Coping strategies for individual and household-level water insecurity: A systematic review

Household water insecurity is a complex socioecological challenge with a range of consequences for health and wellbeing. Understanding individual and household-level coping strategies, i.e., responses or adaptations to manage water insecurity, can shape future research and development practice. We therefore (a) systematically describe the characteristics and contexts of 173 studies documenting coping strategies and (b) classify the types of strategies within four domains of water insecurity: access, use, quality, and reliability. Most studies were from Sub-Saharan Africa or South Asia. In the domain of access, the most common coping strategies were building infrastructure, and storing, purchasing, and sharing water. For use, changing food consumption, agricultural practices, and hygiene were most frequently mentioned. For quality, water treatment was the most common strategy. To ensure water reliability, people most frequently reported changing routines or relocating their homes altogether. Our review provides a useful framework to understand coping strategies, but more research is needed to address three gaps in particular. First, we recommend more representative exploration of the range of coping strategies, particularly in middle- and high-income countries. Second, the links between coping with water insecurity and a range of other nutritional, social, financial, and health outcomes need to be better understood to address overall household wellbeing. Third, we recommend the development of a metric to quantify individual and household-level water insecurity-related coping strategies. This line of inquiry can enable practitioners to design and implement context-specific interventions that leverage preexisting strategies to improve experiences of water insecurity.