2.1. Study design and research partners

To ensure methodological rigor and comprehensive analysis, our research was organized in alignment with COnsolidated criteria for REporting Qualitative research (COREQ) checklist [30]. The checklist is provided in S1 COREQ. This qualitative study engaged participants from communities that received the Strong Women, Strong World: Beyond Access (SWSW) program implemented by World Vision in Guatemala, Honduras, Kenya, and Zimbabwe. SWSW strives to achieve sustainable empowerment of women through integration of water, sanitation, and hygiene (WASH) and livelihoods interventions while mainstreaming issues of gender equality and social inclusion. Funded by World Vision US, Emory University was the lead learning partner for research related to SWSW in four countries where the program was delivered. To enable collaborative learning, the Emory team held workshops with members of each World Vision country team leading SWSW activities to identify priority research questions of interest. As the SWSW program hypothesizes that water access is fundamental to women’s abilities to engage in economic activities, country teams agreed it would be useful to assess this hypothesis. To that end, Emory, together with the World Vision team designed this qualitative research study to investigate if and how water plays a role in women’s economic engagement. The Emory team led a brainstorming session with each World Vision team to note ideas for research. The Emory team then looked across all the brainstormed ideas and found that each country team independently expressed interest in understanding if and how water played a role in women’s economic engagement. The Emory team then proposed methods for conducting this research in each country with the World Vision teams, and all were in agreement. The Emory team then developed KII and FGD guides based on the proposed research questions and ideas, and in alignment with the Strong Women Strong World hypothesis. In each country, World Vision selected a local learning partner to lead data collection activities, including obtaining local ethical clearance certificates, recruitment, consenting, facilitation of interviews and discussions, translation, and data management under the guidance of the Emory University team. The local learning partners were: Centro Universitario de Occidente, Universidad de San Carlos de Guatemala, Universidad Nacional Autónoma de Honduras, St. Paul’s University (Kenya), and Datalyst Africa (Zimbabwe). Members of the Emory team trained local research partners in each country. Training (described in section 2.3) was interactive and provided opportunities for the local learning partner team members to provide feedback on the research protocol and tools. See S1 Tools.

Members of the Emory team led analysis of data collected across all four countries. To gain reflections and insights about the research findings and to facilitate team members’ broad involvement and contribution as authors on the final manuscript [31] (which has been particularly challenging among WASH researchers in low and middle income counties [32], the Emory team held interactive workshops to promote discussion around findings with members of local learning partner and WV country office teams. Discussions informed the present paper, particularly the presentation of the results and discussion.

2.2. Study eligibility and sampling

We carried out multi-stage sampling to select study participants [33]. First, World Vision US purposively selected the four countries where research was to take place; these countries were eligible because they were in the process of initiating SWSW programming and had the potential to integrate research learnings into these programs going forward (SWSW programming was not being initiated in any other countries at this time). Second, the WV teams leading the SWSW programming in each country purposively selected areas where the research was to take place. Geographical areas were eligible if they had already initiated SWSW programming or were set to in the months to come. Kenya and Zimbabwe teams selected two rural areas, Guatemala teams selected three rural areas for cultural variability, and Honduras selected one rural and one peri-urban area. Third, the WV teams leading SWSW programming purposively selected the specific communities for research activities within each geographical area. Communities were eligible if they were to receive SWSW programming. Consideration was given to contextual factors like diversity of water source types, geographical placement, and socio-cultural variability. The safety of those carrying out and supporting data collection was also a key consideration in community selection. In all, 25 communities across four countries were engaged (Guatemala: N = 7; Honduras: N = 6; Kenya: N = 6; Zimbabwe; N = 6); 2 (both in Kenya) had received improved water infrastructure, specifically, boreholes, as part of the project intervention.

The seven communities in Guatemala were in the mountainous regions of Quetzaltenango and Totonicapán in the southern part of the country. Guatemala has a tropical climate: hot humid in lowlands and cooler in highlands; data collection activities happened in the rainy season. Guatemala is a multicultural, multiethnic, and multilingual country with approximately 56% of the population identifying as mixed indigenous-Spanish descent and 42% as Mayan. Spanish is predominantly spoken by approximately 70% of the population, while 8% speak K’iche’, and 4% speak Mam [34]. Study participants were women and men specifically from Mayan linguistic groups (K’iche’ and Mam). In Guatemala, access to basic drinking water service, defined as water from an improved source requiring not more than 30 minutes roundtrip for collection, is high, with 91% coverage in rural areas and 98% in urban areas [35].

In Honduras, the six communities selected were in the mountainous rural areas and hilly forested peri-urban areas of El Paraíso in eastern part of the country. Honduras experiences a sub-tropical climate in lowlands and temperate climate in the mountains; research activities took place during the rainy season. Approximately 90% of Honduran population is of mixed indigenous and European descent, while 7% is indigenous. Spanish is the official language [36]. In Honduras, 96% of the population has at least basic drinking water service, including 91% in rural areas and more than 99% in urban areas [35].

Six rural communities in Kenya, located in Isiolo and Samburu Counties were included in the study. These areas are classified as arid and semi-arid and characterized by drought and water scarcity; data were collected during the dry season. Kenya is a multicultural, multiethnic, and multilingual country. English and Swahili are both official languages and there are numerous indigenous languages [37]. In Kenya, 63% of the population has access to at least a basic drinking water service, with coverage at 53% in rural areas and 86% in urban areas [35].

In Zimbabwe, data collection was conducted during the dry season in six rural communities in Gwanda and Nyanga districts. The districts are drought-prone, with Gwanda characterized by flat agricultural lands whereas Nyanga features forested, mountainous terrain and flat low-lying areas suitable for agriculture. The official languages of Zimbabwe are Shona (spoken by 80.9% of the population), Ndebele (11.5%), and English (0.3%) [38]. In Zimbabwe, 62% of the population (48% rural; 93% urban) has access to at least basic drinking water service [35].

Within identified study communities, learning partners selected a convenience sample of individuals to participate in the qualitative research activities. Individuals were eligible to participate if they were aged 18 years and above, resided in the selected communities, and were able to provide informed consent. Learning partners collaborated with local administrative authorities to identify key informants. Individuals were selected based on their leadership positions or recognition as opinion leaders in the communities. Key informants included water committee members, chiefs, assistant chiefs, village elders, teachers, administrators, and government officials residing in the study communities. Prior to participant selection, local World Vision and learning partner team members engaged with community leaders to discuss the study and seek their approval for the local learning partners to engage with community members. Additionally, to recruit potential participants, community leaders worked with the learning partners to identify women and men who met the eligibility criteria. The community leaders were engaged because they were familiar with their communities and understood the characteristics of the community members. Eligible men and women were informed verbally on the day of the interviews, including details of the venue. Local community leaders selected accessible, centrally located venues within participants’ neighborhoods to ensure convenience and encourage participation. Local World Vision teams were not involved in the recruitment of individual participants to minimize bias in participants’ responses. Additional information on ethical, cultural, and scientific considerations specific to inclusivity in global research is provided in S1 Checklist.

