The research, conducted by Matt Stellbauer, Wendy Jepson, Jeremiah Osborne-Gowey, Nicole Lefore, John Casellas Connors, and Edward Kato, analyzed survey data from 1,082 households across rural Mali. The team measured water insecurity using the Household Water Insecurity Experiences scale, widely abbreviated as HWISE, a validated instrument that asks households about concrete experiences over a defined recall period: whether they went to bed thirsty, whether they worried that water would run out, whether they had to change what they ate because water for cooking was scarce, and whether they felt shame or anger over their water situation. By scoring these experiences, the HWISE scale converts a diffuse development problem into a quantifiable, comparable metric.

The conceptual starting point for the study is a shift that has reshaped water policy in lower- and middle-income countries over the past ten years. Traditional water investments were siloed: domestic systems were engineered to meet a household’s drinking and hygiene needs, while irrigation schemes and livestock watering points were planned separately, often by different ministries or donor programs. Yet field observations repeatedly showed that rural households ignore these categories. A hand pump installed for drinking water becomes a laundry station and a cattle trough; an irrigation canal doubles as a source of washing water. Multiple-use water services emerged as a planning philosophy that takes people’s full portfolio of water needs as the point of departure, upgrading or designing systems so that a single service can safely and reliably serve both households and small-scale production.

Earlier studies had suggested that MUS could improve water productivity and generate economic gains for subsistence farming communities, but the evidence base remained fragmented and context dependent. What had never been systematically examined was the question that matters most to families: does practicing multiple-use water services actually reduce the lived experience of water insecurity, defined as inadequate, unreliable, or unaffordable access to the water necessary for a healthy life? The Malian dataset allowed the researchers to test exactly this, linking HWISE scores to whether households used the same water sources for both domestic and productive purposes, and whether they did so year-round or only in certain seasons.

The central finding is striking in its clarity. Households that practiced multiple-use water services throughout the entire year reported significantly lower water insecurity than households that practiced MUS only seasonally. In other words, the families who could rely on the same sources to satisfy drinking, cooking, washing, livestock, and irrigation needs across all seasons scored better on the HWISE scale than families whose productive water access evaporated during part of the year. The seasonal contrast is analytically important, because it isolates the dimension that engineers and planners can actually influence: the temporal reliability of water availability, not merely its existence at some point in the calendar.

The authors are careful, however, to frame the result as an association rather than a causal relationship. Households with year-round MUS may enjoy lower water insecurity because the practice itself buffers them against scarcity, but it is equally plausible that both phenomena share a common underlying driver: reliable, year-round water availability. A household located near a perennial source, or served by infrastructure that functions in both wet and dry seasons, can simultaneously sustain productive uses and avoid the experiences of insecurity that the HWISE scale captures. Disentangling cause from consequence would require longitudinal or experimental designs that are difficult to mount in the region, and the study does not claim more than the cross-sectional data can support.

That caution leads directly to the study’s most policy-relevant conclusion: MUS is not a panacea for household water insecurity. Simply encouraging or permitting multiple uses of a water point does not guarantee security if the underlying service is unreliable, if the source dries up seasonally, or if the quantity available cannot stretch across domestic and productive demands. Improving household water security, the authors argue, will require attention to the reliability, availability, and seasonal stability of water services in addition to support for multiple water uses. This reframing matters for donors and governments, because it suggests that investments should be judged not by whether a system permits productive use, but by whether it sustains that use through the lean months when insecurity peaks.

The technical logic behind the seasonal finding deserves unpacking. In the West African Sahel, hydrology is dominated by a short rainy season followed by a long dry season during which surface water contracts, water tables drop, and demand from livestock and gardens intensifies precisely as supply diminishes. A water system that performs adequately in the wet season can fail catastrophically in the dry months, forcing households to revert to distant, contaminated, or expensive alternatives. Households practicing year-round MUS, by definition, retain access to sources that survive this stress test, which means their productive activities continue and their domestic needs are met without the trade-offs, rationing, and anxiety that characterize insecurity. Seasonal MUS households, by contrast, experience a predictable collapse of their water portfolio, and the HWISE data register that collapse as elevated insecurity.

The implications extend beyond Mali. Across much of sub-Saharan Africa and South Asia, rural livelihoods are built on small-scale mixed farming, and the household is simultaneously a consumption unit and a production unit. Water policies that ignore this duality risk systematically underestimating the volumes communities actually need and misdesigning infrastructure around a single-use fiction. The Malian results suggest that the HWISE scale, originally developed to track domestic water insecurity globally, can serve as an outcome measure for evaluating multiple-use water programs, giving the MUS movement a standardized yardstick it has lacked. They also hint at a virtuous cycle: households with secure, year-round water are better positioned to invest labor and capital in productive uses, which in turn strengthens the economic case for maintaining and upgrading the infrastructure that makes year-round access possible.

