Towards an Integrated Future: Examining Water, Climate, and Gender Dynamics for Sustainable Development in Kenya

Water resources, climate change, and gender dynamics form a complex nexus of interlinkages that influences society’s sustainability and equitable development [1]. Water is essential for human health, food production, energy generation, and ecosystem integrity. Its availability and quality are increasingly compromised by the intensifying impacts of climate change, characterized by erratic precipitation, droughts, floods, glacial melt, and sea-level rise [2,3]. Changes in precipitation patterns and rising global temperatures alter aquifer recharge, river flows, and the timing and intensity of both droughts and floods. This phenomenon exacerbates water scarcity, increases contamination risks, and heightens conflict over the equitable distribution and use of water resources [4]. Diminished water supply combined with increased demand leads to increased competition, prices, and widened access inequities [5]. Consequently, climate induced water stress heightens economic, social, and environmental vulnerabilities across all sectors [6].

Gender roles and social structures mediate how communities experience and respond to water and climate-related stresses [1]. In many parts of Kenya, women and girls play central roles in household water management, yet the literature documents substantial variation by settlement type, livelihood system, household structure, and infrastructure access [7,8]. While women are excluded from some formal decision-making spaces, evidence also highlights women’s agency through informal negotiation, community organizing, livelihood adaptation, and local roles in water governance and conflict resolution [9,10]. Therefore, gendered vulnerability should not be treated as uniform or inevitable; rather, it reflects the interaction of social norms, economic resources, mobility, safety, and institutional design [11,12].

Kenya is categorized as a water stressed country [13,14], and remains at risk of water shortage for an extended period [15]. Water resources are at risk of depletion due to overexploitation, mismanagement, rapid population growth, poor water quality, and climate change [16,17,18]. In addition, climate change, which is associated with rainfall variability, droughts, and floods, severely affects water availability and affordability [19,20,21]. These compromise the achievement of the Sustainable Development Goals (SDGs) and environmental sustainability [22]. It also leads to inter-community water conflicts, resulting in insecurity among residents [23]. Hence, there is a call for prudent water governance and the cooperation of water institutions and civil societies in the management of the scarce water resources.

Recent national indicators underscore the scale of the challenge. Kenya’s population was 56,432,944 in 2024 [24]. According to the 2024 WHO/UNICEF Joint Monitoring Programme (JMP) household estimates, 65.6% of the population had access to at least basic drinking water services, while 18.9% continued to depend on surface water sources (Table 1). Additionally, 40.9% of individuals utilized at least basic sanitation services, and 57.5% had access to basic handwashing facilities with soap and water [25] (Table 1). Women’s presence in formal authority is evident but remains limited (Table 1). As of February 2024, women held 23.3% of seats in Kenya’s parliament [26]. These indicators provide a quantitative baseline for interpreting how climate pressures on water systems intersect with gendered roles, opportunities, and constraints.

Climate change impacts have been demonstrated to generate diverse outcomes for women and men [28,29]. Women and girls are dispropotionately affected due to various delegated responsibilities such as water collection, and management of community natural resources [7,30,31]. In addition, they are affected by other identified consequences such as physical burden associated with water collection, environmental pollution, lost time, and negative impacts on education [32,33]. Further, they face a heavier burden from a lack of sufficient access to clean water resources, proper sanitation, and good hygiene. These inequalities undermine the universal realization of safe water, adequate sanitation, and climate resilience. For example, water scarcity and poor sanitation impede progress on both SDG 6 (clean water and sanitation) and SDG 5 (gender equality), by undermining the health, safety, and education of women and girls [1,34]. This highlights the urgency for integrating gender perspectives and capacity building initiatives into climate and water policies.

The demonstration of the water-climate-gender nexus across Kenyan regions is evident. For example, climate-induced water stress has led women in Kitui to pay water vendors or negotiate access to male-controlled water points through social networks or informal agreements involving cash or labor [7]. Second, the added burden of securing water, managing livestock losses, and dealing with food insecurity due to drought in Marsabit and Samburu increased women’s workload by 48%, compared to 32% for men [35]. Third, although culture dictates that women are primarily water carriers, growing water scarcity has led to increasing male participation through mechanized methods [36]. Finally, water scarcity imposes a heavy burden on women and girls, who often spend hours fetching water, especially during droughts. These, combined with insufficient sanitation, prevent girls from attending school [8]. Thus, the water-climate-gender nexus presents opportunities and challenges for achieving Sustainable Development Goals (SDGs), especially SDG 6 (Clean water and Sanitation), SDG 5 (Gender Equality), and SDG 13 (climate action) [1,37].

