Perspective: The Importance of Water Security for Ensuring Food Security, Good Nutrition, and Well-being

Abstract

Water security is a powerful concept that is still in its early days in the field of nutrition. Given the prevalence and severity of water issues and the many interconnections between water and nutrition, we argue that water security deserves attention commensurate with its importance to human nutrition and health. To this end, we first give a brief introduction to water insecurity and discuss its conceptualization in terms of availability, access, use, and stability. We then lay out the empirical grounding for its assessment. Parallels to the food-security literature are drawn throughout, both because the concepts are analogous and food security is familiar to the nutrition community. Specifically, we review the evolution of scales to measure water and food security and compare select characteristics. We then review the burgeoning evidence for the causes and consequences of water insecurity and conclude with 4 recommendations: 1) collect more water-insecurity data (i.e., on prevalence, causes, consequences, and intervention impacts); 2) collect better data on water insecurity (i.e., measure it concurrently with food security and other nutritional indicators, measure intrahousehold variation, and establish baseline indicators of both water and nutrition before interventions are implemented); 3) consider food and water issues jointly in policy and practice (e.g., establish linkages and possibilities for joint interventions, recognize the environmental footprint of nutritional guidelines, strengthen the nutrition sensitivity of water-management practices, and use experience-based scales for improving governance and regulation across food and water systems); and 4) make findings easily available so that they can be used by the media, community organizations, and other scientists for advocacy and in governance (e.g., tracking progress towards development goals and holding implementers accountable). As recognition of the importance of water security grows, we hope that so too will the prioritization of water in nutrition research, funding, and policy.

Integrated Approach in Addressing Undernutrition in Developing Countries: A Scoping Review of Integrated Water Access, Sanitation, and Hygiene (WASH) + Nutrition Interventions

“…Moving forward, the measurement of water access and strategies to improve it should be considered when designing integrated interventions. Concurring with Young et al ( 37 ), we propose an interdisciplinary approach to improve water and food security to achieve equity, sustainability, and health at the global level. Based on the review of integrated interventions, we concluded that interventions improving sanitation and hygiene at the household level will be more effective with improved water access and bringing about community-level changes to successfully address the ubiquitous nature of fecal and bacterial contamination of the environment.…”

“…It is also important to recognize that water is an essential nutrient, and hence its clean, safe access, and availability, or the “water access” aspect of WASH, can also be counted as a nutrition strategy. In a prospective paper, Young et al ( 37 ) highlighted the importance of accounting for water security in planning food and nutrition programs and policies. It was concluded that consistent availability and access to water should be a goal since they will help to achieve not only SDG no.…”

The Individual Water Insecurity Experiences (IWISE) Scale: reliability, equivalence and validity of an individual-level measure of water security

“…[27][28][29] It has also been useful in assessing intervention impacts and advocating for resources. 8 In addition to being a more proximal measure to health and well-being, several additional advantages are gained by shifting the level of analysis from the household to the individual level. For one, individuals are most knowledgeable about their own experiences.…”

“…13 Availability and physical accessibility are necessary but insufficient for water security. 8 14 For example, millions of people cannot reliably access nearby water due to economic, political and/or other barriers. Further, measurements at the regional and community levels can obscure huge inequalities in the distribution of resources.…”

Widespread global concern over harm from drinking water

“…Regarding water quality, these include organoleptic properties (e.g., taste, smell); (dis)trust in local, regional, and national institutions; knowledge about and familiarity with water management and treatment practices; attitudes toward diverse contaminants; and the beliefs and values of those within an individual's social network 3,20 . Quantifying people's experienced and anticipated harm from drinking water in surveys is also useful because results can be disaggregated to the individual or household level 21 . As such, understanding human experiences with and anticipation of harm from drinking water is critical for designing programs and policies that aim to increase access to and use of safe drinking water.…”