Silent Scars in the Water–Energy–Food Nexus: How Resource Insecurity Shapes Women’s Mental and Reproductive Health in South Africa

Abstract

Women in resource-scarce communities navigate daily scarcity, structural neglect, and gendered violence, leaving profound but often invisible impacts on mental and reproductive health. Women play an active role in the Water-Energy-Food (WEF) space; they provide water, food, and household security daily. This study investigates how chronic deprivation across the WEF nexus shapes experiences of psychological distress, reproductive vulnerability, and social marginalization in South African settings: Lorentzville, a migrant urban informal settlement, and Mqanduli, a peri-urban Eastern Cape community. Using ethnographic methods, including in-depth interviews, focus group discussions, and participatory observation, and an analytical framework combining structural violence and feminist political ecology, we show that insecurity over water, energy, and food constrains reproductive autonomy, amplifies self-reported symptoms of anxiety and depression, and drives coping and adaptation strategies such as informal work, transactional sex, and fragile social support networks. These strategies, while mitigating immediate risks, cannot fully offset systemic harms. By foregrounding women's lived experiences, this study extends the WEF nexus framework to include embodied, emotional, and reproductive dimensions, linking historical legacies of colonial and apartheid neglect to contemporary inequities. The findings offer critical insights for integrated health, social, and resource policy interventions that center on gender, care, and justice within environmental, wellbeing, and livelihood.