- Money maker pumps have increased crop production, incomes, and food security in East Africa. However, women face more constraints than men in accessing and owning the pumps. - Qualitative research found that while decisions are made jointly, men have final say and prefer higher value cash crops. Women prefer crops that can be harvested longer and sold locally. - Quantitative data showed slightly lower disease rates for children where pumps were used, but Tanzania had higher rates than Kenya overall. Pump owners had higher incomes than the general population but less than national averages. - Adjustments were made to programs to increase women's access, like installment plans. However, more work is needed to overcome gender barriers to pump ownership.