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1. In pursuit of ‘safe’ water: the burden of personal injury from water fetching in 21 low-income and middle-income countries

   https://doi.org/10.1136/bmjgh-2020-003328  

   Venkataramanan, Vidya; Geere, Jo-Anne L; Thomae, Benjamin; Stoler, Justin; Hunter, Paul R; Young, Sera L (October 2020, BMJ Global Health)

   null (Ed.)

   Introduction Water fetching for household needs can cause injury, but documentation of the burden of harm globally has been limited. We described the frequency, characteristics and correlates of water-fetching injuries in 24 sites in 21 low-income and middle-income countries in Asia, Africa and Latin America and the Caribbean. Methods In a survey of 6291 randomly selected households, respondents reported whether and how they had experienced water-fetching injuries. Responses were coded for injury type, mechanism, bodily location and physical context. We then identified correlates of injury using a multilevel, mixed-effects logistic regression model. Results Thirteen per cent of respondents reported at least one water-fetching injury. Of 879 injuries, fractures and dislocations were the most commonly specified type (29.2%), and falls were the most commonly specified mechanism (76.4%). Where specified, 61.1% of injuries occurred to the lower limbs, and dangerous terrain (69.4%) was the most frequently reported context. Significant correlates included being female (aOR=1.50, 95% CI 1.15 to 1.96); rural (aOR=4.80, 95% CI 2.83 to 8.15) or periurban residence (aOR=2.75, 95% CI 1.64 to 4.60); higher household water insecurity scores (aOR=1.09, 95% CI 1.07 to 1.10) and reliance on surface water (aOR=1.97, 95% CI 1.21 to 3.22) or off-premise water sources that required queueing (aOR=1.72, 95% CI 1.19 to 2.49). Conclusion These data suggest that water-fetching injuries are an underappreciated and largely unmeasured public health challenge. We offer guidelines for comprehensive data collection on injuries to better capture the true burden of inadequate water access. Such data can guide the design of interventions to reduce injury risk and promote equitable water access solutions. 

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2. Climate Variability and Farmers’ Perception in Southern Ethiopia

   https://doi.org/10.1155/2019/7341465  

   Esayas, Befikadu; Simane, Belay; Teferi, Ermias; Ongoma, Victor; Tefera, Nigussie (June 2019, Advances in Meteorology)

   The study aims to analyze climate variability and farmers’ perception in Southern Ethiopia. Gridded annual temperature and precipitation data were obtained from the National Meteorological Agency (NMA) of Ethiopia for the period between 1983 and 2014. Using a multistage sampling technique, 403 farm households were surveyed to substantiate farmers’ perceptions about climate variability and change. The study applied a nonparametric Sen’s slope estimator and Mann–Kendall’s trend tests to detect the magnitude and statistical significance of climate variability and binary logit regression model to find factors influencing farm households’ perceptions about climate variability over three agroecological zones (AEZs). The trend analysis reveals that positive trends were observed in the annual maximum temperature, 0.02°C/year ( p < 0.01 ) in the lowland and 0.04°C/year ( p < 0.01 ) in the highland AEZs. The positive trend in annual minimum temperature was consistent in all AEZs and significant ( p < 0.01 ). An upward trend in the annual total rainfall (10 mm/year) ( p < 0.05 ) was recorded in the midland AEZ. Over 60% of farmers have perceived increasing temperature and decreasing rainfall in all AEZs. However, farmers’ perception about rainfall in the midland AEZ contradicts with meteorological analysis. Results from the binary logit model inform that farmers’ climate change perceptions are significantly influenced by their access to climate and market information, agroecology, education, agricultural input, and village market distance. Based on these results, it is recommended to enhance farm households’ capacity by providing timely weather and climate information along with institutional actions such as agricultural extension services. 

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3. Water Procurement Time and Its Implications for Household Water Demand—Insights from a Water Diary Study in Five Informal Settlements of Pune, India

   https://doi.org/10.3390/w14071009  

   Zozmann, Heinrich; Klassert, Christian; Klauer, Bernd; Gawel, Erik (April 2022, Water)

   Many private households spend considerable amounts of time accessing water, for instance by walking to and queuing at public access points, or by filling storage vessels at taps with low flow rates. This time has an opportunity cost, which can be substantial and may impact which water services and quantities of water households demand. In a novel form of diary study, we gathered detailed water consumption and time use data from 50 households in five informal settlements of the Indian metropolis Pune, accompanied by a household survey and in-depth interviews. With the data, we characterize water collection behaviors and assign monetary values to water procurement time. We statistically analyze the effects of time cost on consumed quantities in several two-level mixed-effect models. Household members in our sample spend up to several hours each day filling storage vessels, even if a private connection to the piped network is available. Average time cost amounted to the equivalent of 4.23–13.81% of monthly household cash income. Our analyses indicate that procurement time reduces quantitative water demand in a significant way. The households incurring the highest per-unit time cost consumed water quantities below minimum levels recommended for human health. This substantiates that time costs can impede access to water and are a relevant issue for water management and policy. 

