The difference a day can make: The temporal dynamics of drinking water access and quality in urban slums

Abstract

In urban slumshome to approximately 1 billion people worldwide-access to clean drinking water is woefully inadequate despite the United Nations' declaration that access to safe water is a fundamental human right. Households in slums are frequently forced to rely on multiple drinking water sources to meet their needs. Numerous factors influence choice of water source, including water quality, availability, reliability, and affordability. These factors are not temporally static, but rather will vary over multiple timescales (from sub-daily changes to annual changes and beyond) in response to changes in the water source itself and changes in the household's ability to use that source. For example, the cost of water can change over time in response to water availability (e.g. rainy season versus dry season) and a slum household's ability to pay for water will often change over time in response to changes in household income. However, existing national and global monitoring of safe water access, including Sustainable Development Goal 6, overlook these temporal dynamics of water access, quality and health risk in slums. This paper proposes a research agenda for exploring temporal changes in drinking water access and quality in urban slums and their potential influence on health risk. It argues that in the design of research studies, policy interventions, and drinking water monitoring aimed at improving access and health in urban slums, temporal dynamics 2 should be considered over at least three interlinked time scales: short-term (from sub-daily to week-to-week), medium-term (from month-to-month to season-toseason) and long-term (from year-to-year). The paper concludes with recommendations for future research on temporal dynamics of drinking water and health in slums.

Socio‐environmental confounders of safe water interventions

“…Households with piped water access may choose to supplement with unimproved sources when services are intermittent (Price, Adams, & Quilliam, 2019). This introduces additional risk to the existing health burden posed by intermittent water supply (Bivins et al, 2017; Kumpel & Nelson, 2016).…”

Gendered Water Insecurity: A Structural Equation Approach for Female Headed Households in South Africa

“…The initial decision will depend on the source of water available to the household as depicted by Figure 1. A series of factors related to the source (e.g., cost and reliability of the water source) as well as socio-economic (e.g., ability of the household to afford water and perceptions towards its safety) that will shape decision making concerning which source of water to access [10]. The peripheral ring from Figure 1 shows the competing livelihood decision making relative to drinking water.…”

“…Competing demands may influence the ability to queue for water, and thus encourage use of expedient sources even if they are of a lower quality. Intermittent water supplies can influence water collectors to seek more reliable water sources, even if it is of a lower quality [10,36]. Unreliable water supply prompts people to adapt through coping strategies such as storing water and drilling wells and boreholes [37].…”

“…The study aims to identify and provide pathways through which female-headed households are water insecure. Value and choice of water is differentiated according to its attributes (quality, affordability, reliability and availability), dependent on the intended use [10]. The country's National Water and Sanitation Master Plan as well as the National Water Resource Strategy recognise that it is the prerogative of the water sector to provide universal and equitable access to reliable water supply as enshrined in the country's National Water Act and the Water Services Act [35].…”

Water insecurity and urban poverty in the Global South: Implications for health and human biology

“…Many of the urban poor in the Global South rely on water sources outside their premises that are prone to contamination, especially during transport (Wright, Gundry, & Conroy, ). These sources include public standpipes, boreholes, sachet water, tanker‐truck services, and water from small‐scale vendors (Kjellén & McGranahan, , Stoler, , Dos Santos et al, ,), and are often insufficient, shared by many households, unsafe, or costly (Dos Santos, Ouédraogo, & Soura, ; Majuru, Suhrcke, & Hunter, ; Price, Adams, & Quilliam, ). Even when available, improved water sources often run intermittently or require long queuing times, thus forcing households to supplement with unsafe alternatives, a trend observed across Africa (eg, Adams, ; Dagdeviren & Robertson, ), Latin America (eg, Cifuentes & Rodriguez, ; Wutich, Beresford, & Carvajal, ), and Asia (eg, Cheng, ; Raina, Zhao, Wu, Kunwar, & Whittington, ; Truelove, ).…”