Water sharing is a distressing form of reciprocity: Shame, upset, anger, and conflict over water in twenty cross-cultural sites

Anthropological theories of reciprocity suggest it enhances prestige, social solidarity, and material security. Yet, some ethnographic cases suggest that water sharing—a form of reciprocity newly gaining scholarly attention—might work in the opposite way, increasing conflict and emotional distress. Using cross-cultural survey data from twenty global sites (n = 4,267), we test how household water reciprocity (giving and receiving) is associated with negative emotional and social outcomes. Participation in water sharing as both givers and receivers is consistently associated with greater odds of reporting shame, upset, and conflict over water. Water sharing experiences in a large, diverse sample confirm a lack of alignment with predictions of classic reciprocity theories. Recent ethnographic research on reciprocity in contexts of deepening contemporary poverty will allow development of ethnographically informed theories to better explain negative experiences tied to water reciprocity

In pursuit of ‘safe’ water: the burden of personal injury from water fetching in 21 low-income and middle income countries

Introduction: Water fetching for household needs can cause injury, but documentation of the burden of harm globally has been limited. We described the frequency, characteristics and correlates of water-fetching injuries in 24 sites in 21 low-income and middle-income countries in Asia, Africa and Latin America and the Caribbean. Methods: In a survey of 6291 randomly selected households, respondents reported whether and how they had experienced water-fetching injuries. Responses were coded for injury type, mechanism, bodily location and physical context. We then identified correlates of injury using a multilevel, mixed-effects logistic regression model. Results: Thirteen per cent of respondents reported at least one water-fetching injury. Of 879 injuries, fractures and dislocations were the most commonly specified type (29.2%), and falls were the most commonly specified mechanism (76.4%). Where specified, 61.1% of injuries occurred to the lower limbs, and dangerous terrain (69.4%) was the most frequently reported context. Significant correlates included being female (OR 1.50, 95% CI 1.15 to 1.96); rural (OR 4.80, 95% CI 2.83 to 8.15) or periurban residence (OR 2.75, 95% CI 1.64 to 4.60); higher household water insecurity scores (1.09, 95% CI 1.07 to 1.10) and reliance on surface water (OR 1.97, 95% CI 1.21 to 3.22) or off-premise water sources that required queueing (OR 1.72, 95% CI 1.19 to 2.49). Conclusion These data suggest that water-fetching injuries are an underappreciated and largely unmeasured public health challenge. We offer guidelines for comprehensive data collection on injuries to better capture the true burden of inadequate water access. Such data can guide the design of interventions to reduce injury risk and promote equitable water access solutions

Is household water insecurity a link between water governance and well-being? A multi-site analysis

Improving water governance is a top priority for addressing the global water crisis. Yet, there is a dearth of empirical data examining whether better water governance is associated with lower water insecurity and improved well-being. We, therefore, pooled household data from two Sustainable Water Effectiveness Reviews conducted by Oxfam GB in Zambia (n = 997) and the Democratic Republic of Congo (DRC, n = 1,071) to assess the relationship between perceived water governance (using a 12-item indicator), water insecurity [using the Household Water Insecurity Experiences (HWISE) Scale], and four indicators of well-being: life satisfaction, drinking unsafe water, diarrhea, and resilience to cholera outbreak. Using generalized structural equation models controlling for wealth and primary water source, each point increase in water governance score was associated with a 0.69-point decrease in HWISE Scale scores. Good water governance was also directly associated with greater odds of life satisfaction (aOR 1.24) and lower odds of both drinking unsafe water (aOR 0.91) and severe cholera impact (aOR 0.92). Furthermore, the relationships between water governance and drinking unsafe water, diarrhea, and cholera impact were mediated by household water insecurity. Improving water governance has the potential to meaningfully impact entrenched public health issues through changes in water insecurity

Body Composition Trajectories During the First 23 Months of Life Differ by HIV Exposure Among Infants in Western Kenya: A Prospective Study.

