Is household water insecurity a link between water governance and well-being? A multi-site analysis

Joshua D. Miller, Jaynie Vonk, Chad Staddon, Sera L. Young*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


Improving water governance is a top priority for addressing the global water crisis. Yet, there is a dearth of empirical data examining whether better water governance is associated with lower water insecurity and improved well-being. We, therefore, pooled household data from two Sustainable Water Effectiveness Reviews conducted by Oxfam GB in Zambia (n ¼ 997) and the Democratic Republic of Congo (DRC, n ¼ 1,071) to assess the relationship between perceived water governance (using a 12-item indicator), water insecurity [using the Household Water Insecurity Experiences (HWISE) Scale], and four indicators of well-being: life satisfaction, drinking unsafe water, diarrhea, and resilience to cholera outbreak. Using generalized structural equation models controlling for wealth and primary water source, each point increase in water governance score was associated with a 0.69-point decrease in HWISE Scale scores. Good water governance was also directly associated with greater odds of life satisfaction (aOR 1.24) and lower odds of both drinking unsafe water (aOR 0.91) and severe cholera impact (aOR 0.92). Furthermore, the relationships between water governance and drinking unsafe water, diarrhea, and cholera impact were mediated by household water insecurity. Improving water governance has the potential to meaningfully impact entrenched public health issues through changes in water insecurity.

Original languageEnglish (US)
Pages (from-to)320-334
Number of pages15
JournalJournal of Water Sanitation and Hygiene for Development
Issue number2
StatePublished - Jun 1 2020


  • Cholera
  • Diarrhea
  • Household water insecurity
  • Sub-Saharan Africa
  • Water governance
  • Water quality

ASJC Scopus subject areas

  • Development
  • Water Science and Technology
  • Waste Management and Disposal
  • Pollution
  • Public Health, Environmental and Occupational Health


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