.1007/978-3-319-70061-8_192-1
Gendered Water, Sanitation, and Hygiene (WASH) Equality: Challenges and Opportunities
Donkor, F. K. (2022) · Encyclopedia of the UN sustainable development goals · doi:10.1007/978-3-319-95846-0_192
Narratives for Water, Gender, and Human Development
Singh, P., Nagabhatla, N., & Naeem, N. (2022) · Encyclopedia of the UN sustainable development goals · doi:10.1007/978-3-319-95846-0_177
Self-citationUnderstanding Household Water Hygiene in Resource-Limited Settings in Kenya
Robinson, J. E., Majiwa, H., & Howland, O. (2022) · IntechOpen eBooks · doi:10.5772/intechopen.108231
Rahim, M. D. M. A., Puad, S. M. S. M., Rahman, M. W. A., et al. (2023) · International Journal of Academic Research in Business and Social Sciences · doi:10.6007/ijarbss/v13-i6/17293
“Cultural factor also may explain the difference of behavior since female may have specific expectations or restrictions leading to higher level of safety precaution (Pouramin et al., 2020).”
BackgroundOluwasanya, G., Omoniyi, A., Perera, D., et al. (2023) · Research Square · doi:10.21203/rs.3.rs-3110673/v1
Asebe, H. A., Seifu, B. L., Mare, K. U., et al. (2024) · PLoS ONE · doi:10.1371/journal.pone.0298062 · Cited by 1 · see citing works
Implications of Water Security on Indigenous Women—Case from Buffer Zones of Nepal
Joshi, A., Dahal, B. R., Pun, S., Sigdel, P., Sharma, S., Basnet, M., & Baral, H. S. (2024) · Science for sustainable societies · doi:10.1007/978-981-97-1192-5_11
Nkolola, N. B., & Phiri, A. (2024) · Journal of Water Sanitation and Hygiene for Development · doi:10.2166/washdev.2024.214 · Cited by 1 · see citing works
Ramesh, R., Sithara, G. S., Gireesh, G. S., et al. (2024) · IEEE Global Humanitarian Technology Conference (GHTC) · doi:10.1109/ghtc62424.2024.10771543
“A significant share of this inequality falls on women and girls in these communities, as they are the collectors, providers, users, and managers of water at the household level, which is the smallest unit of society [4].”
Cheng, X., Zhang, Z., Kang, W., et al. (2024) · SSRN Electronic Journal · doi:10.2139/ssrn.5053504
Mink, T. L., Patrick, M., Conrad, A., Ahmed, T., Arun, S., Ramanarayanan, V., Chakraborti, N., Reddy, Y. M., Abhilaasha, N., Bhan, T., et al. (2025) · medRxiv · doi:10.1101/2025.01.08.25320223
Bridging the gap: gender-inclusive policies for a sustainable water future in Pakistan
Waqar, K., & Hafeez, M. (2025) · doi:10.5337/2025.214
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“[6,7] If we talk about mortality, the thirteen recorded deaths, particularly among patients with pre‑existing health conditions, emphasize the need for prompt medical management of vulnerable populations during outbreaks.”
Madzaramba, T. H., & Zanamwe, P. (2026) · H2Open Journal · doi:10.1016/j.htopen.2026.100032
Women and Maternal Infectious Diseases in a Changing Climate
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Gender Issues due to Water Scarcity: A Review With Empirical Evidence From Parbhani, Maharashtra
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“…water-related interventions are designed without adequately considering women's experiences, preferences, or chal - lenges (Anderson et al. 2021; Seri 2023a, b), such as time burden, health risks, and limited decision-making power (Dickin et al. 2020; Pouramin, et al. 2020; Apatinga et al. 2024 ).”
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- Authors
- Pouramin, P., Nagabhatla, N., & Miletto, M.
- Affiliations
- United Nations University Institute for Water, Environment, and Health (CA)
- UNESCO (FR)
- Corresponding author
- Pouramin, Panthea
- Venue
- Frontiers in Water
- Publisher
- Frontiers Media SA
- Published
- 2020-04-15
- Volume
- 2
- ISSN
- 2624-9375 (ISSN-L)
- OpenAlex
- W3017028623
- Semantic Scholar
- 1a01416dc028887ebe8641f897db8e128e0b8244
- Cited by
- 96
- References
- 79
- Citations by year
- 2026: 13 · 2025: 18 · 2024: 18 · 2023: 15 · 2022: 23 · 2021: 8 · 2020: 1
- FWCI
- 1.44
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Water (publishedVersion, cc-by)
- Funders
- Global Affairs Canada
- 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
- Social Sciences › Gender Studies › Gender Studies and Social Issues
- Keywords
- water, sanitation and hygiene, gender inequity, women's health, menstrual hygiene management, under-five mortality, stunting, waterborne parasites, Sustainable Development Goals, WASH interventions, resource-limited settings
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