The international development community spends billions of dollars annually on safe drinking water projects globally in low‐ and middle‐income settings. These projects are driven by the World Health Organization's Joint Monitoring Programme metrics that rely on indirect measurements of water insecurity via water source and fetching time, with tacit acknowledgment of price inelasticity. But the success of water interventions, as framed by these metrics, is often tempered by the reality that people do not always use the safest, nearest, or least expensive water source. Drinking water interventions are confounded by diverse social and environmental factors that shape household water seeking behaviors in unexpected or underappreciated ways. These caveats to human water‐related behaviors are littered throughout the drinking water literature—often as an anecdote to a given study's primary findings—and present significant barriers to providing universal safe water as outlined by Sustainable Development Goal 6. We review and categorize these socio‐environmental confounders into six themes at multiple scales: social relations, water properties, intermittency, affordability, fetching practices, and physical and mental health. We illustrate how efforts to mitigate drinking water insecurity are complicated by the interaction of these social and physical processes. We highlight emerging metrics that enable a richer assessment of household water insecurity, and emphasize the importance of transdisciplinary approaches to improve the effectiveness of clean water interventions.

中文翻译：

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安全饮水干预的社会环境混杂因素

国际开发界每年在全球中低收入环境下的安全饮用水项目上花费数十亿美元。这些项目由世界卫生组织的联合监测计划指标驱动，这些指标依赖于通过水源和取水时间对水不安全状况的间接测量，并默认了价格无弹性。但是，按照这些指标来衡量，水干预措施的成功通常受到人们不总是使用最安全，最接近或最便宜的水源这一现实的影响。饮用水干预措施受到各种社会和环境因素的干扰，这些因素以意想不到的或被低估的方式影响着家庭的饮水行为。这些与人类水相关行为的警告在整个饮用水文献中不时出现（通常是给定研究的主要发现的轶事），并构成了可持续发展目标6概述的提供普遍安全水的重大障碍。我们对这些社会行为进行了回顾和分类-将环境因素分解为六个主题，涉及多个层面：社会关系，水属性，间歇性，可负担性，取货方式以及身心健康。我们说明了这些社会过程和自然过程的相互作用如何减轻减轻饮用水不安全的努力。我们重点介绍了可以对家庭用水不安全状况进行更丰富评估的新兴指标，并强调了跨学科方法对于提高清洁水干预措施有效性的重要性。