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Assessing reliability, change after intervention, and performance of a water insecurity scale in rural Ethiopia

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Abstract

There is growing interest in the phenomenon of water insecurity, yet a relative paucity of tools to assess the occurrence and severity of water insecurity at the household level. We sought to assess the validity and reliability of a household water insecurity scale in a rural Ethiopian context. Secondary data on water insecurity from up to 1934 rural Ethiopian households that had participated in a water and sanitation intervention was analysed. Exploratory factor analysis and Cronbach’s alpha were used to assess dimensionality of the water insecurity responses and parametric and non-parametric tests used to test for differences in household water insecurity scores across household types and objective measures of household water access. Factor analysis revealed one dominant factor and the Cronbach’s alpha of the water insecurity scale was 0.94. Households with access to improved water sources, that lived close to water collection points, that did not farm, and that felt they had “enough” water all scored as significantly more water secure on the household water insecurity scale (P < 0.05). The household water insecurity scale also predicted the occurrence of diarrhea among children in the household (aOR 1.2, 95 % CI 1.08, 1.33) whereas no other measure of water access did. Finally, household water insecurity scores improved by 55 % after a water and sanitation intervention.

Our results suggest the possibility of an effective water insecurity tool, which might be deployed to assess the epidemiology of water insecurity including its causes and consequences. Future research should aim to validate the tool against behavioral observations and to link shifts in water insecurity to changes in health and wellbeing.

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References

  • Aihara, Y., Shrestha, S., Kazama, F., & Nishida, K. (2015). Validation of household water insecurity scale in urban Nepal. Water Policy, 17(6), 1019–1032.

  • Bakker, K. (2012). Water management. Water security: research challenges and opportunities. Science, 337(6097), 914–915.

    Article  CAS  PubMed  Google Scholar 

  • Barrett, C. B. (2010). Measuring food insecurity. Science, 327(5967), 825–828.

    Article  CAS  PubMed  Google Scholar 

  • Bartholonew, D., Steele, F., Moustaki, I., & Galbraith, J. (2008). Analysis of multivariate social science data (p. 371). New york: CRC Press.

    Google Scholar 

  • Caruso, B. A., Sevilimedu, V., Fung, I. C., Patkar, A., & Baker, K. K. (2015). Gender disparities in water, sanitation, and global health. The Lancet, 386(9994), 650–651.

  • Coates, J., Frongillo, E. A., Rogers, B. L., Webb, P., Wilde, P. E., & Houser, R. (2006a). Commonalities in the experience of household food insecurity across cultures: what are measures missing? The Journal of Nutrition, 136(5), 1438–1448.

    Google Scholar 

  • Coates, J., Wilde, P. E., Webb, P., Rogers, B. L., & Houser, R. F. (2006b). Comparison of a qualitative and a quantitative approach to developing a household food insecurity scale for Bangladesh. The Journal of Nutrition, 136(5), 1420–1430.

    Google Scholar 

  • Dangour, A. D., Watson, L., Cumming, O., Boisson, S., Che, Y., Velleman, Y., Cavill, S., Allen, E., & Uauy, R. (2013). Interventions to improve water quality and supply, sanitation and hygiene practices, and their effects on the nutritional status of children. The Cochrane database of systematic reviews, 8, CD009382.

    PubMed  Google Scholar 

  • Fewtrell, L., Kaufmann, R. B., Kay, D., Enanoria, W., Haller, L., & Colford, J. M. (2005). Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis. The Lancet Infectious Diseases, 5(1), 42–52.

    Article  PubMed  Google Scholar 

  • Frongillo, E. A. (1999). Validation of measures of food insecurity and hunger. The Journal of Nutrition, 129(2), 506S–509S.

    CAS  PubMed  Google Scholar 

  • Frongillo, E. A., & Nanama, S. (2006). Development and validation of an experience-based measure of household food insecurity within and across seasons in northern Burkina Faso. The Journal of Nutrition, 136(5), 1409S–1419S.

    CAS  PubMed  Google Scholar 

  • Hadley, C., & Wutich, A. (2009). Experience-based measures of food and water security: biocultural approaches to grounded measures of insecurity. Human Organization, 68(4), 451–460.

