Despite worldwide advances in urban water security, equitable access to safely managed drinking water remains a challenge in low- and middle-income countries (LMICs). Piped water on premises is widely considered the gold standard for drinking water provision and is expanding rapidly in small and medium urban centres in LMICs. However, intermittency in urban water supply can lead to unreliability and water quality issues, posing a key barrier to equitable water security. Leveraging mixed methods and multiple data sets, this study investigates to what extent urban water security is equitable in a small town in Northern Ethiopia with almost uniform access to piped water services. We have developed a household water security index that considers issues of quality, quantity, and reliability. We demonstrate that there is high spatial variability in water security between households connected to the piped water system. Moreover, reliability of piped water supply did not equate to high water security in every case, as accessibility of appropriate alternative supplies and storage mediated water security. Urban water planning in LMICs must go beyond the physical expansion of household water connections to consider the implications of spatiality, intermittency of supply, and gendered socio-economic vulnerability to deliver equitable urban water security.REACH is a nine-year programme (2015-2024) led by Oxford University with international consortium of partners and funded with UK Aid Direct from the UK Government’s Foreign, Commonwealth & Development Office.

This research paper uses a mixed methods approach, drawing on multiple studies that were not designed for the purpose of comparison and, therefore, vary in sampling and methodology. Nevertheless, the breadth and depth of the studies allow us to offer nuanced insights into the implication of water insecurity for the most vulnerable urban residents, often missing from studies that rely solely on quantitative methods. We use primary quantitative and qualitative datasets (WASH survey, water diaries and interviews) with secondary quantitative datasets (HDSS survey and utility billing records) details of which can be found in table 1 and in the appendices. Ethical approval was given for primary data collection from Oxford University’s Central University Research Ethics Committee. Despite the benefits of using multiple studies and datasets, a challenge of comparison is the different timeframes over which the data was collected. As the water system was transitioning, it was experiencing periodic interruptions and studies were falling into times when tap water was either more or less available. Therefore, we have navigated this carefully when interpreting the data and offering conclusions. Another hurdle to overcome was matching up the quantitative datasets: 505/701 households in the primary WASH dataset 2019, could be matched to the secondary utility billing records, while 477/701 are matched to the secondary HDSS dataset 2016, hence have a wealth index associated with them. About 355/701 were matched to both the utility billing records and the HDSS dataset 2016. Of 117 households in the primary diaries dataset, 34 are matched to the utility billing records.