2.3. Data collection

Qualitative data were collected from June 2023 to October 2023 (Guatemala: July 10-August 9; Honduras: July 5-August 5; Kenya: June 21-July 24; Zimbabwe: July 14-July 22 and September 20-October 1). Focus group discussions (FGDs) and key informant interviews (KIIs) were conducted with women and men from all four countries.

FGDs. FGDs were conducted because they are well suited to capture a diversity of experiences as well as community consensus around a specific topic, while KIIs were conducted to gather in-depth information from community leaders’ perspectives across the four countries [39,40]. Specifically, FGDs with women sought to understand community norms on water, gender roles, and responsibilities; perceptions and opinions of women’s economic engagement; and women’s experiences and perspectives on their ability to engage in economic activities, including activities women are engaged in and their perceived barriers and facilitators. FGD guide for women had general probes on barriers and facilitators to economic engagement, specific probes on water collection, how water might influence economic activities, and their perceptions about how improved water access may impact their lives, including engagement with economic activities.

FGDs with men were conducted to understand community norms on water, men’s perceptions on women’s involvement in economic activities and their perspectives about women’s ability to engage in these activities. FGD guide for men asked about what activities men and women are engaged in; perceived barriers and facilitators to economic engagement, with probes on water collection; men’s perception on how improved water access may impact women’s lives, with probes on women’s engagement in economic activities; and men’s opinions about women’s engagement in economic empowerment programming.

In each country we planned to conduct at least one FGD with women and one FGD with men per community, resulting in at least 12 per country (14 in Guatemala) sample sizes considered adequate to achieve saturation [41,42]. We allowed for the possibility of adding additional FGDs if it was deemed best to break the FGDs up by age groups, depending on context. In all countries, FGDs were held with men and women separately to provide safer space for participants to share their views freely and to reduce existing power dynamics and social pressure due to cultural norms. In Kenya and Zimbabwe, we held some FGDs with younger and older women and older and younger men separately; partners advised that participants would feel more comfortable in groups with similarly aged peers. In all, we conducted 72 FGDs (38 with women; 34 with men; See Table 1 for a breakdown by country). FGDs had 6–12 participants, took 60–120 minutes, and were conducted in local languages in each country; K’iche’ and Mam in Guatemala, Spanish in Honduras; Samburu in Kenya; and Shona and Ndebele in Zimbabwe.

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Table 1. Data collection activities and participants, by country.

https://doi.org/10.1371/journal.pwat.0000475.t001

KIIs KIIs were conducted with local leaders, both men and women, to better understand community leaders’ experiences and perspectives related to water access and use, and their perceptions of women’s economic engagement. Interview guides had specific questions on demographic information, water access and use, economic empowerment activities and decision making related to water and economic empowerment. We aimed to conduct 50 KIIs with different informants in each country to gather in depth insights and perspectives on issues around water and economic engagement [41]. We conducted 56 KIIs (33 with women; 23 with men). (See Table 1 for a breakdown by country). KIIs were conducted in the participant’s preferred language and lasted 60–90 minutes.

Research Assistants At least eight research assistants, male and female, were engaged in data collection in each country (14 in Guatemala, 10 in Honduras, 10 in Kenya, and 8 in Zimbabwe). The research assistants 1) were from the country where data collection was conducted, 2) had an understanding of the communities where data collection was to take place, and 3) were fluent speakers of the local language. Some had some experience in qualitative data collection, but all were to be trained so previous experience was not a requirement. Prior to data collection, research assistants participated in a week-long training led by Emory University. Training topics covered included the overall purpose of the study, current background on water and economic engagement, qualitative research methods, ethical conduct of research, transcription and translation, debriefing, and data management. Qualitative tools were translated into local languages and validated by the research assistants to ensure accuracy of the translation and cultural appropriateness. Before data collection, the tools were piloted and adapted based on input from those who collected the data. Specifically, adaptations made included clarification and simplification of questions, additional probes, and sequencing of activities informed by duration and timing. Data from pilot testing was not included in the final analysis.

2.4. Data Management

FGDs and KIIs were audio recorded, and the audio files were uploaded on a secure file storage service certified for storage of sensitive data. Audio recordings in K’iche’, Mam, and Spanish were first transcribed into Spanish by trained members of the local research teams and then translated into English by a hired translator. Audio recordings in Samburu, Ndebele, and Shona were simultaneously transcribed and translated into English by trained team members. For quality, transcripts were reviewed against corresponding audios by a different member of the data collection team to ensure accuracy of data. All transcribed data and physical copies were uploaded in the secured service storage.

2.5. Data analysis

A modified grounded theory approach was used to analyze the data. We refer to our approach as Modified grounded theory because we sought to remain grounded in participants’ lived experiences while also drawing on established concepts to inform our coding and theme development. This approach provided the flexibility needed to conduct cross-country comparative analysis, allowing us to identify both context-specific and overarching patterns. Through this iterative and reflexive process, we developed a conceptual framework that is both empirically grounded and theoretically informed, enhancing the relevance of our findings [43].

Analysis began in the field with debriefing [44]. Specifically, the field team debriefed at least once a week after data collection in a specific community to discuss recurring patterns and identifying areas which required more probing [44]. Once fieldwork was completed, analysis continued with memoing of data, which aimed to deepen researchers’ understanding and create an audit trail of their thought process. Back at Emory, four research assistants were responsible for reviewing transcripts; each research assistant was responsible for reviewing data from a specific country and writing memos. Research assistants read and re-read through transcripts, identified key segments. They wrote reflective memos, which were organized in a Microsoft Excel sheet. The Excel sheet served as a tool to facilitate weekly meetings with the broader research team.

During research team meetings, research assistants discussed their memos, enabling the team to identify similarities and differences between the countries. Specific patterns in issues identified across the countries included barriers and facilitators to water access, access to markets, time, labor and other responsibilities, access to resources, training related to economic engagement, skills, education including literacy, language, numeracy, diversity of products to sell, gender norms, women’s and men’s attitudes and perceptions, support, decision-making, and perceived impact of improved economic engagement/opportunities. A codebook was developed, with codes informed inductively by the memo data and related meetings discussions and deductively from the World Vision Women’s Economic Empowerment (WEE) Framework and the UN Women’s Economic Engagement Framework [45,46]. The codebook is provided in S1 Codebook.

