Population-based study of intra-household gender differences in water insecurity: reliability and validity of a survey instrument for use in rural Uganda

Abstract

Hundreds of millions of persons worldwide lack adequate access to water. Water insecurity, which is defined as having limited or uncertain availability of safe water or the ability to acquire safe water in socially acceptable ways, is typically overlooked by development organizations focusing on water availability. To address the urgent need in the literature for validated measures of water insecurity, we conducted a population-based study in rural Uganda with 327 reproductive-age women and 204 linked men from the same households. We used a novel method of photo identification so that we could accurately elicit study participants’ primary household water sources, thereby enabling us to identify water sources for objective water quality testing and distance/elevation measurement. Our psychometric analyses provided strong evidence of the internal structure, reliability, and validity of a new 8-item Household Water Insecurity Access Scale. Important intra-household gender differences in perceptions of water insecurity were observed, with men generally perceiving household water insecurity as being less severe compared to women. In summary, the Household Water Insecurity Access Scale represents a reliable and valid measure of water insecurity, particularly among women, and may be useful for informing and evaluating interventions to improve water access in resource limited settings.

Household water insecurity is associated with a range of negative consequences among pregnant Kenyan women of mixed HIV status

“…Although there is a burgeoning literature in which scales to assess household water security are presented (e.g. Stevenson et al 2012; Jepson 2014; Wutich & Brewis 2014; Tsai et al 2016), few are validated, and none are suitable for cross-cultural use. The development of a short and easy-to-administer cross-culturally valid scale would facilitate data collection on household WI globally and promote harmonized assessments of the consequences of WI.…”

Advancing methods for research on household water insecurity: Studying entitlements and capabilities, socio-cultural dynamics, and political processes, institutions and governance

“…Researchers then develop and test survey items to assess household heads’ reports on experiences of water insecurity. Using scaling methods, such as Guttman scaling or split-half reliability tests (Jepson et al 2017a), these efforts have yielded a number of locally-adapted HWI scales for research in Kenya (Boateng et al 2017), Uganda (Tsai et al 2016), Ethiopia (Stevenson et al 2016, 2012), Nepal (Aihara et al 2015), the United States (Jepson 2014), and Bolivia (Hadley and Wutich 2009, Wutich and Ragsdale 2008). While these scales are well-suited for assessing within-group and longitudinal variation in HWI using statistical tests, future efforts should focus on developing scales and other methods suitable for cross-cultural and cross-site (e.g., urban/rural) comparisons (Jepson et al 2017a).…”

“…Recently Jepson et al (2017b) have argued that a “human capabilities” approach offers a useful conceptual advance on the current preoccupation with physical access. While researchers are creating more comprehensive metrics to measure HWI (e.g., Boateng et al 2017, Tsai et al 2016, Stevenson et al 2016), in general they do not yet properly address the socio-economic, cultural, and political relations at work in producing household water insecurity. To accomplish this, we suggest that researchers must develop robust methods for more comprehensively assessing household water insecurity, its causes, and its effects.…”

Gut carriage of antimicrobial resistance genes in women exposed to small-scale poultry farms in rural Uganda: a feasibility study

“…The local economy is largely dominated by animal husbandry, petty trading, subsistence agriculture, and supplemental migratory work. Food and water insecurity are common [20-22]. In this study, samples were collected between August 11, 2015 and June 8, 2017.…”