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Raymond Yu Wang and Xiaofeng Liu

Household water use accounts for an important portion of water consumption. Notably, different households may behave differently regarding how water is used in everyday life. Trust and risk perception are two significant psychological factors that influence water use behavior in households. Since trust and risk perception are malleable and subject to construction, they are useful for developing effective demand management strategies and water conservation policies. The concepts of trust and risk perception are multidimensional and interconnected. Risk perception varies across social groups and is often shaped by subjective feelings toward a variety of activities, events, and technologies. Risk perception is also mediated by trust, which involves a positive expectation of an individual, an organization, and/or an institution that derives from complex processes, characteristics, and competence. Likewise, different social groups’ trust in various entities involved in household water use is subject to the significant and far-reaching impact of risk perception. The complexity of the two notions poses challenges to the measurement and exploration of their effects on household water use. In many cases, risk perception and trust can influence people’s acceptance of water sources (e.g., tap water, bottled water, recycled water, and desalinated water) and their conservation behavior (e.g., installing water-saving technologies and reducing water consumption) in household water use. Trust can affect household water use indirectly through its influence on risk perception. Moreover, trust and risk perception in household water use are neither given nor fixed; rather, they are dynamically determined by external, internal, and informational factors. A coherent, stable, transparent, and fair social and institutional structure is conducive to building trust. However, trust and risk perception differ among groups with diverse household and/or individual demographic, economic, social, and cultural characteristics. Direct information from personal experiences and, more importantly, indirect information from one’s social network, as well as from mass media and social media, play an increasingly important role in the formation and evolution of trust and risk perception, bringing a profound impact on household water use in an era of information. Future directions lie in new dynamics of risk perception and trust in the era of information explosion, the coevolution mechanism of risk perception and trust in household water use, the nuanced impacts of different types of risks (e.g., controllable and uncontrollable) on household water use, and the interactive relations of risk perception and trust across geographical contexts.


The design of municipal water tariffs requires balancing multiple criteria such as financial self-sufficiency for the service provider, equity among customers, and economic efficiency for society. Globally, various forms of water tariffs are in use (e.g., tariffs based on fixed or volumetric charges, single and two-part tariffs, and increasing or decreasing block tariffs) but increasing block tariffs (IBTs) have become popular worldwide over the last few decades for two main reasons. Apart from the fact that IBTs incentivize households to save water by charging large volumes at a higher price, there is a widespread belief that IBTs are pro-poor. The latter would be the consequence of providing all households with a minimum amount of water at a low (subsidized) price while large water users pay higher prices. However cross-subsidization between wealthy and poor households will occur only if poor households’ consumption falls in the low (subsidized) block and if rich households consume in the higher block and pay a price that is above the average cost of supply. These two conditions are rarely met in reality and IBTs often fail to allocate subsidies to the poor effectively. There are a few examples of water utilities making adjustments to the tariff to take into account that poor households with large families are likely to be adversely affected by IBTs. However, the provision of a minimum amount of water for free (as in South Africa), the design of household-specific low-cost water allowances (as in California), or tariffs being adjusted based on household size do not usually improve the targeting of subsidies to the poorest households. The widespread use of IBTs is difficult to rationalize, in particular while knowing that the use of a (simple) uniform volumetric tariff where water provision is charged at its full cost could improve social welfare by removing price distortions and would be easier for households to understand than IBTs. This simple tariff could be combined with some consumer assistance programs to help the poorest households pay their bills.


Madeleine Short Fabic, Yoonjoung Choi, and Fredrick Makumbi

Sexual and reproductive health (SRH) surveys around the world, especially in low- and middle-income countries, have been and continue to be the primary sources of data about individual-, community-, and population-level sexual and reproductive health. Beginning with the Knowledge, Attitudes, and Practices surveys of the late 1950s, SRH surveys have been crucial tools for informing public health programming, healthcare delivery, public policy, and more. Additionally, major demographic and health modeling and estimation efforts rely on SRH survey data, as have thousands of research studies. For more than half a century, surveys have met major SRH information needs, especially in low- and middle-income countries. And even as the world has achieved impressive information technology advances, increasing by orders of magnitude the depth and breadth of data collected and analyzed, the necessity and importance of surveys have not waned. As of 2021, four major internationally comparable SRH survey platforms are operating in low- and middle-income countries—the Demographic and Health Surveys Program (DHS), Multiple-Indicator Cluster Survey (MICS), Population-Based HIV Impact Assessment (PHIA), and Performance Monitoring for Action (PMA). Among these platforms, DHS collects the widest range of data on population, health, and nutrition, followed by MICS. PHIA collects the most HIV-related data. And PMA’s family planning data are collected with the most frequency. These population-based household surveys are rich data sources, collecting data to measure a wide range of SRH indicators—from contraceptive prevalence to HIV prevalence, from cervical cancer screening rates to skilled birth delivery rates, from age at menarche to age at first sex, and more. As with other surveys, SRH surveys are imperfect; selection bias, recall bias, social desirability bias, interviewer bias, and misclassification bias and error can represent major concerns. Furthermore, thorny issues persist across the decades, including perpetual historic, measurement, and methodological concerns. To provide a few examples with regard to history, because the major survey programs have historically been led by donors and multilateral organizations based in the Global North, survey content and implementation have been closely connected with donor priorities, which may not align with local priorities. Regarding measurement, maternal mortality data are highly valued and best collected through complete vital registration systems, but many low- and middle-income countries do not have complete systems and therefore rely on estimates collected through household surveys and censuses. And regarding methods, because most surveys offer only a snapshot in time, with the primary purpose of monitoring key indicators using a representative sample, most analyses of survey data can only show correlation and association rather than causation. Opportunities abound for ongoing innovation to address potential biases and persistent thorny issues. Finally, the SHR field has been and continues to be a global leader for survey development and implementation. If past is prelude, SRH surveys will be invaluable sources of knowledge for decades to come.