Use of drinking water sold in plastic bags (sachet water) is growing rapidly in west Africa. The impact
on water consumption and child health remains unclear, and a debate on the taxation and regulation of sachet water is
ongoing. This study assessed the feasibility of providing subsidized sachet water to low-income urban households in
Accra and measured the resultant changes in water consumption. A total of 86 children, 6–36 months of age in neighborhoods
lacking indoor piped water, were randomized to three study arms. The control group received education about
diarrhea. The second arm received vouchers for 15 L/week/child of free water sachets (value: $0.63/week) plus education.
The third arm received vouchers for the same water sachet volume at half price plus education. Water consumption
was measured at baseline and followed for 4 months thereafter. At baseline, 66 of 81 children (82%) drank only sachet
water. When given one voucher/child/week, households redeemed an average 0.94 vouchers/week/child in the freesachet-voucher
arm and 0.82 vouchers/week/child in the half-price arm. No change in water consumption was observed
in the half-price arm, although the study was not powered to detect such differences. In the free-sachet-voucher arm,
estimated sachet water consumption increased by 0.27 L/child/day (P = 0.03). The increase in sachet water consumption
by children in the free-sachet-voucher arm shows that provision of fully subsidized water sachets might improve
the quality of drinking water consumed by children. Further research is needed to quantify this and any related child
health impacts.