The intervention physicians did not use the PWS frequently enough to influence information-seeking behavior, health outcomes, or cost. The study design did not determine whether the poor usage resulted from satisfaction with the control system, problems using the PWS intervention, or the functions provided by the PWS intervention. Evaluative studies should include provisions to improve the chance of successful implementation as well as to yield maximum information if a negative study occurs.
Household survey data from 27 sites in 22 countries were collected in 2017–2018 in order to construct and validate a cross-cultural household-level water insecurity scale. The resultant Household Water Insecurity Experiences (HWISE) scale presents a useful tool for monitoring and evaluating water interventions as a complement to traditional metrics used by the development community. It can also help track progress toward achievement of Sustainable Development Goal 6 ‘clean water and sanitation for all’. We present HWISE scale scores from 27 sites as comparative data for future studies using the HWISE scale in low- and middle-income contexts. Site-level mean scores for HWISE-12 (scored 0–36) ranged from 1.64 (SD 4.22) in Pune, India, to 20.90 (7.50) in Cartagena, Colombia, while site-level mean scores for HWISE-4 (scored 0–12) ranged from 0.51 (1.50) in Pune, India, to 8.21 (2.55) in Punjab, Pakistan. Scores tended to be higher in the dry season as expected. Data from this first implementation of the HWISE scale demonstrate the diversity of water insecurity within and across communities and can help to situate findings from future applications of this tool.
Water has always been a driver of human mobility, migration, and displacement. But water is increasingly central to explaining environmental migration in the context of climate change. Most studies of the relationship between water and environmental migration are framed around punctuated, extreme weather events and disasters that either limit agricultural or livestock productivity or make a community physically unlivable. The chronic experiences of household water insecurity and poor water governance also shape migration decision‐making through a variety of social, political, and economic factors, but these relationships have received considerably less attention. This article provides an overview of punctuated and chronic water‐related triggers of environmental migration at the household level. We also offer a conceptual framework based on multiphasic response theory that highlights water's multiple roles in migration decision‐making. We close by reflecting on key gaps in the climate‐water‐migration literature, identifying research questions that might help us better understand these relationships, and considering the implications for sustainable development policies that could potentially ease pressures on water‐related displacement.
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