Data were then coded using the codebook in MAXQDA 2020 (VERBI Software, 2020). The analysis team was comprised of five team members (4 research assistants, each one responsible for coding data from one country), and a staff member (who read and coded all data to ensure codes were applied consistently and to gain insights across all countries). To ensure all who were coding had the same understanding of the codebook and how to apply the codes, a calibration activity was conducted among all team members engaged in analysis, wherein they independently coded the same transcript and met to discuss how codes were used and applied throughout the transcript. If there was disagreement, all discussed to reach consensus on how to apply the code going forward. The analysis team met weekly to discuss potential iterations to the codebook as needed.

Themes were developed from coded data to capture water-related enablers and barriers to women’s economic engagement. Aligned with Jenkins et al., (2018) guide to multisite qualitative analysis approach, research assistants who were in the respective countries during data collection independently analyzed data from KIIs and FGDs to identify preliminary themes, interpreting key meanings within the context of data. These country specific themes were then discussed in detail during weekly meetings, including the rationale behind identification of specific themes. The analysis team subsequently convened to systematically review and identify overarching themes across all four countries. We focused on common, overarching themes in order to make our conceptual framework as broadly relevant as possible. Through iterative dialogue, the team reached consensus on the emerging cross-country themes, integrating insights from each context into a cohesive analysis process [47,48]. Patterns and linkages within and across the identified categories were further reviewed and organized into an inductively developed conceptual framework to show how water impacted women’s economic engagement. The analysis team continually reviewed the data to ensure that the linkages and patterns were drawn from the data. By meeting weekly and discussing the data, the analysis team also was able to critically examine and reflect on any of their own biases and perspectives. Alongside having all data double coded (by one research assistant per country and the supervising staff member across all countries), the weekly meetings aimed to reduce subjectivity in the analysis. Finally, two team members—who were not involved in coding but who brought extensive qualitative research experience and a broader knowledge of WASH and empowerment—provided input to assist in solidifying the framework. Specifically, the two qualitative research experts provided methodological guidance and feedback during analysis and ensured that the framework was well grounded on data.

2.6. Ethics and informed consent

The study was considered exempt by the Institutional Review Board committee of Emory University, Atlanta, Georgia, USA (IRB00005955), and was approved by the Comité de Ética del Centro Universitario de Occidente, de la Universidad de San Carlos de Guatemala (Acta 1.23 C.E. DICUNOC) in Guatemala; Universidad Nacional Autónoma de Honduras (CEIFCS-2023-P18) in Honduras; St. Paul’s University- Institutional Scientific Ethics Committee (ERB No. 38), the National Commission for Science, Technology and Innovation (NACOSTI/P/23/27117) in Kenya; and the Medical Research Council of Zimbabwe (MRCZ/A/3054) in Zimbabwe. All participants provided informed consent and participated voluntarily. In Guatemala, Honduras, and Kenya, participants provided verbal consent, witnessed and affirmed by enumerator signature on data collection forms, as was deemed appropriate by ethical review boards in each of those countries. In Zimbabwe, participants provided a written consent as was mandated by the ethical review board in Zimbabwe. Research assistants read the consent verbatim to each participant in a private setting, allowing participants time to ask questions and seek clarification before consent was obtained.

3.1. Participants’ economic engagement experiences and water access

In all countries, women participants engaged in income-generating activities, though the proportion engaged varied by country. Specifically, 61% of women participants in Zimbabwe reported being engaged compared to 56% in Guatemala, 42% in Honduras, and 35% in Kenya. The types of income-generating activities women participated in were also variable, and included owning small businesses like selling second-hand clothes, accessories, and makeup; running grocery and food kiosks; keeping livestock like chicken, pigs, goats, cattle; selling animal products like eggs, milk, honey and products from smallholder farming like vegetables, tomatoes, and chilies. Some women created and sold products made from knitting, sewing (Guatemala, Honduras), weaving, bead work (Kenya), pottery and brick molding (Zimbabwe). Other paid work included doing laundry (Guatemala and Honduras); working in factories and harvesting coffee (Honduras), collecting pebbles, selling local brew, and harvesting and selling aloe and gum (Kenya); gold panning (Zimbabwe); and selling water and firewood (Guatemala, Zimbabwe). See Table 2 for more information on demographic characteristics.

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Table 2. Demographic and water characteristics of focus group discussion participants, by country.

https://doi.org/10.1371/journal.pwat.0000475.t002

In all the countries, women were the primary persons responsible for water collection. Most women in Guatemala and Honduras had access to piped water, located in the dwelling or in the yard. In Kenya and Zimbabwe, most women collected water from unprotected springs and boreholes respectively, which were located somewhere outside their yard or plot. There was a slight variation in the mean water collection time per trip that women reported for drinking and other uses (including going to the water source, activities at the source, and returning). The overall mean times for drinking water collection in all countries were 123 minutes for women and 106 minutes for men whereas the overall mean times for water collection for other purposes for all countries were 137 minutes and 123 minutes for women and men respectively. Women in Kenya reported the longest mean time for collecting drinking water (314 minutes), while those in Guatemala and Honduras reported the shortest mean time (45 and 51 minutes). Similarly, for water collection used for other purposes, women in Kenya had the longest mean time (326 minutes), and those in Guatemala had the shortest mean time (65 minutes). See Table 3 for more information on water-related characteristics.

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Table 3. Water characteristics of focus group discussion participants, by country.

https://doi.org/10.1371/journal.pwat.0000475.t003

3.2. Relationship between water and women’s economic engagement

Based on participants’ insights and reflections, women’s economic engagement is influenced by their sufficient access to water as well as by factors at the individual, environmental, and societal levels (Fig 1). Specifically, access to water influences factors at the individual level and individual-level factors also influence water access. Further, environmental and societal level factors influence water access and individual-level factors (See Fig 1). Below, we first present and describe our inductive conceptual framework that shows how water and factors at other levels of social ecology (Individual, environmental, societal) influence women’s economic engagement. Next, we discuss the key domains within the conceptual framework in this order: individual level factors and impact on women’s economic engagement; environmental level factors that exacerbate water-related challenges and limit economic engagement; and finally, societal-related factors which cement the water-related challenges that constrain women’s economic engagement.