  • Hadley, C., Borgerhoff Mulder, M., & Fitzherbert, E. (2007). Seasonal food insecurity and perceived social support in rural Tanzania. Public Health Nutrition, 10(6), 544–551.

  • Howard, G., & Bartram, J. (2003). Domestic water quantity, service level, and health. Geneva: World Health Organization.

    Google Scholar 

  • Jepson, W. (2014). Measuring 'no-win' waterscapes: experience-based scales and classification approaches to assess household water security in colonias on the US-Mexico border. Geoforum, 51, 107–120.

    Article  Google Scholar 

  • Mason, L. R. (2014). Examining relationships between household resources and water security in an urban Philippine community. Journal of the Society for Social Work and Research, 5(4), 489–512

  • Maxwell, D., Vaitla, B., & Coates, J. (2014). How do indicators of household food insecurity measure up? An empirical comparison from Ethiopia. Food Policy, 47, 107–116.

    Article  Google Scholar 

  • Melgar-Quinonez, H., & Hackett, M. (2008). Measuring household food security: the global experience. Journal of Physical Therapy Science, 21, 27–37.

    Google Scholar 

  • Pruss-Ustun, A., Bartram, J., Clasen, T., Colford Jr., J. M., Cumming, O., Curtis, V., Bonjour, S., Dangour, A. D., De France, J., Fewtrell, L., et al. (2014). Burden of disease from inadequate water, sanitation and hygiene in low- and middle-income settings: a retrospective analysis of data from 145 countries. Tropical medicine & international health: TM & IH, 19(8), 894–905.

    Article  Google Scholar 

  • Ricci, J., Jerome, N., Megally, N., Galal, O., Harrison, G., & Kirksey, A. (1995). Assessing the validity of informant recall: results of a time use pilot study in peri-urban Egypt. Human Organization, 54(3), 304–308.

    Article  Google Scholar 

  • Ruel, M. T. (2003). Operationalizing dietary diversity: a review of measurement issues and research priorities. The Journal of Nutrition, 133(11), 3911S–3926S.

    CAS  PubMed  Google Scholar 

  • Stevenson, E. G. J., Greene, L. E., Maes, K. C., Ambelu, A., Tesfaye, Y. A., Rheingans, R., & Hadley, C. (2012). Water insecurity in 3 dimensions: an anthropological perspective on water and women's psychosocial distress in Ethiopia. Social Science & Medicine, 75(2), 392–400.

    Article  Google Scholar 

  • Stevenson, E. G. J., et al. (2016). Community water improvement, household water insecurity, and women’s psychological distress: an intervention and control study in Ethiopia. PLoS One, 11(4), e0153432.

  • Stocks, M. E., Ogden, S., Haddad, D., Addiss, D. G., McGuire, C., & Freeman, M. C. (2014). Effect of water, sanitation, and hygiene on the prevention of trachoma: a systematic review and meta-analysis. PLoS Medicine, 11(2), e1001605.

    Article  PubMed  PubMed Central  Google Scholar 

  • Strunz, E. C., Addiss, D. G., Stocks, M. E., Ogden, S., Utzinger, J., & Freeman, M. C. (2014). Water, sanitation, hygiene, and soil-transmitted helminth infection: a systematic review and meta-analysis. PLoS Medicine, 11(3), e1001620.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tsai A, Kakuhikire B, Mushavi R, Vořechovská D, Perkins JM, McDonough AQ, and DR B. 2015. Population-based study of intra-household gender differences in water insecurity: reliability and validity of a survey instrument for use in rural Uganda. Journal of Water and Health in press 14(2):280–292

  • UNICEF/WHO (2015). Progress of sanitation and drinking water: 2015 update and MDG assessment. New York: Joint Monitoring Programme for Water Supply and Sanitation. http://files.unicef.org/publications/files/Progress_on_Sanitation_and_Drinking_Water_2015_Update_.pdf.

  • Webb, P., Coates, J., Frongillo, E. A., Rogers, B. L., Swindale, A., & Bilinsky, P. (2006). Measuring household food insecurity: why it's so important and yet so difficult to do. The Journal of Nutrition, 136(5), 1404–1408.

