A composite metric assessing water security's physical dimension at the micro/ community level is lacking but is essential for setting priorities for program and policy implementations. We prepared an objective index (OI) of water security to measure the physical dimension using a model centered on household water-use behavior in developing countries' urban areas. A cross-sectional household survey (n = 1500) with multi-stage cluster design was conducted from December 2015 to February 2016 in the Kathmandu Valley, which has faced long-term, severe water shortage. A structured questionnaire probed socio-demographic characteristics, water sources, frequency and quantity of water use, cost related to water, etc. A 15-item water insecurity scale was used to measure subjective and experiential dimension of water insecurity. The World Health Organization Quality of Life - BREF was used to measure quality of life (QoL). The QoL has been considered as proxy of well-being in this study. The OI measured differential water security within small cities, the utility's service areas for instance, and identified area-specific key dimensions that need improvement. Overall, the OI and its key dimensions can be useful measures to design water-scarcity averting programs and policies, specific to a particular community's needs. The increased OI values were significantly and positively associated with better physical and psychological health and better social relationship domains of QoL suggesting health implications of water security.

Information regarding domestic water consumption is vital, as the Kathmandu Valley will soon be implementing the Melamchi Water Supply Project; however, updated information on the current situation after the 2015 Gorkha Earthquake (GEQ) is still lacking. We investigated the dynamics of domestic water consumption pre- and post-GEQ. The piped water supply was short, and consumption varied widely across the Kathmandu Upatyaka Khanepani Limited (KUKL) branches and altitude. The reduction in piped, ground, and jar water consumption and the increase in tanker water consumption post-GEQ appeared to be due to the impact of the GEQ. However, the impact did not appear to be prominent on per capita water consumption, although it was reduced from 117 to 99 L post-GEQ. Piped, ground, and tanker water use were associated with an increase and jar water use was associated with a decrease in water consumption. Despite improvements in quantity, inequality in water consumption and inequity in affordability across wealth status was well established. This study suggests to KUKL the areas of priority where improvements to supply are required, and recommends an emphasis on resuming performance. Policy planners should consider the existing inequity in affordability, which is a major issue in the United Nations Sustainable Development Goals.

Kathmandu Valley faces water scarcity from decades of the added burden of water storage and treatment, which imposed cost. We estimated the method-specific cost of in-house drinking water treatment (9 L/day used) based on equipment price and life, daily operation time, fuel used, and consumables replacement frequency, which were Nepalese Rupees (NRs) 23, 57, 392, 586 and 799 for chemicals, ceramic filter, boiling, Euro-Guard and reverse osmosis-ultraviolet (RO-UV) water purification, respectively. The monthly average water treatment cost was estimated based on these estimates and treatment methods used in households, obtained from a questionnaire survey of 1500 households, and its socioeconomic relationship in a Nepalese urban context was investigated. Of the households, 75% practiced at least one treatment method, (average, 1.4). The estimated monthly average cost per household was NRs 380. The fixed effects model showed that the cost was significantly higher in Lalitpur district, and in high school education households. Higher water insecurity perception of respondents was the main determinant of higher treatment cost, which was especially true in Lalitpur district. Water treatment added extra financial burden, especially for the poor households which should be averted or minimized by concerned authorities to provide adequate quantity, quality, and access to drinking water for all.

Groundwater available in the Kathmandu Valley is not suitable for drinking due to chemical and microbial contamination. We installed a treatment system, which was made with locally available materials and was low-cost, and supplied drinking water to the intervention site where groundwater contains high amounts of ammonia, iron, and turbidity. This research aims to evaluate the socioeconomic impact of treated water distribution. One hundred households were randomly selected and asked to use treated water for drinking, and another 100 households in the nearby community were taken randomly as a control. We conducted questionnaire surveys with the enrolled households before and five months after starting water distribution to assess the water use patterns and quality perceptions. The socioeconomic impact of the intervention was evaluated by a pre-post comparison and by the difference-in-difference method. The intervention significantly enhanced most of the parameters of water quality perception, reduced the in-house water treatment, and improved the perceived water stress and quality of life. For the control site, these parameters generally became worse in the post-survey, which suggests that the survey might have affected people’s mindset regarding water security. The system is an option for sustainable management of drinking water in the water-scarce, hard-hit areas in the developing countries.