Sachet drinking water in Ghana's Accra-Tema Metropolitan Area: Past, present, and future

Population growth in West Africa has outpaced local efforts to expand potable water services, and private sector sale of packaged drinking water has filled an important gap in household water security. Consumption of drinking water packaged in plastic sachets has soared in West Africa over the last decade, but the long-term implications of these changing consumption patterns remain unclear and unstudied. This paper reviews recent shifts in drinking water, drawing upon data from the 2003 and 2008 Demographic and Health Surveys, and provides an overview of the history, economics, quality, and regulation of sachet water in Ghana's Accra-Tema Metropolitan Area. Multilevel analysis of two additional household surveys reveals a transition of sachet consumption from higher to lower socioeconomic status households between 2003 and 2009, with particular concentration in low-income neighborhoods. Municipal water rationing is shown to be associated with reliance on sachet water after controlling for individual factors. In addition, sachet consumers may realize a health benefit through the interruption of fecal exposure pathways in poorly-stored household drinking water. Given the pros and cons of sachet water, we suggest that a more holistic understanding of the drinking water landscape is necessary for municipal planning and sustainable drinking water provision.