Factors Influencing Water and Sweet Beverage Purchasing Decisions and Behaviours Among Low-Income Households in Four Peri-Urban Communities in Accra: An Exploratory Study

Background: In May 2023, Ghana implemented a 20% ad valorem tax on bottled water and sweet beverages (SBs), replacing a 17.5% tax; sachet water remained untaxed. The effect on low-income consumers’ purchasing decisions and consumption patterns remains poorly understood. Objective: We aimed to explore factors influencing water and SB purchasing behaviours among low-income households in four peri-urban Accra communities. Methods: This study employed a convergent parallel mixed-methods design. Four focus group discussions (n = 36) and a cross-sectional survey (n = 43) were conducted among purposively sampled household primary shoppers in early 2025 across Oyarifa, Teiman, Kweiman, and Danfa. Data were analysed thematically and descriptively. Results: Of 43 participants, 67% were female and 65% had junior high school education. Water insecurity was common (60%), and sachet water was the main drinking source (77%). SB purchasing was driven by taste and convenience, while sachet water choices were linked to perceived safety, price, and availability. Tax awareness was moderate (56%); many perceived bottled water taxation as unfair and reported intentions to switch to cheaper local alternatives. Conclusions: Limited tax awareness and perceived inequities suggest the need for policy refinements to better align fiscal measures with public health objectives.