Effective pursuit of these SDGs necessitates an integrated governance framework that addresses the nexus of water, climate, and gender. Failure to address this nexus can reverse gains across other SDGs and exacerbate poverty (SDG 1), hunger (SDG 2), poor health (SDG 3), and other inequalities [1]. It requires a collaborative approach that includes local communities and prioritizes women’s input. By doing so, decision making will be better informed and more equitable, leading to stronger social and health outcomes [1]. Unfortunately, women are often left out during important water resource governance decisions [38]. Since women often serve as the backbone of community resilience during and after disasters [2], it is critically important to incorporate their perspectives into all decisions concerning community water resources. It is crucial to develop and implement effective governance and climate adaptation strategies. Based on this background, this study explores: (i) The connection between climate change, gender, and water management, and how it influences achievement of sustainable development goals, (ii) Analyze climate and water policy framework, identifying gaps on integrated governance and gender responsiveness, (iii) How does climate induced water scarcity exacerbate gender inequalities affecting women decision making, education, and economic activities, and (iv) Synthesize how women’s inclusion and community led initiative can enhance sustainable development outcomes in Kenya.

The focus of the study was Kenya (Figure 1). Kenya is bordered by Uganda, Lake Victoria, and Tanzania to the west and southwest, Ethiopia to the north, South Sudan to the northwest, and Somalia and the Indian Ocean to the east and southeast [39]. It lies between latitudes 5° N and 5° S, and longitudes 34° E and 42° E [40]. Kenya lies in tropical East Africa between latitudes 5° N and 5° S, and longitudes 34° E and 42° E [40] and has both tropical and subtropical climates. Due to the worsening arid and semi-arid climate across much of Kenya, the need for proper water management is growing increasingly vital [41].

This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement checklist [42].

This review considered primary studies that studied the combinations of either two or three issues of interest, thus water, gender, and climate change in Kenya. The inclusion and exclusion criteria are reported in Table 2.

The initial search was conducted in March 2025, followed by an update in July 2025 to identify keywords and synonyms. Search strings used in the search included: a gender term (i.e., gender, women, woman, girls, man), SDG term (SDGs, SDG5, SDG6, SDG13), a water term (water, sanitation, food, rainfall, natural resources, natural disaster) and a climate term (climate change, climate adaptation, climate mitigation). The assessed materials used during writing were from year 1994 to 2025, respectively. The location search string was restricted to Kenya. For each of these components, the Boolean “OR” and “AND” operators were used to combine search terms to enable a comprehensive search. The characteristics of reviewed studies involved mixed method research articles, policy analysis, and case studies focusing specifically on climate, gender, and water. The limitation of other studies assessed is that most of them have discussed this theme in isolation, discussing on climate and water while gender is treated as a secondary variable. Furthermore, there was a lack of data intersection, especially on geographical location, age, and social economic status. Because of the amount of available literature, accessibility, and the ability of handling intricate search strings, only three databases: ScienceDirect, Web of Science, and SCOPUS were used. Finally, a manual search was conducted on relevant articles that were not identified in the electronic search.

The identified articles were exported into the EndNote reference manager (version X20) to delete duplicated items. A two-stage screening process was then conducted to ascertain that selected articles related to the study objectives. The first stage involved each reviewer assessing the titles and abstracts of the articles. It is at this stage that full article texts meeting the initial inclusion criteria were downloaded and re-assessed to ensure they met the eligibility criteria. Any discrepancies in article selection were resolved through discussion.

The initial database search yielded 334 articles. Out of these, 103 were duplicates. The duplicates were removed from further screening. Following eligibility screening based on title and abstract, 61 articles remained. 3 papers were retrieved manually, of which 2 were selected, resulting in a total of 63 retained articles (Supplementary Table S1). A PRISMA illustration of the selection process is shown in Figure 2. Please see Table S2 in Supplementary Material for the PRISMA checklist.

Extraction of data into a pre-prepared form was based on the study themes. It was then analyzed using thematic analysis.