What remains open is the causal question and its practical corollary: if reliable year-round availability underpins both MUS practice and water security, then the highest-leverage interventions may be those that extend service reliability, through storage, borehole deepening, solar pumping, or maintenance systems, rather than those that merely designate water points as multiple-use. The study’s authors stop short of prescribing, but the direction of their findings is unmistakable. In rural Mali, the families who escape water insecurity are not simply those with more infrastructure; they are those whose water, for everything they need it to do, is there in every month of the year. Closing that seasonal gap, the research implies, is where the next generation of water development should focus its attention and its funds.

Subject of Research: The association between multiple-use water services and household water insecurity in rural Mali

Article Title: Beyond infrastructure: Linking multiple-use water services and experiences with household water insecurity in rural Mali

Article References: Stellbauer, M., Jepson, W., Osborne-Gowey, J., Lefore, N., Connors, J. C., & Kato, E. (2026). Beyond infrastructure: Linking multiple-use water services and experiences with household water insecurity in rural Mali. PLOS Water, 5(8), e0000600. https://doi.org/10.1371/journal.pwat.0000600

Image Credits: AI Generated

DOI: 10.1371/journal.pwat.0000600

Keywords: water insecurity, multiple-use water services, MUS, HWISE scale, rural Mali, household water access, seasonal water availability, water infrastructure, West Africa, water policy, domestic and productive water use, PLOS Water

The core of the argument is methodological. Conventional assessments of water security rely on hydrological modelling, infrastructure inventories and supply-side statistics: how many pipes exist, how much water is available, how many connections are installed. These measures say nothing about whether the water that reaches a household is safe, reliable, acceptable or affordable, or about the trade-offs families make when it is not. Experiential scales change that. The Household Water Insecurity Experiences Scale, known as HWISE, was developed and validated for low- and middle-income settings and asks households directly about problems such as worrying about having enough water, going without washing, or drinking water they believed was unsafe. Similarly, the Food Insecurity Experiences Scale and the Household Food Insecurity Access Scale capture lived experiences of hunger and dietary compromise. When deployed together, these instruments reveal coupled deprivation that neither measure can expose alone.

The clearest illustration comes from Walgett, a remote town of roughly 2,000 people in northern New South Wales, where the Barwon and Namoi rivers meet. Aboriginal Community Controlled Organisations there had raised concerns about drinking water quality for years. In 2018, national media reported that sodium concentrations in the town supply had reached approximately 300 milligrams per litre, nearly double the Australian palatability guideline and far above levels recommended for people managing chronic conditions such as hypertension and kidney disease, which occur at high prevalence in Aboriginal populations. From a purely infrastructural standpoint, Walgett had a functioning water system. From the perspective of the people drinking the water, it was a system that many could not safely or acceptably use.

In 2022, supported by a National Health and Medical Research Council Ideas Grant, the community ran a survey using the internationally validated HWISE and food insecurity instruments. The results were stark. Forty-six per cent of participants experienced food insecurity and 44 per cent experienced water insecurity, while almost one third experienced both at the same time. Participants who were water insecure were far more likely to be food insecure, a statistical association that turns the abstract policy language of integration into a measurable household reality. Four out of five respondents relied on bottled water, typically spending between 30 and 50 Australian dollars a week on it. In a low-income community, that recurring expenditure directly competes with the household food budget, effectively converting a water quality failure into a nutrition problem.

The surveys also changed the politics. Wendy Spencer, General Manager of the Dharriwaa Elders Group, described the shift in terms that capture why experiential data matters beyond its technical content. Prior to the surveys, she said, the community knew there was a problem but no one would listen; the data gave them a voice and helped inform their solutions. That observation goes to the heart of the authors’ case. Infrastructure descriptors and aggregate supply statistics cannot register the daily decisions of a parent choosing between bottled water and fresh vegetables, but a validated experiential scale can, and in doing so it creates evidence that institutions are obliged to engage with.

Walgett is not an outlier. Modelling by the Australian National University, published in npj Clean Water, estimated that more than 600,000 people across more than 400 locations are likely consuming water that does not meet health guidelines for quality, and that 44 per cent of those locations are Aboriginal communities. Read together with the Walgett survey findings, this points to a systemic national problem rather than a collection of local anomalies. Yet the authors note that Australia’s current consultation on a National Food Security Strategy does not explicitly position water insecurity as a priority area. Without experiential indicators embedded in national monitoring, they argue, the strategy risks addressing food supply and affordability while overlooking the fundamental constraint that unsafe or unacceptable water places on what households can prepare, drink and afford.

