The Glass Before the Plate
- Sarah Anderson
- 4 hours ago
- 6 min read
Water, Nutrition and the Women Who Carry Both
A World Water Day Perspective from the Lens of Food, Nutrition and Health
Author: Gerald Cheruiyot
Reviewed by Sarah Armes, Sarah Anderson, Professor Sumantra (Shumone) Ray
Before the plate is laid, the glass must be filled. It’s a simple, everyday step that many of us rarely think about. But in many parts of the world, getting that water requires significant time, effort, and risk.
For millions of women and girls around the world, it means hours of walking, physical labour and daily exposure to risk, drawn from sources that are unprotected, contaminated, and often shared. This year, the United Nations marks World Water Day under the theme Water and Gender, anchored by the campaign message message “Where Water Flows, Equality Grows.” Water insecurity is simultaneously a gender crisis, a nutrition crisis and a child development crisis, and the evidence is clear that no meaningful response to any one of these can succeed whilst the others remain unaddressed. Improving nutrition for the world's most vulnerable populations begins, quite literally, with the glass before the plate.
Water Is Not Just a Drink. It Is What Makes Food Work.
To understand why water belongs at the centre of any serious nutrition conversation, it helps to consider what water does in the body. Research published in Nutrition Reviews confirms that water is not simply a thirst quencher.[1] It is the substance that makes digestion possible: breaking down food in the stomach, carrying vitamins and minerals from the gut into the bloodstream, supporting the liver and enabling the kidneys to clear metabolic waste. Without sufficient clean water, none of those processes function as they should.
The implication for nutrition is direct and still insufficiently acknowledged in how programmes and policies are designed. Good food consumed without good water does not translate into good nutrition. When water is unsafe or insufficient, the body cannot properly absorb what it is given, regardless of how nutritious the food may be. Water security and nutrition security are not two separate concerns. They are the same concern, and addressing one without the other will always fall short.
What the Research Shows: Water, Food and Child Growth
The real-world consequences of this gap disproportionately affect those with the fewest resources. A study published in BMJ Nutrition, Prevention and Health followed infants in rural Zimbabwe and found that when families lacked reliable access to sufficient food, children grew more slowly in their first 18 months of life.[2] The researchers also noted that addressing food and water insecurity together carries benefits well beyond child growth, including keeping girls in school and freeing up women's time and agency. Where these two forms of insecurity coexist in the same household, they must be tackled together.
A second paper in the same journal deepens this picture, examining how gender inequality shapes child nutrition in conflict-affected settings.[3] It found that when women and girls are consistently last in line for food and water within the home, the consequences reach beyond their own health into the next generation. Children in households where mothers go without are more likely to experience poor nutrition, slower development and poorer long-term outcomes. These patterns do not resolve within one generation. They carry forward.
She Carries the Water. She Carries the Cost.
Understanding the nutritional consequences of water insecurity requires understanding who bears its burden. In households without a water source on the premises, women and girls are responsible for collecting water in eight out of ten cases globally.[4] That daily journey can take anywhere from half an hour to several hours. Over the course of a year, it represents hundreds of hours that women and girls are not in school, not earning, not resting and not caring for young children. Each of those hours has a direct bearing on the health and nutrition of the whole family.
The toll is greatest for pregnant and breastfeeding women, whose nutritional needs are higher than at almost any other stage of life. When the water they drink is contaminated, the harm extends well beyond illness. Unsafe water interferes with the absorption of iron and folate, both essential for a healthy pregnancy, and exposes infants to infections that damage the gut lining in early life. This condition, known as Environmental Enteric Dysfunction, carries no obvious symptoms, yet it silently prevents the body from absorbing nutrients from food, even when food is available. No level of nutritional support can fully address this whilst the water source itself remains contaminated. The glass before the plate, if unsafe, continues to undo the plate's work.