In Kenya, the intricate connections between water resources, climate change, and gender dynamics form a nexus with far reaching implications for livelihoods, health, socio-economic, and environmental dimensions [35]. Most water needs are met from surface water sources. However, these are being threatened by industrial, agricultural, and urban pollution [33]. Despite its potential to enhance water security, rainwater is underutilized, a problem worsened by overexploitation and contamination that plague groundwater resources [18,43]

Climate change is exacerbating these challenges by disrupting hydrological cycles, altering rainfall patterns, intensifying droughts and floods, and accelerating surface water loss [44,45]. For example, rainfall is increasingly erratic and irregularly distributed with more frequent and severe droughts, drying of seasonal rivers, and depletion of groundwater recharge [46]. In contrast, some regions experience extreme rainfall and flooding that can destroy sanitation infrastructure, contaminate water sources, and increase waterborne disease risks. Glacier retreat on Mount Kenya further disrupts river flows [47]. These climate-induced alterations impact both water quantity and quality. Additionally, water governance challenges such as poor management, overuse, and illegal connections compound these issues [48]. The result is reduced streamflow, lowered groundwater recharge, and deteriorated water resources threatening food security and livelihoods [49]. It is therefore essential to understand how this climate change impacts on water resources interacts with gender dynamics to formulate equitable and climate resilient policies.

Climate change water challenges disproportionately burden Kenyan women and girls because of their socially assigned roles in water collection and household management, yet they lack ownership and control over water conveyance technologies [10,50]. Pre-existing gender inequality and societal norms, along with a heavy reliance on natural resources, make women more vulnerable to climate change [51]. This is especially true during droughts, when increased household demand makes limited water sources even less accessible [45]. For example, erratic rainfall and droughts result in a decline in water sources, thereby forcing women and girls to walk long distances to search and collect water. Furthermore, flooding contaminates water sources, increases the incidence of waterborne diseases, creates breeding grounds for disease, and often displaces communities [52]. This not only escalates health and safety risks and increased workloads but also denies them opportunities for education, water governance activities, and other income-generating opportunities [7,8]. In extreme cases, they face the risk of violence and sexual assault, malnutrition, and adverse reproductive effects [53,54]. These compounded risks create a cycle of disempowerment, where lack of resources and voice in adaptation strategies perpetuate women’s and girls’ vulnerability to climate shocks. Therefore, creating a just and sustainable future requires us first to identify and resolve gender inequalities and then ensure equal access to resources, water, and decision-making roles.

Even though women are significantly underrepresented in formal water governance structures, they are active agents of adaptation and resilience [54]. They innovate localized coping strategies by practicing small-scale irrigation, basket weaving, planting drought-resistant crops, organizing water-sharing groups, and advocating for borehole development [51,55,56]. While men dominate high-value adaptation strategies, women’s adaptive capacity is often constrained by systemic barriers. These include limited access to financial resources, technology, and support services, as well as reduced participation in formal planning and decision-making processes [3,51].

Kenya has established a robust policy and legal framework aimed at climate change adaptation, water resource management, and gender equality. Gender considerations are being integrated into policy, both at the constitutional level and within national sectoral plans [57]. This is affirmed in the country’s 2010 Constitution statement that proclaims equitable access to clean and safe water as a fundamental human right for everyone (Kenya 2010 Constitution). Gender vulnerabilities and promotion of women’s participation are addressed through the National Climate Change Action Plan (NCCAP) 2023–2027, the National Adaptation Plan (2015–2030), Climate Change Act, Gender Policy in the energy sector, and Climate Finance Strategy [58,59].

The Kenyan Constitution mandates gender equity in governance structures, while relevant sector policies, such as the Water Act (2016), include provisions meant to effectively integrate women into water management [60]. Other water institutions, such as the Water Services Regulatory Board (WASREB); the National Drought Management Authority (NDMA), and other county level policies, provide regulatory and management structures for water resources governance [61,62] Affirmative action measures are being taken to ensure a minimum threshold of women’s representation in local water user associations (WUAs) and resource management committees [63]. Despite this, water access remains inadequate with noticeable gender and rural urban disparities [7].

Mainstreaming gender in these policies at the operational level remains weak. According to [12,59,63], the significant hurdles to implementation include:

This is influenced by institutionalized patriarchal attitudes and deeply embedded cultural traditions that marginalize women in decision making processes. While women in some Kenyan cultures may be included, their involvement is often confined to a token or symbolic capacity, leaving meaningful influence in the hands of men [64]. Furthermore, entrenched gender stereotypes constrain women’s ascent to leadership roles [51]. Persistent gender inequality in water access, governance, and climate resilience is rooted in these factors [65]. Further, the burden of accessing water, whether through direct payment or the time and effort required to collect it, falls more heavily on women [66].

