Validity and Reliability Analysis of the Household Water Insecurity Experiences Scale: The Case of Argentina

Abstract

The objective is to evaluate the validity and reliability of the Household Water Insecurity Experiences (HWISE) Scale as a tool to assess the experiences of households and the Argentine population regarding insecurity of access to water. Addressing water insecurity is critical for advancing several Sustainable Development Goals (SDGs), particularly SDG 6 (Clean Water and Sanitation), SDG 3 (Good Health and Well-Being), and SDG 1 (No Poverty), given the strong links between access to safe water, health, and poverty reduction. The scale was administered as part of the Argentine Social Debt Survey (EDSA), on a probabilistic sample of 5799 households. The HWISE Scale demonstrated high reliability both overall and at the item level (Cronbach’s alpha of 0.95 at a total level and greater than 0.94 for each of the items) and criterion validity in terms of correlation with a broad set of indicators: social deprivations, sanitary infrastructure, food insecurity, and psychological health. Finally, the scale showed internal consistency, with a total omega coefficient value of 0.96, suggesting that all scale indicators refer to the same concept of deprivation in water access. In sum, the HWISE Scale applied to the case of Argentina is deemed appropriate for estimating household water insecurity.

1. Introduction

Several international instruments have recognized the human right to water [1,2,3]. The UN Committee on Economic, Social and Cultural Rights recognizes water as a social, cultural, and economic good. On 28 July 2010, the United Nations General Assembly passed the resolution 64/292, called The Human Right to Water and Sanitation, recognizing that drinking water and sanitation are essential for the full development of life and all human rights [4]. In 2015, that entity established the Sustainable Development Goals (SDGs) of the 2030 Agenda, one of which is “ensure access to water and sanitation for all” (Goal 6) [5].

Despite these advances, the global reality remains alarming: the World Health Organization estimates that 2.2 billion people still lack safely managed drinking water services, with Latin America particularly vulnerable due to profound inequalities and deteriorating infrastructure [6]. Beyond infrastructural deficits, growing evidence [7,8] has highlighted that water insecurity exerts multidimensional impacts, not only compromising physical health (SDG 3: Good Health and Well-Being) but also deepening poverty cycles (SDG 1: No Poverty) by constraining livelihoods, education, and psychosocial well-being [6,7,8].

Water insecurity is defined as the inability to access and benefit from adequate, reliable, and safe water for one’s well-being and a healthy life [9]. Interest in the impacts of unreliable water supplies has grown, with studies highlighting the effects of water scarcity or poor quality on health and well-being [10,11,12,13,14,15,16,17]. Within this framework, the HWISE Scale arises, which offers the possibility to evaluate and quantify people’s experiences in their households regarding water access and use. It has been validated in several countries, both high- and low-income ones [11], which makes it a comparative measurement for different communities, regions, or countries, as well as for comparisons over time. In April 2023, a Pan-American meeting on the measurement of water insecurity was convened with the participation of experts from more than 30 institutions across nine countries and from the United Nations as well. In this meeting, the importance of promoting the use of valid and reliable measurements to support sustainable progress toward the full realization of the human right to water was acknowledged [18].

In Argentina, the official tools available for the measurement of this phenomenon focus solely on water access and availability in terms of infrastructure. These indicators, such as those aligned with SDG targets 6.1 and 6.2, are useful for monitoring access to improved water sources and sanitation but fail to capture lived experiences, daily disruptions, and psychosocial impacts of water scarcity. The HWISE Scale complements this gap by addressing the experiential dimension of water insecurity at the household level. With the aim of improving water security information—understood as the ability to access sufficient, adequate quality water for human consumption—in 2023, the HWISE Scale was integrated into the Argentine Social Debt Survey (EDSA) of the Pontifical Catholic University of Argentina (UCA). This study seeks, as its general objective, to determine the validity and reliability of the HWISE Scale as an instrument for evaluating the experiences of Argentine households regarding insecurity.

