Correlates of high fecal coliforms in stored water among low-income households in Accra, Ghana

Intraurban differentials in access to safe drinking water in developing cities have been exacerbated by population growth that exceeds expansion of municipal water infrastructure. Despite progress in urban residents' access to an improved drinking water source, the cross-contamination of stored water in lowest-income neighborhoods may erode perceived benefits. We explore correlates of drinking water quality, access, and expenditures for households in low-income neighborhoods of Accra, the rapidly growing yet underdeveloped capital of Ghana. A Housing and Welfare Study (HAWS) was administered by Harvard School of Public Health and the University of Ghana-Legon to women 18+ in 1703 households in 37 census areas classified as slum areas according to UNHABITAT criteria. For a subset of households, we tested source and stored water samples for residual chlorine and total/fecal coliforms (TC and FC) using membrane filtration and an innovative petrifilm-based method called the EC-Kit. Several in-depth interviews were also conducted to better understand the social dynamics of stored water and relevant behaviors. Preliminary results show elevated TC and FC levels for stored water, multiple possible routes for cross-contamination, and differentials in water access. We conclude with implications for water provision projects in slums. Cross-contamination of stored water may undermine global efforts to achieve MDG Targets for access to safe drinking water, thereby diluting associated health benefits.