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SummaryApart from Drawers of Water (DOW I) published in 1972, there have been only a handful of published studies on domestic water use and environmental health in East Africa, based on direct observations or other reliable research methods. The objective of this study was to carry out a repeat analysis of domestic water use and environmental health in East Africa based on DOW I. The study was conducted in the same sites as DOW I. Field assistants spent at least 1 day in each household observing and conducting semi-structured interviews. They measured the amount of water collected, recorded the amount of water used in the home, and noted household socio-demographic characteristics, prevalence of diarrhoea, state and use of latrines, sources of water and conditions of use. We surveyed 1015 households in 33 sites in Uganda, Tanzania and Kenya in 1997. From 1967to 1997, the prevalence of diarrhoea, in the week preceding the survey, increased from 6% to 18% in Kenya and from 16% to 21% in Uganda; it declined slightly in Tanzania (11-8%). Determinants of diarrhoea morbidity included poor hygiene (unsafe disposal of faeces and wastewater), education level of household head, obtaining water from surface sources or wells and per capita water used for cleaning. Hygiene practices are an important complement to improved water and sanitation in reducing diarrhoea morbidity.

This paper reports on changes in water supplies in 16 sites in nine East African urban centres (including Nairobi and Dar es Salaam) between 1967 and 1997. The sites included both low-income and affluent neighbourhoods. In most sites, water supplies had deteriorated. For sites that already had piped water in 1967, most received less water per day in 1997 and had more unreliable supplies. For households without piped supplies, the average time spent collecting water in 1997 was more than three times that in 1967. One of the most notable changes when comparing 1997 to 1967 was the much greater importance of private water vending through kiosks or vendors; these had become a booming business in many of the low- and middle-income sites. But on average, those using kiosks were spending almost 2 hours a day collecting water and the water from kiosks was nearly twice the price of piped supplies.

Policy mix analysis has been applied in research on energy, climate, urban and transport policy, and more recently biodiversity conservation and ecosystem services. However, policy mix analysis has thus far been employed at a high conceptual level, focusing on describing interactions between instrument types. Policy mix analysis rarely describes instrument ‘structure’ or functional characteristics in a way that would answer the question ‘what constitutes an instrument’? We describe how the rules‐in‐use taxonomy of the Institutional Analysis and Development (IAD) framework, developed for research on common pool resource management, can be used to characterize conservation policy instrument interactions. We demonstrate the approach on the well‐known payments for ecosystem services (PES) program in Costa Rica and cross‐compliance policies, arguing that PES is a policy mix rather than a single economic instrument. Our analysis shows how design features of PES described in the economics literature map to ‘rules‐in‐use’ in the IAD framework. The framework provides a terminology for defining what constitutes institutional context, comparing economic, regulatory and information instruments, and studying their interactions. The rules‐in‐use taxonomy of IAD is a ‘structural’ diagnostic approach, which needs to be combined with other tools that analyse the role and ‘agency’ of actors, as part of integrative environmental governance research. Copyright © 2017 John Wiley & Sons, Ltd and ERP Environment