2. Materials and Methods

2.1. Source of Information

In the present work, the microdata of EDSA, a multipurpose survey that has periodically provided since 2004 a broad set of development indicators, were used. A multistage probability sample of 5799 households was selected, using clustering in the first stage and stratification in the second. This sample represents private households living in Argentine urban centers with more than 80 thousand inhabitants. The estimated margin of error is ±1.3%, with an estimated population proportion of 50% and a confidence level of 95%.

Table 1. Operational definition of the analyzed variables.

Variable	Operational Definition	Variable Values
Poverty [19]	Percentage of households whose income does not allow them to acquire the value of the Total Basic Basket (CBT) and/or does not allow them to acquire the value of the Basic Food Basket (CBA).	0. Not poor 1. Poor but not indigent 2. Homeless
Food insecurity [19]	Percentage of households that reported reducing food portions and/or experiencing hunger due to economic hardship during the past 12 months.	Moderate Deficit: Households in which it is expressed that they had to reduce the portion of food in the last 12 months. Severe Deficit: Households in which it is expressed that they have felt hungry in the last 12 months. Secure: Households in which it is not reported that they have reduced the portion of food in the last 12 months.
Socioeconomic level in quartiles [20]	Percentage of households that are classified into four categories based on a factorial index that takes into account the educational capital of the head of household, access to durable household goods, and the residential condition of the housing, this index being re-coded into socioeconomic strata according to quartiles of the distribution.	1. Very low (1st quartile) 2. Low (2nd quartile) 3. Middle (3rd quartile) 4. Middle–high (top 25%)
Urban agglomeration [20]	Percentage of households residing in four large regions of urban agglomerations taken in the sample according to their spatial distribution, geopolitical importance, and degree of socioeconomic consolidation.	1. Autonomous City of Buenos Aires 2. Buenos Aires Metropolitan Area 3. Other metropolitan areas 4. Other urban areas in the interior
Neighborhood type [19]	Percentage of households residing in three different forms of urbanization with varying degrees of formality in terms of planning, regulation, and public investment in urban assets and with a heterogeneous presence of different socioeconomic levels.	1. Emergency village/settlement 2. Social housing/monoblocks 3. With an urban layout
Lack of access to the sewer network [19]	Percentage of households living in homes without access to the sewer network.	0. With access 1. No access
Perception of lack of water in the home [19]	Percentage of households in which the respondent reports that the neighborhood has the problem of a lack of water.	0. No deficit 1. Deficit
Psychological distress [21]	Percentage of households in which the respondent reports having symptoms of anxiety and depression, integrated into a score that indicates a moderate or high risk of psychological distress on the KPDS-10 scale (score ranging from 10 to 50 points, and the distribution is categorized into tertiles).	1. High 2. Moderate 3. Low

shows the operational definitions of the main variables analyzed in this study.

2.2. Evaluation of Water Insecurity

The 12-item HWISE Scale was administered to a randomly selected household member aged 18 years or older. The scale’s language was adapted from the homologous scale incorporated into the 2021 National Health and Nutrition Survey (ENSA-NUT) in Mexico [22]. The 12 items comprising the scale are as follows:

In the last 4 weeks…

• How frequently did you or anyone in your household worry you would not have enough water for all of your household needs?
• How frequently has your main water source been interrupted or limited (e.g., water pressure, less water than expected, river dried up)?
• How frequently have problems with water meant that clothes could not be washed?
• How frequently have you or anyone in your household had to change schedules or plans due to problems with your water situation (activities that may have been interrupted include caring for others, doing household chores, agricultural work, income-generating activities, sleeping, etc.)?
• How frequently have you or anyone in your household had to change what was being eaten because there were problems with water (e.g., for washing foods, cooking, etc.)?
• How frequently have you or anyone in your household had to go without washing hands after dirty activities (e.g., defecating or changing diapers, cleaning animal dung) because of problems with water?
• How frequently have you or anyone in your household had to go without washing their body because of problems with water (e.g., not enough water, dirty, unsafe)?
• How frequently has there not been as much water to drink as you would like for you or anyone in your household?
• How frequently did you or anyone in your household feel angry about your water situation?
• How frequently have you or anyone in your household gone to sleep thirsty because there was not any water to drink?
• How frequently has there been no useable or drinkable water whatsoever in your household?
• How frequently have problems with water caused you or anyone in your household to feel ashamed/excluded/stigmatized?

