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Abstract
Introduction The work of carrying water falls mainly on women and children, particularly in sub-Saharan Africa and rural areas. While concerns have been raised, how water carriage is associated with health of the water carrier is not clear. The aim of this review is to summarise evidence on whether, and how, water carriage is associated with the water carrier’s health.
Methods A systematic review of literature was conducted, searching Embase; Medline; Web of Science Social Sciences Citation Index; Web of Science Arts and Humanities Citation Index; International Initiative for Impact Evaluation website; WHO Virtual Health Sciences Library and WHO African index medicus, from inception to 8 November 2017.
Results Forty-two studies were included. Their ability to demonstrate cause and effect relationships was limited by study design and fair or poor methodological quality. Overall, the studies suggest that water carriage is associated with negative aspects of the water carriers’ health. There is moderate quantitative and strong qualitative evidence that water carriage is associated with pain, fatigue, perinatal health problems and violence against vulnerable people, and inconclusive evidence of an association with stress or self-reported mental health and general health status.
Conclusion In many circumstances, water carriage is a potential barrier to Sustainable Development Goal (SDG) 6 target ‘universal and equitable access to safe and affordable drinking water for all’ and SDG 3 ‘ensure healthy lives and promote well-being for all at all ages’. Efforts should focus on providing water on premises, and where this is not possible, providing water close to home and reducing risk of gender-based violence.
- public health
- maternal health
- child health
- other infection, disease, disorder, or injury
- systematic review
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Footnotes
Handling editor Seye Abimbola
Contributors J-ALG conceived of the review, completed the electronic data base searches, selected papers to include in the review against selection criteria, extracted data, appraised articles reporting qualitative and quantitative data, wrote the first draft of the paper, reviewed subsequent drafts and reviewed and approved the final draft; MC conceived of the review, contacted experts in the field of water and health, provided translation of Swedish papers, reviewed drafts and reviewed and approved the final draft of the paper; JHG appraised articles reporting quantitative data, reviewed drafts and reviewed and approved the final draft of the paper; CCH appraised articles reporting qualitative data, reviewed drafts and reviewed and approved the final draft of the paper; PRH selected papers to include in the review against selection criteria, provided translation of French papers, appraised articles requiring consensus on quality rating, reviewed drafts and reviewed and approved the final draft of the paper.
Funding This review was supported, but not funded, by the International Labour Organisation. The work was also supported, and preliminary data extraction during scoping searches funded in part by Stockholm International Water Institute.
Competing interests None declared.
Patient consent Not required.
Provenance and peer review Not commissioned; externally peer reviewed.