Background: Access to safe drinking water remains a critical public health concern in rural Ghana, particularly in climatically vulnerable and underserved settings. This study assessed the microbiological and chemical quality of drinking water and evaluated nitrate-related health risks in the North Gonja and North-East Gonja Districts of the Savannah Region. Methods: A cross-sectional study was conducted between January and March 2025. A total of 460 water samples were collected from groundwater sources and household storage containers. Microbial analyses targeted total coliforms and Escherichia coli. Physicochemical and chemical parameters included nitrate-nitrogen, pH, residual chlorine, major ions, and trace metals. Data was analyzed using descriptive statistics, chi-square tests, spatial interpolation, and non-carcinogenic health risk assessment based on the hazard quotient (HQ) approach. Results: Widespread microbial contamination was observed, with 91.5% of household water samples positive for total coliforms and 46.6% for E. coli. Contamination of source water was significantly higher in North Gonja than in North-East Gonja. Overall, 49.1% (n = 55) of groundwater sources exceeded the World Health Organization guideline value for nitrate-nitrogen, with exceedances predominantly occurring in North Gonja. Additionally, 67.0% (n = 75) of samples were outside the acceptable pH range (6.5–8.5), including 74 samples below 6.5 and one above 8.5. Residual chlorine was not detected in any of the samples. Health risk assessment indicated potential non-carcinogenic risks associated with nitrate exposure, particularly among infants and children. Conclusions: The study demonstrates significant microbial contamination and nitrate-related health risks in the study area, particularly in North Gonja. Interventions such as improved source protection, routine water quality monitoring, chlorination, household water treatment, and implementation of Water Safety Plans are recommended to enhance drinking water safety and reduce associated public health risks.

Lead (Pb) is a neurotoxin with no known safe level of exposure. Widespread lead contamination has been reported in rural groundwater-supplied drinking water systems in low- and middle-income countries (LMICs), primarily arising from the corrosion of lead-containing plumbing materials such as galvanized steel and leaded brass. The National Sanitation Foundation (NSF) 372 standard certifies drinking water system components as “lead-free” when the lead content is below 0.25% by weight for wetted surfaces. NSF 61 standard, in contrast, certifies the safety of “endpoint” drinking water system components based on their potential to leach chemical contaminants, including lead. This study evaluates the lead content (NSF 372) and lead leaching behavior (NSF 61) of plumbing components commonly used in LMIC rural community water systems to determine their suitability for delivering safe drinking water. Galvanized borehole handpump tanks (specifically, spouts) and brass taps widely used in Ghana and other LMICs were tested alongside stainless-steel alternatives and lead-free PVC pipe controls against NSF 61 and NSF 372 standards. Stainless-steel components and PVC controls met both standards, whereas galvanized steel spouts and leaded brass taps did not. Average water lead levels leached over the 19-day experimental period were 192 µg/L (SD = 89) for leaded brass taps, 34 µg/L (SD = 3) for galvanized steel spouts, 0.4 µg/L (SD = 0.1) for stainless-steel taps, 0.3 µg/L (SD = 0.3) for PVC pipes, and below the detection limit (0.5 µg/L) for stainless-steel spouts. These findings indicate that lead-containing galvanized steel and leaded brass components that exceed NSF 372 and/or NSF 61 standards pose a significant health risk and should not be used in potable water systems. Lead-free alternatives that meet NSF 372 and NSF 61 standards, such as stainless steel, are strongly recommended for safer rural water infrastructure due to their minimal lead-leaching risk.

Lead (Pb) is a neurotoxin with no known safe level of exposure. Widespread lead contamination has been found in rural groundwater-supplied drinking water systems in low- and middle-income countries, potentially from corrosion of lead-containing materials such as galvanized steel and brass. National Sanitation Foundation (NSF) 61 is an international standard for certifying the safety of water system components in contact with drinking water based on their capacity to leach chemical contaminants, especially lead, into drinking water. Another standard, NSF 372, certifies the material composition of drinking water system components as ’lead-free' if lead content is ≤0.25% by weight for wetted surfaces. This work investigates the lead leaching potential of components frequently used in these systems and explores potential alternatives to determine which components can be safely used in drinking water systems. Galvanized handpump spouts and leaded brass taps of types widely used in rural water systems in Ghana and stainless-steel alternatives, were tested against NSF 61 and NSF 372 standards. Lead-free PVC pipe segments were used as controls. Test results indicated that all stainless-steel components and PVC controls met NSF 61 and NSF 372 standards while galvanized spouts and brass taps did not meet either. The average lead levels leached over the experiment period from the brass taps, galvanized spout, stainless-steel taps, PVC pipes, and stainless-steel spouts were 192 (SD=89), 34 (SD=3), 0.3 (SD=0.1), 0.2 (SD=0.3), and 0.1 (SD=0.1) µg/L, respectively. Overall, the use of lead-containing galvanized handpump spouts and brass taps should be avoided in water systems due to their lead leaching potential; alternative products made from lead-free materials such as stainless steel should be substituted.