The mechanism linking water to food is worth spelling out, because it operates through several distinct pathways. Poor water quality forces substitution: households avoid the tap and buy bottled water or switch to sugar-sweetened beverages, a pattern documented in international research on tap water avoidance and diet-related disease. Unreliable supply disrupts food preparation and hygiene, raising the risk of gastrointestinal illness that itself worsens nutritional status. And the financial burden of alternative water sources crowds out spending on healthy food. Each pathway is invisible in infrastructure statistics, and each becomes quantifiable when water insecurity is measured experientially alongside food insecurity. This is why the authors describe integration as a methodological necessity rather than an advocacy aspiration.

The same logic is now spreading through the Asia Pacific. In Timor-Leste, an Australian Centre for International Agricultural Research-funded project led by Permatil, a community-based organisation promoting permaculture and sustainable livelihoods, has begun training local practitioners and piloting the Food Insecurity Experiences Scale and the Water Insecurity Experiences Scales. Outcome data are not yet available, but the initiative demonstrates a capacity-building model in which local organisations lead survey implementation, ethical data collection and community-centred evidence generation, embedding experiential measurement within broader water management and food system work. For a young nation where households face interacting pressures from climate variability, the approach offers a way to detect vulnerability that conventional indicators alone cannot capture.

For the water research and engineering community, the implications are practical rather than rhetorical. The authors point to case studies from Nepal and Sierra Leone showing that experiential water insecurity measures are useful for monitoring and evaluating WASH programs, revealing behavioural and economic barriers that determine whether technically sound interventions actually improve lives. Paired with biophysical indicators, experiential data provide a fuller picture of system performance: they can sharpen targeting, strengthen accountability, and test whether policies are moving the outcomes that matter to households. The metrics the authors propose are concrete and demanding: fewer families forced to spend scarce income on bottled water, fewer households facing trade-offs between water and food, and more equitable access to safe, reliable drinking water.

What makes the argument compelling is that it reframes who defines the problem. A water system can look adequate on paper while failing the people it serves, and a food strategy can project national abundance while households in remote communities ration both what they drink and what they eat. Measuring experiences closes that gap between system-level adequacy and household-level reality, and the Walgett case shows the data can shift power as well as policy, giving Aboriginal community organisations the evidence to demand and design their own solutions. As climate change accelerates and water variability deepens across Australia and the Asia Pacific, the authors’ conclusion is blunt: integrating experiential measures of water insecurity into food security measurement and policy is no longer optional. It is the difference between a strategy that counts pipes and one that counts people.

Subject of Research: Experiential measurement of household water and food insecurity to inform integrated food and water security policy in Australia and the Asia Pacific

Article Title: Measuring people’s experiences to inform integrated solutions to food and water security in Australia and the Asia Pacific region

Article References: Webster, J., Spencer, W., Corby, C., Lemos, E., & Leslie, G. (2026). Measuring people’s experiences to inform integrated solutions to food and water security in Australia and the Asia Pacific region. PLOS Water, 5(10), e0000647. https://doi.org/10.1371/journal.pwat.0000647

Image Credits: AI Generated

DOI: 10.1371/journal.pwat.0000647

Keywords: water insecurity, food security, HWISE scale, Walgett, Timor-Leste, Aboriginal health, drinking water quality, experiential measures, PLOS Water, climate variability, national food strategy, Asia Pacific

The economic and moral case for investing in young people has never been clearer, and it is increasingly framed as a triple dividend. Money spent on adolescents pays off three times over: in benefits to young people today, in benefits to the healthier and more productive adults they will become, and in benefits to the children they may eventually parent. Major global investments rightly support the first 1,000 days of life, a period of extraordinary developmental sensitivity. But development does not stop there. Later sensitive periods, including adolescence, continue to shape lifelong health trajectories, and these windows receive far less attention and far less money. The numbers are stark. Between 2016 and 2021, adolescent health received less than 3 percent of global development assistance, despite the substantial disease burden carried by this age group. As attention to adolescent wellbeing grows, the authors argue, so must efforts to expand access to the WASH services on which that wellbeing fundamentally depends.

Adolescence is a period of rapid neurological and psychosocial change, when the habits that persist into adulthood are formed. Reliable water and sanitation services are foundational during this life stage, shaping health both directly and indirectly through the behaviors they influence. The technical evidence assembled by Miller and Borja paints a detailed picture of how WASH failures cascade through adolescent lives. When water is scarce or distrusted, young people may substitute sugar-sweetened beverages for drinking water, a shift that elevates lifelong risk of noncommunicable diseases such as diabetes and cardiovascular disease. Inadequate school sanitation contributes to absenteeism and dropout, undermining the educational gains that development programs seek to protect. Barriers to menstrual hygiene management can cause stress, shame, and social withdrawal among adolescent girls, with consequences that ripple through schooling and social participation.

