Urban water network upgrades improve quality and access to drinking water in the PAASIM matched cohort study in Beira, Mozambique.

Rigorous evaluations of community water supply interventions are necessary to understand their impact on water quality and access. Our study in Beira, Mozambique assessed the impact of water infrastructure improvements in neighborhoods with or without piped water network upgrades. Data were collected from 642 households on microbial contamination in stored and source water, water access, and satisfaction with water service. The intervention reduced source water contamination by 33% and stored water by 14%. Regardless of intervention status, having a direct connection to the piped water network (versus none) was associated with 24% lower in source water but no difference in stored water. Intervention households and households with a direct connection had better water access and higher satisfaction. These findings suggest that urban water supply interventions can improve access to a safe water supply, but improvements may be compromised by water storage practices due to water intermittency.