The response options for each item were on an ordinal scale. Scores were calculated by summing the frequency-based responses, following Young et al. (2019) [9]. Four categories were used: never (0), rarely (1–2 times), sometimes (3–10 times), and often (11 or more times), which were scored 0, 1, 2, and 3, respectively. If the respondent of the household chose the option “do not know/no answer” in any of the questions, the household was excluded from the sample. The same criterion is followed in the case of missing values. As a result, 115 observations were excluded, which represent 2.6% of the original sample.

Following the methodology, it is considered that households with a score equal to or greater than 12 experience water insecurity. Although this threshold has not yet been locally validated for the Argentine sample, it is widely supported in international research—including studies conducted in Latin American contexts [22]—and is consistent with the theoretical design of the HWISE Scale, which emphasizes the multidimensional nature of water insecurity without prioritizing any specific domain.

2.3. Validity and Reliability Measurements

To evaluate the reliability of the HWISE Scale and its robustness as an instrument in the case of Argentina, validity and reliability tests were conducted. The validity of the instrument was verified by demonstrating that the indicators of the water insecurity scale are valid measurements related to lack of water access and use. For this, the relationships of the HWISE Scale with other variables that have previously proven to be related to water insecurity were tested. The following variables were selected: access to sewer networks, lack of water in the neighborhood, total and severe food insecurity in the household [23], and the respondent’s psychological distress.

2.4. Data Analysis

Logistic regression models were applied, which regress these dichotomous variables on the individual indicators of the water module, the water insecurity indicator, and the HWISE. Furthermore, control variables related to the household socioeconomic and demographic characteristics, such as the logarithm of per-capita family income, the number of household members, the gender of the head of household, and the urban agglomeration where the household is at, were included [24].

Reliability was assessed using Classical Test Theory (CTT) (Cronbach’s alpha, Revelle’s beta, Guttman’s lambda, omega) [25]. A Cronbach’s alpha coefficient equal to or greater than 0.7 was considered as acceptable [26]. A threshold value of 0.5 was used for beta and a threshold of 0.7 for Guttman’s lambda and omega.

Finally, a hierarchical cluster analysis was conducted as a variable clustering technique. The hierarchical cluster analysis is employed to examine how items relate to each other based on their proximity [27].

3. Results

In the second semester of 2023, the HWISE Scale estimated that 6.5% of urban Argentine households experienced water insecurity. A higher water insecurity prevalence was found in the least socioeconomically advantaged households. On this matter, it was observed that water insecurity affected 14% of people in extreme poverty, and in the lowest social stratum (25% lower), it affected 12.8%. Simultaneously, it affected the residents from the Buenos Aires Conurbation (Conurbano Bonaerense) and other large metropolitan areas from the Argentine provinces more than the citizens from the City of Buenos Aires (CABA) and other small metropolises from the provinces. It is worth acknowledging that it rose above the average in informal housing (shanty towns and settlements) and in social housing neighborhoods and monoblocks (public housing projects). Moreover, a significant difference in households with children and adolescents was registered. This difference persisted after controlling for urban agglomeration, social stratum, and neighborhood type (

Table 2. Water insecurity prevalence according to associated characteristics (N = 5684).

