Development of water insecurity scale for rural households in Cameroon- Central Africa

Abstract

Background : Water represents the core of food-energy nexus and is vital for human survival. In developing countries, contaminated water and lack of basic water services undermine efforts to improve nutritional status and related health issues. In the rural areas of Central Africa, a majority of the population lacks access to improved water sources and has to devote considerable efforts to obtain water. Objectives : Using the following definition of water insecurity, i.e. it exists when access to adequate amount of safe and clean water does not occur all the times for the entirety of household members to lead a healthy and active life, the study aimed to develop and test a household-level experiential water insecurity scale for rural households in Central Africa. Methods : The research was conducted in three phases: 1) the formative data collection; 2) the scale development; and, 3) the scale testing. In the third Phase, the scale was tested with 250 women who were water managing person of their households. Statistical analysis included items reduction, reliability, as well as criterion and construct validity assessment. The testing led to a final scale of 17 statements (WATINE-17), covering three domains of water insecurity: 1) psychosocial distress; 2) quantity; 3) quality of water. Results : The scale showed an excellent reliability (Cronbach’s alpha = 0.92) and was significantly associated with lower frequency of water intake among women (p = 0.007, concurrent validity). In assessing WATINE-17’s predictive validity, it was found that water insecurity was positively related to food insecurity (p < 0.001) and the level of water insecurity was the highest among severely food insecure households [F (3, 246) = 22.469, p < 0.001]. Conclusion : The WATINE-17 is able to capture key elements of water insecurity and can be used to monitor and evaluate SDG# 6 and water-related programs, such as WASH, in Central Africa.

Integrated Approach in Addressing Undernutrition in Developing Countries: A Scoping Review of Integrated Water Access, Sanitation, and Hygiene (WASH) + Nutrition Interventions

“…It was also noted that, due to limited water, the use of toilet facilities was avoided, since cleaning them required water. A positive correlation has also been found between limited water access in water insecurity and handwashing ( 13 , 36 ). In the interventions, information on the use of handwashing stations or the frequency of handwashing among intervention households was not collected to determine whether water access is associated with the use of handwashing stations among caretakers.…”

Examination of the Cameroon DHS data to investigate how water access and sanitation services are related to diarrhea and nutrition among infants and toddlers in rural households

“…Based on the review of other integrated interventions, we concluded that first and foremost W of WASH needs to be addressed. Changes in hygiene behavior and the prevention of cross-contamination cannot be expected until households are water secure or have access to the sufficient amount of clean water at all times (Nounkeu & Dharod 2021). For instance, in the development of household level, water insecurity scale in Cameroon called WATINE-17, it was found that the use of water for household activities, including cooking and daily intake of water, decreased when 'W' was limited (Nounkeu et al 2021).…”

“…Similarly, in the review of other small-scale WASH plus nutrition interventions, the modest level of reduction in the diarrhea rate was observed, but no significant joint effect was noted in children's growth. In this review, the complexity and interconnection among various WASH components and nutrition were recognized, and it was highlighted that improvement in the infrastructure at the community level is critical to see WASHrelated health improvement at the household and individual levels (Nounkeu & Dharod 2021).…”

Assessment of drinking water access and household water insecurity: A cross sectional study in three rural communities of the Menoua division, West Cameroon

“…In contrast to water security, insecurity refers to when access to adequate amount of safe and clean water does not occur all the times for the entirety of household members to lead a healthy and active life [17]. To measure water insecurity, the UN developed standards based on per capita water availability and translating equitable and sufficient access to water: (1) per capita daily water use �50 liters; (2) total water collection time �30 minutes; (3) water source � 1,000 meters of home, and; (4) water cost �5% of the household income [18].…”