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.

If current trends of water insecurity continue, nearly two-thirds of the world’s population will live in water-scarce conditions by 2025. Nevertheless, qualitative studies on barriers to water access, particularly in informal settlements, remain limited. This study used in-depth interviews to examine the daily barriers to water access faced by urban poor households in Ghana. A total of 30 (n = 30) semi-structured in-depth interviews were conducted with residents in water-insecure areas in Tamale and Accra, Ghana. Four themes emerged from our analysis: lack of financial resources, distance and travel time, land and topography, and poor water infrastructure. Sustainable Development Goal Six cannot be achieved if the water needs of the urban poor, particularly those who dwell in informal settlements, are unmet. Thus, governments and systems must implement measures to eliminate inequalities and inequities in water distribution.

Frequent hand washing has been recommended by public health officials as one of the key preventive measures to reduce the transmission of COVID-19. Yet globally, 844 million people live without access to a safe drinking water source. This study explores the impact of the COVID-19 pandemic, its associated public health response measures and government social support on water access in informal settlements in Ghana using qualitative studies. Thirty (30) participants were interviewed in Accra and Tamale. Data were transcribed and inductively analyzed using NVivo. Overall, participants indicate that COVID-19 exacerbated their water insecurity issues in many ways including (1) limiting water source visits for fear of contracting the virus; (2) through public health restrictions that affected their ability to access water outside their households; and (3) increased cost of vended water. Most participants also highlighted that they did not benefit from the ‘6 months of free water initiative’ by the government of Ghana. As countries formulate plans to rebuild their economies, the inequalities underscored by the COVID-19 pandemic should offer renewed attention to the significance of safe water access for all, particularly concerning public and population health.