Rural Tanzanian communities often suffer from poor water quality, leading to adverse health outcomes such as diarrheal diseases and parasitic infections. A mixed-methods approach combining quantitative surveys (n=300) with qualitative interviews (n=50) to evaluate programme effectiveness and community feedback. Users showed high acceptance of improved water quality, with a 72% satisfaction rate. However, there was variability in reported health improvements, especially among women. Water quality improvement programmes are generally well-received by rural Tanzanian communities but require targeted interventions to enhance health benefits for all populations. Tailored education and support strategies should be implemented to maximise the programme's impact on health outcomes in underserved groups, particularly women. water quality, user acceptance, health outcomes, rural Tanzania, mixed-methods study