Access to water is key to better gender capital and health

Water is essential for every household; however, the burden of water collection and management at home has implications for the millions of girls and women responsible for it in India in terms of their health, educational and economic pursuits, and social interactions and expectations. Initiatives like the Jal Jeevan Mission that strive to provide piped water to homes have an important gender lens, as they influence women’s health and well-being.

Access to water and water quality affects health, across ages, sexes, and socio-economic categories. Yet, the adverse effects of limited access and poor water quality disproportionately affect certain groups – with gender and socio-economic status (and the interplay between the two) further intensifying negative outcomes. The gendered aspects of water access and management bring to light the unequal and at times detrimental norms, roles and power dynamics linked with domestic water supply, collection, and use of water that unfavourably shape girl's and women’s lives. These gender aspects are manifold and manifest in terms of inequalities in health (e.g., disease burden, health care seeking) and caregiving responsibilities, education and workforce participation (e.g., missing school/work due to poor health, caregiving, or as a result of water-related responsibilities), and social norms (e.g., not touching drinking water during menstruation, lower priority of water for personal hygiene needs).

The health effects include and go beyond the most obvious related to contaminated drinking water – for instance, diarrhea and typhoid arising from fecal contamination, and fluorosis, and arsenicosis from chemical contamination. These diseases affect everyone. however, women’s caregiving roles intensify with sick children and adults, and their own health and health care needs may be allotted lower priority within the family. Women may miss work to care for the ill, losing a day or more of daily wages. When access is constrained, water is often rationed; women’s own personal and unique hygiene and health needs (e.g., during menstruation, pregnancy and post-partum needs, incontinence) are deprioritised, increasing their susceptibility to discomfort and even infections.

Some research points to the negative health effects of carrying heavy loads on girls and women, such as back and knee pain, and in extreme cases, pregnancy loss and uterine prolapse. Water access challenges may further place girls and women at risk for violence as they travel far from home. The intimate linkages between water, sanitation and hygiene are profound for girls and women, owing to their biological needs and social-cultural contexts.

Household access to safe water is undoubtedly essential for health and well-being for all, and India’s Jal Jeevan Mission plays a pivotal role in enabling functional tap water connections across the country. India’s National Family Health Survey – 5 (2019 – 2021) reported that 96% of households had an improved drinking water source (that could be piped water to the household premise, handpump, tubewell, protected well or spring). While improved drinking water sources are critical to reduce the disease burden associated with contaminated water, household tap water connections can play a catalytic role for in changing the health and social burden on women and girls. The Jal Jeevan Mission has intensified action on this, with over 14 crore households (~73% of all rural homes) having a functional tap connection within the home premise as of January 2024. At this critical juncture, building upon the progress achieved, there are opportunities to intensify action to further address the gender inequalities in water access.

A key component of the Jal Jeevan Mission is women’s engagement in planning, decision-making, implementation, monitoring, and operations and maintenance of tap water connections. A tap connection at home is a fundamental intervention, and women’s engagement can help households decide where to physically locate the tap connection or connections to aid and ease water use for essential tasks related to hand and personal hygiene, toilet use, and safe cooking and drinking. For instance, piped water to a home with two tap connections can support easier water access in or near the toilet, and in or near the cooking area – both of which are critical spaces where water is needed to prevent the spread of germs, contamination or disease.

Girls and women are well-positioned to provide such practical insights. Further, involving women at the community level (through existing women’s groups) in designing influential communication directed at their peers and adolescent girls can help hone messaging to be personally relevant to their daily lives and priorities. For example, messaging about safe drinking water and water for handwashing may appeal to mothers with children under age six, an age group that is particularly vulnerable to preventable infections. Women’s participation as decision-makers in a community can also bring benefits in terms of determining the adequacy of the supply of water, the timing of water supply (to prevent disruptions to school, household work, and employment schedules) and equitable distribution of water across households.

As seen with the Swachh Bharat Mission, women can monitor the implementation of schemes, identifying roadblocks and levers for change, if supported with tools and opportunities that enable them to be active agents in understanding, designing, delivering and assessing piped water connections in their homes and communities.

The UN 2023 Water Conference envisioned that inclusively managed water could support a healthier, more resilient future. G20 leaders in India further declared a need to include women in decision-making around water, sanitation and hygiene (WaSH) solutions to ensure water security and empower women. Progress with inclusion and gender equality as strong underlying drivers can accelerate and support continual and meaningful action towards the Sustainable Development Goal for Clean Water and Sanitation for all by 2030. Only through this holistic approach can we break the unseen chains that bind women to a cycle of water-related burdens and consequent health risks and opportunity loss perpetuated by entrenched patriarchal norms. As we approach 2030, progress in water access must not only be measured in terms of statistics but also in the transformative impact on the lives of women.

This article is authored by Arundati Muralidharan, co-founder, MHAi and coordinator, Global Menstrual Collective, New Delhi.