Urban water network upgrades improve quality and access to drinking water in the PAASIM matched cohort study in Beira, Mozambique

Abstract

Rigorous evaluations of community water supply interventions are necessary to understand their impact on water quality and access. Our study in Beira, Mozambique, assessed the impact of water infrastructure improvements in neighbourhoods with or without a newly replaced water service line. We collected data from 642 households on microbial contamination in stored and source water, water access and satisfaction with water service. The intervention reduced the presence of any E. coli contamination by 33% in household source water and by 14% in stored water. Regardless of intervention status, having a direct household connection to the piped water network (versus none) was associated with 24% lower prevalence of E. coli in source water but no difference in stored water. Intervention households and households with a direct connection had better water access and higher satisfaction. These findings suggest that urban water supply interventions can improve access to a safe water supply, but improvements may be compromised by water storage practices due to water intermittency. Urban water systems in low-income cities often face contamination risks and unreliable supply, motivating evaluations of infrastructure upgrades. An assessment of the impact of water service line replacements on water quality and access in Beira, Mozambique, reveals reduced source water contamination and improved access.