The psychological and social tolls extend further. Water insecurity has been linked to depression among adolescents, including refugee youth living in humanitarian contexts in Uganda. In rural Tanzania, a cross-sectional study found that water insecurity was associated with intimate partner violence among female adolescents and young women, but not among males, a gendered pattern that underscores how water stress interacts with social vulnerability. These burdens are not evenly distributed. Adolescent girls, along with young people in humanitarian settings, displacement camps, and other low-resource environments, often face the greatest risks. And today’s adolescents carry a burden no previous generation has faced: they are the first cohort to come of age in a climate-altered world, where intensifying extreme weather events, from droughts to floods, present additional and growing barriers to safe and sufficient water, sanitation, and hygiene.

Achieving universal WASH coverage, the promise embedded in the Sustainable Development Goals, requires rigorous evidence on what drives service shortfalls, who is most affected, and which strategies equitably improve outcomes. Yet, according to the authors, conventional measurement approaches systematically obscure where WASH is failing adolescents, and standard study designs often miss their perspectives entirely. The problem begins with how the world counts. The WHO/UNICEF Joint Monitoring Programme, the custodian of global WASH monitoring, primarily draws on household surveys that ask which services household members use and whether those services are accessible, available, and safe. These data are essential for tracking global progress, but they carry two key limitations when it comes to understanding the realities of adolescent life.

The first limitation is structural. Because responses are collected from a single respondent for the entire household, the data cannot be disaggregated for individual members, hiding differences by age and gender. A household survey cannot reveal whether a teenage girl’s sanitation needs differ from those of her father, or whether an adolescent boy’s water access differs from his grandmother’s. The second limitation concerns what the monitoring ladder actually measures. The JMP drinking water service ladder provides little insight into whether services are sufficient, acceptable, and reliable for the many uses beyond drinking on which young people’s health depends. A household may officially qualify as having a safely managed drinking water service, yet resident adolescents may go thirsty because they perceive the water to be unsafe, or they may be unable to bathe because the service delivers too little water for uses beyond drinking. On paper, the household is served. In lived experience, it is not.

Schools, where adolescents spend much of their time, are monitored even less rigorously. WASH in schools reporting focuses on the presence of services rather than their sufficiency, so a school may be counted as having toilets even when those facilities are unusable, unsafe, or inadequate for menstrual hygiene needs. Experiential measurement tools offer a way to close these gaps. The Water Insecurity Experiences, or WISE, Scales directly ask users whether available services are adequate for their basic needs, capturing the lived reality that infrastructure counts miss. The Individual WISE Scale enables disaggregation by age and gender, and its four-item version has been recommended by WHO and UNICEF as a priority gender-specific indicator for WASH monitoring. The scale has been validated among individuals aged 15 years and older, and evaluating its suitability for younger adolescents is an important next step. Meanwhile, the School WASH Insecurity Experiences project is developing analogous tools designed specifically for students. Together with qualitative methods, these instruments can help elevate adolescent voices by centering their lived experiences in the data that drive policy.

Beyond national monitoring, the authors argue for embedding these measures in studies that link WASH conditions to health and educational outcomes, revealing which strategies most effectively improve adolescent wellbeing. Longitudinal, mixed-methods designs are especially powerful, and the Longitudinal Cohort Study on the Filipino Child offers a working model. To understand how Filipino adolescents fare across the 2015 to 2030 Sustainable Development Goal period, the study enrolled almost 5,000 ten-year-olds in 2016 and follows them nearly every year into adulthood. It collects data at multiple levels: on individuals, including mental health, hygiene, and diets; on households, including WASH conditions; and on communities, including water supplies. The study has begun integrating the WISE Scales into its surveys and is conducting a parallel qualitative study to record young people’s experiences in their own words. Because such cohorts follow the same individuals over time, they can capture how needs shift across adolescence and how they differ by gender, geography, and household circumstances, providing exactly the kind of insight into how and where policymakers should act that one-off cross-sectional surveys cannot deliver.

The article closes with a concrete call to action aimed at three audiences. Global monitoring bodies and the national agencies that implement household surveys are urged to complement service-level indicators with individual-level experiential measures within existing survey platforms and through adolescent-focused studies, and to disaggregate findings by age and gender. Researchers and funders are asked to prioritize longitudinal, mixed-methods studies that link WASH to health, learning, and livelihoods, and that estimate intervention costs and returns, giving ministries of health, education, and water the data they need to act. Researchers, non-governmental organizations, and program implementers are called to involve young people as co-researchers and co-designers rather than passive subjects. Such engagement is demonstrably feasible: young adolescents in Kenya have already generated actionable recommendations for strengthening water and sanitation security in their own communities, and participatory approaches consistently yield interventions that are more relevant, more acceptable, and more lasting. With deliberate investment, the authors conclude, today’s adolescents could become the healthiest generation in history. Whether they do depends on choices being made now: what the world measures, which studies get funded, and whose experiences are centered when the WASH and health agenda is set.

