Nexus between Water Security Framework and Public Health: A Comprehensive Scientific Review

In Water
Peer-reviewed Article
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Water scarcity, together with the projected impacts of water stress worldwide, has led
to a rapid increase in research on measuring water security. However, water security has been
conceptualized under different perspectives, including various aspects and dimensions. Since public
health is also an integral part of water security, it is necessary to understand how health has been
incorporated as a dimension in the existing water security frameworks. While supply–demand
and governance narratives dominated several popular water security frameworks, studies that are
specifically designed for public health purposes are generally lacking. This research aims to address
this gap, firstly by assessing the multiple thematic dimensions of water security frameworks in
scientific disclosure; and secondly by looking into the public health dimensions and evaluating their
importance and integration in the existing water security frameworks. For this, a systematic review
of the Scopus database was undertaken using Preferred Reporting Items for Systematic Reviews
and Meta-Analyses (PRISMA) guidelines. A detailed review analysis of 77 relevant papers was
performed. The result shows that 11 distinct dimensions have been used to design the existing
water security framework. Although public health aspects were mentioned in 51% of the papers,
direct health impacts were considered only by 18%, and indirect health impacts or mediators were
considered by 33% of the papers. Among direct health impacts, diarrhea is the most prevalent
one considered for developing a water security framework. Among different indirect or mediating
factors, poor accessibility and availability of water resources in terms of time and distance is a big
determinant for causing mental illnesses, such as stress or anxiety, which are being considered when
framing water security framework, particularly in developing nations. Water quantity is more of
a common issue for both developed and developing countries, water quality and mismanagement
of water supply-related infrastructure is the main concern for developing nations, which proved to
be the biggest hurdle for achieving water security. It is also necessary to consider how people treat
and consume the water available to them. The result of this study sheds light on existing gaps for
different water security frameworks and provides policy-relevant guidelines for its betterment. Also,
it stressed that a more wide and holistic approach must be considered when framing a water security
framework to result in sustainable water management and human well-being.

Binaya Kumar