	%	95% CI *
OVERALL AVERAGE	6.5%	5.6%	7.5%
SEX OF HEAD OF HOUSEHOLD
Female	6.8%	5.5%	8.3%
Male	6.3%	5.2%	7.6%
AGE OF THE HEAD OF HOUSEHOLD
18 to 29 years old	5.4%	3.6%	7.8%
30–49	7.2%	5.8%	9.0%
More than 50 years old	6.1%	4.9%	7.5%
ACCESS TO THE SEWER NETWORK
No access	10.8%	8.7%	13.4%
With access	4.9%	4.1%	5.9%
PRESENCE OF CHILDREN AND ADOLESCENTS IN THE HOME
With children	8.6%	7.2%	10.3%
Without children	4.3%	3.4%	5.4%
SOCIOECONOMIC LEVEL
Very low	12.8%	10.4%	15.6%
Low	7.0%	5.4%	9.1%
Middle	3.4%	2.4%	4.8%
Middle–high	2.4%	1.5%	3.8%
POVERTY AND INDIGENCE BY INCOME
Indigent	14.0%	9.6%	20.0%
Poor but not indigent	10.1%	8.1%	12.6%
Not poor	4.1%	3.3%	5.0%
URBAN REGIONS
Autonomous City of Buenos Aires	1.7%	0.6%	4.3%
Buenos Aires Metropolitan Area	8.0%	6.4%	9.9%
Other metropolitan areas	7.1%	6.0%	8.4%
Other urban areas in the interior	6.0%	4.7%	7.7%
TYPE OF NEIGHBORHOOD
Emergency village/settlement	12.6%	7.9%	19.3%
Social housing/monoblocks	23.2%	14.0%	36.0%
With an urban layout	5.9%	5.0%	6.8%

* CI is the abbreviation for confidence interval. It is a range of values calculated from sample data that, with 95% probability, contains the true population value. Source: authors’ elaboration based on the Argentina Social Debt Survey-Agenda for Equity Series (2017–2023), Argentina Social Debt Observatory, UCA.

).

This study also explored the relationship between water insecurity and two health indicators: psychological distress and severe food insecurity (

Table 3. Water insecurity indicators according to food insecurity and psychological distress (N = 5684).

	%	95% CI *
OVERALL AVERAGE	6.5%	5.6%	7.5%
FOOD INSECURITY
Severe	23.1%	17.8%	29.3%
Moderate	12.5%	9.1%	16.9%
Secure	3.8%	3.1%	4.6%
PSYCHOLOGICAL DISTRESS
High	10.5%	8.5%	12.9%
Moderate	5.2%	4.1%	6.7%
Low	4.3%	3.1%	5.8%

* CI is the abbreviation for confidence interval. It is a range of values calculated from sample data that, with 95% probability, contains the true population value. Source: authors’ elaboration based on the Argentina Social Debt Survey-Agenda for Equity Series (2017–2023), Argentina Social Debt Observatory, UCA.

). It was found that households where the respondent has “high” psychological distress represent 10.5% of water insecurity and that, in households with severe food insecurity, the percentage is 23.1%.

Among the 12 HWISE Scale items, interruptions in water supply (20%) were the most frequently reported, followed by feelings of worry about not having enough water (17.7%) and problems with washing clothes (14.6%) (Figure 1).

Table 4. Logistic regression model of household water insecurity (WI) (N = 5684).

	WI
Female head of household	0.127
	(0.156)
Age of the head of household	0.005
	(0.005)
Household has no access to sewers	0.360 **
	(0.181)
Presence of children (0 to 17 years) in the home	0.324 *
	(0.180)
POVERTY LEVEL (BASE = not poor)
Poor but not indigent	0.621 ***
	(0.184)
Indigent	0.914 ***
	(0.264)
URBAN AGGLOMERATION (BASE = CABA)
Greater Buenos Aires	1.222 **
	(0.546)
Other large metropolitan areas	1.188 **
	(0.531)
The rest of the urban areas	1.103 **
	(0.544)
TYPE OF NEIGHBORHOOD (BASE = with urban layout)
Social housing/monoblocks	1.515 ***
	(0.310)
Emergency village/settlement	0.669 **
	(0.291)
With an urban layout	−4.798 ***
	(0.613)
Pseudo-R2	0.0714
Remarks	5.684