Subject of Research: Adolescent water, sanitation, and hygiene (WASH) access, measurement, and policy

Article Title: Centering adolescents in global water, sanitation, and hygiene research and policy

Article References: Miller, J. D., & Borja, J. B. (2026). Centering adolescents in global water, sanitation, and hygiene research and policy. PLOS Water, 5(8), e0000608. https://doi.org/10.1371/journal.pwat.0000608

Image Credits: AI Generated

DOI: 10.1371/journal.pwat.0000608

Keywords: adolescent health, water security, sanitation, hygiene, WASH, global health, water insecurity, WISE Scales, menstrual hygiene, Sustainable Development Goals, public health policy, climate change

Resource insecurity is a growing concern for Indigenous populations worldwide, many of whom depend directly on local ecosystems for food, water, and livelihoods. Climate change, deforestation, mining, and infrastructure development are altering the hydrological and ecological foundations of these livelihoods at unprecedented speed. Yet the relationship between access to water and access to food is rarely studied together, despite the obvious practical connections between the two. Drawing water, purifying it, and transporting it all consume time, energy, and health; when any of those resources are stretched thin, the ability to procure and prepare diverse foods can suffer. The new study set out to quantify precisely these linkages in an Awajún population for whom both water and food systems remain closely tied to the surrounding forest and rivers.

The researchers analyzed cross-sectional data from 212 Awajún adults, using linear and logistic regression models with robust standard errors to test associations between water insecurity, food insecurity, and dietary diversity. Water insecurity was assessed through a composite score as well as through individual indicators capturing distinct lived experiences, such as being unable to collect water because of distance, being unable to collect water due to illness or weakness, going for extended periods without drinking water, and not boiling water before use. Food insecurity was likewise measured with a validated score, while dietary diversity captured the variety of foods consumed, a widely used proxy for overall diet quality. This dual approach, combining a composite index with its component indicators, proved to be the study’s most consequential methodological decision.

The results confirmed that both food and water insecurity are prevalent among the Awajún, a finding that may surprise outsiders who imagine the Amazon as a landscape of limitless water. Abundance in the environment does not guarantee access at the household level. Rivers and streams may be contaminated, distant, or dangerous to reach, and seasonal variation can leave families dependent on sources that are unreliable for months at a time. The study’s statistical models showed that these everyday struggles with water translate directly into struggles with food, even after adjusting for other factors.

In adjusted linear regression models, higher composite water insecurity scores were significantly associated with higher food insecurity scores, with a beta coefficient of 0.24 and a 95 percent confidence interval of 0.11 to 0.36, and a p-value below 0.001. In practical terms, this means that as Awajún adults experienced more severe and more frequent water problems, their food insecurity rose in a predictable, measurable way. The association was independent of other variables in the model, strengthening the case that water insecurity is not merely a symptom of general poverty but a distinct driver of hunger. Interestingly, however, the composite water insecurity score was not significantly associated with dietary diversity, suggesting that the aggregated measure was averaging away some of the most important signals.

That is where the component-level analysis became revelatory. When the researchers disaggregated the composite score, individual indicators turned out to be more strongly associated with food insecurity and dietary diversity than the composite measure itself. Being unable to collect water due to distance was associated with a 0.61-point increase in food insecurity scores (95 percent CI: 0.19 to 1.03; p = 0.005). Being unable to collect water due to illness or weakness showed an even stronger association, with a beta of 0.68 (95 percent CI: 0.20 to 1.16; p = 0.006). Not boiling water before drinking was associated with a 0.60-point increase in food insecurity (95 percent CI: 0.15 to 1.05; p = 0.009). Each of these associations was stronger than the one observed for the composite score, indicating that specific, concrete hardships carry more statistical and practical information than a blended index.

Perhaps the most striking result concerned dehydration. Going for extended periods of time without drinking water was associated with lower dietary diversity scores, with a beta of -0.79 and a 95 percent confidence interval of -1.43 to -0.16 (p = 0.01). This inverse relationship hints at a physiological and behavioral cascade: people who cannot drink enough water may reduce their consumption of foods that are difficult to eat or digest without adequate hydration, or they may lack the energy to prepare varied meals. It may also reflect that households facing the most acute water deprivation are those whose entire subsistence system, from farming to fishing to forest gathering, is under strain. Whatever the precise mechanism, the finding links an extreme form of water deprivation to the quality of the diet itself, not just its quantity.

The authors argue that these findings carry significant implications for how governments and aid organizations monitor and address resource insecurity in vulnerable populations. Composite scores, while useful for standardization and cross-cultural comparison, can dilute the signal of specific experiences that are both more measurable in practice and more actionable in policy. A survey that records only an aggregate water insecurity number might miss the fact that distance to water, physical illness, and lack of water treatment are each distinct levers for intervention. Building a well closer to a community addresses one indicator; a mobile water delivery program for sick or elderly residents addresses another; a boiling or filtration campaign addresses a third. The study suggests that tracking these dimensions separately could sharpen the targeting and evaluation of such programs.

