Climbing the water ladder in poor urban areas: Preferences for 'limited' and 'basic' water services in Accra, Ghana.

While providing drinking water on premises to all citizens in urban areas may be desirable, economic and institutional challenges coupled with poverty, insecure tenure, and other barriers prevent many water utilities from providing private taps to all households. To meet growing water demand and fill gaps in service delivery, alternative forms of public water service provision are critical. We implemented a choice experiment in Nima-Maamobi, a poor, underserved urban settlement in Accra, Ghana, to investigate household preferences for public standpipes based on the basic and limited water service categories under the WHO/UNICEF Joint Monitoring Programme's new water ladder. We also elicited local preferences for potential service administrators of the standpipes. Choice responses provided by 344 respondents were analyzed using a generalized multinomial logit model. Households were willing to pay up to US$1.25 for a 20-liter bucket of safe drinkable water, which is consistent with the average household water expenditure in the study site. Households spend at least 22% of their monthly income on water. Households' willingness to pay varied according to alternative levels of accessibility, availability, and quality of water services. Households showed strong preferences for community-based committees and nongovernmental organizations over the current water utility and the municipal assembly. The policy implications of the findings are discussed.