Water carriage and general health
| First author and date | Population | Study type | Date | Key findings | Quality |
| Buor 200421 | Ghana: 210 females aged 12+ years in Kumasi; 90 from urban ‘core’, 120 form urban periphery | Cross-sectional survey | 2001 | During water scarcity: ill once every 2 weeks (fetching water≥4 hours 39.2%; 2–3 hours 19.3%; <2 hours 21.3%); ill once a month (fetching water≥4 hours 31.4%; 2–3 hours 26.6%; <2 hours 27.7%); ill once in 3 months (fetching water≥4 hours 19.6%; 2–3 hours 41.3%; <2 hours 31.9); ill rarely (fetching water≥4 hours 9.8%; 2–3 hours 12.8%; <2 hours 19.1%); multiple regression: beta-coefficients total sample (−0.255; p=0.000), core (−0.261; p=0.011), and periphery (−0.293; p=0.003). Type of regression model not stated. If multiple linear regression, for each extra hour of water fetching, health status score reduced by 26%–29%. However, health status measured on 4-point categorical scale (1=sick once every 2 weeks, 4=rarely sick), for which proportional odds regression is more appropriate. This would mean that for each hour spent water fetching, the likelihood of going from a lower level of the outcome variable (higher frequency of illness) to the next (lower frequency off illness) reduces by 25%–29%. | Poor* |
| Foggin 200623 | Tibet: herders in Sanjiangyuan region, Tibetan Plateau, southwest Qinghai Province; 50 families in Suojia Township, 49 in Zhahe Township | Cross-sectional survey and qualitative | 2002 | Tibetan pastoralists who spend>15 min collecting water are almost 10 times more likely to report being ill in the past month than those spending ≤15 min (OR=9.853; p≤0.001). | Poor* Good† |
| Hemson 200726 | South Africa: 1052 children aged 5–17 years from 366 households, in three villages with no piped water supply; two dry flat villages in Limpopo, one hilly village, with natural springs in Kwazulu Natal | Cross-sectional survey and qualitative | NR | Compared with children collecting water 0–13 hours per week, smaller proportions of children collecting water for ≥14 hours pw rated their health as ‘improved’ (0–13 hours 42%; ≥14 hours 37%) or the same (0–13 hours 53%; ≥14 hours 45%) and a greater proportion as worse (0–13 hours 5%; ≥14 hours 19%). Of children reporting worsened health, 77% spent≥14 hours pw collecting water and 87% stated that their health was worsened by collecting water. Of children who said their health had got worse 82% reported collecting water>once a day vs 18% collecting water once a day. Of children reporting their health as improved or the same, 56% collected water>once a day, 44% collected water once a day. | Poor* Fair† |
| Geere 2010b46 | South Africa: 39 adults and children observed fetching water, six rural villages, Limpopo Province | Qualitative | 2008 | Children linked water carriage and health in various ways, including feeling ‘better and healthy’ or having greater resilience to diseases like influenza, as a result of the exercise required for water carriage. Children also related health to being able to participate in activities such as water fetching, as well as to having basic needs met and experiencing fair workloads. | Good† |
| Geere 201843 | South Africa, Ghana, Vietnam: 1 adult and 1 child from 673 households with at-house and off-plot water supply | Cross-sectional survey | 2012–2013 | Adults who previously carried water had a better (lower=healthier) mean general health score than adults who never carried water (β=−0.58, 95% CI −0.80 to −0.35, p<0.001) and adults who currently carried water had a better mean general health rating score than adults who had never carried water (β=−0.91, 95% CI −1.12 to −0.70, p<0.001). Children who currently carry water had a better mean score rating for general health than children who had never carried water (β=−0.20, 95% CI −0.37 to −0.31, p=0.003). Children who previously carried water had a worse mean score rating for general health (β=0.39, 95% CI 0.02 to 0.75, n=10). | Fair* |
*Methodological quality rating of cohort study or cross-sectional survey.
†Methodological quality rating of qualitative study or reporting of qualitative findings as part of a mixed methods study.