Limited financial investment, often caused by women’s lack of asset ownership, along with inadequate technical skills and deep-seated structural barriers, impede women’s empowerment and, by extension, gender mainstreaming [51,58,59]. They lack access to training and improved technologies that could make water management less burdensome [59]. Insecure land tenure negatively impacts women by also restricting their ownership and control over critical natural resources such as water [51,67]. In these circumstances, women bear a disproportionately higher burden for water, either by paying more for it or by spending excessive time and labor collecting it. In Western Kenya, women have developed strategies for obtaining water, even when facing hardship, by mobilizing the trust and cooperation inherent in their social networks [68]. In another instance, Mathare slum women use back doors or illegal options to get water, such as paying for illegal water connections [48].

In areas characterized by poor terrain, the capacity for water to infiltrate the subsurface is reduced, causing a deficient and protracted groundwater recharge process. The reduced groundwater supply impedes the drilling of boreholes and leads to water scarcity. This situation harms women and girls, who are primarily responsible for finding water for household consumption [69].

While stakeholders lack sufficient awareness, women face limited access to education and training, both of which negatively impact engagement. Effective monitoring and evaluation are difficult without gender-disaggregated data, as it is impossible to fully comprehend the differential impacts experienced by men and women. Additionally, formulated projects and policies may reinforce inequalities by failing to account for gendered needs and realities or by treating women as a homogenous, vulnerable group. They should be equipped with the tools and knowledge to facilitate change.

Achieving sustainable development requires examining water, climate, and gender as an interconnected nexus rather than as separate policy domains [1]. Across the reviewed studies, climate-related water stress is repeatedly linked to uneven household and community impacts, particularly where water acquisition, sanitation maintenance, and care work fall disproportionately on women and girls. Literature presents varying perspectives, with some studies highlighting infrastructure and service delivery as the principal leverage points, while others focus on the governance structure and the political economy of access. This includes examination of institutional rules that shape participation and influence over decision-making processes [7,11].

Importantly, evidence also diverges on whether “participation” reliably improves outcomes. Studies indicate that women exercise significant knowledge and leadership in local, informal systems, such as water management and conflict resolution [9,10]. However, other research highlights that women’s representation often remains symbolic due to structural constraints, including restrictive membership requirements and limited control over resources [12,70]. These contrasts show that gender-responsive water governance does not automatically produce uniform benefits. Its success depends on the institutions involved, the decisions made, and whether participation is backed by real authority, resources, and accountability.

The literature identifies three key points: climate variability impacts water quality and availability, gender norms dictate domestic responsibilities, and institutional frameworks determine resource access during scarcity [1,7]. Authors differ on the impact of women’s participation. While some view it as inherently beneficial, others argue that representation does not guarantee influence, particularly when institutional rules or high transaction costs exclude younger or poorer women [11,12]. A further evidence gap concerns change over time. Relatively few studies track how gendered water practices shift with mechanized transport, marketized water access (vendors/kiosks), infrastructure expansion, demographic change, or migration [7,8].

Gendered norms shape the management of water resources in Kenya, but these norms are neither uniform nor static. Many studies report that women and girls carry a larger share of domestic water responsibilities, yet patterns vary by region, livelihood system, household structure, and infrastructure access [7,71]. The literature indicates that changing demographics and technology, such as the rise of motorcycles, carts, piped kiosks, and paid vendors, are shifting water access methods. These changes are reshaping women’s time burdens, household bargaining power, and safety risks [6,7,8]. Understanding gender and water management, therefore, requires attention not only to who collects water, but also to how access routes, costs, and governance arrangements evolve under climate stress [12].

As water scarcity increases due to climate stress, competition intensifies between herders and settled users, upstream and downstream communities, and peri-urban households relying on informal vendors [7,15,23]. In pastoral and agro-pastoral areas, reduced surface water increases the need for migration, raises tensions at water sources, and increases the time and safety risks involved in securing water for families and livestock [35,52]. In peri-urban contexts, scarcity may be expressed through price escalation, queue conflict at kiosks, or coercive access arrangements [7]. Research shows that conflict pathways are deeply gendered. While women and girls often face greater risks of harassment and violence when traveling further for resources, they also play vital roles in mediating disputes and organizing community access arrangements [10].These documented pathways and evidence gaps are summarized in Table 3.

