Coping with water insecurity despite access and abundance in the urban Amazon

Research on household water insecurity continues to overemphasize water scarcity and rural contexts, resulting in a poorer understanding of water insecurity in urban, water-abundant settings. At the same time, while the dimensions of water insecurity include availability, access, utilization and stability, current instruments focus on access to water, thus, inadequately explore people's experiences utilizing available water. This study aimed to characterize and explore the impacts of household water insecurity on residents of the city of Belém, Pará, Brazil, where water is available and access to piped municipal water is common, but its provision and quality vary. We applied the Household Water Insecurity Experiences Scale (HWISE) to evaluate water insecurity in 188 households (110 LSES; 78 HSES). In a subset of 47 households, we complemented the HWISE with a novel instrument, developed via participant observation, that assessed all points of water access and use within the home. Per HWISE, 28% of households were water insecure, with a higher proportion of water insecurity occurring in LSES households. Data collected via our complementary instrument indicate that HWISE underestimated water insecurity in our sample, as 87% of the subset households reported issues affecting their utilization of water regardless of household water insecurity status.