Department of Geography and Earth Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, NC 28223, USA.
School of Kinesiology and Health Studies, SKHS Building 28 Division Street, Queen's University, Kingston, ON K7L 3N6, Canada.
Int J Environ Res Public Health. 2020 Jan 31;17(3):890. doi: 10.3390/ijerph17030890.
Water security is critical to the health and well-being of people around the world, especially among populations experiencing water stresses and rapid urbanization in low- to middle-income countries (LMICs). Recent research suggests water insecurity is associated with negative mental health outcomes. Despite global improvement in access to safe water across the world, the World Health Organization (WHO) reports that access to safe water in urban areas has not changed significantly or has stagnated in certain countries. In most African cities, entrepreneurial water vendors have stepped up to fill supply gaps in the formal delivery system by selling vended water. As part of a larger research program that aims to assess and analyze public perceptions around vended water, this paper explores the links connecting water insecurity and emotional distress among urban slum dwellers who mostly use vended water in Accra, Ghana. We used a parallel mixed-methods approach. Our quantitative results show that water-insecure households (OR = 2.23, = 0.01) were more likely to report emotional distresses compared to water-secure households. However, households with improved sanitation (OR = 0.28, = 0.01) and those willing to participate for improved water and sanitation (OR = 0.28, = 0.01) were less likely to report emotional distress. Our qualitative results offered support for the quantitative results, as participants not only hold various perceptions regarding the safety and quality of vended water but expressed emotional distresses such as fear of contamination, discomfort, worry over arbitrary change in prices, and anxiety. The implications of the results for policy and practice, specifically to ensuring access to safe water, are discussed.
水安全对于全世界人民的健康和福祉至关重要，特别是在那些面临水资源紧张和快速城市化的中低收入国家（LMICs）的人群中。最近的研究表明，水不安全与负面心理健康结果有关。尽管全球范围内安全饮用水的获取情况有所改善，但世界卫生组织（WHO）报告称，城市地区安全饮用水的获取情况并没有显著变化，或者在某些国家已经停滞不前。在大多数非洲城市，企业家水供应商通过销售销售水来填补正规供水系统的供应缺口。作为旨在评估和分析公众对销售水的看法的更大研究计划的一部分，本文探讨了与加纳阿克拉城市贫民窟居民的水不安全和情绪困扰有关的联系，这些居民大多使用销售水。我们使用了并行的混合方法。我们的定量结果表明，与水安全的家庭相比，水不安全的家庭（OR = 2.23，p = 0.01）更有可能报告情绪困扰。然而，改善卫生设施的家庭（OR = 0.28，p = 0.01）和愿意参与改善水和卫生设施的家庭（OR = 0.28，p = 0.01）报告情绪困扰的可能性较小。我们的定性结果为定量结果提供了支持，因为参与者不仅对销售水的安全性和质量持有各种看法，而且还表达了情绪困扰，例如对污染的恐惧、不适、对价格任意变化的担忧以及焦虑。讨论了结果对政策和实践的影响，特别是在确保获得安全饮用水方面。
