02069nas a2200277   4500000000100000008004100001260001900042653000900061653001500070653002600085653002000111653001000131653001000141653001100151653001200162653001300174653001300187653001700200653001000217100001300227700001500240245012500255300001400380490000700394520139000401       2016                            d  bIWA Publishing10aWASH10aInequality10aPsychological aspects10aAccess to water10aIndia10aNepal10aMexico10aBolivia10aEthiopia10aZimbabwe10aSouth Africa10aKenya1 aBisung E1 aElliott SJ00aPsychosocial impacts of the lack of access to water and sanitation in low-and middle-income countries: a scoping review.  awh20161580 v143 a<p>The lack of access to safe water and adequate sanitation has implications for the psychosocial well-being of individuals and households. To review the literature on psychosocial impacts, we completed a scoping review of the published literature using Medline, Embase, and Scopus. Fifteen studies met the inclusion criteria and were reviewed in detail. Of the included studies, 6 were conducted in India, 1 in Nepal, 1 in Mexico, 1 in Bolivia, 2 in Ethiopia, 1 in Zimbabwe, 1 in South Africa, and 2 in Kenya. Four interrelated groups of stressors emerged from the review; physical stressors, financial stressors, social stressors, and stressors related to (perceived) inequities. Further, gender differences were observed, with women carrying a disproportionate psychosocial burden. We argue that failure to incorporate psychosocial stressors when estimating the burden or benefits of safe water and sanitation may mask an important driver of health and well-being for many households in low- and middle-income countries. We propose further research on water-related stressors with particular attention to unique cultural norms around water and sanitation, short and long term psychosocial outcomes, and individual and collective coping strategies. These may help practitioners better understand cumulative impacts and mechanisms for addressing water and sanitation challenges.</p>