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Increasing frequency and severity of drought is driving increased use of groundwater resources in arid regions of Northern Kenya, where approximately 2.5 million people depend on groundwater for personal use, livestock, and limited irrigation. As part of a broader effort to provide more sustainable water, sanitation, and hygiene services in the region, we have collected data related to site functionality and use for approximately 120 motorized boreholes across five counties. Using a multilevel model to account for geospatial and temporal clustering, we found that borehole sites, which counties had identified as strategic assets during drought, ran on average about 1.31 h less per day compared to non-strategic borehole sites. As this finding was contrary to our hypothesis that strategic boreholes would exhibit greater use on average compared to non-strategic boreholes, we consider possible explanations for this discrepancy. We also use a coupled human and natural systems framework to explore how policies and program activities in a complex system depend on consistent and reliable feedback mechanisms. Funding was provided by the United States Agency for International Development. The views expressed in this article do not necessarily reflect the views of the United States Agency for International Development or the United States Government.