Source: authors’ elaboration based on the Argentina Social Debt Survey-Agenda for Equity Series (2017–2023), Argentina Social Debt Observatory, UCA. Robust standard errors in parentheses. *** p < 0.01, ** p < 0.05, * p < 0.1.

contains the results of the maximum likelihood estimation from the proposed logistic model. As was expected, income poverty and extreme poverty maintained a positive and statistically significant relationship with water insecurity (p < 0.001). In addition, having children and adolescents in the household increases the probability of experiencing water insecurity (p < 0.10). Also, in low-socioeconomic-status neighborhoods, the probability of having water insecurity increased (p < 0.05). On the other hand, a lack of access to sewer networks had a significant and positive relationship with water insecurity (p < 0.05). Finally, validity was evaluated through logistic regressions, where severe lack of access, lack of water in the neighborhood, total and severe water insecurity, and the respondent’s psychological distress were statistically correlated with all the items included in the HWISE Scale. The validity tests were successful, as all coefficients were significant at least at the 10% level. Moreover, reliability was verified through Cronbach’s alpha, Revelle’s beta, Guttman’s lambda, and omega statistics. The alpha was satisfactory, and as can be observed in

Table 5. Reliability coefficients (N = 5684).

	Cronbach’s Apha If the Item Is Deleted
Total alpha (without the deletion of any items)	0.95
The supply was interrupted	0.94
You worried	0.94
You did not do the laundry	0.94
You got upset	0.94
You could not take a bath	0.94
You had to change plans	0.94
Absolute lack	0.94
You had to change the food	0.94
You did not wash your hands	0.94
Not enough water to drink	0.94
You fell asleep thirsty	0.95
You felt ashamed	0.95
Beta coefficient	0.81
Lambda 2	0.95
Lambda 3 = alpha	0.95
Lambda 4	0.97
Omega_t	0.96

Source: authors’ elaboration based on the Argentina Social Debt Survey-Agenda for Equity Series (2017–2023), Argentina Social Debt Observatory, UCA.

even if any of the indicators are removed, the alpha does not increase. In relation to Guttman’s lambda and the beta and omega statistics, all of them exceed the suggested threshold of 0.8 (Table 5).

4. Discussion

The HWISE Scale is a key instrument for estimating household water insecurity globally, advancement towards achieving the Sustainable Development Goals—though it has been tested in only a few Latin American countries [28]—and addressing the social gaps that condition and restrict children’s opportunities for a better development [29]. For instance, in a study by Shamah Levy et al. [22], the application of the HWISE Scale was studied at a national level in Mexico, among other countries in the region [23,30]. The results of this study show that the HWISE Scale can also be used as an estimate of water insecurity experiences in the case of Argentina, where it was previously qualitatively validated in terms of comprehension, acceptance, and relevance [31] and, in this article, quantitatively validated.

A significant association was observed between higher water insecurity scores measured using the HWISE Scale and different variables of interest included in the analysis, such as monetary poverty, number of children in the household, and socio-residential space, among others, coinciding with the findings of previous research [9,28]. Additionally, it was found that households headed by women showed a slightly higher likelihood of experiencing water insecurity, although this result was not statistically significant. This aligns with previous studies suggesting that women often bear a greater burden in managing household water needs. Regarding the age of the household head, a non-significant but positive association was observed, which could be explained by older individuals facing greater physical or economic barriers to securing access to water—especially in contexts with poor infrastructure. As for the type of urban development, households in social housing neighborhoods exhibited a significantly higher probability of water insecurity. This may be due to structural deficiencies inherent in these housing complexes or lower levels of investment in public service maintenance. This pattern reflects how urban configurations and structural conditions of the environment can impact water access and quality.

Thus, the HWISE Scale is deemed as a valid tool in terms of its measuring water insecurity and its association with other situations of deprivation and social vulnerability [28,32,33,34,35,36]. Similarly, water insecurity was evaluated in Bolivia and was related to infant feeding [28]. In a study by Young et al. [28], the association between water insecurity and food insecurity was studied using representative samples of 25 low-income and middle-income countries, including Brazil, Guatemala, and Honduras. The correlation between household food insecurity and water insecurity has been previously reported [10,36,37,38,39]. Also, we found a relationship between water insecurity and psychological distress. This has been previously reported, which further supports that its consequences are not only physical [36] but also psychological [10,13,36,38,39,40]. This finding supports the theory that water insecurity is multidimensional, with varying impacts across populations and contexts [41].

