“It makes us really look inferior to outsiders”: Coping with psychosocial experiences associated with the lack of access to safe water and sanitation

Bisung, Elijah; Elliott, Susan J.

doi:10.17269/cjph.108.5546

Cited by 27 publications

(18 citation statements)

References 23 publications

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“…These findings suggest that women in rural Orissa, India may suffer assaults to their mental well-being and have high levels of anxiety, depression, and distress when urinating and defecating as a result of experiencing sanitation insecurity, even if they have a facility. Our results align with qualitative findings, which report that women may experience psychosocial impacts related to sanitation behaviors despite facility access ( Bisung and Elliott, 2016a , Bisung and Elliott, 2017 ; Hirve et al, 2015 ; Sahoo et al, 2015 ). This research moves beyond these studies, identifying quantitative associations with multiple mental health outcomes, and supports the argument that sanitation-related programs should include intervention components beyond technology to comprehensively impact women’s health ( Caruso, Clasen, Hadley, et al, 2017 ).…”

Section: Discussionsupporting

confidence: 90%

The association between women's sanitation experiences and mental health: A cross-sectional study in Rural, Odisha India

Caruso

Cooper

Haardörfer

et al. 2018

SSM - Population Health

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Emerging qualitative research suggests women’s sanitation experiences may impact mental health. However, specific associations remain unclear. We aimed to determine if sanitation access and sanitation experiences were associated with mental health among women in rural Odisha, India. Using a cross-sectional design, we evaluated the association between sanitation access and sanitation experiences and selected mental health outcomes. Data were collected from 1347 randomly selected women across four life course stages in 60 rural communities (December 2014-February 2015). Our four primary outcomes included: mental well-being, and symptoms of anxiety, depression, and distress. The primary exposures were (1) access to a functional latrine within the household compound and (2) sanitation insecurity (SI), evaluated using a seven domain measure assessing women’s negative sanitation experiences and concerns. We used hierarchical linear modeling to determine associations between the exposures and mental health outcomes, adjusting for covariates (life stage, poverty, current health status, social support). Mean well-being scores were moderate and mean anxiety, depression, and distress scores were above a threshold indicating the potential presence of any of the three conditions. Access to a functional household latrine was associated with higher well-being scores, but not with anxiety, depression or distress. Women’s SI domains were associated with all four outcomes: four domains were significantly associated with lower well-being scores, two were significantly associated with higher anxiety scores, three were significantly associated with higher depression scores, and three were significantly associated with higher distress scores, all independent of functional household latrine access. Women in rural Odisha, India may suffer assaults to their well-being and have higher symptoms of anxiety, depression, and distress when urinating and defecating, even if they have an available facility. These findings suggest that sanitation-related interventions should consider how to accommodate women’s experiences beyond excreta management to comprehensively impact health.

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Section: Discussionsupporting

confidence: 90%

The association between women's sanitation experiences and mental health: A cross-sectional study in Rural, Odisha India

Caruso

Cooper

Haardörfer

et al. 2018

SSM - Population Health

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“…In many cases, these overlapped, for example, households purchased water from distantly located sources due to a lack of availability of free water within or near their households (Hossain & Ahmed, 2015). Less common was the reliance on humanitarian aid for water, mentioned in only two studies (Bisung & Elliott, 2017; Paul & Routray, 2010).…”

Section: Resultsmentioning

confidence: 99%

Coping strategies for individual and household‐level water insecurity: A systematic review

et al. 2020

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Household water insecurity is a complex socioecological challenge with a range of consequences for health and wellbeing. Understanding individual and household‐level coping strategies, i.e., responses or adaptations to manage water insecurity, can shape future research and development practice. We therefore (a) systematically describe the characteristics and contexts of 173 studies documenting coping strategies and (b) classify the types of strategies within four domains of water insecurity: access, use, quality, and reliability. Most studies were from Sub‐Saharan Africa or South Asia. In the domain of access, the most common coping strategies were building infrastructure, and storing, purchasing, and sharing water. For use, changing food consumption, agricultural practices, and hygiene were most frequently mentioned. For quality, water treatment was the most common strategy. To ensure water reliability, people most frequently reported changing routines or relocating their homes altogether. Our review provides a useful framework to understand coping strategies, but more research is needed to address three gaps in particular. First, we recommend more representative exploration of the range of coping strategies, particularly in middle‐ and high‐income countries. Second, the links between coping with water insecurity and a range of other nutritional, social, financial, and health outcomes need to be better understood to address overall household wellbeing. Third, we recommend the development of a metric to quantify individual and household‐level water insecurity‐related coping strategies. This line of inquiry can enable practitioners to design and implement context‐specific interventions that leverage preexisting strategies to improve experiences of water insecurity. This article is categorized under: Human Water > Water Governance Engineering Water > Planning Water

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“…Surprisingly, however, water availability (measured by use and two seasonality measures) was not associated with emotional distress. Building on this approach, Bisung and Elliott (2016, 2017) used a qualitative approach in a very different context—a Kenyan town—to confirm in a different context that experiences of water insecurity produced feelings of anxiety, frustration, embarrassment, and marginalization.…”

Section: What Have We Learned About Household Water Insecurity From Amentioning

confidence: 99%

Localizing resource insecurities: A biocultural perspective on water and wellbeing

et al. 2020

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A biocultural approach provides an emerging framework for clarifying the mechanisms that connect water security to human health and wellbeing. Five basic tenets of the biocultural approach are outlined: The focus on the local, the centrality of culture, the notion of embodied disadvantage, a concern with proximate mechanisms as a means to test theorized pathways, and recognition of intersecting and potentially amplified (syndemic) risks. From a review of both new and dispersed biocultural literature on household water, four key themes emerge: (a) individual vulnerabilities to the biological effects of water insecurity are shaped by cultural practices; (b) water insecurity is a powerful biocultural stressor on mental health; (c) water insecurity mediates between low power and worse health within communities, and through multiple mechanisms; (d) the household is a nexus for food–water interactions, each likely worsening each other and health through syndemic relationships. This sets an agenda for a biocultural approach to the household as a localizing nexus for manifesting the very human costs to mental and physical health of managing under conditions of extreme household resource insecurity. This article is categorized under: Engineering of Water > Planning Water Human Water > Water Governance Human Water > Water as Imagined and Represented

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“It makes us really look inferior to outsiders”: Coping with psychosocial experiences associated with the lack of access to safe water and sanitation

Cited by 27 publications

References 23 publications

The association between women's sanitation experiences and mental health: A cross-sectional study in Rural, Odisha India

The association between women's sanitation experiences and mental health: A cross-sectional study in Rural, Odisha India

Coping strategies for individual and household‐level water insecurity: A systematic review

Localizing resource insecurities: A biocultural perspective on water and wellbeing

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