Though there is little evidence on their effectiveness, decentralized community water systems (CWS) such as market-based kiosks are thought to be appropriate where piped services are infeasible or unreliable. We assess changes in household behaviors, water quality and health following installation of CWS in rural India, using quasi-experimental methods. Three negative findings stand out: Few households use the CWS, whereas water quality is lower, and childhood diarrhea higher, among CWS users. This appears to stem from reduced selfprotection by users amidst continuing reliance on multiple water sources. Decentralized solutions will not deliver environmental quality unless protective behaviors are maintained.