Firstly, the high response rate to the scale (97.4%) stands out, similar to that achieved in the Mexican case [22], indicating that the scale’s questions were understood by the urban Argentine population, confirming the results obtained through qualitative approaches [31].

According to Cronbach’s alpha coefficient, the scale demonstrates very good internal consistency. This result is consistent with the validation of the scale for Mexico [22] and with the validation of a household water insecurity measure for low- and middle-income countries [15].

A key limitation of our study is that the data were collected during winter in Argentina, potentially underestimating water insecurity. Since the HWISE Scale questions refer to experiences reported over the previous four weeks, the reported prevalence of water insecurity may be underestimated. This is because water access problems often intensify during the summer, when high temperatures and increased demand exacerbate scarcity conditions. Therefore, it would be more appropriate to administer the scale during the summer season or to consider a broader time window. Furthermore, as observed in studies conducted in Mexico [22], the measurement of household water insecurity may be influenced by climate change and extreme seasonal variations.

Nonetheless, a key strength of our study lies in the use of a large and diverse sample of individuals, which allows comparisons between sociodemographic groups. In addition, other variables were measured that not only allowed us to evaluate the criterion validity of the scale for Argentina, but it also provides new evidence to monitor and to evaluate water insecurity in the region and worldwide.

Safe water access has long been monitored using established metrics for water resources and availability [24]. Nevertheless, it is well understood that these old metrics are inaccurate and that they contribute to the underestimation of water insecurity [38,42].

The evidence presented contributes to the validity of measuring water insecurity using the HWISE Scale. The case of Argentina also provides evidence within Latin America on the importance of the HWISE Scale as a key instrument for estimating water insecurity, its causes, and consequences, considering social and geographical inequalities and its evolution over time.

The validation process of a scale is long and complex. Given the nature of the scale, it is essential to ensure its validity across diverse contexts; in this sense, the present study offers a context-specific validation to the case of Argentina. Contexts are highly diverse, even within a single country, so each contribution that demonstrates the scale’s validity is a step toward its global use.

Additionally, the correlations of the scale with poverty, food insecurity, habitat deprivations, and even indicators of psychological distress confirm the relevance of studying deprivations in access to water as a vital resource (and right) for human development and well-being.

Water insecurity affects the overall health of a population and, therefore, has consequences for the fulfillment of basic rights to subsistence and life, as well as the potential for human and social development in a country.

It is important to note that the scoring method used in this study relies on an additive model in which all 12 items are equally weighted. This approach follows the original HWISE Scale methodology, which showed consistent psychometric properties across countries and was developed under the assumption of unidimensionality. While internal consistency indicators (Cronbach’s alpha, omega) were high, we recognize that a factor analysis (exploratory or confirmatory) would provide further evidence of the scale’s dimensional structure in the Argentine context. Moreover, although some items may carry different real-world relevance, equal weighting ensures comparability with international studies. Future research should explore whether differential item weighting or a latent variable modeling approach better captures the patterns of water insecurity experiences in Argentina.

5. Conclusions

Access to safe water has historically been monitored through established metrics designed to assess water resources and their availability. However, it is widely acknowledged that these traditional metrics are often inaccurate and may underestimate the extent of water insecurity, for example, if they do not take into account the time of year in which the measurements are taken. In this context, the validation of the HWISE Scale for Argentina—despite the data having been collected during the winter—represents a key advancement, as it allows for a more nuanced and accurate measurement of household-level water deprivations; 6.5% of urban Argentine households were classified as water-insecure. In 2025, the EDSA will once again include the HWISE Scale, this time applying a broader time frame to better reflect households’ experiences during the summer months, when water access issues are typically more acute. This adjustment aims to address the seasonal limitations identified in the current study and move toward a more comprehensive and reliable measurement of water insecurity.

