SynthesisPloS one2023
Evidence on the links between water insecurity, inadequate sanitation and mental health: A systematic review and meta-analysis.
Synthesis in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed.
- Association between household environment and the risk of depression and anxiety among women in Bangladesh: analysis of the Bangladesh Demographic and Health Survey (2022).The Lancet regional health. Southeast Asia · 2026Article
- Psychosocial stressors related to extreme weather events and multiple resource insecurities: qualitative insights from refugee youth in an Ugandan humanitarian setting.SSM. Mental health · 2026Article
- Household living conditions and mental health of youth and adults: differences between urban and rural regions.BMC psychology · 2026Article
- Water Insecurity is Associated with Intimate Partner Violence Among Women Living with HIV in Western Kenya.AIDS and behavior · 2026Article
- What Makes Household Sanitation Systems Resilient to Floods? Evidence from Ethiopia, Uganda, and Nepal.ACS ES&T water · 2026Article
- Water, sanitation, and depressive symptoms in Indonesia: The mediating role of life satisfaction.PloS one · 2026Article
- Water, sanitation, and hygiene insecurity and psychological distress in South Sudan.Social psychiatry and psychiatric epidemiology · 2026Article
- A study of the link between food-water insecurities and self-reported psychotic experiences among young adults in Gaza Strip: What role does social support play under conditions of war and extreme suffering?International journal for equity in health · 2025Article
- Association between poor mental health in mothers and child stunting: a population-based cross-sectional study in Rwanda.BMJ open · 2025Article
- Urban mental health: a position paper of the European psychiatric association.European psychiatry : the journal of the Association of European Psychiatrists · 2025Review
- Examining the association between toilet access and major depression among older adults in India: a cross-sectional analysis of the Longitudinal Aging Study in India from 2017 to 2018.Age and ageing · 2025Article
- A Critical Gap in Addressing Mental Health in Heat-Health Action Plans Worldwide.Current environmental health reports · 2025Review
- Interacting Water Insecurity and Food Insecurity: Recent Advances in Theory and Application.American journal of human biology : the official journal of the Human Biology Council · 2025Article
- Uncovering the hidden implications of water scarcity for maternal health: a photovoice study in rural Malawi (Thyolo district).Frontiers in global women's health · 2025Article
- Article
- Mental health and post-traumatic stress among unprivileged people in the aftermath of COVID-19 pandemic in Southwest Bangladesh: a cross-sectional study.Cogent mental health · 2025Article
- How water intermittency and water perceptions influence household coping strategies in northwestern Ecuador.PLOS water · 2025Article
- Coping strategies for household water insecurity in rural Gambia, mediating factors in the relationship between weather, water and health.BMC public health · 2024Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWater insecurity and inadequate sanitation have adverse impacts on the mental health of individuals.
objectiveTo review and synthesize evidence on the relationship between water insecurity, inadequate sanitation, and mental health globally. DATA SOURCES: Relevant studies were identified by searching PubMed, PsycINFO, and EMBASE databases from inception up to March 2023. STUDY ELIGIBILITY CRITERIA: Only quantitative studies were included. The exposure was water insecurity and or inadequate sanitation. The outcome was common mental disorders (CMD: depression or anxiety), mental distress, mental health or well-being. There was no restriction on geographical location.
participantsGeneral population or people attending health facilities or other services. EXPOSURE: Water insecurity and/ or inadequate sanitation. RISK OF BIAS: The effective Public Health Practice Project (EPHPP) assessment tool was used to assess quality of selected studies. SYNTHESIS OF
resultsA meta-analysis was conducted using a random effects statistical model.
resultsTwenty-five studies were included, with 23,103 participants from 16 countries in three continents: Africa (Kenya, Ethiopia, Ghana, Uganda, South Africa, Malawi, Mozambique, and Lesotho), Asia (Nepal, Bangladesh, India, and Iran) and the Americas (Brazil, Haiti, Bolivia and Vietnam). There was a statistically significant association between water insecurity and CMD symptoms. Nine studies reported a continuous outcome (5,248 participants): overall standardized mean difference (SMD = 1.38; 95% CI = 0.88, 1.87). Five studies reported a binary outcome (5,776 participants): odds ratio 5.03; 95% CI = 2.26, 11.18. There was a statistically significant association between inadequate sanitation and CMD symptoms (7415 participants), overall SMD = 5.36; 95% CI = 2.51, 8.20. LIMITATIONS: Most of the included studies were cross-sectional which were unable to examine temporal relationships.
conclusionsWater insecurity and inadequate sanitation contribute to poorer mental health globally. IMPLICATIONS OF KEY
findingsInterventions to provide basic water, sanitation and psychosocial support, could substantially contribute to reducing the burden of CMD alongside other health and social benefits.
trial registrationPROSPERO registration number: CRD42022322528.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.