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Subsidized sachet water to reduce diarrheal disease in young children: a feasibility study in Accra, Ghana

Subsidized sachet water to reduce diarrheal disease in young children: a feasibility study in Accra, Ghana
Subsidized sachet water to reduce diarrheal disease in young children: a feasibility study in Accra, Ghana
Use of drinking water sold in plastic bags (sachet water) is growing rapidly in west Africa. The impact on water consumption and child health remains unclear, and a debate on the taxation and regulation of sachet water is ongoing. This study assessed the feasibility of providing subsidized sachet water to low-income urban households in Accra and measured the resultant changes in water consumption. A total of 86 children, 6–36 months of age in neighborhoods lacking indoor piped water, were randomized to three study arms. The control group received education about diarrhea. The second arm received vouchers for 15 L/week/child of free water sachets (value: $0.63/week) plus education. The third arm received vouchers for the same water sachet volume at half price plus education. Water consumption was measured at baseline and followed for 4 months thereafter. At baseline, 66 of 81 children (82%) drank only sachet water. When given one voucher/child/week, households redeemed an average 0.94 vouchers/week/child in the free sachet-voucher arm and 0.82 vouchers/week/child in the half-price arm. No change in water consumption was observed in the half-price arm, although the study was not powered to detect such differences. In the free-sachet-voucher arm, estimated sachet water consumption increased by 0.27 L/child/day (P = 0.03). The increase in sachet water consumption by children in the free-sachet-voucher arm shows that provision of fully subsidized water sachets might improve the quality of drinking water consumed by children. Further research is needed to quantify this and any related child health impacts.
0002-9637
239-246
Wright, James
94990ecf-f8dd-4649-84f2-b28bf272e464
Dzodzomenyo, Mawuli
b3bafe27-4542-4ece-a82a-4717a72df187
Fink, Guenther
dd8c4b17-5e7d-48ed-af0f-b36232852e43
Wardrop, Nicola
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Aryeetey, Genevieve
c1d29b15-bbf2-4eec-8906-c150bd810ebd
Adanu, Richard
f30addfb-ccd8-42c9-a638-18b32ed2dc62
Hill, Allan
5b17aa71-0c14-4fbf-8bc9-807c8294d4ae
Wright, James
94990ecf-f8dd-4649-84f2-b28bf272e464
Dzodzomenyo, Mawuli
b3bafe27-4542-4ece-a82a-4717a72df187
Fink, Guenther
dd8c4b17-5e7d-48ed-af0f-b36232852e43
Wardrop, Nicola
8f3a8171-0727-4375-bc68-10e7d616e176
Aryeetey, Genevieve
c1d29b15-bbf2-4eec-8906-c150bd810ebd
Adanu, Richard
f30addfb-ccd8-42c9-a638-18b32ed2dc62
Hill, Allan
5b17aa71-0c14-4fbf-8bc9-807c8294d4ae

Wright, James, Dzodzomenyo, Mawuli, Fink, Guenther, Wardrop, Nicola, Aryeetey, Genevieve, Adanu, Richard and Hill, Allan (2016) Subsidized sachet water to reduce diarrheal disease in young children: a feasibility study in Accra, Ghana. American Journal of Tropical Medicine and Hygiene, 95 (1), 239-246. (doi:10.4269/ajtmh.15-0854).

Record type: Article

Abstract

Use of drinking water sold in plastic bags (sachet water) is growing rapidly in west Africa. The impact on water consumption and child health remains unclear, and a debate on the taxation and regulation of sachet water is ongoing. This study assessed the feasibility of providing subsidized sachet water to low-income urban households in Accra and measured the resultant changes in water consumption. A total of 86 children, 6–36 months of age in neighborhoods lacking indoor piped water, were randomized to three study arms. The control group received education about diarrhea. The second arm received vouchers for 15 L/week/child of free water sachets (value: $0.63/week) plus education. The third arm received vouchers for the same water sachet volume at half price plus education. Water consumption was measured at baseline and followed for 4 months thereafter. At baseline, 66 of 81 children (82%) drank only sachet water. When given one voucher/child/week, households redeemed an average 0.94 vouchers/week/child in the free sachet-voucher arm and 0.82 vouchers/week/child in the half-price arm. No change in water consumption was observed in the half-price arm, although the study was not powered to detect such differences. In the free-sachet-voucher arm, estimated sachet water consumption increased by 0.27 L/child/day (P = 0.03). The increase in sachet water consumption by children in the free-sachet-voucher arm shows that provision of fully subsidized water sachets might improve the quality of drinking water consumed by children. Further research is needed to quantify this and any related child health impacts.

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Accepted/In Press date: 20 March 2016
e-pub ahead of print date: 23 May 2016
Published date: July 2016
Organisations: Population, Health & Wellbeing (PHeW)

Identifiers

Local EPrints ID: 393090
URI: https://eprints.soton.ac.uk/id/eprint/393090
ISSN: 0002-9637
PURE UUID: 06e44057-6809-4577-8f6c-b394550c070f
ORCID for James Wright: ORCID iD orcid.org/0000-0002-8842-2181
ORCID for Allan Hill: ORCID iD orcid.org/0000-0002-4418-0379

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Date deposited: 26 Jul 2016 11:07
Last modified: 07 Aug 2019 00:42

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Contributors

Author: James Wright ORCID iD
Author: Mawuli Dzodzomenyo
Author: Guenther Fink
Author: Nicola Wardrop
Author: Genevieve Aryeetey
Author: Richard Adanu
Author: Allan Hill ORCID iD

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