Piped water flows but sachet consumption grows: The paradoxical drinking water landscape of an urban slum in Ashaiman, Ghana

Highlights

• This research explores drinking water perceptions in Old Tulaku, an urban slum in Ashaiman, Ghana.

• The study synthesizes results from 4 focus groups and survey data from 95 households.

• Sachet water consumption is associated with socioeconomic and knowledge factors.

• Drivers of water-seeking behaviour are complex and can inform water provision policy.

Abstract

Packaged “sachet” water has become the primary drinking water source for millions of West Africans despite ongoing controversy over inadequate management of the new waste streams created by all the plastic wrappers. While recent literature from Ghana has shown that municipal water rationing and lower socioeconomic status tend to drive sachet consumption at the metropolitan scale, some low-income communities with a reliable piped water supply still exhibit diverse drinking water-seeking behaviours. This paper explores the drinking water landscape of one poor, informal community in Ashaiman, Ghana, as a case study of the individual- and community-level factors that shape household drinking water decisions. Using the results of a water questionnaire completed by 95 households and the transcripts of four focus groups, our findings suggest that, after controlling for demographics, sachet water consumption is associated with proxies for higher disposable income and lack of knowledge about household water treatment methods, while social processes and attitudes toward water quality do not seem to drive drinking water decisions. This community presents a paradoxical drinking water landscape, as poverty abounds despite excellent piped water access, and low-income households with slightly greater means tend to opt for packaged water as opposed to being driven to it by piped water shortages. These nuances in drinking water purchasing behaviour can inform policy and planning for drinking water provision in urban slums across the region.

Introduction

The proportion of global disability-adjusted life years (DALYs) attributable to unimproved water and sanitation has fallen steadily over the last two decades, though with substantial regional heterogeneity as diarrhea remains a leading killer in sub-Saharan Africa (Lim et al., 2012, Pullan et al., 2014). Despite the UN announcement in March 2012 that Target 7C of the Millennium Development Goals (MDG) was met ahead of schedule globally (WHO/UNICEF, 2012), sub-Saharan Africa continues to have the lowest percentage of population with access to an improved water source among all world regions, particularly in urban areas (WHO/UNICEF, 2013), and a number of critiques have noted the inadequacy of the metric “access to an improved water source.” Drinking water access in sub-Saharan Africa may be qualified by water quality (Bain et al., 2012, Onda et al., 2012), fragmented distribution (Bakker, 2010), unsustainability (Stoler, 2012), usage patterns (Kayaga, Fisher, & Franceys, 2009) and government corruption (Nganyanyuka, Martinez, Wesselink, Lungo, & Georgiadou, 2014). Along similar lines, Obeng-Odoom (2012) frames “deep” access as the interaction between four dimensions: quality, reliability, cost, and equity. Other recent studies continue to refine the methods for estimating the burden of inadequate water, sanitation, and hygiene (Clasen et al., 2014), as well as underscore the persistent role in the global diarrheal disease burden among low- and middle-income nations (Prüss-Ustün et al., 2014, Wolf et al., 2014).

It has been estimated that just a quarter of Accra's population has 24-h access to a piped water supply (WaterAid, 2005), and this estimate has not changed despite much growth and development of Greater Accra over the last decade. Like many developing nations, Ghana has struggled to keep pace with infrastructure improvements amid rapid population growth and urbanization (Ainuson, 2010). In the 1990s, nearly half of urban residents in Accra were living below the World Bank's absolute poverty threshold, and the poor tended to concentrate in fringe settlements or in defined areas within the urban core with limited access to basic services (McGranahan, Jacobi, Songsore, Surjadi, & Kjellen, 2001: 71). Over a quarter of Accra's residents are still estimated to live below the poverty line (Ainuson, 2010).

The political economy of water service in Ghana is rife with poor governance and missed opportunities that have historically plagued Ghana's water resource management and induced subsequent drinking water shortages (Nsiah-Gyabaah, 2001). While the post-colonial political elite lacked the vision of universal public water provision strategies (Yeboah, 2006), the ruling class used it as a tool to recompense the electorates that favour government and penalize opposition-leaning constituencies resulting in a phenomenon McCaskie (2009) referred to as “water wars.” McCaskie (2009) offers a historical portrait of drinking water access in Kumasi, Ghana's second-largest city, which mirrors that of Accra: a colonial legacy of patchy water systems, low investment in asset maintenance, breakneck–speed urbanization, and subsequent chronic acute water shortages politicized by each successive decade's ruling elite and ethnic majorities. McCaskie's analysis illuminates the institutional and structural antecedents to the present disequilibrium in supply and demand of water, which is further exacerbated by inefficiencies in public water provision, governmental budgetary difficulties in the context of rising population, and the search for financial capital investments. This confluence of factors opened the door for the private sector to fill gaps in demand (Yeboah, 2006), a process also described by McCaskie (2009: 148): “soaring demand, acute shortages, new technologies and increasing desire to inhabit the world of globalised capitalist modernity produced a revolution in the business of selling water.” Similar reasons were advanced in support of water privatization during the adoption of the structural adjustment programme implemented as Ghana's Economic Recovery Programme (Obeng-Odoom, 2014). The neoliberalist approach to water policy which resulted in Aqua Vitens Rand Limited's management contract from 2006 to 2011, although heavily contested by civil society, is well-documented (Dreschel and Van-Rooijen, 2008, Yeboah, 2006), and has invoked rights-based discourses (Eguavoen and Spalthoff, 2008, Obeng-Odoom, 2012). Since Ghana's cancellation of that contract in 2011, areas connected to the municipal water grid through the current operator, Ghana Water Company Limited (GWCL), continue to experience water rationing and generally unreliable water service (Stoler et al., 2012, Stoler et al., 2012) due to Accra's daily water shortfall of over 130,000 m³, or 25% of daily water demand (UN-Habitat, 2011), despite substantial surface water resources. According to the 2008 Ghana Demographic and Health Survey, only an estimated 57% of urban residents had access to piped water in their dwelling or compound, or a public tap (Macro International Inc, 2013). This is clear evidence that the marketization of water as an inheritance of the neoliberal state—the creation of the requisite policy terrain with incentives that produce business settings that perpetuate neoliberalism (Obeng-Odoom, 2014)—has not achieved the claimed intended outcomes since its inception.

