title: An Analysis of Water Collection Labor among Women and Children in 24 Sub-Saharan African Countries.
abstract: BACKGROUND
  It is estimated that more than two-thirds of the population in sub-Saharan Africa (SSA) must leave their home to collect water, putting them at risk for a variety of negative health outcomes. There is little research, however, quantifying who is most affected by long water collection times.
  
  
  OBJECTIVE
  This study aims to a) describe gender differences in water collection labor among both adults and children (< 15 years of age) in the households (HHs) that report spending more than 30 minutes collecting water, disaggregated by urban and rural residence; and b) estimate the absolute number of adults and children affected by water collection times greater than 30 minutes in 24 SSA countries.
  
  
  METHODS
  We analyzed data from the Demographic Health Survey (DHS) and the Multiple Indicator Cluster Survey (MICS) (2005-2012) to describe water collection labor in 24 SSA countries.
  
  
  RESULTS
  Among households spending more than 30 minutes collecting water, adult females were the primary collectors of water across all 24 countries, ranging from 46% in Liberia (17,412 HHs) to 90% in Cote d'Ivoire (224,808 HHs). Across all countries, female children were more likely to be responsible for water collection than male children (62% vs. 38%, respectively). Six countries had more than 100,000 households (HHs) where children were reported to be responsible for water collection (greater than 30 minutes): Burundi (181,702 HHs), Cameroon (154,453 HHs), Ethiopia (1,321,424 HHs), Mozambique (129,544 HHs), Niger (171,305 HHs), and Nigeria (1,045,647 HHs).
  
  
  CONCLUSIONS
  In the 24 SSA countries studied, an estimated 3.36 million children and 13.54 million adult females were responsible for water collection in households with collection times greater than 30 minutes. We suggest that accessibility to water, water collection by children, and gender ratios for water collection, especially when collection times are great, should be considered as key indicators for measuring progress in the water, sanitation and hygiene sector.
authors.affiliation: Department of Environmental and Occupational Health and Department of Global Health, Milken Institute School of Public Health at George Washington University, Washington, DC, United States of America.
authors.forename: Jay P
authors.identifier: http://orcid.org/0000-0001-7062-6293
authors.initials: JP
authors.lastname: Graham
authors.affiliation: Department of Global Health, Milken Institute School of Public Health at George Washington University, Washington, DC, United States of America.
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Hirai
authors.affiliation: Department of Public Health Sciences, Korea University, Seoul, South Korea.
authors.forename: Seung-Sup
authors.initials: SS
authors.lastname: Kim
mesh_terms: D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D002648:Child; D005260:Female; D006801:Humans; D014881:Water Supply