Water source preferences and water quality perceptions among women in the eastern region, Ghana: a grounded theory study.
Open accessAbstract
Residents in the Eastern Region, Ghana with access to improved water sources (e.g., boreholes and covered wells) often choose to collect water from unimproved sources (e.g., rivers and uncovered wells). To assess why, we conducted two field studies to coincide with Ghana's rainy and dry seasons. During the rainy season, we conducted semi-structured in-depth interviews among a convenience sample of 26 women in four rural communities (including one woman in the dry season). We asked each participant about their attitudes and perceptions of water sources. During the dry season, we observed four women for ≤4 days each to provide context for water collection and water source choice. We used a grounded theory approach considering the multiple household water sources and uses approach to identify three themes informing water source choice: collection of and access to water, water quality perception, and the dynamic interaction of these. Women selected water sources based on multiple factors, including season, accessibility, religious/spiritual messaging, community messaging (e.g., health risks), and ease-of-use (e.g., physical burden). Gender and power dynamics created structural barriers that affected the use of unimproved water sources. A larger role for women in water management and supply decision-making could advance population health goals.
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Providing water on premises is important for overall wellbeing through benefits to quality of life, positive health effects, reduced labour and calorie expenditure, and a potential increase in water quantity for other activities.
“Other research suggests that providing water on premises is important for overall wellbeing90 through benefits to quality of life, such as the ability to reallocate time previously used for water collection to income generation or leisure,91 positive health effects (eg, on musculoskeletal disorders),92 reduced labour and calorie expenditure,93 and a potential increase in water quantity for other”
Women's and girls' bodily integrity has been constrained due to water and sanitation conditions, including limiting bathing and washing, restricting food and water, suppressing defecation and urination urges, delaying changing menstrual materials, and taking anti-diarrheal medicines when lacking sufficient, safe or clean water and sanitation.
“Specifically, women limited bathing and washing hands, clothes, menstrual materials, and bathrooms; [76,86,98,100,123,144,165,197,198,200,202,229,232,281] restricted food and water to avoid defecation and urination; [135, 168, 174, 179, 184, 192, 212, 224] suppressed defecation and urination urges; [2,62,181,184,188,190,191, 214, 217, 229, 235, 236, 238, 241, 247, 248, 250, 270] delayed changing”
From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [197]
Women qualitatively reported perceived linkages between various illnesses and their water and sanitation environments, including diarrhea, vomiting, dysentery, cholera, hepatitis, schistosomiasis, and skin diseases due to polluted water, and diarrhea due to limitations on hygiene in times of water scarcity.
“Women reported experiencing or fearing diarrhea, vomiting, dysentery, cholera, hepatitis, schistosomiasis, and skin diseases due to polluted water, [65,70,86,111,144,177,178,197,199,214,220,225,231,248,259,273,288] and experiencing diarrhea due to limitations on hygiene in times of water scarcity [70,123,202].”
From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [197]
Seasonal changes impacted time spent on water acquisition: during the dry season, women waited for unpredictable water deliveries, spent extra time collecting water when sources dried up, slept or cooked at sources when lines were long, and walked long distances in the dark.
“Seasonal changes impacted time spent on water acquisition: during the dry season, women waited for often unpredictable and therefore disruptive water deliveries (Philippines [100]); spent extra time collecting water when sources dried up (Ghana [197]); slept or cooked at sources when lines were long (Mozambique [261]); and walked long distances in the dark (Mozambique [153]).”
From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [197]
Constraints on women's time limit access to safe water or resources needed to treat or boil water; women also spend considerable time caring for family members ill with water-related diseases.
“Constraints on women's time limit access to safe water or resources needed to treat or boil water [92,118,197,199,208]. Women also spend considerable time caring for family members ill with waterrelated diseases [26,63,111,177,193,239,240,248,259].”
From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [197]
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Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis
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- Authors
- Chew, J. F., Corlin, L., Ona, F., Pinto, S., Fenyi-Baah, E., Osei, B. G., & Gute, D. M.
- Affiliations
- Tufts University (US)
- Boston University (US)
- Government of Ghana (GH)
- Wageningen University & Research (NL)
- Corresponding author
- Chew, Jhanel F.
- Venue
- International Journal of Environmental Research and Public Health
- Publisher
- MDPI AG
- Published
- 2019-10-11
- Volume
- 16
- Issue
- 20
- Pages
- 3835
- ISSN
- 1660-4601 (ISSN-L)
- PMC
- PMC6843409
- OpenAlex
- W2980074894
- Cited by
- 35
- References
- 23
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 9 · 2023: 6 · 2022: 6 · 2021: 1 · 2020: 2
- FWCI
- 0.81
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- National Science Foundation (0966093)
- National Institutes of Health (1T32HL125232)
- Philanthropic Educational Organization Esther Garrett Edgerton Endowed Scholar Award (NA)
- Tufts University Vice Provost for Research (NA)
- Tufts University Department of Civil and Environmental Engineering (NA)
- Tufts University Jonathon M. Tisch College of Civic Life (NA)
- Tufts University Institute for Global Leadership (NA)
- Topics
- Physical Sciences › Environmental Science › Water Science and Technology › Water Resource Management and Quality
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Physical Sciences › Environmental Science › Water Science and Technology › Water Quality and Resources Studies
- Keywords
- water quality perception, women, rural water supply, unimproved water sources, seasonal variation, religious and spiritual beliefs, women in water management, Eastern Region of Ghana
- MeSH terms
- Adult, Aged, Aged, 80 and over, Female, Ghana, Humans, Middle Aged, Rural Population, Seasons, Water Supply, Women, Water Quality, Drinking Water, Grounded Theory
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