Toward a More Systematic Understanding of Water Insecurity Coping Strategies
Uncovering the Hidden Challenges of Water Insecurity
Water insecurity – the inability to access and benefit from affordable, reliable, and safe water for basic needs – is a pervasive global challenge with far-reaching consequences for health, livelihoods, and social wellbeing. As communities around the world grapple with water scarcity, contamination, and unreliable access, households employ a diverse range of coping strategies to manage this critical resource. However, these behavioral responses have not been systematically documented or measured.
Drawing on the most comprehensive empirical dataset to date, this article aims to characterize the landscape of water insecurity coping strategies, explore their relationship with experiences of water insecurity, and propose a practical toolkit for assessing these crucial household-level adaptations. By shedding light on this understudied aspect of the water crisis, we hope to empower practitioners, policymakers, and researchers to develop more targeted and effective interventions to support the most vulnerable communities.
Mapping the Breadth of Water Insecurity Coping Strategies
Through an analysis of open-ended responses collected across 11 sites in 10 low- and middle-income countries, our research team identified 19 distinct coping strategies that households use when facing water insecurity. These range from practical adjustments, such as borrowing water from neighbors or collecting it from alternative sources, to more psychosocial responses, including praying, suffering, and resignation.
The most commonly reported strategy was borrowing water, practiced by around half of all respondents. This suggests that social capital and resource-sharing networks play a crucial role in how households manage water scarcity. However, the sustainability of this approach is questionable, as scarcity may strain reciprocal relationships and undermine long-term resilience.
Another prominent finding was the prevalence of psychosocial coping mechanisms, such as anger, fear, and despair. Historically, these emotional responses have been framed as consequences of water insecurity, but our inductive analysis indicates that respondents actively employ them as strategies to manage their circumstances. This nuanced understanding challenges the notion of ‘coping’ as inherently successful and highlights the need to consider the psychological burdens of water insecurity.
Beyond these two dominant themes, our results also uncovered a range of other coping behaviors, including using unsafe water sources, reducing or modifying water consumption, and even relocating households closer to water access points. Importantly, several strategies that have been documented in prior literature, such as desalination, wastewater recycling, and illegal water connections, were not reported by participants in our study. This discrepancy underscores the value of grounding our understanding of coping in the lived experiences of water-insecure communities.
Examining the Relationship between Coping and Water Insecurity
To further elucidate the dynamics between water insecurity and household-level responses, we analyzed the association between reported coping strategies and scores on the Household Water Insecurity Experiences (HWISE) scale – a validated instrument for measuring the multidimensional nature of water insecurity.
Our results indicate that as HWISE scores (i.e., experiences of water insecurity) increase, households are more likely to resort to borrowing water, using unsafe water sources, and engaging in psychosocial coping. Conversely, they are less likely to use alternative water sources, economize their water use, or do nothing in response to scarcity.
These findings suggest that water insecurity may drive households toward increasingly precarious and potentially harmful coping mechanisms over time. Borrowing water, for example, may temporarily alleviate immediate needs but could also strain social networks and undermine long-term resilience. Similarly, the use of unsafe water sources and psychosocial distress pose direct threats to health and wellbeing.
Importantly, the cross-sectional nature of our data limits our ability to determine the directionality of these relationships. It is possible that certain coping strategies, such as using alternative water sources, actually help to reduce water insecurity experiences. Longitudinal research is needed to elucidate the dynamic interplay between coping and water insecurity over time.
Introducing the Water Insecurity Coping Strategies Assessment Toolkit
To advance the systematic measurement of water insecurity coping, we have developed the Water Insecurity Coping Strategies Assessment Toolkit. Drawing on the empirical findings from our study and a comprehensive review of the existing literature, this resource provides a standardized roster of documented coping behaviors, along with guidance on assessing their prevalence, frequency, and severity.