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Fig 1. Conceptual Framework on Water and Women’s Economic Engagement.

https://doi.org/10.1371/journal.pwat.0000475.g001

We used a conceptual framework to organize the presentation of our results. The central components of the conceptual framework (Fig 1) show the relationship between sufficient water access, individual level factors—including available time, livelihood opportunities, economic resource options, life stage, and health and wellbeing—and women’s economic engagement. Each of the individual-level factors will be discussed in depth below. We use different types of arrows to show the relationship between domains, highlighted by the directionality of the arrows. The straight double headed arrow from sufficient water access box to the central box (available time, livelihood opportunities, economic resource constraints) shows a direct influence. That is, when women have sufficient access to water, it positively affects their time availability, livelihood options, and economic resources, and vice versa. The straight arrow from the central box to women’s economic engagement indicates a direct pathway on how improvements in time, livelihood opportunities, and economic resources directly enhances women’s ability to engage in economic activities. The broken arrow from health and wellbeing box to women’s economic engagement box represents a hypothesized or indirect link that is health, and wellbeing may influence economic engagement, but the relationship is less direct or not yet fully established. Finally, the broken arrow from life stage to sufficient access to water represents hypothesized link of life stage to sufficient access to water. In brief, when women do not have time, which can be compromised by limited access to sufficient quantities of water, they cannot engage in economic opportunities. Livelihood activities like agriculture and livestock production that women engaged in can be reduced due to lack of access to water. Women’s economic resources can be constrained due to water, for example if they need to pay for water or for costs associated with water access, which can limit the economic resources they may need to participate in income-generating activities. Lastly, health and wellbeing, specifically, physical health issues like fatigue, exhaustion, physical injuries, and pain, and from water collection work, can leave women depleted of energy needed for economic engagement activities.

Our conceptual framework further shows that societal and environmental factors exacerbate the influences of access to water on individual level factors and women’s economic engagement (Fig 1). Gender norms shape roles and responsibilities for men and women and ascribe water collection as the primary responsibility of women and girls in all four countries. Environmental factors, such as drought and seasonality, diminished sufficient access to water, further reducing women’s time and energy as they had to go to more distant sources, and negatively impacted livestock and agricultural productivity due to diminished pasture and reduced water supply.

3.3. Individual level factors and Impact on Women’s Economic Engagement

Women’s ability or lack of ability to access water in sufficient quantities influenced both their lives and the options available for their economic engagement. Water collection is among one of the many tasks women are expected to do, and is a priority task because water is necessary both for survival and to complete many of their other responsibilities. Women highlighted how water is essential in all aspects of life, from health and hygiene to cooking and caring. Further, the availability of water dictated how women pursued activities beyond their responsibilities, including rest. Women expressed the psychological toll of water scarcity, such as stress associated with not having water and how this affected their emotional wellbeing. Moreover, time poverty resulted from inadequate water access. Participants in Kenya and Guatemala summarized the primacy of water in their lives:

“Water is a basic need. As a woman you can’t be able to have your things alright and arranged when there is unavailability of water in the household. We get a lot of stress when we lack water, you can’t do anything without water…” FGD2(W): Age 35, Community 1, Kenya

“There is no life without water; nothing will survive without water either for the animals or people.” FGD2(M): Age 27, Community 5, Kenya

“A woman’s life is really hard. We must take care of the children, wash clothes, clean and carry out all the housework. We go to bed late. We don’t have time to sit down and rest. We do other jobs. We get up at three in the morning…We get up early to do our tasks. That’s what we do. At the moment, what we need the most is water.” FGD1(W): Age 58, Community 5, Guatemala

Women reported that lack of sufficient water was a crucial factor that hindered them from engaging in economic activities. Specifically, they discussed how sufficient access to water impacted their (a) available time, (b) livelihood opportunities, (c) access to economic resources, and (d) health and well-being, all of which influenced their ability to engage in economic activities. Each of these is discussed in turn below.

3.3.1. Available time.

Lack of access to sufficient water and consequent related water-work influenced the time women had available to engage in economic and other activities. In this context, time refers to the amount of time needed for water collection and other water-related work, as well as when in the day women can participate in economic activities.

How women spent their time each day largely was determined by water, including the quantity and quality of water needed, the distance to and availability at the source, and the water-related work they needed to do. For many women, the water collection process could take an extensive amount of time, given the great distances women had to walk to get to water sources and back. Their long journeys to the sources could be further slowed if they faced rough terrain, needed to prioritize livestock or give way to wild animals at a water source (e.g., elephants in Kenya), or carried heavy weights (e.g., water, children, laundry). In Kenya, participants reported that it could take as many as eight hours to travel up to 20 kilometers on a round trip to get water, and in Zimbabwe, participants said it took between two and five hours to collect water, and potentially longer in times of drought or during dry seasons. Women in Guatemala, Honduras, and Zimbabwe discussed having to make multiple trips per day to the water source when water was available at the source, leaving them with little time to complete their other household duties, let alone engage in income-generating activities. And women in Kenya expressed that most of their day was devoted to water collection:

“Time is not enough to engage in economic activities because where we go, and fetch water is very far. Sometimes you can ask your child not to go to school that day, but you cannot ask the child not to go to school two times, so water is a major problem that is hindering us from engaging in economic activities.” FGD(W2): Age 27, Community 2, Kenya

Beyond the time needed for going to and from the source, women from all countries reported that they required substantial amounts of time at the source, further compromising their ability to plan for and attend to other activities, including meetings related to economic activities in the community, economic ventures, and even household responsibilities. At water sources, women spent time waiting in queues, doing laundry, pumping at rusty or old boreholes, scooping water from dry riverbeds, or searching for clean water, which also diminished their energy. Due to the extensive amount of time and energy for this water related work, women were exhausted, and prioritized completion of household chores before economic activities. In all countries, women had a clear hierarchy of activities to perform, with the expectation that household duties were completed before economic activities could begin. Women still faced time-burden challenges even where water sources were close to their homes, specifically in Guatemala, Honduras, and some communities in Zimbabwe. Women reported experiencing increased waiting time for water due to absence of water operators at the source (Zimbabwe), intermittent water supplies due to water rationing (Guatemala, Zimbabwe), breakages of pipes from heat (Guatemala), clogging of pipes during heavy rains (Honduras), and insufficient and delayed maintenance of pipes, which constrained access (Guatemala, Honduras, Zimbabwe). As a result, women said they opted for alternative water sources which were further or waited longer to get water, which diminished their time. See Table 4 for illustrative quotes related to time.