The research also speaks directly to the United Nations Sustainable Development Goals, particularly SDG 6 on clean water and sanitation and SDG 2 on zero hunger. Progress toward these goals is often measured and pursued separately, with water programs in one ministry and nutrition programs in another. The Awajún data demonstrate that in Indigenous Amazonian communities, the two agendas are empirically inseparable: water insecurity predicts food insecurity, and specific water deprivations shape dietary quality. Interventions that treat water access as a food security strategy, and vice versa, are likely to outperform siloed approaches. For health surveillance systems, the message is equally clear: questionnaires that capture the lived, granular experiences of water hardship, such as walking long distances, collecting water while ill, or going hours without a drink, may identify at-risk households that aggregate indices overlook.

Beyond its policy relevance, the study is a methodological caution for the growing field of water insecurity research. As instruments like composite water insecurity scales are deployed across dozens of countries, researchers have tended to report the headline score. This analysis shows that the components of such scores can behave differently, and sometimes more powerfully, than the sum of their parts. For the Awajún, whose food systems and water systems are bound together by rainforest ecology, by the labor of collection, and by the daily decisions of households, the path to both clean water and adequate food runs through the same small, hard details of ordinary life. Recognizing those details, the authors suggest, is the first step toward measuring them, and measuring them is the first step toward fixing them.

Subject of Research: Associations between water insecurity, food insecurity, and dietary diversity among Indigenous Awajún adults in the Peruvian Amazon

Article Title: Water insecurity, food insecurity, and dietary diversity among Awajún adults living in the Peruvian Amazon

Article References: Tallman, P. S., & Collins, S. M. (2026). Water insecurity, food insecurity, and dietary diversity among Awajún adults living in the Peruvian Amazon. PLOS Water, 5(9), e0000556. https://doi.org/10.1371/journal.pwat.0000556

Image Credits: AI Generated

DOI: 10.1371/journal.pwat.0000556

Keywords: water insecurity, food insecurity, dietary diversity, Awajún, Peruvian Amazon, Indigenous health, PLOS Water, Sustainable Development Goals, clean water access, nutrition surveillance, resource insecurity, Water

Juliana Bem-Lignani of the State University of Rio de Janeiro and Rosana Salles-Costa of the Federal University of Rio de Janeiro analyzed data from the First Survey on Food and Nutritional Insecurity in Rio de Janeiro, conducted in 2024. The survey drew a probabilistic sample of 2,000 households spread across the municipality’s five residential zones: South, Central, North, West and Southwest. Because the sample was designed to represent the city’s households rather than merely the people willing to answer a questionnaire, the results can be generalized to the population of each territory, a critical feature for a study whose central question is precisely geographic.

The instrument at the heart of the study was the Portuguese version of the Water Insecurity Experiences Scale, known as WISE. Unlike measures that simply ask whether a home has a piped connection, experience-based scales probe what actually happens in daily life: whether there was enough water for drinking and cooking, whether the supply was interrupted, whether households had to change routines to cope. This distinction matters technically because a connection to the network does not guarantee an adequate, regular and safe flow, and the authors argue that lived experience captures dimensions of water access that infrastructural indicators miss.

The territorial pattern that emerged was stark. The South and Southwest zones, home to better socioeconomic conditions, reported daily water supply in 82.2 percent and 75.9 percent of households respectively. By contrast, the Central and North zones showed worse socioeconomic indicators and more frequent supply interruptions, affecting 19.2 percent and 20.6 percent of households. The West zone occupied an intermediate position overall but stood out for rationing, with 30.8 percent of households reporting intermittent service. These are not marginal differences; in a city where water is constitutionally recognized as a social right, a fifth of households in some territories facing interruptions represents a substantial equity gap.

Experience-based water insecurity tracked the same geography. In the South and Southwest zones, 25.1 percent and 27.1 percent of households respectively reported water insecurity. In the Central and North zones the figures climbed to 46.9 percent and 48.3 percent, nearly one household in two. In other words, residents of the city’s central and northern territories were experiencing water insecurity at nearly double the rate of those in the wealthier southern coast, a gradient that parallels well-documented disparities in income, food security and health across the same zones.

To test whether the association between territory and water insecurity was real rather than an artifact of household composition, the researchers used multinomial logistic regression, a statistical model suited to outcomes with multiple ordered or unordered categories. Here the outcome was water insecurity at low, moderate or higher levels, and the models were adjusted for the socioeconomic characteristics of the household reference person and for the household’s water access conditions. Adjusting for these covariates is what allows the analysis to ask whether place itself, with all its social and infrastructural history, adds explanatory power beyond the individual household’s profile.

