The utility of experiential water insecurity measures for monitoring and evaluating WASH programs: Case studies from Nepal and Sierra Leone

Progress toward safe water for all is predominantly tracked using directly observable, resource-based indicators, including primary water source and water collection travel time. There is growing interest in complementing these indicators with experiential data about water access, use, and reliability, but there is limited evidence about their value for evaluating water service interventions. We therefore compared findings from observable and experiential water measures that were used to evaluate the impact of two multilevel interventions among households in Nepal (n = 83) and Sierra Leone (n = 981). We used t-tests, chi-square tests, and multivariable models to determine whether drinking water services (classified using the Joint Monitoring Programme’s drinking water service ladder) and water insecurity experiences (measured using the Household Water Insecurity Experiences Scale) changed following intervention. Additionally, we assessed for potential differential impacts on water insecurity by sociodemographic characteristics to understand if any groups were being left behind. In both settings, access to at-least-basic drinking water services among sampled households increased, from 60.8% to 100% in Nepal and from 33.0% to 48.2% in Sierra Leone. The percentage of households experiencing moderate-to-high water insecurity declined from 18.3% to 1.4% in Nepal and from 66.3% to 24.8% in Sierra Leone. Affirmation and reported frequency of being unable to wash clothes due to water problems, worrying about water insufficiency, and feeling angry about one’s water situation decreased but remained salient issues in both sites. There were no observed differences in project impact on water insecurity by respondent gender or age. In Nepal, project impact varied by districts, suggesting opportunities to better tailor interventions to local needs. These findings provide empirical evidence that experiential data complement traditional resource-based indicators and offer actionable information to address water insecurity.