Use of the household water insecurity experiences (HWISE) scale to evaluate rural water delivery in small Ecuadorian communities

Community-led water systems are an important strategy to provide water to rural and disperse communities. However, evaluating the effect of these systems on small communities is challenging. To complement the WHO/UNICEF Joint Monitoring Programme (JMP) water service ladder, the Household Water Insecurity Experiences (HWISE) Scale, an experiential measure of water availability, accessibility, use, acceptability, and reliability, may support an improved understanding of how improvements in water access affect communities. In 2023, Green Empowerment, an organization that supports the development of community-managed water systems in Ecuador, and local partner organizations, integrated the HWISE Scale into routine monitoring and evaluation surveys for communities where a new piped water system, or an upgrade to an existing piped water system, was planned. Baseline data were collected from 19 communities in three regions (coastal, highland, and Amazon) and in three languages (Spanish, Kichwa, and Cha’palaa). This included communities with no piped water and communities with water systems with varying levels of service quality. Endline (post-intervention) evaluations were completed in 4 communities. We also collected data from 1 Colombian community where a non-perceivable infrastructure modification in the water system was implemented. We used logistic regression to evaluate risk factors for reported water insecurity at baseline and unpaired two-sided t-tests to evaluate differences in reported water insecurity pre- versus post-intervention. We found that communities with unreliable piped water often reported considerable water insecurity variation between households, with mean HWISE scores similar to those of communities fully reliant on surface or rainwater. Reported water insecurity was reduced by 1.6-3.3 points on the HWISE-4 Scale post-intervention in 4 communities with a tangible system improvement, and by 0.8 points in the community with the non-perceivable intervention. The HWISE Scale enriched traditional water service/access indicators, and were sensitive to changes in households’ experiences of water or attitudes towards their water infrastructure. This manuscript is available in Spanish, in its entirety, in the Supplemental Materials. / Este manuscrito está disponible en español, en su totalidad, en los Materiales Suplementarios.