The objectives of a cross-sectional, semi-quantitative study were to: i) assess the prevalence of water insecurity and its association with water access-related behaviors such as time, distance, and sources of water; ii) identify major themes of concern raised in reference to anxiety, water quality/quantity, and perceived health risk domains of water insecurity, and; iii) examine the relationship between water insecurity, hygiene practices, and diarrhea lincidence among children in rural areas of the Menoua Division in the Western Region of Cameroon In-person interviews were conducted with 18 years or older women living with at least one child between 2 and 5 years old (n=134). Participants spent on average 17±12 minutes walking to a drinking water source. Prevalence of water insecurity was 58%, and it was associated with a lower hygiene score among caretakers, i.e., hygiene score of water secure: 9.2±1.2 vs. insecure: 8.2±2.2, F(1, 132)=8.096, P<0.01). Overall, the incidence of diarrhea among children was 18%, and it was significantly higher among water insecure house-holds (79%) compared with secure house-holds (21%, P=0.02). In conclusion, access to improved sources of water is an issue in rural areas. Addressing water insecurity is critical in promoting optimal health and development of children due to its association with poor hygiene practices among caretakers.

Food insecurity is a significant public health issue, since it causes malnutrition and engenders millions of deaths every year. A significant association is found between water and food insecurity. However, it remains unclear what are the pathways through which water shortage impacts food insecurity. Hence, a qualitative study was conducted in rural areas in Cameroon to (1) examine water access, its management, and its daily use and (2) investigate common behavior changes and coping strategies adults used in managing limited water availability in their households. Three rounds of focus group discussions and six key informant interviews were conducted with men and women. The results demonstrated that water access was limited, involving long walking distances and making several trips to the water sources. The household size, number of adults vs. children, and presence of storage containers affected water availability and its daily use. To manage limited water, coping behaviors included skipping drinking, changing cooking plans, and recycling water. In conclusion, limited water access increases food insecurity through several pathways. Governments, policy makers, and international organizations should recognize the interwoven link between water and food security. Joint actions and collaborative efforts are needed to improve success and reduce tradeoffs in achieving Sustainable Development Goals # 2 and # 6.

Background : Water represents the core of food-energy nexus and is vital for human survival. In developing countries, contaminated water and lack of basic water services undermine efforts to improve nutritional status and related health issues. In the rural areas of Central Africa, a majority of the population lacks access to improved water sources and has to devote considerable efforts to obtain water. Objectives : Using the following definition of water insecurity, i.e. it exists when access to adequate amount of safe and clean water does not occur all the times for the entirety of household members to lead a healthy and active life, the study aimed to develop and test a household-level experiential water insecurity scale for rural households in Central Africa. Methods : The research was conducted in three phases: 1) the formative data collection; 2) the scale development; and, 3) the scale testing. In the third Phase, the scale was tested with 250 women who were water managing person of their households. Statistical analysis included items reduction, reliability, as well as criterion and construct validity assessment. The testing led to a final scale of 17 statements (WATINE-17), covering three domains of water insecurity: 1) psychosocial distress; 2) quantity; 3) quality of water. Results : The scale showed an excellent reliability (Cronbach’s alpha = 0.92) and was significantly associated with lower frequency of water intake among women (p = 0.007, concurrent validity). In assessing WATINE-17’s predictive validity, it was found that water insecurity was positively related to food insecurity (p < 0.001) and the level of water insecurity was the highest among severely food insecure households [F (3, 246) = 22.469, p < 0.001]. Conclusion : The WATINE-17 is able to capture key elements of water insecurity and can be used to monitor and evaluate SDG# 6 and water-related programs, such as WASH, in Central Africa.

Adequate and safe water is critical in promoting all 3 pillars of food security. Hence, ensuring availability of water for all is one of the 2030 Sustainable Development Goals. To monitor progress of this goal and understand the role of water in addressing food insecurity, development of a household-level water insecurity scale has become very critical. As such, using the following concept of water insecurity: inconsistent access to sufficient amount of safe and clean water for active and healthy life, several scale development studies have been conducted to measure water insecurity experiences at the household level. Hence, in this review, the science literature was evaluated to 1) describe the scale development process; 2) assess the validity results by comparing scale measurements results with the established 4 United Nations (UN) water standards on water access; and 3) examine key water- and food-related dimensions covered by the scales in measuring water insecurity at the household level. Eight published studies were identified from the following scientific databases: EBSCO, PubMed, Google Scholar, and JSTOR. Five of the 8 selected studies were conducted in sub-Saharan Africa, 2 were conducted in North and South America, and 1 was conducted in South Asia. A majority of the studies were conducted with women and included preliminary qualitative/ethnographic phases to identify scale items. Of the 4 UN water standards, the amount of water used/stored was commonly used to test the scale results. However, no consistent results were found in its association with water insecurity. In a rural setting, distance to water source was positively associated with water insecurity. Psychosocial distress/anxiety and reduced water use for hygiene were key dimensions of scale in all the studies. Rigorous research is needed to establish various levels of water insecurity, its scoring scheme, and its association with daily intake of water—an essential nutrient.

The objective of this study was to assess and compare water access and sanitation-related behaviors with self-reported water insecurity among women. The cross-sectional study involved household observations and in-person interviews with women living in rural areas of West Cameroon (n = 134). Water insecurity was prevalent with 37% of women having affirmative responses to the statement ‘being worried about household not having enough water.’ Only 7% of the women reported having any water source (well/pump) in the household compound, and water insecurity was more common among those who did not have an ‘on premise’ water source (p = 0.038). Additionally, women walking more than 10 minutes to reach the water source were more insecure than their counterparts (p = 0.022). Amount of water stored at home was lower in water insecure households (37.07 liters) compared to secure households (58.93 liters, p = 0.042). Sanitation rate was low in the study area, with 20% of women reporting open defecation for their children. Water insecurity is associated with long distance to water source and limited water availability at the household level. Future research is needed to understand the association between water insecurity and daily water intake and related dietary behaviors.