Table 8.

Water carriage and perinatal health

First author and date	Population	Study type	Dates	Key finding	Quality
McCray 200422	South Africa: 327 HH surveys: mothers of child aged 12–23 months in randomly selected household Kwazulu Natal	Cross-sectional survey	1998	Report that fetching water was daily activity affected by making a trip to the health clinic associated with level of prenatal care utilisation (ꭓ2=6.64, p=0.036); women two times more likely to use prenatal care services at low level than at an average level (1/OR=2.43).	Fair*
Gibson 200624	Ethiopia: 1548 women (aged 15–49 years) in demographic survey of 1976 HHs; 682 children, 264 women in anthropometric study (four villages)	Cohort study	2003	Odds of woman with access to water points giving birth in any given month three times greater than a woman without an improved water supply (OR 3.78, p=0.009). Installation of taps did not improve or predict maternal health indicated by anthropometric measures of BMI and MUAC.	Fair*
Ono 201438	Kenya: 306 mothers aged 18–49 years, who brought their babies to Sosiot Health Center for immunisation within their first year of life, in September to November 2011. Data from 303 respondents (99%) were analysed	Cross-sectional survey	2011	Unmarried women whose sisters helped them fetch water more likely to deliver at health facilities (HF) (p=0.042) and married women whose neighbours helped them fetch water less likely to deliver at HF (p=0.021) than those without support. Married women, borderline significant (p=0.054) association between birth at home and support from husband water fetching; of women who received help from their husband to fetch water, 1 of 20 (5%) gave birth at home, 19 of 20 (95%) gave birth in a HF; women who did not have help from their husband to fetch water, 50 of 211 (23.7%) gave birth at home, 161 of 211 (76.3%) gave birth in HF. Married women more likely to deliver at HF if they did not have the support of sisters-in-law fetching water (OR=2.2, 95% CI 1.0 to 4.7, n=245; husband helping not in logistic regression model).	Fair*
Mukhulani 201450	Zimbabwe: respondents of three Bulawayo suburbs	Qualitative	NR	Physical strain and health complications from carrying 20 L container on head while pregnant highlighted in illustrative quote from qualitative data.	Poor†
Bisung 201552	Kenya: convenience sample of eight women living in Usoma, 15 km from Kisumu	Qualitative (photovoice)	2013	Photograph of pregnant woman carrying 20 L of water on head and holding 10 L used to exemplify association of water carriage with maternal health.	Good†
Ghosh 201655	India: 79 mothers from 8 groups of 8–10 mothers of at least 1 child under 6, in four villages in the Sundarbans of West Bengal	Qualitative	NR	Mothers did not get sufficient rest during pregnancy and perceived that this led to giving birth to malnourished children. ’The women have to fetch water from a distant source even in their last few months of pregnancy. They force themselves to do so to avoid the quarrels with the mother-in-law’.	Good†

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

†Methodological quality of qualitative study or qualitative findings of mixed methods study.

BMI, body mass index; MUAC, middle upper arm circumference.