Food, water, and sanitation insecurities: Complex linkages and implications for achieving WASH security

Workman, Cassandra L.; Stoler, Justin; Harris, Angela; Ercümen, Ayşe; Kearns, Joshua; Mapunda, Kenneth M.

doi:10.1080/17441692.2021.1971735

Cited by 4 publications

(2 citation statements)

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“…In fact, there is wide‐ranging literature demonstrating how WASH insecurity disrupts people's lives in many more ways than waterborne diseases. Many of these pathways demonstrate intricate links between resource insecurities, such as food, water, and sanitation securities, and likely exacerbate diarrheal diseases and child stunting (Workman, Stoler, et al, 2021). To many interdisciplinary WASH scholars, the burden of diarrheal diseases is a drop in the proverbial bucket.…”

Section: The Water Quality Paradigmmentioning

confidence: 99%

Measuring transformative WASH: A new paradigm for evaluating water, sanitation, and hygiene interventions

2023

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Progress toward achieving Sustainable Development Goal 6, clean water and sanitation for all, is behind schedule and faces substantial financial challenges. Rigorous water, sanitation, and hygiene (WASH) interventions have underperformed, casting doubt on their efficacy and potentially undermining confidence in WASH funding and investments. But these interventions have leaned on a narrow set of WASH indicators—linear growth and diarrhea—that reflect a 20th‐century prioritization of microbiological water quality as the most important measurement of WASH intervention success. Even when water is microbiologically safe, hundreds of millions of people face harassment, assault, injury, poisoning, anxiety, exhaustion, depression, social exclusion, discrimination, subjugation, hunger, debt, or work, school, or family care absenteeism when retrieving or consuming household water. Measures of WASH intervention success should incorporate these impacts to reinforce the WASH value proposition. We present a way forward for implementing a monitoring and evaluation paradigm shift that can help achieve transformative WASH.This article is categorized under: Engineering Water > Water, Health, and Sanitation Human Water > Value of Water Human Water > Methods

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Section: The Water Quality Paradigmmentioning

confidence: 99%

Measuring transformative WASH: A new paradigm for evaluating water, sanitation, and hygiene interventions

2023

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“…Therefore, in this study, we defined WASH insecurity as the lack of at least basic access to drinking water, sanitation, hygiene, and improved water for bathing, drug preparation and cleaning of wounds. WASH insecurity experiences can increase exposure to waterrelated health risks [7][8][9]. People living in areas with WASH insecurity could be more likely to acquire and transmit water-related diseases, especially those experiencing intersectional vulnerabilities, such as people experiencing homelessness and engaging in substance use [4,[9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Water, sanitation, and hygiene access among people who inject drugs in Tijuana and San Diego in 2020–2021: a cross-sectional study

Calderón-Villarreal,

Avelar Portillo,

Abramovitz

et al. 2024

Int J Equity Health

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Background Water, sanitation, and hygiene (WASH) access is critical to public health and human dignity. People who inject drugs (PWID) experience stigma and structural violence that may limit WASH access. Few studies have assessed WASH access, insecurity, and inequities among PWID. We describe WASH access, social and geographic inequalities, and factors associated with WASH insecurity among PWID in the Tijuana-San Diego metropolitan area. Methods In this cross-sectional binational study, we interviewed PWID (age 18+) in 2020–2021 about WASH access and insecurity. City of residence (Tijuana/San Diego) and housing status were considered as independent variables to describe key WASH access outcomes and to assess as factors associated with WASH insecurity outcomes. Measures of association between outcomes and independent variables were assessed using log modified-Poisson regression models adjusting for covariates. Results Of 586 PWID (202 Tijuana; 384 San Diego), 89% reported basic access to drinking water, 38% had basic hand hygiene, 28% basic sanitation, and 46% access to bathing, and 38% reported recent open defecation. Participants residing in Tijuana reported significantly higher insecurity in accessing basic drinking water (aRR: 1.68, 95%CI: 1.02–2.76), basic hygiene (aRR: 1.45, 95%CI: 1.28–1.64), and bathing (aRR: 1.21, 95%CI: 1.06–1.39) than those living in San Diego. Participants experiencing unsheltered homelessness experienced significantly higher insecurity in accessing basic drinking water (aRR: 2.03, 95%CI: 1.07–3.86), basic sanitation (aRR: 1.68, 95%CI: 1.48, 1.92), bathing (aRR: 1.84, 95%CI: 1.52–2.22), and improved water sources for cleaning wounds (aRR: 3.12, 95%CI: 1.55–6.29) and for preparing drugs (aRR: 2.58, 95%CI: 1.36–4.89) than participants living in permanent housing. Conclusion WASH access among PWID in the Tijuana-San Diego metropolitan area was low by international standards and lower than the national averages in both countries. Homelessness was significantly associated with WASH insecurity in this population. Concentrated efforts are needed to guarantee continuously available WASH services for PWID—especially those who are unsheltered.

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Revisiting transformative WASH: measuring impact

Stoler¹,

Guzmán²,

Adams³

2023

The Lancet Global Health

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Food, water, and sanitation insecurities: Complex linkages and implications for achieving WASH security

Cited by 4 publications

References 91 publications

Measuring transformative WASH: A new paradigm for evaluating water, sanitation, and hygiene interventions

Measuring transformative WASH: A new paradigm for evaluating water, sanitation, and hygiene interventions

Water, sanitation, and hygiene access among people who inject drugs in Tijuana and San Diego in 2020–2021: a cross-sectional study

Revisiting transformative WASH: measuring impact

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