Improvement in access to safe water, household water insecurity, and time savings: A cross-sectional retrospective study in Kenya.

This study uses a cross-sectional survey (n = 557) with a retrospective design to examine relationships between improvement in access to safe water supply (i.e. extension of municipal piped water) and a range of social outcomes including water insecurity, household time savings and allocation, and household water expenditure in Usoma, Kenya. Data were collected in July 2016, about 3 years after the intervention, using a modified version of the Household Water Insecurity Access Scale (HWIAS). Having assessed the validity and reliability of the modified HWIAS, we examine how differences in levels of access to safe water influence reported levels of water insecurity as well as amount of money and time savings, post the water intervention. Findings suggest that higher levels of access reduce risk of water insecurity. Households with piped water on premises scored 2.95 points less on the water insecurity scale compared to households with access to unimproved sources. As anticipated, time saved on water collection was re-directed to income generating activities, while money saved was spent primarily on food. Important gender differences were reported, with female headed households having 1.15 points less on the HWIAS than male headed households. This study establishes an innovative approach to evaluating water interventions that can be used in program design and evaluation. The study also emphasises the need for universal access to safe water as envisioned in the Sustainable Development Goals (SDGs).