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Table 4. Illustrative quotes about available time, by country.

https://doi.org/10.1371/journal.pwat.0000475.t004

In some communities in Guatemala, water -work included mandatory service on water boards and committees for every household for one to two years, which added substantial burden to the already limited time that women could utilize for economic activities. The time women spent serving on water committees diverted their time away from economic-related activities like weekly markets, produce production and sales, and participation in training and loan group meetings, and made it challenging to balance household responsibilities. This mandatory service disproportionately affected single and widowed women as women reported that they had to shoulder the responsibility since they did not have partners to share the responsibility.

“It happens that many of the committee members are single mothers or widows. If the service is in their name, then they have to assume their position on the committee when appropriate. This is why this year the committee is made up mostly of women, since it has been their turn to assume that responsibility.” KII(F): Age 40, Community 3, Guatemala

In all countries, participants indicated that consistent access to sufficient and quality water could alleviate the time burden associated with water collection and water work, allowing them to dedicate the time saved to other activities. Specifically, women mentioned that they would do housework, childcare, rest, sleep longer, and engage in income-generating activities including livestock-rearing (poultry, pig, cattle, and goats) and crop production. In Honduras, one woman mentioned that she would do other activities like household activities quickly to have time to engage in economic activities and another said the time would be used to take care of grandchildren and not necessarily for engaging in economic activities. In Guatemala, women mentioned that they would use the time to work, care for children, wash clothes, and rest. In Kenya and Zimbabwe, women indicated that they would sleep longer, rest, and engage in gardening and income-generating activities.

“I would engage in poultry farming and avoid the long journeys to fetch water. It would give us more time to rest our old bodies and consider money-making projects like poultry, selling eggs, and making more money.” FGD(W): Age 55, Community 2, Zimbabwe

The need to prioritize water collection for household needs over livelihood activities threatened the sustainability of economic activities women engaged in. Women reported that even if they had products to sell, water collection time dictated when they could sell products, negatively affecting the quality of their businesses. For example, in all four countries, participants sometimes had to open businesses or other income-generating activities late in the day or close their businesses to prioritize water collection. One woman from Kenya describes how water fetching impacted her business opportunities:

“This water problem is also not letting us engage in businesses because if you have things that you wanted to sell but you have no water (at) home so you decide to go fetch water and while on the way some people come to look for goods while you are away, and they go back and get what they wanted from somewhere else. Has that not led to the fall of your business? Your business just falls due to that.” FGD(W): Age 50, Community 5, Kenya

3.3.2. Livelihood Opportunities.

Women reported that livelihood activities -- defined here as income-generating activities that require water for agriculture, livestock production, pottery, brick molding, laundering clothes for money, and water vending -- were limited by insufficient water access, diminishing women’s economic opportunities.

Women’s inability to access sufficient quantities of water hindered their ability to take part in businesses deemed profitable, like food production in Guatemala, pig-farming in Honduras, goat-rearing in Kenya, and poultry projects in Zimbabwe. Participants in Honduras, Kenya, and Zimbabwe reported that the lack of water resulted to spread of vectors which affected livestock resulted in vector borne diseases, contributing to the thinning and death of livestock. These losses significantly affected women’s ability to start up and sustain existing economic activities, particularly when livestock served as a primary source of livelihood. Additionally, human-animal conflicts over shared water sources by people, livestock, and wildlife led to direct attacks on livestock and wildlife, further contributing to the loss of livestock. Women also noted that competing for water made it difficult to maintain hygiene for small animals such as pigs and chickens which required substantial amount of water for proper care. In Honduras, Kenya, and Zimbabwe, scarce water sources were prioritized for animals over gardening of vegetables and tomatoes which often were women’s income generating sources. These challenges in turn impacted women’s economic activities as they depended on livestock and agricultural produce for their livelihood. See Table 5 for illustrative quotes related to livelihood.

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Table 5. Illustrative quotes about livelihood, by country.

https://doi.org/10.1371/journal.pwat.0000475.t005

Flourishing agriculture and large-scale crop production for economic gain are dependent on water availability and are diminished when insufficient quantities of water are available. In Honduras, Guatemala, and Zimbabwe, water shortages were linked to women’s inability to grow vegetables—such as tomatoes, butternut squash, onions, chilies, and leafy greens—for consumption and sale. In Kenya, women reported not being able to grow vegetables at all, even though they expressed wanting to garden. Despite their existing knowledge on irrigation, women reported not being able to do much in terms of agriculture because of lack of water.

Although participants in all four countries described the negative effects of insufficient water access, they also noted that access to water sources close to their homes that provided sufficient quantities of water could enable economic opportunities. As one woman from Zimbabwe reported, “If we have water, we have money.” Women described how such sources could ensure healthy and quality livestock, facilitate their ability to grow vegetables to sell, and enable other water-dependent businesses, like clothes laundering. In Guatemala, one participant mentioned that if she had access to water at home, she would have the flexibility to carry out her activities without worrying about going to the river, and that improved availability and access to water could additionally allow women to grow crops and rear livestock, contributing to income generation. One woman from Zimbabwe described the critical role of water and how improved access would open economic opportunities. Women in all four countries reflected on the potential for economic opportunities if water was available:

“In many ways, if there was water, we could have orchards. Who wouldn’t have money? Who wouldn’t have a business? Even if we didn’t have a place to plant, it is easier to rent a place to plant, but without water it is not possible.” FGD(M): Age 59, Community 2, Guatemala

“Sometimes there are neighbors who are looking for someone to wash their clothes. Having water in my house, I could take care of this job because I wouldn’t have to go wash it in the river. So, in my case, access to water would already be of great help to me.” FGD(W): Age 50, Community 4, Honduras

“When water is near, it will help us a lot because there are some areas we border, and we have seen how they work. If we get water, people will start other ways of survival. They will cultivate and grow things like vegetables. Areas like [name of a place] have water and they have grown things like kales and other vegetables, and those villages are benefiting a lot.” FGD(M): Age 45, Community 2, Kenya

“At times it is lack of water. Water sources are far for women to get water to start garden projects and to grow vegetables to sell so that they can get capital. We go far to get water from Silikwe River and at times from Umzingwane River. If there is water nearby, we can do garden projects and get capital. Water is the most crucial factor that hinders us from starting businesses.” FGD(W): Age 34, Community 2, Zimbabwe

3.3.4. Health and wellbeing.

Women’s physical health and mental wellbeing were impacted by a lack of access to water, further limiting their ability to engage in other activities. While women did not explicitly state that their health and well-being was impacted by water which then impacted their ability to engage in economic activities, many women reported experiencing fatigue, exhaustion, physical injuries, and pain from water collection work, which left some so depleted that they said they had no energy left to do anything else. One man from Zimbabwe remarked on how water work was so demanding that it does not allow women the ability to think about a business.

