Coping with water insecurity in urban Ghana: patterns, determinants and consequences

In Sub-Saharan Africa (SSA), rapid urbanization poses unprecedented challenges in terms of water security and associated health risks. Like most SSA countries, many Ghanaian households lack access to safely managed drinking water sources and resort to a patchwork of alternative sources for their water needs. This paper examines determinants and implications of water insecurity coping strategies in resource-constrained neighborhoods in Ghana, using a survey (n = 1192) of adult active water collectors within households in Accra and Tamale. Findings suggest that water insecure households were more likely to adopt behavioral, physical and a mix of behavioral and physical coping strategies. Households were more likely to use behavioral (OR = 5.64, p = 0.00), physical (OR = 3.18, p = 0.00) and behavioral and physical (OR = 4.20, p = 0.00) coping strategies in the dry season. Compared with the wealthy, the less wealthy (OR = 0.27, p = 0.00) were less likely to employ a mix of physical and behavioral coping strategies. Likewise, males were less likely (OR = 0.64, p = 0.03) to employ a behavioral coping strategy. The findings can help practitioners identify vulnerable groups and provide targeted interventions that seek to build or strengthen coping strategies in the short term.