When access to water in Bulgaria is discussed, the conversation usually focuses on infrastructure and investment. Much less attention is given to what the lack of water means in the daily life of a family with a young child.
In early childhood, the effects of inadequate access to water are directly linked to health and development. When water is scarce, regular handwashing, maintaining clean utensils, and safely preparing food become difficult or impossible. This increases the risk of gastrointestinal infections, skin diseases, and parasitic infections, problems that rarely appear in statistics as “water-related issues”, yet are often a direct consequence of inadequate access to water.
This problem is most visible in unregulated settlements. Water may physically exist nearby, but there may be no legal way to access it. This often means carrying water in containers, relying on informal water sources, or sharing a single tap among multiple households. For an adult, this is an inconvenience. For a young child this creates an environment where risk becomes the norm.
At the same time, limited access to water affects nutrition. In households with inadequate water access, preparing infant formula and complementary foods becomes more challenging. Combined with low household incomes, this can lead to the early introduction of inappropriate foods or the dilution of infant formula, with direct consequences for a child’s growth and development.
The problem is compounded by the fact that the systems that should provide solutions rarely recognize it. The healthcare system treats the consequences: infections, malnutrition, and skin conditions. The social protection system focuses on income and benefits, but not on access to services such as water. Meanwhile, the water utility system operates through infrastructure and registered customers, categories that often exclude some of these families altogether.
Addressing this systemic gap is the aim of the new project, “United Communities for Fair Access to Water”, implemented by the Trust for Social Achievement, which starts on 1 April 2026 and will run for 18 months with funding from the Civic Engagement and Transparency Facility of the Swiss-Bulgarian Cooperation Programme.
The project places the relationship between access to water and child health at the center of its analysis and advocacy work, rather than treating it as a side effect.
The work begins with field research in eight locations, including unregulated settlements where the problem is most concentrated and often remains outside official statistics on water scarcity.
Data will be collected through a combination of surveys, focus groups, and interviews, not only to describe the lack of access, but also to trace how it affects everyday childcare practices: nutrition, hygiene, and care during illness.
The next stage is analysis. Sociologists will identify patterns, for example how different barriers related to lack of access lead to different health risks. Legal analysis will examine why these situations exist in the first place, such as the lack of mechanisms to support households that cannot pay their water bills or the inability to connect homes in unregulated areas. The Bulgarian Water Association will assess what technical solutions are feasible in each situation.
At the same time, in three of the locations (Peshtera, Yambol, and the village of Kozarevo), with the participation of the partners Bolni ot Asthma Foundation and the Peshtera Community Investment Fund, local parent groups are being formed. They will work on concrete proposals to municipalities based on the collected data and expert analyses. In the context of child health, this means raising questions that are rarely asked directly: how does lack of water affect access to healthcare services, what temporary solutions are possible, and how can the most vulnerable households be protected.
In the next stage, the results will be consolidated into policy recommendations and presented at the national level, with a focus on financing opportunities and policy changes. Here, child health becomes an argument for action rather than a side effect. If lack of water leads to higher healthcare costs and poorer early development outcomes, this is no longer only an infrastructure issue, but a matter of public policy effectiveness.
In this sense, the project does not attempt to “solve” water access. It aims to change the way it is understood, from an isolated sectoral problem to a factor that directly affects children’s health and long-term societal costs. When water is lacking, the consequences appear later: in the healthcare system, in education, and in inequalities that have already become entrenched. By then, the cost is far higher than that of a single infrastructure project.
The project “United Communities for Fair Access to Water” is implemented with the support of the Swiss-Bulgarian Cooperation Programme through the Civic Engagement and Transparency Facility (CETF) 2024–2029. The views and opinions expressed are solely those of the author(s) and do not necessarily reflect those of the governments of Switzerland and Bulgaria.