Sachet water in Ghana: A spatiotemporal analysis of the recent upward trend in consumption and its relationship with changing household characteristics, 2010–2017

Abstract

The consumption of packaged water in Ghana has grown significantly in recent years. By 2017, “sachet water”—machine-sealed 500ml plastic bags of drinking water—was consumed by 33% of Ghanaian households. Reliance on sachet water has previously been associated with the urban poor, yet recent evidence suggests a customer base which crosses socioeconomic lines. Here, we conduct a repeated cross-sectional analysis of three nationally representative datasets to examine the changing demography of sachet water consumers between 2010 and 2017. Our results show that over the course of the study period sachet water has become a ubiquitous source of drinking water in Ghana, with relatively wealthy households notably increasing their consumption. In 2017, the majority of sachet water drinking households had access to another improved water source. The current rate and form of urbanisation, inadequate water governance, and an emphasis on cost recovery pose significant challenges for the expansion of the piped water supply network, leading us to conclude that sachet water will likely continue to be a prominent source of drinking water in Ghana for the foreseeable future. The main challenge for policymakers is to ensure that the growing sachet water market enhances rather than undermines Ghana’s efforts towards achieving universal and equitable access to clean drinking water and sanitation.

Spatial heterogeneity in drinking water sources in the Greater Accra Metropolitan Area (GAMA), Ghana

“…The use of sachet water among many residents of GAMA (see Table 2 and Fig. 3) reinforces Moulds et al (2022) assertion that sachet water has become ubiquitous in urban Ghana.…”

“…The second view emphasizes individual and household-level interventions such as chlorine-based disinfectants, filtration, and solar disinfection that can be done cheaply and evaluated easily (Geremew & Damtew, 2020;WHO, 2019). The third, and most recent, highlights the growth of a large private sector that distils and distributes water mostly via sachets, bottles, and dispensers (Burrows, 2019;Moulds et al, 2022;Prasetiawan et al, 2017;Zhen et al, 2019).…”

“…Planned and affluent residential areas generally have access to piped water services, whereas low-income and peri-urban areas often lack access to the piped network and largely depend on non-piped water services such as sachet water, tanker services, and bottled water (Cole et al, 2018;Deshpande et al, 2020;Geremew & Damtew, 2020;WHO, 2019). However, even where piped water is available, the use of non-piped sources for drinking water is commonplace (Moulds et al, 2022). These broad categories can further be divided into a multiplicity of water sources as provided by the Joint Monitoring Programme (JMP) of the WHO and the UNICEF in the JMP ladder for drinking water services.…”

“…Previous studies relied on sample survey data of selected neighborhoods of GAMA and were not comprehensive enough to identify fine-scale patterns (Ablo & Yekple, 2018;Asante-Wusu & Yeboah, 2020;Benneh et al, 1993;Songsore & McGranahan, 1993;Stoler et al, 2012b). An exception is the case of Moulds et al (2022) that used census data to partially analyze sachet water consumption among the administrative districts of Ghana but did not examine the spatial heterogeneities of drinking water sources at the enumeration area level.…”

Associations of Water Quality with Cholera in Case-Control Studies: A Systematic Review and Meta-Analysis

“…However, the JMP categorization does not reflect this actual risk and the possibility of contamination (in its service ladder). This is especially concerning given the growing trend of consuming packaged water in LMICs as a result of water shortages and as an alternative to unimproved water sources [104, 105].…”