Objectives  To find out the status and management of the water supply system in township hospitals in China.

Methods  A total of 385 township hospitals were sampled nationwide from 77 counties in 10 provinces by multistage stratified random sampling methods, and the management of water supply system was investigated.

Results  Public tap water was used in 67.01% of township hospitals, self-owned tap water was used in 29.35% of them, and decentralized water supply was used in 3.64% of them. The proportion of township hospitals using public tap water in the western districts (85.00%) was significantly higher than that in central districts (69.09%), eastern districts (50.77%) and northeastern districts (56.00%). The proportion of township hospitals using self-owned tap water in western districts (7.50%) was significantly lower than central districts (27.27%), eastern districts (48.46%) and northeastern districts (44.00%). The reservoir was sealed in 84.62% of secondary water supply system, and the disinfection for water was perennially (11.54%), seasonally (19.23%) or not disinfected (69.23%). Self-owned water source was mainly from well water (92.91%), and the hygienic protection was fully (15.26%), inadequately (79.66%) or no protection at all (5.08%). The disinfection for well water was perennially (11.02%), seasonally (16.95%) or no disinfection (72.03%).

Conclusions  The main type of water supply in township hospitals was centralized system. The proportion of township hospitals using public tap water in western districts was higher than those in other districts and the proportion of using self-owned tap water in western districts was lower than those in other districts. The water supply system in western districts was more safe and easier to manage than other districts. The protection of drinking water in secondary water supply system and self-owned water supply system was defective and the proportion of water disinfection was low; and there was a risk on the safety of drinking water in township hospitals.