Communities are exposed to significant risks of preventable waterborne illnesses such as cholera, hepatitis E, and diarrheal diseases due to a lack of access to clean water, sanitation, and hygiene [72,73]. This can be caused by the use of contaminated water or exposure to environmental toxins in their water related chores [74]. The changing climate drives multiple environmental hazards, more frequent and intense droughts, floods, famine, and heatwaves, that elevate public health risks and intensify vulnerabilities vector borne diseases. The detrimental effects of this are more pronounced for women [75]. For example, women who tend to stay home during disasters are more likely to be hurt than men who move from one place to another in search of work [76]. This demonstrates how existing gender inequalities and social structures make women more vulnerable to both the immediate and lasting consequences of climate change related impacts [77,78].

In Kenya, both structured formal schooling and unstructured informal learning contribute significantly to societal development [79]. Exposure to basic education and training helps shape the career path of many youths in society [80]. When skills are successfully transferred to sectors like industry, agriculture, and water, they drive the nation’s development [81,82]. Access to education is constrained by a combination of socio-economic, cultural, and environmental factors. Key impediments include insufficient financial resources, geographic isolation, climate-related disasters such as floods and droughts, and inadequate infrastructure, including poor road conditions and deficiencies in water and sanitation systems[12,83]. The hours girls spend collecting water and handling household chores represent an opportunity cost, preventing them from acquiring an education [6,68,84]. If selection criteria for water managers include certain professional standards, this could disadvantage women who have not been given the same opportunities for professional development. These challenges emphasize the urgent need for strategies that consider gender to improve access to clean water and reduce the unfair burden on women and girls.

In Kenya, both the national government and the forty-seven county governments are responsible for managing water resources. This multi-level structure involves national bodies setting policy and regulation, while counties oversee planning and budgeting. Together, various agencies and providers collaborate to manage water resources and deliver supply services [48,85,86]. Literature shows that institutions share responsibilities in several areas, including policy formulation, regulation, planning, water resource management, and providing water services. Studies highlight that overlaps in mandates and coordination challenges can weaken climate adaptation and service reliability, particularly where accountability for financing, operations, and maintenance is unclear [48,86]. Governance dynamics play a critical role in determining whose interests are given precedence regarding water point placement, resource allocation during shortages, tariff policy formulation, and maintenance funding decisions. They also affect whether women’s involvement leads to real influence or is limited to representation alone [11,12]. Table 4 summarizes the institutional landscape discussed in the reviewed studies and the main implications for coordination and inclusion.

Achieving sustainable development, particularly SDG 5, SDG 6, and SDG 13, in Kenya requires integrated pathways that address the interconnected challenges of water insecurity, climate change impacts, and gender disparities. Failure to effectively address these synergistic issues risks worsening poverty, food insecurity, health disparities, and institutional exclusion [1].

Kenya has established a robust policy and legal framework aimed at climate change adaptation, water resource management, and gender equality. This is affirmed in the country’s 2010 Constitution statement that proclaims equitable access to clean and safe water as a fundamental human right for everyone (Kenya 2010, Constitution). The Water Act (2016) and related institutions, such as the Water Services Regulatory Board (WASREB) and the National Drought Management Authority (NDMA), provide regulatory and management structures for water resources and climate resilience [87]. Moreover, Kenya’s National Climate Change Action Plan (NCCAP 2018–2022), the National Adaptation Plan (2015–2030), and other county-level policies integrate climate adaptation imperatives that acknowledge the need for gender responsiveness. Empowering women as active participants in water governance and adaptive responses not only supports SDG 5 (Gender Equality) but also enhances water security and climate resilience, facilitating inclusive, sustainable development.

