Table 7.

Water carriage and stress, mental well-being or life satisfaction

First author and date	Population	Study type	Date	Key findings	Quality
BeLue 200827	South Africa: mothers, 9 months post partum aged 17–30 years, Khayelitsha, Western Cape	Cross-sectional survey	1999–2000	Piped water in the dwelling associated with significantly lower perceived stress (PSS); PSS 14.2, (SD 4.8) for piped into dwelling, 19 (SD 7.4) piped water to yard, 17 (SD 6.6) for public standpipe).	Poor*
Devoto 201230	Morocco: 845 households in Tangiers, not connected to a city water network, comparing subgroup of households reporting above median baseline time fetching water	Cohort study	2007–2008	With subgroup analysis of households reporting above average median baseline water fetching time, no significant effect of allocation to water supply ‘encouragement’ project, or actual connection to piped water supply on (a) summary index averaging 3 scores of mental well-being (over past 7 days respondent felt more often than not, sad/worried/satisfied), and (b) respondent’s rating of life satisfaction level being ≥5 (on 0–10 scale).	Good*
Stevenson 2013	Ethiopia: women from cluster sample of 104 households for free listing, convenience sample of 39 women from three kebeles for ranking exercise, three focus group discussions totalling 30 women form three kebeles, cluster sample of 324 women	Mixed methods	2009–2010	The 24-item water insecurity scale was correlated with time required to fetch water (r=0.52; p<0.0001), and was positively but weakly correlated with psychosocial distress (r=0.22, p<0.001), indicating that women who experienced more water insecurity also reported more symptoms of common mental disorders. Qualitative data indicate that social and environmental factors contribute to stress during water carriage.	Poor* Good†
Henley 201436	Kenya: randomly selected subsample (200 of 1000 participants in health survey) from settlements in Naivasha and Mogotio	Cross-sectional survey	2011	Participants who reported feeling unsafe when they collected water or went to the toilet had increased mean hair cortisol content by 127 ng/g (yes (safe) 607±282 ng/g; no (not safe) 734±335 ng/g; p=0.0370).	Fair*
Zolnikov 201657	Kenya: 52 semi-structured interviews to examine relationship experiences among primary water gatherers and their families after receiving nearby access to water, in Kitui.	Qualitative	NR	Primary water gatherers: before water interventions easily annoyed; after intervention additional time for discussions with spouse and of school-related achievements and issues with children. Household heads: before interventions angry at lack of water availability, challenged by lack of time for household discussions, unsatisfied with work; after water interventions time for discussions and planning with spouse, made additional money. Children: after intervention school fees available, time with mother and family more frequent, more time for friendships and schoolwork, no time outside of school spent gathering water.	Good†
Thomas 201844	Ethiopia: survey and focus groups with 200 households in Welenchiti, Oromia region, and interviews with senior water utility staff	Mixed methods	NR	Most households (64%) felt ‘bothered’ by collecting water in the previous 7 days, mostly because of having to collect water at night; emotional distress was not significantly associated with accessibility (total water collection time in minutes) of the main water source (β =−0.03, p=0.677) indicating that a longer time spent collecting water did not increase the intensity of emotional distress.	Poor*†

*Methodological quality rating of cohort study or cross-sectional survey.

†Methodological quality rating of qualitative study or reporting of qualitative findings as part of a mixed methods study.