Simple household water tests trigger major behaviour change that could reduce E.coli risk

New research has shown that simply telling people whether their drinking water is safe can lead to major improvements in health behaviour, even without household equipment or financial help.

The study, , tested drinking water in 24 villages in Punjab, Pakistan, where many families rely on unsafe supplies. Over 70 per cent of the 1,388 participating homes were found to have E.coli in their drinking water - a type of bacteria that can cause serious illness. 

Households whose water was found to be contaminated were randomly placed into three groups. One group received no information at all (the control group), a second group was told their water was contaminated (the partial treatment group), and a third group received both the contamination results and a one-page guide on how to purify water at home - such as boiling, filtering, or switching sources.

Three months later, researchers returned to find out whether families had changed their behaviour in response. When told their water contained harmful bacteria, 4 out of 10 started purifying it (40 per cent). When they were also given simple tips in a one-page leaflet that number rose to nearly 1 in 2 (48 per cent). In the group that didn’t get any information, fewer than 2 in 100 made changes (1.5 per cent).

Co-author Dr Zahra Murad, Associate Professor from the ǿ����Ƶ in England, said: “This shows how powerful information can be. When people know their water is unsafe, they want to protect their families and they do something about it. The best part is that this kind of change doesn’t need huge spending. It can start with a simple test.”

The study found that this type of intervention could potentially save lives at a much lower cost than many other public health programmes, particularly in low-income settings. The research used a method recommended by the World Health Organization and World Bank data.

In most cases, this simple approach - just testing water and giving people basic advice - was much more cost-effective than many other health programmes in poorer countries. This is especially important in places where clean water is hard to get, and where people may not realise the risk from what they drink.

“What this shows is that people don’t always need incentives or equipment to take action - they need timely, specific and credible information”, added Dr Murad. 

“Our findings also contribute to a growing body of evidence that behavioural interventions - especially those that are context-specific and individually targeted - can support public health efforts in the Global South.”

As the study looked at people’s behaviour just a few months after they got the information, the researchers suggest repeating the study over a longer time and in other countries to see if the results remain the same.

Lead author, from COMSATS University Islamabad, Pakistan, added: “By demonstrating that even a simple water test and informational leaflet can significantly increase safe water practices, the study paves the way for scalable, community-level health initiatives. 

“Policy makers can integrate water testing and tailored messaging into existing infrastructure investments for clean water and community health programmes. With minimal resources, such interventions can yield outsized benefits.”

The study was a collaboration between the COMSATS University Islamabad in Pakistan, the ǿ����Ƶ in England and the Leeds University Business School in England.