Elsevier

Health & Place

Volume 10, Issue 1, March 2004, Pages 85-103
Health & Place

Water needs and women's health in the Kumasi metropolitan area, Ghana

https://doi.org/10.1016/S1353-8292(03)00050-9Get rights and content

Abstract

This paper examines the impact of water fetching by women and the quality of water during periods of water scarcity on the health of women in the Kumasi metropolitan area. A sample of 210 women drawn using systematic random procedure is used for the study. Formal interview is the main instrument used. The survey has established that income, quality of water, hours spent fetching water during scarcity and age are the main factors influencing women's health in the metropolis during water scarcity. In both the core and periphery, the water-related problem influencing health is hours spent fetching water during scarcity. An empirical model on water needs and women's health has emerged from the survey. Recommendations have been made on strategies to ensure regular volume of surface water, effective management of scarce water resources with the participation of women, and ensuring gender equity in domestic services.

Section snippets

Introduction and the problem

This study examines the health effects of water scarcity on women in the Kumasi metropolitan area, the second largest urban centre in Ghana. Water needs have had serious socio-economic and health effects in urban environments in developing countries where population concentrations have put a serious strain on available resources. Globally, as population grows, the quantity of water per capita decreases. In 1989 there were about 9000 m3 of freshwater per person available for human use (Clarke,

Objectives

The objectives of the survey are fourfold, namely to,

  • (a)

    Assess the impact of poor water quality and the burden of water fetching on the health of women in the metropolitan area and by place of residence within the metropolis, i.e. urban core and urban periphery.

  • (b)

    Examine the relationship between water scarcity and the health of women by education and income.

  • (c)

    Examine the relative influence of water scarcity compared with the demographic and socio-economic factors that influence women's health.

  • (d)

The study area

The study is a cross-sectional survey, which seeks to establish the relationship between water supply and women's health. The study area, Kumasi metropolitan area which is the fastest expanding metropolis in the Ashanti Region, was chosen for the survey (Fig. 1). It is a centre of diverse culture and commerce, and indeed reflects the socio-economic scenarios of the country. In Ghana, the family system is matrilineal, and the extended family system predominates. Though there is a significant

Population growth and water supply

The rate of the metropolitan population growth has been quite significant. The growth pattern is indicated in Table 1. The significant increases in the metropolitan population are due to high fertility, lower mortality, and cultural, administrative, industrial, commercial and migratory factors. First, Total Fertility Rate (TFR) is high, especially at the metropolitan margins and slums. Even though the national TFR is 4.6 (Ghana Statistical Service, GSS, 1999), it could be as high as 6 or even

Distribution of study variables

The sample was made up of women aged 12 and above including schoolchildren, homemakers, traders and small-scale entrepreneurs. Appendix A presents the distribution of the sample across the selected variables for total sample and place of residence (core or periphery). Whereas percentages are reported for all the category variables, means and/or standard deviations are reported for the continuous variables. The largest number of women of marriageable age is married. The unemployment rate appears

Discussion

It is evident in the survey that income, water quality and hours spent fetching water during scarcity are the significant factors influencing the health of women in the metropolis during water scarcity. Water scarcity has been found to affect income, as evident in the economic activities of the entrepreneurs and traders. In effect therefore, the water problem directly and indirect affects the health of women in the metropolis. Water quality has a direct effect on the health of women, whilst

Policy implications

To address the perennial water shortage and concomitant repercussions on the health, and generally, the development of women, and to ensure gender equity in the burden of accessing water for domestic use, the following policy implications emerge:

  • (1)

    There must be aggressive measures to forestall the encroachment on the land at the dam areas. The degraded watersheds must be re-afforestated to ensure regular volume of water and to avoid the excessive evaporation that results in declining volumes and

Conclusion

This survey has attempted to analyse the health effects of water on women in an expanding metropolis in Ghana. It is evident by the survey that women, who bear the burden of water fetching in the home, suffer adverse health effects during water scarcity. Nonetheless, income makes the most significant impact on the health of women in the metropolis during water scarcity, thus, amplifying class as a factor in health status in the metropolis. At the urban core, education is the most significant

Acknowledgements

I am grateful to The Netherlands Foundation for the Advancement of Tropical Research (WOTRO), Den Haag, that funded this research, and to The Netherlands Institute for Health Services Research (NIVEL), Utrecht, that provided some logistic support. I am also grateful to Professor Jouke van der Zee and Professor Peter Groenewegen, both of NIVEL, for their comments and contributions.

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