“The issue of water availability is a serious challenge. I am sure you haven’t met any voluptuous woman since you came into our community. Our women work too hard to even accumulate any fat. They are always very, very slim. There is no time and energy left to think of business after the suffering and struggling [for water].” FGD(M): Age 60, Community 2, Zimbabwe

See Table 6 for other illustrative quotes related to health and wellbeing.

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Table 6. Illustrative quotes about health and wellbeing, by country.

https://doi.org/10.1371/journal.pwat.0000475.t006

Beyond walking long distances and carrying heavy weights, water collection could also involve strenuous processes that strained women’s energy. In Guatemala and Honduras, women filled and hauled large containers with water when they had access because flow was intermittent, and they wanted to ensure that they had enough water supply to last when water was not flowing. Moreover, due to inconsistent access, women sometimes had to make multiple trips to ensure they could get water when it was available. In Zimbabwe, some women pumped water from rusty pumps, requiring much energy. In Kenya and Zimbabwe, women engaged in sand abstraction which required them to dig at dry riverbeds and scoop out sand until water started coming out, then wait for the water to clear up and use a small bowl or container to collect and pour the water into jerricans to carry home. To get this water home, some women in Zimbabwe and Kenya pushed heavy wheelbarrows and scotch carts holding their water containers or rolled their heavy jerricans on the ground if they lacked scotch carts or donkeys. This form of hauling water causes strain on women, especially elderly, sick or pregnant women.

In all the countries, women reported risks of physical injuries along their journeys to reach a water source, as well as physical pain from hauling water. Injuries could result from the steep and rough terrain or even encounters with wild animals, including elephants. In Kenya, participants reported that other women in the communities experienced miscarriages or broken bones from the challenging walk to the water sources. Despite pain involved with water collection, women had to persist as best they could. One woman in Honduras described how she limited the amount of water she collected due to pain she experiences carrying water with an existing back problem:

“In my situation, when I go to pick up my bucket of water, I only make two trips because afterwards I experience pain in my spine and find it difficult to get up. I have back problems, so carrying the bucket from where I go to get water twice affects me. Therefore, I need someone to help me lower my bucket of water when I go with someone else, since my spine no longer allows me to do it on my own. Sometimes, I find myself having to ask a child to accompany me and help me.” FGD(W): Age 55, Community 4, Honduras

Women also reported being stressed by thinking about water collection processes and related activities. Women reported thinking about where to get water, queuing for water, the distance to the sources, childcare during water collection, and resultant effects of lack of water in the households, like children not being able to eat or attend school. One woman in Kenya described this mental burden:

“Even when you are sleeping, you start planning for your things as you sleep like you start saying tomorrow, I do not have water. You pray even for God to give you that water early. When you wake up in the morning you already have plans for the entire day. After I collect water, I need to clean the clothes, I need to go somewhere; I need to be cooking, so, all those are woman tasks.” FGD(W): Age 49, Community 4, Kenya

3.4 Environmental-level factors exacerbate water-related challenges constraining economic engagement

Environmental factors, like seasonality and drought, were reported to impact water sources, exacerbating water-related challenges that constrain women’s participation in economic activities. Across the four countries, participants reported that water levels had noticeably reduced in dams, rivers, and groundwater tables due to drought and seasonality, reducing the quantity of water participants would have access to for meeting household and other needs, like cooking, drinking, personal hygiene, livestock and agricultural production, and economic opportunities that require water. Across all the countries, participants continually noted that many of their struggles were either caused by or worsened by a lack of water. In Kenya and Zimbabwe, prolonged drought vastly decreased water availability at the water sources, with adverse effects on agriculture and livestock. In Honduras and Guatemala, participants reported seasonality affecting water availability, as water scarcity was more acute in summer, during the dry season. The decrease in water availability due to seasonality or drought necessitated women to use alternative water sources like springs, wells, and dams, which participants reported to be farther from their homes. These alternative sources provided insufficient quantities of water, were shared by domestic and wild animals, and were not safe for consumption. Additionally, geographical factors also exacerbated water scarcity, as some communities were in places where there were no natural water sources or had low groundwater potential which could not allow for drilling boreholes and wells.

The burdens exacerbated by seasonality and drought disproportionately affected pregnant women, women with young children, and elderly women. For example, in Honduras, Kenya, and Zimbabwe, elderly people, pregnant women and women with young children reported strain from walking long distances to collect water from alternative water sources. Older and pregnant women have greater challenges walking long distances to the water sources, carrying water due to the weight burden, and making multiple trips. Women with young children may need to carry them to the water source, which increased weight burden and depleted energy and time. These experiences minimize women’s livelihood options by reducing their time and affecting their health and wellbeing. (See illustrative quotes describing life-stage related experiences in Table 7.)

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Table 7. Illustrative quotes about life stage, by country.

https://doi.org/10.1371/journal.pwat.0000475.t007

3.5. Societal-level factors cement water-related challenges constraining economic engagement

In all countries, women’s ability to engage in income-generating activities was constrained by gender norms requiring them to handle all domestic labor, including the provision of water. Gender norms determined women’s and men’s household roles and responsibilities. In all the countries, men, as household heads, dictated what women can and cannot do and women were largely expected to take care of all unpaid household duties, like fetching water and firewood, childcare, cooking, cleaning, laundry, and attending to small animals, even if they were engaged in other paid work. In Honduras, for example, men and women perceived women as keepers of homes, and women were described as housewives whose role was in the kitchen; they were expected to take care of household chores in addition to taking care of their children and husbands. In Guatemala one man indicated that “los hombres son superiores” (men are superior), and that women themselves did not have a voice and would not be involved in leadership. Furthermore, some women in all countries indicated that they had to seek permission from their partners to be able to engage in income-generating activities as well as how money was spent. See Table 8 for illustrative quotes related to gender norms.

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Table 8. Illustrative quotes about gender norms and water, by country.

https://doi.org/10.1371/journal.pwat.0000475.t008

Men and women in all countries reported that water collection was the primary responsibility of women and older girls, and occasionally younger children, but was not expected of men. Men and women noted that this responsibility particularly constrained women’s abilities to engage in paid economic activities. Across all countries, gender norms prevented men from engaging in water collection, except in Guatemala where women reported that men helped in times of scarcity. In Honduras, while women reported that water collection was a shared responsibility at the household, men would typically be busy working in the fields and were only able to collect water occasionally. In Kenya, women mentioned that it was shameful for men to collect water, and the men involved in water collection were perceived as “madai” [stupid] and faced isolation in the community. In Zimbabwe, cultural norms dissuaded men from water collection. Women indicated that men did not engage in water collection work, did not know how difficult pumping water from the borehole is, and perceived that it was impossible for men to carry buckets to go to collect water.