While Ghana has made some progress toward the MDG Target for drinking water, the WHO characterization of “access to an improved source” often masks true drinking water coverage given the intermittency of the municipal water supply. For example, a localized definition of drinking water access in low-income Accra communities produces estimates of access that fall egregiously short of WHO estimates (Mahama, Anaman, & Osei-Akoto, 2014). The burden of water inadequacies continues to fall disproportionately upon disadvantaged or low-income communities as seen elsewhere in sub-Saharan Africa (Hopewell & Graham, 2014), and higher costs of maintenance and billing present obstacles for GWCL to expand municipal services to the urban poor. Decentralization of service provision is one means to address the infrastructural challenges of the rapid urban growth seen in Ghana, but recent efforts by Metropolitan Assemblies in Accra and Sekondi-Takoradi to address the needs of slum communities through public–private partnerships and community-based participation have fallen short of stated goals and alienated the Assemblies from many poor communities (Owusu & Afutu-Kotey, 2010).

A notable, recent response to the gap in Ghana's urban water provision has been the proliferation of sachet water, known on the street by the more suggestive product name pure water, which are single-serve 500 ml polyethylene bags of drinking water sold at markets, kiosks, and by street vendors, and are now a ubiquitous feature of the drinking water landscape (Dada, 2011). Recent population studies in Accra have shown that sachet water consumption is driven by younger age, lower socioeconomic status, and poorer self-reported health (Stoler, Weeks, & Appiah Otoo, 2013), and exacerbated by municipal water rationing (Stoler et al., 2012, Stoler et al., 2012). Yet the multilevel models implemented in those two studies reflect substantial unexplained variability in sachet consumption, as well as “spatial outliers,” i.e. areas of stable piped water access that still exhibit high rates of sachet consumption. As Yeboah (2006) notes, ordinary Ghanaians who are excluded from the political discourse on Ghana's water problems have spoken with actions rather than words. The power of human agency in daily drinking water acquisition, given the available market options, has shaped the growth and ubiquity of the sachet water industry. But community-level factors specific to sachet water use, such as gender or attitudinal differences, have not been investigated, and social scientists have only recently started exploring the evolution of drinking water-seeking behaviour in peri-urban Accra.

A recent study in one such community, the newly-created district of Ashaiman, notes how residents “chase for water” and use a patchwork of coping mechanisms to fill gaps in water security, as many residents often cannot pay monthly water bills and have little trust in GWCL to manage their water needs (Peloso & Morinville, 2014). Ashaiman is a significant urban area on the periphery of the Accra Metropolitan Area where poverty persists in some neighborhoods amid some of the best, albeit variable, water access in Greater Accra. Ashaiman may epitomize the challenges of fast growing peri-urban communities that are poised to absorb most of West Africa's projected population growth over the next few decades.

This study presents a case study from an informal urban slum community, Old Tulaku in Ashaiman, Ghana, to improve our understanding of local drinking water knowledge, attitudes, and practices, as well as the social, economic, and educational drivers of sachet use. We present the results of a household survey of 95 residents and summarize themes from four focus groups in an effort to dissect the complexity of drinking water decision-making in a low-income, urban context. We build on prior knowledge of sachet water consumption among younger and lower-income consumers (Stoler et al., 2013); household employment gender patterns, with women more likely to work at home and bear a greater burden of water fetching responsibilities (Sorenson, Morssink, & Campos, 2011); and attitudes toward drinking water expressed in previous in-depth interviews, and shaped by social and economic pressures that culminate in hybrid approaches to water security (Peloso and Morinville, 2014, Yeboah, 2006). From these prior studies, we identify four sets of factors that we hypothesize would make residents more likely to rely on sachet water in Old Tulaku:

• The demographic hypothesis, i.e. residents who are younger, male, and poorer;

• The knowledge hypothesis, i.e. residents who are less educated or unfamiliar with water treatment options;

• The social attitudes hypothesis, i.e. residents who neither know anyone else who treats their water, nor have anyone encouraging them to do so;

• The individual attitudes hypothesis, i.e. residents who perceive a need to treat their water or have low confidence in their ability to effectively treat their own drinking water.

The study contextualizes these results using themes derived from focus groups about drinking water conducted in Old Tulaku one week prior to the household survey. We conclude by discussing the quality and appeal of sachet water, and the implications for its inclusion in a decentralized urban water provision strategy.