Understanding Water Access Beyond Piped Connections: A Comprehensive Study in Mexico

Traditionally, metrics for assessing water access have centered on the availability of piped water connections to households. However, a landmark research project supported by CGHE offers a more comprehensive understanding of water accessibility by assessing water intermittency at the household level in Mexico. This interdisciplinary project, led by Elizabeth Roberts from the Department of Anthropology at the University of Michigan, helps close a significant gap in knowledge as policymakers seek to make urban water safer, more sustainable and more equitable.

Global efforts have significantly boosted the number of people able to access a water connection, with some estimates placing the world on target for 94% coverage by 2030. These numbers represent one of the largest public health victories achieved to date. However, simply having a water connection nearby is not a guarantor of clean water, emphasizes Roberts. When water supply is intermittent, people need to collect and store water to ensure they have enough to meet their needs. This, in turn, increases the the risk of contamination from bacterial growth as the water stagnates. Almost one billion people worldwide are estimated to live with an intermittent water supply—with these numbers predicted to increase as water supplies are strained in the face of rapidly changing weather patterns and infrastructure declines. Marginalized communities often bear the brunt of this threat to health, further exacerbating already existing health and economic disparities. In particular, women within these communities are doubly burdened as they are often responsible for both water management as well as ongoing household management responsibilities. Despite the known challenges related to intermittent water supplies around the world, emphasizes Roberts, data related to how often individuals actually receive water from their primary collection point remains scarce. “The binary metric of ‘piped water: yes or no’ often used in evaluations overlooks the crucial aspect of water supply reliability”.

Both she and her co-investigators — students and researchers with deep ties to Mexico — wanted to know how this challenge impacted communities across the country. Representing a wide range of disciplines, the team’s approach was remarkable for the breadth of expertise the team brought to the table with specialists from public health, anthropology, nutrition, economics, and biostatistics. The composition of the team, representing both academia and the public health sector, exemplifies the critical role that such co-designed research and interventions play in driving systemic changes and enhancements that benefit community populations.

The team comprised (in alphabetical order):

• Zoe Boudart, Anthropology, U-M Medicine
• Juan Carlos Figueroa Morales,  Biostatistics, Drexel University 
• Faith Cole, Anthropology, UCLA
• José Luis Figueroa-Oropeza, Health Economics, Evaluation & Survey Research at the National Institute of Public Health, Mexico
• Alejandra Rodríguez, Health Economics, Evaluation and Survey Research, National Institute of Public Health, Mexico
• Brisa Sánchez, Biostatistics, Drexel University
• Martha (Mara) Téllez Rojo, Center for Nutrition and Health Research, National Institute of Public Health, Mexico

While almost 95% of Mexican households have a water connection (according to the national census) preliminary research conducted by the team found that this number does not necessarily mean that households have regular and predictable access to water.  Combined results from open-ended household interviews, ethnographic observations about household water infrastructure and water management, and analysis of a large survey from Mexico City, found that household members spent significant parts of their day managing their water supply. And, the team found, that households have developed robust storing practices to buffer themselves from the impacts of intermittent supply.

According to research team lead Mara Téllez Rojo, “Overconfidence in this 95% number as a metric of success hides the fact that regular and predictable water supply is not a guarantee for these families. The challenge now is to understand the depth of this intermittency issue and find solutions to ensure reliable water access for all.”

Téllez Rojo, Roberts, Figueroa-Oropeza and their team led an effort to place several questions about water intermittency on the Encuesta Nacional de Salud y Nutrición (ENSANUT), an annual national survey about health and nutrition carried out in 10,000 households. As part of the 2022 edition of the national survey, the team gathered information about how many days per week and hours per day respondents had access to water, rather than simply asking if households had a water connection.

The findings show that, even with extensive water network connections, numerous households contend with considerable challenges due to intermittent water supply. In fact, only 17% of families had continuous water all year long, necessitating the need for water storage solutions. While households across socio-economic classes  experienced some level of intermittency, households not connected to the water infrastructure faced the most extreme levels of water scarcity. These households relied on neighbors to share their public supply or on water deliveries from tanker trucks that deliver water to fill neighborhood or household storage containers for a fee. And, emphasized researcher Figueroa-Oropeza, the team’s findings are important to help other researchers better understand the challenges faced by communities so that future health interventions are more successful.

“The results of our new study help to quantify the scale of the problem in Mexico so that researchers can better understand important contributors to chronic health conditions and, one day, build the interventions necessary to improve the health of these communities."