Water Insecurity as Health Crisis: Everyday Embodiment and Gendered Vulnerability Among Girls in Ghana’s Upper West Region

Abstract

In semi-arid Ghana, girls bear primary responsibility for household water collection in communities without on-premises access, a burden intensified by climate change associated with rising temperatures and frequent droughts. Yet little is known about how this responsibility shapes their embodied health and well-being. Guided by a political ecology of health framework, this qualitative study examined how water insecurity shapes girls’ physical, psychosocial, and neurological health in two communities, Wechiau and Kandue, in Ghana’s Upper West Region. We conducted in-depth interviews with nineteen purposively selected girls aged 10 to 19 and analyzed the transcripts thematically. Four interconnected themes emerged: structural and political determinants of water access, environmental and ecological conditions, gendered social relations, and embodied health consequences. Financial barriers, governance failures, and infrastructure deficits force girls into long queues and repeated trips, a burden that falls disproportionately on girls under cultural norms exempting boys from water duties. This gendered allocation of labour produces gendered health harm, whereby girls sustain musculoskeletal pain and injury carrying heavy loads over hazardous terrain, while chronic time loss disrupts sleep, schooling, and psychological well-being. Girls with pre-existing conditions such as epilepsy face the most acute risk, as water fetching directly exacerbates their vulnerability to seizures. These findings show that addressing this crisis requires more than infrastructure investment. Coordinated public–private investment in water access must be paired with social protection for vulnerable households, gender-responsive water policy, and rainwater-harvesting strategies that confront the structural and gendered inequities placing this burden on girls.