Characterizing the gendered health burdens of poor water quality in the Global South

Safe water is crucial for human health and sustainable development, yet unsafe water disproportionately affects vulnerable populations like women and children. Targeting the Global South, this study combines a systematic literature review and a health risk assessment to examine the gendered health consequences of unsafe water. The review identified 1916 articles in the original search; 428 articles were screened, and 73 articles from 2015 to 2022, onset to midway the UN Sustainable Development Goals era, were included. Nitrate (40%), fluoride (33%), and arsenic (16%) were the most reported water contaminants in the Global South. Fluoride and arsenic were selected for detailed health risk analysis based on the reporting frequency and global data availability. The results show that infants, children, and pregnant women face higher health risks from water contaminants. Women are more susceptible to endocrine-disrupting chemicals and enteric pathogens, while men have slightly higher non-carcinogenic health hazard quotients (HQ) from fluoride and arsenic exposure. Despite low fluoride HQs in most countries, several nations in South America and Asia showed high arsenic HQs, indicating elevated risks of arsenicosis, cancers, and neurological disorders. The study underscores the need to address the gendered impacts of water quality decline, recognizing that water-related issues are not gender-neutral.