4.1. Available time

While health has remained the primary justification for improving water access [50], some have argued for improving water access specifically to reduce the time burden of water collection placed on women, potentially enabling them to engage in other opportunities, including but not limited to income generation [50,51]. Aligned with this argument, women across all four countries in our study discussed how the time burden of water collection constrained their ability to engage in economic opportunities. That said, research to date assessing water collection time and associations with economic engagement has been mixed, indicating both positive and negative associations of improved water access to women’s economic engagement. Ilahi and Grimard (2000) affirmed that improved water infrastructure increased the proportion of Pakistani women’s time that was allocated in income-generating activities and further reduced total work burden of female household members [52]. Conversely, in Kyrgyzstan, improved water access amounted to an 80 minute increase in leisure time and a 90 minute increase in farm labor resulting in increased household cereal production, but not income-generating market labor [53]. Likewise, in Benin, improved water supply resulted in a reduction in time for water collection by 41 minutes, resulting in women making additional trips, with no increase in market labor due to time gains [17]. Furthermore, in their study on water access, women’s work, and child outcomes in nine countries across North and sub-Saharan Africa, South Asia, and the Middle East, Koolwal and Van De Walle (2013) reported no association between reduction in water collection time with women’s off-farm work and wage work in Yemen, Uganda, Nepal, Malawi, India, and Pakistan. In other countries, reduced water collection time led to less unpaid work and more leisure for women but did not result in higher participation in market work or linked improved water access to economic engagement [49].

Consistent with other studies, our results also indicated that some women may not necessarily use the extra time on income generation; having time does not always translate to being able to participate in income-generating activities, since women may still lack skills, tools, or opportunities needed to find a job or start a business [49,53,54]. Women may prioritize activities hierarchically based on their order of importance, which may leave economic engagement at the bottom of the hierarchy. Therefore, research on time use, particularly how much time in a woman’s day is taken up by water and other domestic activities, is essential to understanding whether women’s time use is shaped by domestic responsibilities, economic engagement and gendered expectations that prioritize domestic tasks over income-generating activities. In addition, as noted above, men in all countries dictated women’s activities, and women indicated that they required men’s permission to engage in economic activities, suggesting that women may have low agency to decide how to spend any time that is saved. Although improved access can alleviate water collection time needs, understanding women’s time needs, priorities, and time-use agency [55,56] beyond water access is critical to ascertain the type, quality and sustainability prospects of activities women would engage in, including whether income generation is a viable option.

Beyond time needed to access water, women in Guatemala also discussed the time burden of engaging in committees. Women’s participation in water management is vital, since they are primary water collectors and users. Although water user committees with higher numbers of female members are more active, record high functionality of water sources, and ensure better access to water [57], women’s involvement in water committees, and the amount of time commitment, could deprive women of time to engage in other economic activities. A study in India found that an increase in women’s engagement in water management-related unpaid domestic services resulted in women’s lower labor force participation compared to men [58]. Women in our study recognized that despite the time burden, their level of involvement in leadership roles within water committees would motivate them to fully participate, although other studies have indicated that major leadership roles in water committees are taken up by men, leaving women as participants and not actual contributors [59–61]. As aligned with our findings, women may have no options but to contribute to community water programs if they are widowed, single or are the only available person to take up the role due to household complexities [62]. Therefore, water programs must recognize intersectionality and the differences between women if the poorest and most disadvantaged women are to benefit [63], consider additional burden that water initiatives can have on women and men, and include strategies that can alleviate women from more unpaid work and benefit both men and women.

4.2. Livelihood opportunities

Consistent with other research, we found women’s engagement in agriculture and livestock production to be hindered by limited water access. Water access has been argued to be a ‘prerequisite’ for business and livelihood [50], and research shows that women’s livelihood-related water needs and access may be different and potentially more constrained compared to men in their own household [64,65]. Besides common water uses, including production such as agriculture and livestock production, and domestic purposes like bathing, washing, drinking, kitchen gardening, and watering animals, water needs for women and men differ based on crop preferences [66]. These differences are also influenced by factors such as reduced availability of male family labor, for instance if women are widowed, divorced, or if husband migrated, and the transaction cost required to get water [67]. These other factors may constrain women from engaging in livelihood opportunities even if there is water.

Furthermore, drought in Kenya and Zimbabwe, and seasonality in Guatemala and Honduras contributed to water scarcity, demonstrated through intermittent water supply defined as water supply that for a period of time is unavailable during rainy or dry season [68]. Drought and seasonality continue to create significant challenges for access to water across different countries, phenomena that will possibly be worsened by climate change [69]. Kenya and Zimbabwe have experienced reduced water tables and drying of available water sources as reported in other countries [70,71]. Beyond the importance of water for income generation, interviews with women in our study revealed how a depletion or lack of water can be detrimental to economic engagement. Specifically, women described how a reduction in water led to thinning and death of livestock and drying up of gardens and other crops. Taken together, our research and that of others suggests that programs aiming to improve water access in order to enable income generation through agriculture and livestock production must ensure the sustainability of water initiatives [72]. Such programs could incorporate climate resilient WASH technologies as appropriate such as retention ponds or drip irrigation and sustainable catchment management practices that increase ground water recharge to address the increasing impact of climate change on water infrastructure [73]. In addition, an in-depth understanding of the influence of intermittent water supply on agriculture and livestock productivity is needed.

4.3. Economic resource constraints

The payment for water at sources and costs incurred on installation and maintenance of water infrastructure were extensively mentioned by participants, and these factors could influence women’s economic engagement. Women described paying for water at the source, remitting monthly water bills, purchasing water storage vessels, and paying for water repairs and installation, which depleted their household income. Like other studies [27,74], women in this study were engaged in agriculture, livestock rearing and other water intensive businesses, which increased their water demands and expenditure. Such expenses can reduce profit and viability of businesses. While women were primarily responsible for securing and managing water for household use, intra-household financial decision-making or control over resources could be a challenge especially for women. For instance, women may have control over where and how much water to obtain, but husbands may influence that decision by controlling the money needed to purchase water and water assets [75]. Understanding how gendered financial roles influence water-related expenditures is critical for future research, particularly in contexts where men may manage household finances while women are tasked with water-related purchases and responsibilities. Understanding these dynamics is essential for implementers designing interventions such as cash transfers or voucher programs, to ensure that women have both access to and agency over resources intended to support household water needs. While improved water supplies can reduce direct costs of water, our findings, similar to another study, showed that the increased cost of operation and maintenance for water infrastructure (due to cost of pipes and labor) made it harder to access adequate water [76]. Therefore, infrastructure improvements need to provide sufficient quantities of water and time savings, ideally without resulting in increased costs that can reduce women’s capital thereby reducing their ability to engage in business [17].