When Women Have a Voice, Water Works Better for Everyone
Recognising the burden is necessary, but it is not sufficient. World Water Day 2026 goes further, calling for a genuine shift in who shapes the solutions. The UN campaign calls for women to have an equal say in how water systems are planned, managed and governed, from the community level to national policy.[4]
This matters because women who collect water daily hold knowledge that is rarely reflected in planning. They know which sources are seasonal, which are unsafe and what distances are realistic for a woman in the later stages of pregnancy. That knowledge is directly relevant to building systems that genuinely serve communities, yet it remains largely absent from the decision-making process.
Joining the Dots: Water, Nutrition, Gender and the Global Goals
Taken together, the evidence reviewed here points to something important. Water insecurity, gender inequality and poor nutrition are not three separate problems that happen to occur in the same communities. They are deeply entangled, each reinforcing the other. A child who is stunted may be eating but drinking contaminated water that prevents absorption. A girl who drops out of school may be needed at the river each morning. A woman who is anaemic during pregnancy may have access to nutritious food, but not to water safe enough to allow her body to use it. The United Nations Sustainable Development Goals reflect this interconnection: SDG 2 (Zero Hunger), SDG 3 (Good Health and Wellbeing), SDG 5 (Gender Equality) and SDG 6 (Clean Water and Sanitation) are designed to reinforce one another. The evidence from the BMJ Nutrition, Prevention and Health review presented here provides a concrete, human foundation for interdependence.
Yet in practice, water and nutrition programmes are still too often designed and funded in isolation. The families living with both challenges are left to navigate the gap between them. Integrating water safety and access into nutrition programming, and making gender equity a guiding principle in both, is not an aspirational ambition. It is a practical, evidence-based necessity.
Fill the Glass. Change the Outcome.
The evidence is both sobering and instructive. Water insecurity, poor nutrition and gender inequality are deeply connected, but none are inevitable. They are the product of choices, priorities and systems that can be changed: by integrating water into nutrition programming, by including women in water governance and by treating water safety as a core, non-negotiable part of any serious effort to improve nutritional outcomes.
Before a single meal can nourish a body, before a child can grow, before a mother can provide her family with what they need, the glass before the plate must be filled with water that is clean, safe and available to all. On World Water Day 2026, that is the commitment worth renewing.
“Where Water Flows, Equality Grows” — UN World Water Day 2026
We at NNEdPro are proud to have been a collaborator on the cutting-edge SAFEWATER project led by our strategic partner Ulster University, as well as to have contributed to the advisory board of this excellent global challenges work, supported across three Latin American countries by UKRI over 2017-2022.
As of March 2026, we are contributing two talks to the 1st São Paulo International Water Seminar, organised by SABESP, one of the key collaborators of the SAFEWATER project.
References
[1] Popkin, B.M., D'Anci, K.E. & Rosenberg, I.H. (2010). Water, hydration, and health. Nutrition Reviews, 68(8), 439–458. DOI: 10.1111/j.1753-4887.2010.00304.x. PubMed Central: PMC2908954. https://pmc.ncbi.nlm.nih.gov/articles/PMC2908954/
[2] Aryeetey, R., Kordas, K., Li, C-S., Tavengwa, N.V., Majo, F.D. et al. (2022). Growth and growth trajectory among infants in early life: contributions of food insecurity and water insecurity in rural Zimbabwe. BMJ Nutrition, Prevention and Health, 5(2), 332–343. DOI: 10.1136/bmjnph-2022-000470. Data: SHINE Trial. PubMed Central: PMC9813639. https://pmc.ncbi.nlm.nih.gov/articles/PMC9813639/
[3] Meyer, S.R., Vahedi, L., Lasater, M.E. et al. (2025). Gender-based violence and child nutrition in fragile settings: exploring intersections and opportunities for evidence generation. BMJ Nutrition, Prevention and Health, 8(1), e000682. DOI: 10.1136/bmjnph-2023-000682. PubMed Central: PMC12322537. https://pmc.ncbi.nlm.nih.gov/articles/PMC12322537/
[4] UN-Water, UNICEF & UN Women (2026). World Water Day 2026: Water and Gender. Where Water Flows, Equality Grows — Campaign Launch. United Nations.
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