Piped water flows but sachet consumption grows: The paradoxical drinking water landscape of an urban slum in Ashaiman, Ghana Justin Stoler a, b, * , Raymond A. Tutu c, 1 , Kiana Winslow a, 2 a Department of Geography and Regional Studies, University of Miami, Coral Gables, FL, USA b Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA c Global Societies Program, Delaware State University, Dover, DE, USA article info Article history: Available online Keywords: Africa Ghana Urban slums Drinking water Poverty Sachet water abstract Packaged “sachet” water has become the primary drinking water source for millions of West Africans despite ongoing controversy over inadequate management of the new waste streams created by all the plastic wrappers. While recent literature from Ghana has shown that municipal water rationing and lower socioeconomic status tend to drive sachet consumption at the metropolitan scale, some low- income communities with a reliable piped water supply still exhibit diverse drinking water-seeking behaviours. This paper explores the drinking water landscape of one poor, informal community in Ashaiman, Ghana, as a case study of the individual- and community-level factors that shape household drinking water decisions. Using the results of a water questionnaire completed by 95 households and the transcripts of four focus groups, our findings suggest that, after controlling for demographics, sachet water consumption is associated with proxies for higher disposable income and lack of knowledge about household water treatment methods, while social processes and attitudes toward water quality do not seem to drive drinking water decisions. This community presents a paradoxical drinking water land- scape, as poverty abounds despite excellent piped water access, and low-income households with slightly greater means tend to opt for packaged water as opposed to being driven to it by piped water shortages. These nuances in drinking water purchasing behaviour can inform policy and planning for drinking water provision in urban slums across the region. © 2015 Elsevier Ltd. All rights reserved. Introduction The proportion of global disability-adjusted life years (DALYs) attributable to unimproved water and sanitation has fallen steadily over the last two decades, though with substantial regional het- erogeneity as diarrhea remains a leading killer in sub-Saharan Af- rica (Lim et al., 2012; Pullan, Freeman, Gething, & Brooker, 2014). Despite the UN announcement in March 2012 that Target 7C of the Millennium Development Goals (MDG) was met ahead of schedule globally (WHO/UNICEF, 2012), sub-Saharan Africa continues to have the lowest percentage of population with access to an improved water source among all world regions, particularly in urban areas (WHO/UNICEF, 2013), and a number of critiques have noted the inadequacy of the metric “access to an improved water source.” Drinking water access in sub-Saharan Africa may be qualified by water quality (Bain et al., 2012; Onda, LoBuglio, & Bartram, 2012), fragmented distribution (Bakker, 2010), unsus- tainability (Stoler, 2012), usage patterns (Kayaga, Fisher, & Franceys, 2009) and government corruption (Nganyanyuka, Martinez, Wesselink, Lungo, & Georgiadou, 2014). Along similar lines, Obeng-Odoom (2012) frames “deep” access as the interaction be- tween four dimensions: quality, reliability, cost, and equity. Other recent studies continue to refine the methods for estimating the burden of inadequate water, sanitation, and hygiene (Clasen et al., 2014), as well as underscore the persistent role in the global diar- rheal disease burden among low- and middle-income nations (Prüss-Ustün et al., 2014; Wolf et al., 2014). * Corresponding author. Department of Geography and Regional Studies, Uni- versity of Miami,1300 Campo Sano Avenue, Coral Gables, FL 33146, USA. Tel.: þ1 305 284 6692. E-mail addresses: stoler@miami.edu (J. Stoler), rtutu@desu.edu (R.A. Tutu), k. winslow1@umiami.edu (K. Winslow). 1 Global Societies Program, Department of History, Political Science, and Philos- ophy, Delaware State University, 110 ETV Building, 1200 N. DuPont Highway, Dover, DE 19901, USA. Tel.: þ1 302 857 6847. 2 Department of Geography and Regional Studies, University of Miami, 1300 Campo Sano Avenue, Coral Gables, FL 33146, USA. Contents lists available at ScienceDirect Habitat International journal homepage: www.elsevier.com/locate/habitatint http://dx.doi.org/10.1016/j.habitatint.2015.01.009 0197-3975/© 2015 Elsevier Ltd. All rights reserved. Habitat International 47 (2015) 52e60