4.4. Health and wellbeing

Women in our study talked about how water collection impacted their health and well-being, and while they did not draw direct connections between their health and well-being and their economic engagement, previous research suggests a link likely exists and is worth further investigation. It is already widely acknowledged that women’s reproductive health is important for their economic empowerment, particularly women’s ability to control the timing and spacing of births during their years of peak economic productivity [77,78]. However, studies have more often treated health as an outcome of economic empowerment, rather than as a predictor of economic empowerment. For example, studies show that women’s economic rights to own and inherit property and have control over their earnings significantly improve their access to maternal health care, dietary diversity, and overall welfare [79–83]. Women in our study highlighted how a lack of access to water influences their health and wellbeing including pain, fatigue, exhaustion, injury and others. Like in other studies, women walked long distances to collect water, exposing them to sexual and physical violence, and intimate partner violence due to inability to meet domestic obligations due to household water inadequacy [84]. Similarly, other research has found that water fetching is associated with poor musculoskeletal health like pain in the head, upper back, chest, hands, feet, and abdomen, and noted that these issues can be chronic (due to habitual head loading) or acute (due to environmental hazard-related injuries such as broken bones) [85,86]. Importantly, musculoskeletal conditions have been shown to profoundly affect economic wellbeing as well as physical and mental wellbeing and physical and emotional relationships [87]. Evidence also suggests that water carriage impacts women’s health acutely. A cross-sectional study with 1001 women of reproductive age in Nepal found that women who did not receive help with water carriage had a 4.4 times higher odds ratio for uterine prolapse [88]. Treatment of such injuries and conditions may be costly, potentially depleting household income and capital, and may render women physically unable to engage in economic activities. Musculoskeletal pains can often go undiagnosed [87], and may lead to long term physical disability, hence limiting opportunities and hindering women from fully participating in income-generating activities. In addition to physical pain and injury, women in our study described how the burden of water collection deprived them of time to rest, relax and sleep, further impacting their overall wellbeing. This finding is consistent with other studies that have reported how inadequate water access limits women’s opportunities to rest, socialize, and maintain familial connections [7,89,90]. When women lack time for rest or pleasurable activities, both their wellbeing and their capacity for participating in income generating activities can be compromised. An understanding of how health and wellbeing, influenced by water collection, impacts women’s economic engagement, is crucial for developing interventions that support women’s economic activities while addressing the challenges posed by water collection.

Like findings from other studies [13,89,91], existing gender norms in our study context reinforced the expectation that water collection be carried out by women. These expectations can be exacerbated by the deeply rooted patriarchal systems which support them and make it difficult to challenge these harmful norms [92]. For instance, our study found that it was “shameful” for men to collect water, that women perceived men as “superior” and could not collect water, and that men were dissuaded from collecting water. A mixed-methods study that explored the gender differences in water collection in Makondo Parish in Uganda also found that traditional norms and stereotypes deemed it shameful, demeaning, and unusual for men to collect water [13]. These gender norms reinforce the invisibility of the significant work of women, a finding also reported in a study which examined how the water fetching burden differed by gender among rural households in west region of Cameroon [93]. Although culture and traditions can contribute to the reinforcement of harmful gender norms related to water collection [92], in our study, women discussed how men in Guatemala and Honduras could participate in water collection if they had time. This demonstrated that norms are malleable. Changing norms is necessary to relieve women of the burden of water collection, and to challenge the perception that it is expected and ‘free’ for women’s bodies to be used as a pathway or conduit to enable the flow of water to households [92].

4.5. Implications for research and practice

The findings from this study point to the need for integrated programmatic and research approaches that address both water access and women’s economic engagement. WASH and livelihoods programs, informed by evidence and learning, should consider combining WASH improvements with livelihood support to reduce time and energy burdens, especially for women. Programs could consider gender-sensitive infrastructure and labor-saving technologies such as household water piping which can mitigate physical strain and enhance productivity. Further, such WASH programs that seek to change outcomes related to women’s lives (e.g., time burden, energy expenditure) need to be evaluated to determine if they have the intended impact. A recent re-review of WASH interventions and evaluations found that women are often engaged to carry out tasks for program success (e.g., water treatment) or to enable research unrelated to their own lives (e.g., respond to surveys about child health). Studies rarely evaluated outcomes specific to women [94]. Our work provides further support to the call made in the re-review to ensure WASH programming and research does not exploit women but puts women at the center. Additionally, health-focused initiatives and climate-resilient planning are essential to sustain access and economic participation amid environmental stressors such as drought. Quantitative studies could model the financial burden of water access, assess health impacts such as fatigue and musculoskeletal pain, and integrate environmental and gender norm variables to understand how broader societal and ecological factors moderate individual-level outcomes. These insights can inform policy programs and investments that recognize water access as a structural barrier to women’s engagement and promote gender-transformative strategies to shift norms around water-related responsibilities.

4.6. Strengths and Limitations

Using qualitative data collection methods to understand barriers to economic engagement as they relate to water access was crucial in capturing diverse voices, experiences, and perspectives. Participants were able to explain how and why the identified barriers influenced women’s economic engagement, providing a comprehensive understanding of how these factors interacted within and across different settings. Men’s participation in FGDs and KIIs allowed for the exploration of how gender norms are operationalized and provided validation of women’s experiences, considering that male involvement can contribute to strengthening effectiveness of programming which address gender norms. Engaging local enumerators enabled building trust with participants as they knew the language and culture and shared lived experiences with the participants. Some limitations exist. Audio records were translated from local languages to English and during this process the meanings of some topics could have been lost or misconstrued. Additionally, there was limited information from the men’s guide that enabled the direct comparison of women verses men perceptions surrounding water, time use and economic engagement which could have been useful. Future studies could incorporate more deliberate comparative analysis of male and female perspectives. Furthermore, using community gatekeepers to recruit participants and selecting a convenience sample are limitations, as we may have missed key perspectives from diverse individuals who were not contacted. The season in which data were collected could have led participants to reference the most current season in their discussion of water access. Collecting data in other seasons could potentially illuminate other challenges that influence women’s economic empowerment.