Co-author: Katie Connolly
In our previous blog, we outlined how low-income households in Latin America are more likely to burden women with the responsibilities of fetching water, thus exposing a relationship between poverty and gender inequity.
But while additional work is needed to further flesh-out some of the factors driving this relationship, this preliminary analysis lends evidence to a hypothesis, supported by the literature; women in low-income households have limited access to financial services and educational opportunities, which in turn restricts their ability to tap into the labor market and cements their role as caretakers of the household. In other words, poverty likely reinforces gender roles in the household, and this is evidenced by disparities in water-fetching responsibilities.
The unequal distribution of water-fetching responsibilities not only has a financial toll on women, but also a physical one. A study on the health impacts of fetching water in Ghana, South Africa and Vietnam revealed that those who were previously or are currently responsible for fetching water were more likely to report pain in multiple areas of the body including their hands, upper back, head, chest, abdomen and feet. The repeated stress put on the body from carrying water, and the pain it causes, may also contribute to longer-term disabilities and musculoskeletal diseases.
Still, the burden of water-collection responsibilities is only one of the many ways in which these unequal gender dynamics manifest themselves in the WASH sector. A recent meta-analysis of 59 research articles from 30 countries worldwide outlined the many ways in which women suffer inequalities in the WASH sphere: in addition to being overwhelmingly burdened with carrying water, women lack access to sanitation facilities that allow for proper menstrual-hygiene management (MHM), and to latrines that are safe, secure and private. The study also found that poor WASH is, in general, associated with schistosomiasis, under-5 mortality and childhood stunting.
Furthermore, there is research documenting the link between inadequate WASH access and stunting1, as well as evidence drawing the connection between gender and childhood stunting. A 2009 study lays out a potential causal path for linking inadequate WASH services to stunting: it finds that repeated exposure to fecal bacterial, which is associated with inadequate sanitation and hygiene facilities, can lead to the development of environmental enteric dysfunction (EED) – a pervasive, small-bowel dysfunction that can lead to nutritional deficiency by preventing a child from absorbing nutrients. The hypothesized connection between EED and a lack of access to WASH services is further explored in a 2019 study.
Moreover, there is also research drawing the connection between gender and childhood stunting. A review of 96 countries found that the GII explained 10 percent of the variance in wasting and stunting and 41 percent of the variance in child mortality. Recent literature also suggests that stunting is both a deep-rooted cause of poverty, as well as a way in which poverty is propagated across generations; women who are stunted are more likely to have stunted children. And the detrimental effects of childhood stunting are long-lasting: a global review covering the magnitude of developmental loss from stunting estimates a 22 percent loss in adult yearly income from being stunted in childhood. This is amplified among low-income households: the adult yearly loss in income from being both stunted and in poverty is 30 percent.
Overall, the evidence is clear that a lack of access to adequate and reliable WASH services reinforces gender disparities in multiple ways – by reducing the time women and girls have available for education and income-generating activities, and increasing their risk of poor nutritional status and stunting – factors that are not only linked to poverty, but also perpetuate it. Moreover, these gender disparities are especially magnified in low-income households.
The association between water fetching responsibilities and poverty, although preliminary, points to a set of initial recommendations: first, it raises the need for an expansion of on-site water facilities which, in addition to marking progress towards the 2030 SDG agenda of offering universal access to safely managed water, would release household members from the responsibility of having to fetch water. Second, it raises the need to push for a series of behavioral-change strategies aimed at ending intra-household gender inequalities by, among other things, helping promote the notion of water fetching as a shared household responsibility.
The current pandemic has magnified issues of poverty, social inequality and exclusion. It has also increased the importance of expanding on-site WASH facilities, especially among low-income households. Increasing the number of on-site facilities will go a long way in lessening the economic and health burdens associated with COVID-19, as well as in helping disrupt the gendered dynamics of water-fetching within households.
Without suggesting any causal relationship, and while underlining that this line of work merits further understanding, a first-look at the data in Latin America hints at the notion that improving household WASH infrastructure, and boosting overall socioeconomic conditions of low-income families, may help start to reduce the gender inequities that permeate household relationships.
1 According to the World Health Organization (WHO): Stunting is the impaired growth and development that children experience from poor nutrition, repeated infection, and inadequate psychosocial stimulation. Children are defined as stunted if their height-for-age is more than two standard deviations below the WHO Child Growth Standards median.