journal article 2026

Improving water security through social protection: Findings from a natural experiment with Ghana's Livelihood Empowerment Against Poverty (LEAP) Program

Urbanus Azupogo, Elijah Bisung, Meshack Achore, Sarah Dickin, Joseph Kangmennaang

Social Science & Medicine, 2026

Health Ghana Research Sustainability Water Security Social Innovation in Health

Abstract

Water insecurity in sub-Saharan Africa significantly drains women's time and energy, worsening the financial constraints that already limit their economic empowerment. Despite this, little research has examined the role of social protection programs and cash transfers in addressing water insecurity. This study examined the combined impact of Ghana's Livelihood Empowerment Against Poverty (LEAP) program on household water access and its ability to enhance household water infrastructure. We conducted a natural experiment by comparing the experiences of water insecurity among 267 LEAP beneficiaries and 290 extremely poor households on the Ghana National Household Registry (GNHR). Experiences of water insecurity were measured using the 12-item Household Water Insecurity Experiences (HWISE) scale. The data was collected in six communities served by community-based piped supply programs in the Upper West Region of Ghana. Simple and multiple linear regression were applied to assess the relationship between participation in LEAP and water insecurity, and bivariate and multivariate logistic regression were used to evaluate the likelihood of owning durable water storage containers. The results show a strong positive association between LEAP beneficiary households and water insecurity (β = 5.88, 95% CI [4.69, 7.07], p < .001), as well as being enrolled in LEAP and owning a water storage container (OR = 5.65, 95% CI [3.72, 8.57]; p < .001). Women's active participation in group credit schemes also independently reduced the likelihood of water insecurity (β = −1.39, 95% CI [-269, −0.09], p = .037) and more than doubled the odds of owning a water storage container (OR = 2.33, 95% CI [1.51, 3.59]; p < .001). This research indicates that cash transfer programs, in conjunction with community-based credit programs, could address some of the structural barriers to water insecurity in communities with piped water systems. Social protection programs could incorporate women-centered savings schemes to enhance water security benefits, reduce gendered time poverty, and support Sustainable Development Goals 5 and 6.

Citation

Azupogo, U., Bisung, E., Achore, M., Dickin, S., & Kangmennaang, J. (2026). Improving water security through social protection: Findings from a natural experiment with Ghana's Livelihood Empowerment Against Poverty (LEAP) Program. Social Science & Medicine, 400, 119222. https://doi.org/10.1016/j.socscimed.2026.119222

Type

Journal article

Year

2026

Publisher

Social Science & Medicine