Safe drinking water is a fundamental human right, yet more than 785 million people do not have access to it. The burden of water management disproportionately falls on women and young girls, and they suffer the health, psychosocial, political, educational, and economic effects. While water conditions and disease outcomes have been widely studied, few studies have summarized the research on drinking water and implications for gender equity and empowerment (GEE). A systematic review of primary literature published between 1980 and 2019 was conducted on drinking water exposures and management and the implications for GEE. Ten databases were utilized (EMBASE, PubMed, Web of Science, Cochrane, ProQuest, Campbell, the British Library for Development Studies, SSRN, 3ie International Initiative for Impact Evaluation, and clinicaltrials.gov). Drinking water studies with an all-female cohort or disaggregated findings according to gender were included. A total of 1280 studies were included. GEE outcomes were summarized in five areas: health, psychosocial stress, political power and decision-making, social-educational conditions, and economic and time-use conditions. Water quality exposures and implications for women's health dominated the literature reviewed. Women experienced higher rates of bladder cancer when exposed to arsenic, trihalomethanes, and chlorine in drinking water and higher rates of breast cancer due to arsenic, trichloroethylene, and disinfection byproducts in drinking water, compared to men. Women that were exposed to arsenic experienced higher incidence rates of anemia and adverse pregnancy outcomes compared to those that were not exposed. Water-related skin diseases were associated with increased levels of psychosocial stress and social ostracization among women. Women had fewer decision-making responsibilities, economic independence, and employment opportunities around water compared to men. This systematic review confirms the interconnected nature of gender and WaSH outcomes. With growing attention directed towards gender equity and empowerment within WaSH, this analysis provides key insights to inform future research and policy.

Intimate partner violence (IPV) occurs in high proportions among young women, with long-lasting adverse health and social outcomes. Recent research findings suggest that experiencing economic vulnerability may influence the ways in which young women experience or are at risk for IPV, including economic abuse. Economic abuse, a form of IPV, involves a partner’s control over money and other economic resources or activities. This study explored economic vulnerability and IPV, including economic abuse, among young Nigerian women reporting a recent history of IPV. In-depth interviews (n = 25) were conducted with women aged 18–30 years who had experienced IPV in the past year. Women were recruited from community and health facilities in low-income neighborhoods of Ibadan, Nigeria. A semi-structured interview guide was used to gather data on women’s economic vulnerability (e.g., food security, living situation, employment/education opportunities, family financial support, economic independence) and experiences of IPV. An analysis was conducted using a thematic analysis approach. The coding scheme was based on interview protocols, adding open codes from emergent themes identified in the interviews. On average, participants were 21 years old, most had children (68%) and reported to be cohabitating with a male partner (56%), and 48% had less than a secondary level of education. Among the emergent themes, women reported economic vulnerability as being financially dependent on a male partner for basic needs. Among this sample, economic vulnerability was exacerbated by limited education, training, and work opportunities, and a disproportionate burden of household labor. Economic vulnerability precipitated all forms of IPV, including economic abuse, as well as sexual and pregnancy coercion. Economic abuse was reported to occur when male partners controlled household finances and denied women adequate allowance to purchase household food, including food for children. Findings from this qualitative study suggest that interventions promoting educational and employment opportunities may be critical to reducing financial reliance on male partners and young women’s vulnerability to economic abuse and other forms of IPV. More research and programmatic work are needed on food deprivation as a form of economic abuse affecting women and their children.