The answer was yes. Compared with households in the South zone, living in the West zone was associated with 2.4 times the odds of low water insecurity, with a 95 percent confidence interval of 1.5 to 3.7, and living in the North zone carried 2.1 times the odds, with a confidence interval of 1.3 to 3.5. In the Central zone, households had 2.5 times the odds of moderate water insecurity relative to the South, with a confidence interval of 1.2 to 5.2. Because these intervals exclude one, the associations are statistically robust at conventional thresholds, and the consistency of the twofold pattern across separate zones strengthens the interpretation that territory is a meaningful analytical unit for water insecurity.

The study’s conceptual framing draws on the idea that access to water can serve as a marker of social inequities more broadly. Brazil recognizes water as a social right, yet the persistence of unequal access, reliability and quality means that formal legal recognition has not translated into uniform lived experience. The authors conclude that the differences between territories reflect and reinforce social inequalities, and that being connected to the water network alone does not ensure an adequate supply. That finding carries direct policy weight: investments that stop at extending pipes may leave untouched the interruptions, rationing and quality problems that define insecure water access in the poorest territories.

For Rio de Janeiro, the implications point toward policies that target structural and social determinants rather than infrastructure alone. The municipality’s water system is operated by the State Water and Sewage Company, and the city’s history of pronounced territorial disparity, intensified by economic shocks, means that rationing and interruption regimes fall unevenly on households with the fewest resources to buffer them, such as those unable to buy bottled water or store large reserves. The researchers suggest that water insecurity should be monitored alongside food insecurity as a dimension of social inequality, an approach reflected in the survey’s integrated design.

The study was approved by the Research Ethics Committee of the Clementino Fraga Filho University Hospital at the Federal University of Rio de Janeiro, and all participants gave informed consent. Funded by Brazil’s National Council for Scientific and Technological Development, the Rio de Janeiro State Research Support Foundation and the city’s municipal council, the work illustrates how experience-based measurement combined with territory-level sampling can turn a diffuse sense of urban unfairness into precise, actionable evidence. As climate variability tightens pressure on urban water systems worldwide, the Rio findings offer a replicable template: map the lived experience of water insecurity, match it to the social geography of the city, and direct policy where the odds are doubled.

Subject of Research: Association between territorial socioeconomic inequality and household water insecurity in Rio de Janeiro

Article Title: Territories marked by social inequities associated with household water insecurity in Rio de Janeiro/Brasil

Article References: Bem-Lignani, J., & Salles-Costa, R. (2026). Territories marked by social inequities associated with household water insecurity in Rio de Janeiro/Brasil. International Journal for Equity in Health. https://doi.org/10.1186/s12939-026-03020-9

Image Credits: AI Generated

DOI: 10.1186/s12939-026-03020-9

Keywords: water insecurity, Rio de Janeiro, social inequality, WISE scale, household water access, urban equity, public health, Brazil, cross-sectional study, territorial disparities, water policy, socioeconomic factors

The research, published in SSM – Mental Health, draws on ten focus group discussions with 80 adult women in five rural communities in Isiolo and Samburu Counties, arid and semi-arid regions that were in the grip of severe drought when data were collected between June and July 2023. The interviews were conducted in the Samburu language by local research assistants and analyzed by a team from Emory University working with St. Paul’s University and World Vision Kenya as part of a multi-country initiative called Strong Women, Strong World: Beyond Access. The analysts used a modified grounded theory approach, applying established frameworks on cognitive labor and mental load to accounts that emerged spontaneously during broader conversations about water, time use, and economic life.

What the team found is striking in its consistency. Across every focus group, women described water collection not as a discrete physical chore but as a continuous cognitive project composed of four interlocking components: anticipation, identification, decision-making, and monitoring. Anticipation began in sleep. As one participant put it, even while sleeping women would start planning for the next day, calculating whether they would have water and how to fit collection into an already packed schedule. Upon waking, the mental sequencing resumed immediately—deciding what could be postponed, what demanded attention, and how the day’s chores could be arranged so that the long trip for water did not derail everything else.

Identification, the second component, involved continuously evaluating which water sources were viable, safe, and accessible under shifting conditions. During the rainy season, temporary sources such as water pans, gullies, and shallow dug wells appeared nearby, offering brief relief that might last only a week or two before drying up. In the dry season, women weighed distant sources that offered cleaner water against closer points contaminated by livestock and wildlife. They layered other tasks onto water trips—washing clothes, watering animals, shopping on market days—to conserve time and energy, and they adjusted plans when husbands requested extra water or when children’s needs intervened.

Decision-making, in turn, was not a single choice but a constantly revised calculation. Women chose whether to leave at dawn, before water points grew crowded and before livestock arrived, even though leaving early meant sacrificing time for school preparation and breakfast. They decided how much to carry, when to make a second trip, how to ration what they had collected across drinking, cooking, bathing, and cleaning, and when it was safe to walk routes where elephants had been spotted. Fatigue shaped these decisions in tangible ways: some women reported carrying smaller volumes of water or returning home earlier than planned because the cognitive and physical demands of the morning had already depleted them—a detail the researchers note adds empirical nuance to behavioral science, which increasingly recognizes that mental burden directly affects the performance of physically demanding tasks.

