When urban taps run dry: Sachet water consumption and health effects in low income neighborhoods of Accra, Ghana

► Half of low-income households in Accra, Ghana now use sachet water as their primary drinking water source. ► We examine the effect of municipal water rationing on sachet use and health effects in slum neighborhoods. ► Sachet-using households are generally the poorest of the poor with least access to basic services. ► Neighborhood rationing and select socio-demographic factors are predictive of sachet use. ► In a subset of children, lower maternal self-reported overall health and sachet avoidance are predictive of recent diarrhea.