    Google Scholar 

  • WHO/UNICEF. 2008. Core questions on drinking-water and sanitation for household surveys. In: Sanitation NYWUJMPfWSa, editor. New York. http://apps.who.int/iris/bitstream/10665/43489/1/9789241563260_eng.pdf.

  • Wolf, J., Pruss-Ustun, A., Cumming, O., Bartram, J., Bonjour, S., Cairncross, S., Clasen, T., Colford Jr., J. M., Curtis, V., De France, J., et al. (2014). Assessing the impact of drinking water and sanitation on diarrhoeal disease in low- and middle-income settings: systematic review and meta-regression. Tropical medicine & international health: TM & IH, 19(8), 928–942.

    Article  Google Scholar 

  • Wutich, A. (2009). Intrahousehold disparities in women and men's experiences of water insecurity and emotional distress in urban Bolivia. Medical Anthropology Quarterly, 23(4), 436–454.

    Article  PubMed  Google Scholar 

  • Wutich, A., & Brewis, A. (2014). Food, water, and scarcity toward a broader anthropology of resource insecurity. Current Anthropology, 55(4), 444–468.

    Article  Google Scholar 

  • Wutich, A., & Ragsdale, K. (2008). Water insecurity and emotional distress: coping with supply, access, and seasonal variability of water in a Bolivian squatter settlement. Social Science & Medicine, 67(12), 2116–2125.

    Article  Google Scholar 

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Acknowledgments

Funding for this study was provided by the Millennium Water Alliance through a grant from the Conrad N. Hilton Foundation. We are grateful to the field teams from the partner organizations that collected the data. Jed Stevension provided assistance on tool development. Anna Chard supported data collection and cleaning. Leslie Greene provided important input at the early stages of the study. We thank Alexander Tsai for additional advice on the paper.

Author information

Authors and Affiliations

  1. Department of Anthropology, Emory University, 1557 Dickey Drive, Atlanta, GA, 30322, USA

    Craig Hadley

  2. Department of Environmental Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA

    Matthew C. Freeman

Authors
  1. Craig Hadley
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  2. Matthew C. Freeman
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Corresponding author

Correspondence to Craig Hadley.

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Conflicts of interest

Craig Hadley - no conflicts of interest.

Matthew Freeman - no conflicts of interest

Appendix

Appendix

Items on the Household Water Insecurity scale

  1. 1.

    In the past 30 days, did you worry that you would not have enough water for all of your household needs?

  2. 2.

    In the past 30 days, because there was not enough water or because it was too difficult to collect water, did you reduce the amount of water you used for

    1. a.

      Drinking

    2. b.

      Cooking

    3. c.

      Washing utensils

    4. d.

      Cleaning house

    5. e.

      Making coffee

    6. f.

      Laundry

    7. g.

      Bathing

  3. 3.

    In the past 30 days, did you or anyone in your household drink water that you thought might not be safe for health?

  4. 4.

    In the past 30 days, did you or someone in your household not cook a desirable food because there was not enough water?

  5. 5.

    In the past 30 days, did you or anyone else in your household sleep very few hours because they wake up very early in the morning to go for collecting water?

  6. 6.

    Within the past 30 days, was there any time that you or anyone else in your household did not collect water when you wanted to because…

    1. a.

      Too far away or takes too long

    2. b.

      Too risky or dangerous?

    3. c.

      Takes too long to wait at source

    4. d.

      Not enough water at source

  7. 7.

    In the past 30 days, did you or any member of your household collect water from an undesirable or dirty source because you could not collect from your preferred source?

  8. 8.

    In the past 30 days, did you or anyone else in your household take water from someone else in your village?

  9. 9.

    In the past 30 days, were you or anyone in your household unable to complete all of your work due to water collection?

  10. 10.

    In the past 30 days, did you or anyone else in your household go to sleep thirsty because there was not enough water?

  11. 11.

    In the past 30 days, did you or anyone else in your household go a whole day without drinking water because there was not enough water?

  12. 12.

    In the past 30 days, did you or anyone in your household not participate in church, a funeral, wedding, or kebele meeting when you wanted to because you had too many chores?

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Hadley, C., Freeman, M. Assessing reliability, change after intervention, and performance of a water insecurity scale in rural Ethiopia. Food Sec. 8, 855–864 (2016). https://doi.org/10.1007/s12571-016-0599-1

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