In developing countries, most households transport water from distant sources, placing physical burdens on women and children, who commonly carry water on their heads. A lightweight backpack was developed to alleviate physical stress from water carriage and provide a safe storage container. In 2015, we conducted a baseline survey among 251 Kenyan households with children <5 years old, distributed one backpack per household, and made 6 monthly home visits to ask about backpack use. At baseline, the median reported water collection time was 40 minutes/round trip; 80% of households reported collecting water daily (median 3 times/day). At follow-up visits, respondents reported backpack use to carry water ranged from 4% to 20% in the previous day; reported backpack use for water storage in the previous day ranged from 31% to 67%. Pain from water carriage was reported at 9% of all follow-up visits. The odds of backpack use in the past day to collect water were lower during rainy season (OR: 0.3, 95% CI: 0.2–0.3) and not associated with reported pain (OR: 1.7, 95% CI: 0.9–3.3). Our study suggests that participants preferred using the backpacks for storage rather than transport of water. Further dissemination of the backpacks is not recommended because of modest use for transport.

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