Household water insecurity will complicate the ongoing COVID-19 response: Evidence from 29 sites in 23 low- and middle-income countries

Justin Stoler; Joshua D Miller; Alexandra Brewis; Matthew C Freeman; Leila M Harris; Wendy Jepson; Amber L Pearson; Asher Y Rosinger; Sameer H Shah; Chad Staddon; Cassandra Workman; Amber Wutich; Sera L Young; Household Water Insecurity Experiences Research Coordination Network (HWISE RCN)

doi:10.1016/j.ijheh.2021.113715

Household water insecurity will complicate the ongoing COVID-19 response: Evidence from 29 sites in 23 low- and middle-income countries

Int J Hyg Environ Health. 2021 May:234:113715. doi: 10.1016/j.ijheh.2021.113715. Epub 2021 Feb 19.

Collaborators

Household Water Insecurity Experiences Research Coordination Network (HWISE RCN):
Ellis Adams¹⁴, Farooq Ahmed¹⁵, Mallika Alexander¹⁶, Gershim Asiki¹⁷, Mobolanle Balogun¹⁸, Michael J Boivin¹⁹, Genny Carrillo²⁰, Kelly Chapman²¹, Stroma Cole²², Shalean M Collins²³, Hassan Eini-Zinab²⁴, Jorge Escobar-Vargas²⁵, Hala Ghattas²⁶, Monet Ghorbani²⁷, Ashley Hagaman²⁸, Nicola Hawley²⁸, Zeina Jamaluddine²⁶, Divya Krishnakumar²⁹, Kenneth Maes³⁰, Jyoti Mathad³¹, Jonathan Maupin²⁷, Patrick Mbullo Owuor³², Hugo Melgar-Quiñonez³³, Milton Marin Morales³⁴, Javier Moran³⁵, Nasrin Omidvar²⁴, Sabrina Rasheed³⁶, Luisa Samayoa-Figueroa³³, Ernesto C Sánchez-Rodriguez³⁷, Marianne V Santoso³², Roseanne C Schuster²⁷, Mahdieh Sheikhi²⁴, Sonali Srivastava²⁹, Andrea Sullivan³⁸, Yihenew Tesfaye³⁹, Nathaly Triviño²⁵, Alex Trowell⁴⁰, Desire Tshala-Katumbay⁴¹, Raymond Tutu⁴²

Affiliations

¹ University of Miami, Coral Gables, FL, USA. Electronic address: stoler@miami.edu.
² University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: josh.miller@unc.edu.
³ Arizona State University, Tempe, AZ, USA. Electronic address: alex.brewis@asu.edu.
⁴ Emory University, Atlanta, GA, USA. Electronic address: matthew.freeman@emory.edu.
⁵ University of British Columbia, Vancouver, BC, Canada. Electronic address: lharris@ires.ubc.ca.
⁶ Texas A&M University, College Station, TX, USA. Electronic address: wjepson@tamu.edu.
⁷ Michigan State University, East Lansing, MI, USA. Electronic address: apearson@msu.edu.
⁸ Pennsylvania State University, University Park, PA, USA. Electronic address: axr579@psu.edu.
⁹ University of British Columbia, Vancouver, BC, Canada. Electronic address: sameer.shah@alumni.ubc.ca.
¹⁰ University of the West of England, Bristol, UK. Electronic address: chad.staddon@uwe.ac.uk.
¹¹ University of North Carolina at Greensboro, Greensboro, NC, USA. Electronic address: clworkma@uncg.edu.
¹² Arizona State University, Tempe, AZ, USA. Electronic address: amber.wutich@asu.edu.
¹³ Northwestern University, Evanston, IL, USA. Electronic address: sera.young@northwestern.edu.
¹⁴ University of Notre Dame, South Bend, IN, USA.
¹⁵ Quaid-e-Azam University Islamabad, Pakistan.
¹⁶ Johns Hopkins University-Byramjee Jeejeebhoy Medical College Clinical Trials Unit, Pune, India.
¹⁷ African Population and Health Research Center, Nairobi, Kenya.
¹⁸ College of Medicine of the University of Lagos, Lagos, Nigeria.
¹⁹ Michigan State University, East Lansing, MI, USA.
²⁰ Texas A&M University, College Station, TX, USA.
²¹ University of Florida, Gainesville, FL, USA.
²² University of Westminster, London, UK.
²³ Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
²⁴ Shahid Beheshti University of Medical Sciences, Tehran, Iran.
²⁵ Pontificia Universidad Javeriana, Bogotá, Colombia.
²⁶ American University of Beirut, Beirut, Lebanon.
²⁷ Arizona State University, Tempe, AZ, USA.
²⁸ Yale University, New Haven, CT, USA.
²⁹ Anode Governance Lab, Bengaluru, India.
³⁰ Oregon State University, Corvallis, OR, USA.
³¹ Weill Cornell Medicine, New York, NY, USA.
³² Northwestern University, Evanston, IL, USA.
³³ McGill University, Ste-Anne-de-Bellevue, Quebec, Canada.
³⁴ Universidad Autónoma del Beni José Ballivián, Bolivia.
³⁵ Autonomous University of Coahuila, Coahuila, Mexico.
³⁶ International Centre for Diarrhoeal Disease Research Bangladesh, Mohakhali, Dhaka, 1212, Bangladesh.
³⁷ Hospital Agustin O'Horan, Mérida, Yucatan, Mexico.
³⁸ University of Miami, Coral Gables, FL, USA.
³⁹ Bahir-Dar University, Bahir-Dar, Ethiopia.
⁴⁰ University of Amsterdam, Amsterdam, the Netherlands.
⁴¹ Oregon Health & Science University, Portland, OR, USA.
⁴² Delaware State University, Dover, DE, USA.

Abstract

In March 2020, the World Health Organization (WHO) issued a set of public guidelines for Coronavirus Disease 2019 (COVID-19) prevention measures that highlighted handwashing, physical distancing, and household cleaning. These health behaviors are severely compromised in parts of the world that lack secure water supplies, particularly in low- and middle-income countries (LMICs). We used empirical data gathered in 2017-2018 from 8,297 households in 29 sites across 23 LMICs to address the potential implications of water insecurity for COVID-19 prevention and response. These data demonstrate how household water insecurity presents many pathways for limiting personal and environmental hygiene, impeding physical distancing and exacerbating existing social and health vulnerabilities that can lead to more severe COVID-19 outcomes. In the four weeks prior to survey implementation, 45.9% of households in our sample either were unable to wash their hands or reported borrowing water from others, which may undermine hygiene and physical distancing. Further, 70.9% of households experienced one or more water-related problems that potentially undermine COVID-19 control strategies or disease treatment, including insufficient water for bathing, laundering, or taking medication; drinking unsafe water; going to sleep thirsty; or having little-to-no drinking water. These findings help identify where water provision is most relevant to managing COVID-19 spread and outcomes.

Keywords: COVID-19; Global health; SARS-CoV-2; WASH; Water insecurity.

Publication types

Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

COVID-19*
Communicable Disease Control / methods
Communicable Disease Control / statistics & numerical data*
Developing Countries / statistics & numerical data
Family Characteristics*
Hand Disinfection
Health Behavior
Humans
Hygiene
Physical Distancing
Poverty / statistics & numerical data*
SARS-CoV-2
Water Insecurity*

Household water insecurity will complicate the ongoing COVID-19 response: Evidence from 29 sites in 23 low- and middle-income countries

Authors

Collaborators

Affiliations

Abstract

Publication types

MeSH terms

Grants and funding