In this paper, advocate for a systemic approach to water management for improved health and nutrition. Focus on rural and peri-urban areas of the developing world, where multipurpose water systems are particularly relevant. As competition for safe water resources intensifies, it is important to understand the trade-offs between specific uses and their implications for health and nutrition, based on the gender and age of individuals. Conduct statistical and econometric analyses of secondary, nationally representative data for four countries: Bangladesh, Ethiopia, Ghana and India. These data sets have been routinely used to report on progress toward SDG 6 (availability and sustainable management of water and sanitation for all) and SDG 2 (ending hunger and achieving food security and improved nutrition for all).