BackgroundInfants who are HIV-exposed and uninfected have suboptimal growth patterns compared to those who are HIV-unexposed and uninfected. However, little is known about how these patterns persist beyond 1 year of life.ObjectivesThis study aimed to examine whether infant body composition and growth trajectories differed by HIV exposure during the first 2 years of life among Kenyan infants using advanced growth modeling.MethodsRepeated infant body composition and growth measurements (mean: 6; range: 2-7) were obtained from 6 weeks to 23 months in the Pith Moromo cohort in Western Kenya (n = 295, 50% HIV-exposed and uninfected, 50% male). Body composition trajectory groups were fitted using latent class mixed modeling (LCMM) and associations between HIV exposure and growth trajectories were examined using logistic regression analysis.ResultsAll infants exhibited poor growth. However, HIV-exposed infants generally grew suboptimally than unexposed infants. Across all body composition models except for the sum of skinfolds, HIV-exposed infants had a higher likelihood of belonging to the suboptimal growth groups identified by LCMM than the HIV-unexposed infants. Notably, HIV-exposed infants were 3.3 times more likely (95% CI: 1.5-7.4) to belong to the length-for-age z-score growth class that remained at a z-score of < -2, indicating stunted growth. HIV-exposed infants were also 2.6 times more likely (95% CI: 1.2-5.4) to belong to the weight-for-length-for-age z-score growth class that remained between 0 and -1, and were 4.2 times more likely (95% CI: 1.9-9.3) to belong to the weight-for-age z-score growth class that indicated poor weight gain besides stunted linear growth.ConclusionsIn a cohort of Kenyan infants, HIV-exposed infants grew suboptimally compared to HIV-unexposed infants beyond 1 year of age. These growth patterns and longer-term effects should be further investigated to support the ongoing efforts to reduce early-life HIV exposure-related health disparities

The Individual Water Insecurity Experiences (IWISE) Scale: Reliability, Equivalence and Validity of an Individual-Level Measure of Water Security

Objective: The lack of a validated and cross-culturally equivalent scale for measuring individual-level water insecurity has prevented identification of those most vulnerable to it. Therefore, we developed the 12-item Individual Water InSecurity Experiences (IWISE) Scale to comparably measure individual experiences with access, use, and stability (reliability) of water. Here, we examine the reliability, cross-country equivalence, and cross-country and within-country validity of the scale in a cross-sectional sample. Methods: IWISE items were implemented by the Gallup World Poll among nationally representative samples of 43 970 adults (15 y) in 31 low-income and middle-income countries (LMICs). Internal consistency was assessed with Cronbach\u27s alpha. Equivalence was tested using multigroup confirmatory factor analysis (MGCFA), the alignment method, and item response theory. Cross-country validity was assessed by regressing mean national IWISE scores on measures of economic, social, and water infrastructure development. Within-country validity was tested with logistic regression models of dissatisfaction with local water quality by IWISE score and regressing individual IWISE scores on per capita household income and difficulty getting by on current income. Findings: Internal consistency was high; Cronbach\u27s alpha was ≥0.89 in all countries. Goodness-of-fit statistics from MGCFA, the proportion of equivalent item thresholds and loadings in the alignment models, and Rasch output indicated equivalence across countries. Validity across countries was also established; country mean IWISE scores were negatively associated with gross domestic product and percentage of the population with access to basic water services, but positively associated with fertility rate. Validity within countries was also demonstrated; individuals\u27 IWISE scores were positively associated with greater odds of dissatisfaction with water quality and negatively associated with lower financial standing. Conclusions: The IWISE Scale provides an equivalent measure of individual experiences with water access and use across LMICs. It will be useful for establishing and tracking changes in the prevalence of water insecurity and identifying groups who have been \u27left behind\u27

Probing the accretion disk and central engine structure of NGC4258 with Suzaku and XMM-Newton observations

[abridged] We present an X-ray study of the low-luminosity active galactic nucleus (AGN) in NGC4258 using data from Suzaku, XMM-Newton, and the Swift/BAT survey. We find that signatures of X-ray reprocessing by cold gas are very weak in the spectrum of this Seyfert-2 galaxy; a weak, narrow fluorescent-Kalpha emission line of cold iron is robustly detected in both the Suzaku and XMM-Newton spectra but at a level much below that of most other Seyfert-2 galaxies. We conclude that the circumnuclear environment of this AGN is very "clean" and lacks the Compton-thick obscuring torus of unified Seyfert schemes. From the narrowness of the iron line, together with evidence for line flux variability between the Suzaku and XMM-Newton observations, we constrain the line emitting region to be between $3\times 10^3r_g$ and $4\times 10^4r_g$ from the black hole. We show that the observed properties of the iron line can be explained if the line originates from the surface layers of a warped accretion disk. In particular, we present explicit calculations of the expected iron line from a disk warped by Lens-Thirring precession from a misaligned central black hole. Finally, the Suzaku data reveal clear evidence for large amplitude 2-10keV variability on timescales of 50ksec as well as smaller amplitude flares on timescales as short as 5-10ksec. If associated with accretion disk processes, such rapid variability requires an origin in the innermost regions of the disk ($r\approx 10r_g$ or less).Comment: 10 pages, 6 figures. Accepted for publication in the Astrophysical Journa