Socio‐environmental confounders of safe water interventions

Abstract The international development community spends billions of dollars annually on safe drinking water projects globally in low‐ and middle‐income settings. These projects are driven by the World Health Organization's Joint Monitoring Programme metrics that rely on indirect measurements of water insecurity via water source and fetching time, with tacit acknowledgment of price inelasticity. But the success of water interventions, as framed by these metrics, is often tempered by the reality that people do not always use the safest, nearest, or least expensive water source. Drinking water interventions are confounded by diverse social and environmental factors that shape household water seeking behaviors in unexpected or underappreciated ways. These caveats to human water‐related behaviors are littered throughout the drinking water literature—often as an anecdote to a given study's primary findings—and present significant barriers to providing universal safe water as outlined by Sustainable Development Goal 6. We review and categorize these socio‐environmental confounders into six themes at multiple scales: social relations, water properties, intermittency, affordability, fetching practices, and physical and mental health. We illustrate how efforts to mitigate drinking water insecurity are complicated by the interaction of these social and physical processes. We highlight emerging metrics that enable a richer assessment of household water insecurity, and emphasize the importance of transdisciplinary approaches to improve the effectiveness of clean water interventions. This article is categorized under: Engineering Water > Planning Water Engineering Water > Sustainable Engineering of Water Human Water > Water as Imagined and Represented Human Water > Value of Water