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Geography and Environmental Science

Research project: Urban Drinking Water and Health Outcomes - Early Phase Study for a Randomized Controlled Trial in Accra, Ghana

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This study examined the safety of sachet water (water sold in 500ml bags) in Accra, Ghana and the feasibility of developing a subsidy scheme for making such water affordable to poor urban households. We found a pilot discount voucher scheme was acceptable to households and vendors.

Start Date: 1/7/2014

End date: 31/12/2015

Consumption of sachet water (water sold in 500ml plastic bags) is widespread in many West African cities. In Ghana, most urban households now use it as their main drinking-water source, though its consumption remains lower among the poor. Sachet water is both convenient and provides a source of drinking-water where tap-water is intermittent or unavailable. This MRC/DfID-funded project brought together teams at University of Southampton, Ghana School of Public Health, and the NGO Innovations for Poverty Action. One project component examined sachet water safety, drawing on a nationwide household survey that included a water testing component. We found that in water fetched ‘as though for a child to drink’, sachet water was far less microbiologically contaminated than water piped to the home. We also found that our own sachet water samples were also free from microbiological contamination. However, when we cross-referenced sachet brands against databases of products registered with the industry’s regulators, we found a minority of brands were not listed. This suggests that some sachet production remains unregulated.

Given limited sachet consumption among the poorest urban households, we also evaluated the feasibility of subsidising sachets for such households with young children, combining a discount voucher distribution scheme with household education and retrieving used plastics. We found the vouchers were widely used by households and accepted by retail outlets selling sachets. This suggests that such a subsidy scheme could have potential as an interim measure to widen the apparent protection against faecally contaminated water afforded by sachets. However, the presence of unregulated sachet brands and its affordability remain obstacles to such a subsidy scheme. Perhaps more significantly, the public health benefits of apparently low faecal contamination of sachet water need to be balanced against the environmental costs of plastic waste from sachet consumption by households lacking waste disposal systems.

Related research groups

Population, Health and Wellbeing (PHeW)
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