New Delhi: India’s flagship rural tap water programme, Jal Jeevan Mission (JJM), has substantially reduced the time women and marginalised communities spend collecting water. But in districts where JJM expanded most rapidly, it may also be associated with a rise in child mortality, “at least in the short term”, according to a new academic study released on December 31, 2025.A working paper, “Gendered and Distributional Impacts of Scaling Water Access: Evidence from Tap Water Policy in India,” by Marc Jeuland, Julia YuJung Lee and Kazuki Motohashi, three researchers at Duke University, Colorado State University and Hitotsubashi University, respectively, examines the early effects of JJM, launched in August 2019 to provide household tap water connections in all rural homes. It analyses how the programme’s rapid scale-up altered time use and child health across gender and caste groups.The findings add to a growing body of work assessing India’s rural water rollout. Earlier assessments by the World Bank and UNICEF have documented gains in access and time savings from piped water schemes, while flagging persistent concerns around water quality, system maintenance and last-mile delivery. In India, audits and policy reviews by research institutions, including PLOS One, have similarly cautioned that coverage expansion has often outpaced quality assurance and monitoring.Between 2018 and 2023, rural tap water coverage rose from about 18% to over 75%, making JJM one of the largest drinking water infrastructure programmes in the world. While earlier research has shown that small-scale water interventions reduce collection time and improve health, the authors of the present paper note that evidence from nationwide rollouts, especially those implemented at speed, remains limited.“This is the first generation of studies trying to understand what happens when scale precedes systems,” said Nitin Bassi, a senior water policy researcher at the Council on Energy, Environment and Water (CEEW), speaking to The Wire. He noted that programmes of JJM’s size often expose stress points that smaller pilots do not.Also read: 80% Rural Households Covered Under Jal Jeevan Mission, Centre Tells ParliamentThe study focuses on short-run impacts during JJM’s initial phase, drawing on data from the 2019 Time Use Survey, the National Family Health Survey (NFHS-5), weather records from the India Meteorological Department and district-level JJM implementation data.Decline in water collection timeOne part of the analysis examines how tap water access affects the time households spend collecting water. The researchers use daily temperature variation as a proxy for changes in water demand, since higher temperatures typically increase water use for drinking, cooking and bathing.On average, a one-degree Celsius rise in daily temperature increases household water collection time by around 1.5 minutes. However, this increase disappears in districts where JJM tap connections have already been rolled out.Tap water access effectively insulates households from the additional burden associated with higher temperatures, particularly in homes where women are the sole water collectors. In most rural households, water collection remains a gendered task, often requiring long walks to shared or distant sources.Speaking to The Wire, Ashwini Deshpande, labour economist said: “These time savings are not just about convenience. They alter how women allocate energy across paid work, care work and rest; changes that are rarely captured in infrastructure accounting.”Uneven gains across social groupsThe study finds that Scheduled Caste (SC), Scheduled Tribe (ST) and Other Backward Class (OBC) households experience the largest reductions in water collection time following JJM expansion. No statistically significant change is observed for general caste households.Researchers attribute this to historical disparities in water access. Census data shows SC and ST households are more likely to depend on public sources and face discrimination at shared water points. Private household connections reduce both physical distance and social barriers.Also read: Happy New Year Jal Jeevan Mission India“Piped water does more than shorten the walk,” Dr Dhaneshwar Bhoi, a sociologist specialising in caste and public services, told The Wire. “It bypasses the everyday negotiations, exclusions and humiliations that structure access to shared resources.”The study also finds larger time-use gains for Hindu households than Muslim households, and for larger families compared to smaller ones. The authors note that Muslim households in rural India tend to have relatively higher baseline access to private water and sanitation infrastructure, limiting marginal gains from new tap connections.Child health outcomes tell a different storyThe time-use gains, however, are not mirrored in child health outcomes.Using birth history data from NFHS-5, the researchers analyse infant and under-five mortality across districts with differing levels of pre-JJM tap water coverage. Districts with lower baseline coverage experienced the fastest expansion, allowing for comparative analysis.The study finds that districts with larger increases in tap water access saw a rise in infant mortality seven to eight months after JJM’s launch. A 10-percentage-point lower pre-JJM tap water coverage is associated with an increase of roughly 11.6 to 12.8 infant deaths per 1,000 births; around a one-third rise from pre-policy levels.No differential mortality trends are observed before the programme began, strengthening the temporal link between JJM expansion and the observed outcomes. Similar patterns emerge for under-five mortality.Chandrakant Lahariya, a public health specialist familiar with large infrastructure transitions, told The Wire: “This looks less like a failure of access and more like a failure of safeguards during rapid rollout.”Disproportionate impact on marginalised communitiesThe increase in infant mortality is concentrated among SC, ST and OBC households; the same groups that saw the largest gains in water access. No statistically significant effects are observed among General caste households.Gender differences also emerge. The rise in mortality is seen among male infants but not female infants. The study does not conclusively explain this pattern, but notes that male infants are biologically more vulnerable to health shocks and may also be more exposed to newly supplied water within households.Also read: No Har Ghar Jal by 2024: ReportThe overlap between access gains and health risks, the authors argue, highlights how infrastructure expansion without quality control can reproduce existing inequalities.Water quality as a possible mechanismTo explore potential mechanisms, the researchers analyse post-JJM administrative data on water quality. Districts with more new tap connections report a higher number of villages with contaminated water samples.The association is strongest for bacterial contamination; such as E. coli and total coliform, commonly linked to diarrhoeal disease. No similar pattern is observed for chemical contaminants like arsenic or nitrate.This, the authors argue, suggests the findings are not merely a function of increased testing. “If testing intensity alone were driving the results, contamination would rise across multiple indicators,” the paper notes.Water sector specialists say this aligns with known risks during rapid infrastructure expansion. “Pipelines without consistent chlorination, storage tanks without cleaning protocols, and poor last-mile connections are classic failure points,” said R.K. Malhotra, a former engineer with a state water board.Short-term lens, long-term questionsThe authors stress that the analysis captures only the short-term effects of JJM. Infrastructure quality, treatment practices and household behaviour may evolve as systems stabilise. They also note behavioural shifts: households may stop boiling or filtering water once taps are installed, assuming piped water is safe. If quality is uneven, such assumptions could elevate health risks, especially for infants.The study adds to existing literature by examining a nationwide programme rather than local pilots, and by foregrounding gender and caste differences in both benefits and risks. As JJM moves from coverage targets to sustainability and quality, longer-term data will be critical to determine whether early health effects persist or reverse.