Mainstreaming gender in these policies at the operational level remains weak, with limited gender-disaggregated data hindering effective monitoring and targeted interventions. On this concern, the Climate Change Act (2016), National Water Policy, and National Gender Policy, acknowledge the distinct impacts of climate change on women and men, particularly concerning water management [59]. To fully realize the potential of these policies, it’s crucial to enhance gender-responsive implementation strategies. This will enhance policy effectiveness and ensure that climate and water management initiatives are inclusive and equitable for all citizens. Such strategies include:

It is essential to recognize women’s roles in water management and climate adaptation while avoiding the assumption that “women” constitute a single, uniform group [8]. Evidence shows that women’s inclusion in local water groups can be associated with improved accountability and fiscal management, but outcomes depend on local rules, authority, and resourcing [10,12]. Therefore, meaningful engagement should specify (i) which groups are targeted (e.g., younger women, women in pastoralist households, women in informal settlements, female-headed households), (ii) which institutions are involved (e.g., Water User Associations and community committees, county water planning forums, Water Service Provider accountability platforms), and (iii) which decisions are being influenced (e.g., siting of water points, tariff setting, allocation rules during scarcity, maintenance budgets, and grievance mechanisms) [11,70]. Table 5 provides a summary of making “participation” specific. It highlights who should be involved, in which institutions, and how they influence decisions, along with the expected benefit.

Actions that can be taken to achieve this include:

Investing in sustainable water infrastructure that addresses the specific needs of women yields multiple benefits. For example, it will alleviate the disproportionate burden of water collection that currently falls on women and girls [12]. It will also enhance access to safe water and sanitation for everyone, while fostering a more equitable and healthier community. This approach recognizes the significant impact of water scarcity on women and girls by creating more equitable and sustainable solutions for all. This involves:

Addressing deeply rooted gender inequalities is crucial. These inequalities restrict women’s access to vital resources like land, credit, and education, as well as their ability to participate in decision-making processes. This, in turn, diminishes their capacity to adapt to the impacts of climate change and to participate fairly in the governance of natural resources. This can be achieved through:

It is crucial to develop robust monitoring and evaluation frameworks. They will effectively track progress and ensure accountability in achieving the interconnected SDGs, especially when considering the differential gender impacts and needs.

Realizing the nexus goals depends on collaborative action by government agencies, civil society organizations, development partners, and local communities. This collaboration must be supported by targeted funding for gender-responsive water and climate initiatives. Some of the critical practical actions that should be taken include:

Mainstreaming gender in budget and planning for climate change, water, and gender issues is crucial [77,107]. In Kenya, it is supported by national and international commitments. To ensure gender-responsive climate action, it is necessary to integrate gender analysis and budgeting at all levels. This includes:

These are community-based climate adaptation programs that improve women’s access to water resources and increase their involvement in decision making [60]. Their goal is to empower women to enhance their adaptive capacity, lead water user associations (WUAs), and participate in climate smart agricultural practices. Their participation will address gender-based disparities in water and climate resilience by facilitating equal access to resources, fostering financial inclusion, and mitigating socio-cultural barriers that constrain access.

This review examines how climate change and water scarcity intersect with gender dynamics in Kenya, highlighting that these impacts vary significantly by region, livelihood, and socio-economic status. Climate-induced water scarcity disproportionately intensifies the unpaid domestic and care labor of women and girls, who remain the primary managers of household water resources. While often lacking formal authority, women demonstrate agency via informal governance and resource management, navigating constraints through livelihood diversification and conflict resolution. Evidence diverges on whether participation alone improves outcomes; studies caution that representation may be symbolic if decision rules, resource control, or accountability mechanisms remain unchanged. There is an ongoing lack of longitudinal research tracking changes in gender-related water practices as populations shift, access becomes more commercialized (through vendors and kiosks), transport methods become more mechanized, and infrastructure expands.

To promote sustainable development, actions should clearly identify the institutions and decisions involved, and specify anticipated benefits such as shorter collection times, greater safety, more reliable services, and enhanced accountability. This includes strengthening coordination across water governance levels, designing services that reduce time poverty and safety risks, and improving gender-disaggregated monitoring to link participation to measurable outcomes. Finally, further research is needed to apply an intersectional framework to the study of gender, age, and socioeconomic status to better understand and address the unique vulnerabilities of marginalized populations.

The following supporting information can be found at: https://www.sciepublish.com/article/pii/924, Table S1. Literature considered in the SLR (n = 63) ordered according to title. Table S2. Prisma checklist.

All authors contributed equally to conceptualization, original draft writing, review, and editorial input. Each author has read and agreed to publish this version of the manuscript.

Not Applicable.

Not applicable.

All data and materials used in this study are available within this article.

This study received no external funding.

The authors declare no conflict of interest.