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4. Predictions of household water affordability under conditions of climate change, demographic growth, and fresh groundwater depletion in a southwest US city indicate increasing burdens on the poor

   https://doi.org/10.1371/journal.pone.0277268  

   Heyman, Josiah M.; Mayer, Alex; Alger, Jessica (November 2022, PLOS ONE)

   Li, Wenliang (Ed.)

   Reduced river flows and groundwater depletion as a result of climate change and population growth have increased the effort and difficulty accessing and processing water. In turn, residential water costs from municipal utilities are predicted to rise to unaffordable rates for poor residential water customers. Building on a regional conjunctive use model with future climate scenarios and 50-year future water supply plans, our study communicates the effects of climate change on poor people in El Paso, Texas, as water becomes more difficult and expensive to obtain in future years. Four scenarios for future water supply and future water costs were delineated based on expected impacts of climate change and groundwater depletion. Residential water use was calculated by census tract in El Paso, using basic needs indoor water use and evaporative cooling use as determinants of household water consumption. Based on household size and income data from the US Census, fraction of household income spent on water was determined. Results reveal that in the future, basic water supply will be a significant burden for 40% of all households in El Paso. Impacts are geographically concentrated in poor census tracts. Our study revealed that negative impacts from water resource depletion and increasing populations in El Paso will lead to costly and difficult water for El Paso water users. We provide an example of how to connect future resource scenarios, including those affected by climate change, to challenges of affordability for vulnerable consumers. 

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5. Effects of Climatic Factors on Diarrheal Diseases among Children below 5 Years of Age at National and Subnational Levels in Nepal: An Ecological Study

   https://doi.org/10.3390/ijerph19106138  

   Dhimal, Meghnath; Bhandari, Dinesh; Karki, Khem B.; Shrestha, Srijan Lal; Khanal, Mukti; Shrestha, Raja Ram; Dahal, Sushma; Bista, Bihungum; Ebi, Kristie L.; Cissé, Guéladio; et al (May 2022, International Journal of Environmental Research and Public Health)

   Introduction: The incidence of diarrhea, a leading cause of morbidity and mortality in low-income countries such as Nepal, is temperature-sensitive, suggesting it could be associated with climate change. With climate change fueled increases in the mean and variability of temperature and precipitation, the incidence of water and food-borne diseases are increasing, particularly in sub-Saharan Africa and South Asia. This national-level ecological study was undertaken to provide evidence linking weather and climate with diarrhea incidence in Nepal. Method: We analyzed monthly diarrheal disease count and meteorological data from all districts, spanning 15 eco-development regions of Nepal. Meteorological data and monthly data on diarrheal disease were sourced, respectively, from the Department of Hydrology and Meteorology and Health Management Information System (HMIS) of the Government of Nepal for the period from 2002 to 2014. Time-series log-linear regression models assessed the relationship between maximum temperature, minimum temperature, rainfall, relative humidity, and diarrhea burden. Predictors with p-values < 0.25 were retained in the fitted models. Results: Overall, diarrheal disease incidence in Nepal significantly increased with 1 °C increase in mean temperature (4.4%; 95% CI: 3.95, 4.85) and 1 cm increase in rainfall (0.28%; 95% CI: 0.15, 0.41). Seasonal variation of diarrheal incidence was prominent at the national level (11.63% rise in diarrheal cases in summer (95% CI: 4.17, 19.61) and 14.5% decrease in spring (95% CI: −18.81, −10.02) compared to winter season). Moreover, the effects of temperature and rainfall were highest in the mountain region compared to other ecological regions of Nepal. Conclusion: Our study provides empirical evidence linking weather factors and diarrheal disease burden in Nepal. This evidence suggests that additional climate change could increase diarrheal disease incidence across the nation. Mountainous regions are more sensitive to climate variability and consequently the burden of diarrheal diseases. These findings can be utilized to allocate necessary resources and envision a weather-based early warning system for the prevention and control of diarrheal diseases in Nepal. 

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