Introduction of a community water supply in rural western Kenya: impact on community wellbeing and child health

This study aimed to examine water availability and community health before and after tube wells were introduced in a rural western Kenyan community. Differences in impact among income quintile groups were quantified, and users' perceptions of their water supply measured. We conducted a two-part pre- (2009) and post-intervention (2011), cross-sectional study using structured questionnaires for mothers. In total, 1391 (576 in 2009 and 815 in 2011) mothers participated. Well introduction changed the households' drinking-water source from river to ground water. The median distance to the water source was reduced by 40% (500 to 300 metres) and median collection time was reduced by 50% (30 to 15 minutes). Water consumption per household increased by approximately 20% (from 82.6 to 99.0 L) and drinking of untreated water decreased by approximately 10%. Regression analyses revealed mothers with higher monthly incomes had the highest satisfaction levels (beta=0.167, p < 0.001). Positive impacts were strongest among wealthier groups. The small-scale community water supply dramatically affected user hygiene behaviours and daily life. Water supply access improved from 'no access' to 'basic access'. Household connections to a water supply and hygiene education are important steps to enhance community health.