The findings of this study confirm the reliability and validity of the HWISE Scale for the Argentine context (10% of urban households in Argentina do not have access to the public water network) [19], effectively capturing social and geographical inequalities in water access. Furthermore, its significant correlation with indicators of social deprivation, food insecurity, sanitary infrastructure, and psychological distress reinforces its utility as a comprehensive tool for understanding the multiple dimensions of water insecurity and its impact on population well-being.

From a methodological perspective, this study constitutes a rigorous validation exercise that not only establishes the scale’s reliability in Argentina but also reinforces its applicability in countries with similar characteristics. The validation of measurement instruments is a fundamental step in social research and in the generation of reliable scientific evidence, as it ensures that the indicators employed accurately reflect the phenomenon they are intended to measure. In this regard, the analysis of internal consistency, criterion validity evaluation, and comparison with other social vulnerability factors consolidate the HWISE Scale as a robust and replicable instrument for future research and applications in the region.

In particular, the validation of this scale in Argentina is of special relevance due to the country’s geographical and socioeconomic heterogeneity. The unequal distribution of water resources, deficient infrastructure in certain areas, and extreme climatic conditions result in substantial disparities in water access across regions and socioeconomic groups. The adoption of a locally validated instrument facilitates a precise identification of these disparities and enables the implementation of more effective and context-specific public policies.

For public policy, these results underscore the need to integrate the HWISE Scale into Argentina’s official household surveys as a fundamental input for the diagnosis and better management of existing water access policies. Robust and comparable data will facilitate the design and implementation of strategies aimed at reducing water insecurity and its effects on the population’s quality of life. At the same time, it is essential to continue this line of research with new works that explore cultural, geographic, and infrastructural differences between regions of the country, as these dimensions can profoundly influence the experiences of water insecurity. Likewise, methodological development around the calculation of the scale’s score—for example, discussing the validity of its one-dimensional structure, the relative weighting of the items, or the most appropriate cutoff points—represents a relevant work agenda to refine both the measurement and the interpretation of the results.

Finally, this study reaffirms that measuring water insecurity is not merely a technical or statistical concern but a fundamental ethical and political imperative, directly tied to the global commitment to sustainable development. The ability to rigorously assess water insecurity is essential for advancing key Sustainable Development Goals (SDGs), particularly SDG 6 (Clean Water and Sanitation), SDG 3 (Good Health and Well-Being), and SDG 1 (No Poverty). SDG 6 calls not only for universal access to safe and affordable drinking water but also for the sustainable management of water resources—objectives that remain unattainable if the full extent of household-level water deprivation is obscured by inadequate measurement tools. The inclusion of validated instruments such as the HWISE Scale is thus a prerequisite for exposing and addressing hidden inequities in water access, which are often masked by national-level indicators that fail to capture everyday lived experiences of scarcity, unreliability, or unaffordability.

Moreover, the relationship between water insecurity and SDG 3 is undeniable. The absence of reliable access to water exacerbates public health crises, fueling the spread of waterborne diseases, intensifying food insecurity, and contributing to chronic stress and psychological distress. Yet, policy responses remain fragmented when water insecurity is not adequately measured as a structural determinant of health. Likewise, SDG 1’s objective of eradicating poverty is inextricably linked to water security, as the economic burdens associated with unreliable access—ranging from lost labor hours to the financial cost of alternative water sources—reinforce cycles of deprivation. Without precise, context-sensitive data on these dynamics, interventions risk being superficial, failing to dismantle the systemic inequalities that perpetuate water insecurity.

Thus, beyond its methodological contributions in the Argentine context, this study underscores the urgent need to redefine how water insecurity is conceptualized within global and national policy frameworks. By providing a tool capable of capturing the multidimensional nature of water access challenges, it contributes not only to academic discourse but also to the broader struggle for social justice, equity, and the realization of fundamental human rights.