Monitoring, the fourth component, extended the labor well beyond the journey itself. Once home, women tracked water levels throughout the day, restricted household consumption, ensured children and livestock were supplied, and observed whether sources were drying, lowering, or becoming contaminated—observations that triggered fresh rounds of anticipation and planning. This vigilance was largely invisible within the household, unobservable to those who benefited from it, and therefore unrecognized and unshared. Women emphasized that the mental work of tracking what remained continued long after the physical labor of collection had ended, keeping water permanently on their minds.

Woven through all of this was emotional labor: regulating fear, suppressing frustration, buffering family members from scarcity, and absorbing responsibility for everyone’s wellbeing at the expense of their own. Women described the anguish of rationing, of giving the last water to others while going without bathing themselves, and the shame of borrowing food from neighbors after a long water journey. They described painful trade-offs between fetching water and preparing food, protecting children and earning income. They also described the emotional weight of watching daughters begin to shoulder the same burdens, and their determination to send girls to school to break the cycle. Women persistently subordinated their own needs—eating last, skipping meals, continuing to cook and care for others after reaching physical and emotional depletion.

The cumulative consequence, the researchers argue, is what they call the mental load of water collection: neither the sum of cognitive and emotional labor nor a synonym for stress, but the distinct product of their sustained co-occurrence. It manifested as sleepless nights, constant perseveration, headaches and lightheadedness, exhaustion, and neglected self-care. One woman summed it up: us women get sleepless nights knowing that in the morning you have to go and fetch water. The load was continuous, present day and night; boundaryless, following women across cooking, farming, childcare, and rest; and invisible, sustained by gender norms that frame water collection as women’s natural, unquestioned duty. Men’s participation was widely viewed as culturally inappropriate, with men risking social shame even for carrying a container a short distance, so women performed the work without household support—even as pregnant women faced risks including miscarriage from the weight of jerricans or sudden flight from wildlife.

The findings place rural Kenyan women’s experiences within a growing global literature linking water insecurity to anxiety, depression, and psychosocial distress, from Bolivia and Ethiopia to Uganda and India. But they extend that literature by demonstrating that the four components of cognitive labor documented in higher-income household research intensify under conditions of scarcity, seasonal variability, physical danger, and infrastructure failure, demanding constant recalibration that comparatively stable domestic settings do not. The burden, the authors stress, is not incidental but structurally produced by the gendered assignment of water responsibility, and it accumulates across the life course, beginning in childhood and intensifying during pregnancy and postpartum periods.

Yet the study also found buffers. Social networks softened the load: women walked to the river in groups, chatting, sharing information about water availability, coordinating decisions, and releasing stress through companionship that sometimes offered the only social connection in isolated homesteads. Membership in women’s groups provided practical help and belonging. These supports did not eliminate the hardship, the researchers note, but they made daily water work more bearable and emotionally sustainable.

The implications reach beyond Kenya. Globally, 1.8 billion people rely on off-premises water sources, and in seven out of ten households that must collect water, women and girls bear primary responsibility. Prior research using smartwatches and scales found that women in four countries walked an average of 3.5 kilometers and expended 231 kilocalories per collection trip; separate survey data show women have 1.5 times higher odds than men of reporting a water-fetching injury, with falls on dangerous terrain the predominant mechanism. The new study insists that the true burden cannot be measured in distance walked or weight carried alone. Improving water access through infrastructure that delivers safe water to the household could substantially reduce physical, cognitive, and emotional labor, and the authors argue for greater representation of women in water governance and leadership, alongside the application of frameworks such as the International Labour Organization’s 5Rs—recognizing, reducing, redistributing, rewarding, and representing unpaid care work. Until such change arrives, the researchers conclude, water collection must be recognized as a complex, gendered system of labor that shapes women’s time, energy, identities, and mental health—a burden they carry because, as they said repeatedly, everything depends on them.

Subject of Research: The cognitive and emotional labor of water collection and management among women in rural Kenya

Article Title: ‘Everything depends on us’: The cognitive and emotional labor of water collection and management in rural kenya

Article References: Dessalegn, B., Ogutu, E., Mink, T., Patrick, M., Sinharoy, S. S., Atandi, E., Mwangi, P., Koome, P., Onyango, R. O., Otuya, P., Ruto, P., & Caruso, B. A. (2026). ‘Everything depends on us’: The cognitive and emotional labor of water collection and management in rural kenya. SSM – Mental Health, 10, Article 100702. https://doi.org/10.1016/j.ssmmh.2026.100702

Image Credits: AI Generated

DOI: 10.1016/j.ssmmh.2026.100702

Keywords: water insecurity, cognitive labor, emotional labor, mental load, gender norms, rural Kenya, water collection, unpaid care work, mental health, WASH, Samburu, drought