Invisible vulnerability: WASH insecurity of older adults in Ghana during a global public emergency

ABSTRACT The COVID-19 pandemic has exposed and deepened structural inequalities in water, sanitation, and hygiene (WASH) access in the Global South. While older adults, particularly older women, were among the most vulnerable populations, we know little about their WASH experiences during the pandemic. Drawing on the feminist political ecology of health theoretical framework, this paper examined the factors that shaped the WASH conditions of older women and the coping strategies they employed during the pandemic emergency. We analysed cross-sectional surveys of older women in Ghana during the pandemic. The findings suggest that well-being and food insecurity are major determinants of WASH insecurity. Older women with poor well-being and food insecurity had higher odds of reporting water insecurity. In response to water insecurity, older women adopted diverse coping strategies, including rainwater harvesting, borrowing water from social networks, and illegal connections to public networks. The likelihood of adopting a particular coping mechanism is linked to their socio-economic and living conditions. We call for a life course examination of how systemic inequalities shaped WASH insecurity among marginalized populations. In terms of policy, we echo calls for investing in WASH as a public health emergency response and post-pandemic recovery strategy.