The toolkit is structured to align with the recall periods and response options of the HWISE scale, allowing for the concurrent evaluation of water insecurity experiences and coping strategies. This approach facilitates a more holistic understanding of household responses to water scarcity and quality issues.
Additionally, the toolkit includes a module to assess secondary appraisal factors – the resources available to households for buffering the perceived harms of water insecurity. This includes data on water sources, storage capacity, time spent collecting water, and household income. By capturing both primary (i.e., experiences) and secondary (i.e., resources) dimensions, the toolkit can provide a nuanced picture of the complex interplay between water insecurity and coping.
We encourage practitioners, researchers, and policymakers to pilot and refine this toolkit across diverse settings. The systematic measurement of water insecurity coping strategies has the potential to inform the design, implementation, and monitoring of targeted interventions that address the unique challenges faced by the most vulnerable communities.
Toward an Integrated Approach to Water Security and Nutrition
The widespread occurrence of water insecurity coping strategies underscores the critical need to understand their prevalence, severity, and implications for health and wellbeing. This is particularly important given the growing body of evidence linking water insecurity to adverse nutritional outcomes, including undernutrition, obesity, and poor child growth.
Water is essential for sustaining life and enabling a wide range of nutrition-related behaviors, from food production and preparation to infant and young child feeding. When households lack reliable access to safe water, they may be forced to adopt coping strategies that compromise their ability to meet basic nutritional needs. For example, borrowing water from neighbors or using unsafe sources can increase the risk of waterborne illnesses, while reducing water consumption or modifying food preparation practices may limit dietary diversity and nutrient intake.
Conversely, water insecurity can also exacerbate the burden of malnutrition by undermining the ability of households to engage in optimal water, sanitation, and hygiene (WASH) practices. Contaminated water used for handwashing, cleaning, or cooking can introduce pathogens that contribute to the development of environmental enteric dysfunction – a condition characterized by chronic gut inflammation and nutrient malabsorption. Water insecurity may also limit the time and resources available for caregivers to engage in responsive feeding, a critical determinant of child growth and development.
Despite these clear linkages, water and nutrition interventions have historically been siloed, with limited coordination between the respective sectors. Addressing this disconnect is crucial for achieving global health and development goals. Policymakers and practitioners must adopt a more integrated, systems-level approach that considers the multifaceted ways in which water security and nutritional wellbeing are intertwined.
Looking Ahead: Priority Research and Policy Directions
To advance our understanding of water insecurity coping strategies and their implications for nutrition, several key research and policy priorities emerge:
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Longitudinal Evaluation of Coping and Water Insecurity: Conducting longitudinal studies to elucidate the dynamic relationships between water insecurity, coping behaviors, and nutritional outcomes over time. This will help identify which coping strategies are most effective at mitigating adverse impacts and those that pose irreversible harm.
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Disaggregated Data Collection: Collecting high-resolution, disaggregated data on water insecurity, coping, and nutrition indicators to understand how these experiences vary across diverse sociodemographic groups, including by age, gender, and socioeconomic status.
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Holistic Intervention Design: Developing and evaluating “transformative” water, sanitation, and hygiene (WASH) interventions that address multiple dimensions of water insecurity (e.g., availability, accessibility, quality, stability) and their linkages to nutrition, rather than focusing narrowly on water quality or availability alone.
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Cross-Sectoral Collaboration: Fostering greater coordination and knowledge-sharing between the water, sanitation, and nutrition sectors to ensure that policies and programs synergistically address the water-nutrition nexus.
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Innovative Financing Mechanisms: Exploring novel funding strategies, such as blended finance models and impact investment, to mobilize the substantial resources required for sustainable, equitable, and nutrition-sensitive water security solutions.
By pursuing these priorities, we can work toward a more comprehensive and contextually-relevant understanding of water insecurity coping strategies and their implications for health and wellbeing. Ultimately, this knowledge will empower communities, practitioners, and policymakers to develop more effective, evidence-based interventions that support the most vulnerable populations in securing reliable access to this essential resource.
