title: Introduction of a community water supply in rural western Kenya: impact on community wellbeing and child health.
abstract: BACKGROUND
  This study aimed to examine water availability and community health before and after tube wells were introduced in a rural western Kenyan community. Differences in impact among income quintile groups were quantified, and users' perceptions of their water supply measured.
  
  
  METHODS
  We conducted a two-part pre- (2009) and post-intervention (2011), cross-sectional study using structured questionnaires for mothers.
  
  
  RESULTS
  In total, 1391 (576 in 2009 and 815 in 2011) mothers participated. Well introduction changed the households' drinking-water source from river to ground water. The median distance to the water source was reduced by 40% (500 to 300 metres) and median collection time was reduced by 50% (30 to 15 minutes). Water consumption per household increased by approximately 20% (from 82.6 to 99.0 L) and drinking of untreated water decreased by approximately 10%. Regression analyses revealed mothers with higher monthly incomes had the highest satisfaction levels (β=0.167, p<0.001). Positive impacts were strongest among wealthier groups.
  
  
  CONCLUSIONS
  The small-scale community water supply dramatically affected user hygiene behaviours and daily life. Water supply access improved from 'no access' to 'basic access'. Household connections to a water supply and hygiene education are important steps to enhance community health.
authors.affiliation: Organization for Common Education, and Faculty of Policy Studies, Chuo University, Japan Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Japan sakisaka@tamacc.chuo-u.ac.jp sakisaka@m.u-tokyo.ac.jp.
authors.forename: Kayako
authors.initials: K
authors.lastname: Sakisaka
authors.affiliation: Nagasaki University Kenya Research Station, Nairobi, Kenya.
authors.forename: Evans Asena
authors.initials: EA
authors.lastname: Chadeka
authors.affiliation: Graduate School of Biomedical Science Medicine, Nagasaki University, Japan.
authors.forename: Sachiyo
authors.initials: S
authors.lastname: Nagi
authors.affiliation: Department of Social Services, Ministry of Gender, Children and Social Development, Kenya.
authors.forename: Dorcas Shambi
authors.initials: DS
authors.lastname: Mwandembo
authors.affiliation: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Japan.
authors.forename: Masamine
authors.initials: M
authors.lastname: Jimba
mesh_terms: D000328:Adult; D002648:Child; D000067576:Child Health; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004326:Drinking; D060766:Drinking Water; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007182:Income; D007223:Infant; D007630:Kenya; D008297:Male; D008875:Middle Aged; D009035:Mothers; D011634:Public Health; D012111:Residence Characteristics; D012424:Rural Population; D011795:Surveys and Questionnaires; D014881:Water Supply; D060986:Water Wells
chemical_list: D060766:Drinking Water
keywords: Childhood diarrhoea; Developing countries; Hygiene behaviour; Kenya; Water supply; Water treatment