DFID 1998 Guidance Manual On Water Supply and Sanitation Programmes

guidance manual on
water supply and

sanitation programmes
WELL
WAT E R A N D
E N V I R O N M E N TA L H E A LT H AT
LO N D O N A N D
LO U G H B O R O U G H
Prepared by WELL
WELL is a resource centre funded by the Department for International Development (DFID)
to promote environmental health and well-being in developing and transitional countries.
It is managed by the London School of Hygiene & Tropical Medicine (LSHTM) and the
Water, Engineering and Development Centre (WEDC), Loughborough University, UK.
www.lboro.ac.uk/well/
LSHTM/WEDC 1998
Published by WEDC for DFID

ISBN 0906055 58 X
Department for International Development
94 Victoria Street
London SW1E 5JL
United Kingdom
Designed and produced at WEDC by

Helen Batteson, Kay Davey, and Rod Shaw
Editorial contributions by Kimberly Clarke
Cover photographs:
Background:
Top insert:
Centre insert:
Bottom insert:
ii
Eritrean women returning to the village from the river bed carrying full jerrycans of water.
The climb is steep and arduous and takes several hours. (WaterAid/Caroline Penn)
WaterAid/Jim Holmes
WEDC/Darren Saywell
LSHTM/Sandy Cairncross
Foreword
The White Paper on International Development sets out the
Governments policy to seek to strengthen the international
commitment to meet the international poverty elimination targets.
Improved access to safe and affordable water supply and sanitation is
an essential component of the strategy. Lack of such access is a clear
determinant of poverty. It results in millions of children dying
annually from diarrhoea and water-related diseases. For women and
children, collecting water is wearisome and time consuming and often
results in children not being able to attend school.
Better access to safe water and sanitation not only leads to
improvements in health, but also saves time and energy and enhances
livelihood opportunities.
The Department for International Development commissioned this
Guidance Manual to assist staff and partners to develop effective and
sustainable water supply and sanitation programmes. It represents
collaboration across a range of professions within my Department and
from key UK professionals in the sector. It details inter-disciplinary
approaches to planning and implementation of partnership-based
programmes.
The challenge is vast, and cannot be met simply by development aid
and public funds. Partnerships between governments, the
private-sector and civil society are central to sustainable solutions.
I hope that this manual will make a significant contribution to
enhancing the effectiveness of our efforts.
Clare Short
Secretary of State for International Development
iii
Preface
This Manual has been prepared as a tool to help improve DFIDs
support for water supply and sanitation (WS&S) projects and
programmes in developing countries. Its particular focus is on how
DFID assistance can best meet the needs of the urban and rural poor
for WS&S services. To facilitate the targeting of the poor reflects the
objective of UK international development support set out in the
White Paper on International Development better education, health
and opportunities for poor people one of three objectives
contributing to the general aim the elimination of poverty in poor
countries.
The Manual has been written primarily for DFID staff: both those
identifying, appraising, and evaluating WS&S projects; and those
developing, managing, and monitoring such projects. DFID believes
that the discussions of WS&S sector issues and approaches, and the
resulting policies and procedures, will also be of interest to its project
partners in national and local governments, non-governmental
organizations (NGOs), and other external support agencies. The
Manual will also inform DFID contractors and consultants of the
Departments objectives and the approaches to be followed in
achieving them.
Professional engineers, health scientists, economists, and sociologists
are all closely involved in the achievement of sustainable WS&S
services for the poor. Each needs to know not only his/her own role
and objectives, but also the experiences and approaches which guide
the others. The comparatively lengthy discussion of key principles and
practices in Section 2 of the Manual is intended to contribute to this
cross-fertilization. Specialists are urged to read the sections related to
other disciplines and to accept the extended elaboration of concepts
which should be familiar to them in their own sections.
The Guidance Manual has been prepared for DFID by WELL (Water
and Environmental Health at London and Loughborough), with the
following specialist authors contributing material: Jo Beall,
Sandy Cairncross, Ben Cave, Andrew Cotton, Val Curtis, Pete Kolsky,
Jeremy Parr, Sarah Parry-Jones, Bob Reed, Kevin Sansom, Ian Smout,
Hugh Tebbutt, and Judy White.
Numerous DFID staff assisted with discussion of ideas and
experience.
The contributions were co-ordinated and drawn together by WELL
Associate Director, Ian Smout, with assistance from Technical Editor,
Brian Appleton.
iv
About this manual

The overall aim of the Department for International Development
(DFID) is identified in the UK Governments White Paper on
International Development as the elimination of poverty in poorer
countries. Three specific objectives are set:
1. Policies and actions which promote sustainable livelihoods
2. Better education, health, and opportunities for poor people
3. Protection and better management of the natural and physical
environment
In the White Paper, increased UK support for water supply and
sanitation (WS&S) is seen as contributing particularly towards the
second objective. In fact, improving WS&S services for the poor
contributes significantly to the goal of sustainable livelihoods and
community development. Better sanitation practices also have a major
impact on the local environment and help to preserve freshwater
resources. Investments in WS&S may therefore be justified as
supporting all three objectives.
UK contributions are targeted towards programmes that enable the
rural and urban poor to gain access to safe supplies of drinking water
and hygienic means of excreta disposal. They favour too the
software components (hygiene promotion, local capacity and
institution building, stakeholder involvement, monitoring, and
feedback) that help to ensure that installed systems deliver the
optimum health and social benefits and can be sustained in the
long term.
The primary purpose of this Manual is to set out the principles,
procedures, and practices that should guide decisions on the choice,
design, and management of appropriate WS&S projects. Because the
effectiveness and sustainability of WS&S projects depends not only
on technology choice, but also, critically, on user involvement, the
right gender approaches, innovative community-based financing, and
the promotion of behavioural change, the guidance includes
discussion of social, financial, and institutional aspects as well as
engineering and health concerns.
Basis of the guidance
There is a wealth of literature covering experiences in the WS&S
sector during the last 20 years. To consolidate the information into a
form which could be most useful to DFID and its partners, WELL
appointed nine Theme Leaders. Their task was to prepare individual
papers setting out current thinking on guiding principles and good
practices in relation to the critical themes and to convert these into
practical guidance for DFID staff involved in different aspects of the
project cycle.
v
The themes chosen reflect the multidisciplinary nature of WS&S

development:
Social development and poverty

The water and sanitation sector
Health and hygiene
Economics and finance
Institutional development
Engineering and technology
Hygiene promotion
Environmental sustainability
Project management and the project cycle (the linking theme)
The aim is not just to provide individual guidance for each group of
specialists, but to present the information in such a way that each
specialist is aware of the needs and potential contributions of the
others.
From the papers prepared by the specialist authors, the Team Leader
and Editor assembled the guidelines to suit the anticipated readership
and to promote cross-fertilization of knowledge and expertise during
the progress of a WS&S programme.
Chapter 1 sets the scene. It explains the philosophy behind DFIDs
focus on WS&S services for the poor, provides working definitions of
the terms water supply and sanitation, describes the historical
development of the sector and the co-operative process that has
developed within it, and introduces the programme and project
process within DFID that forms the background for the guidance.
Chapter 2 expands on the nine key themes. It describes the principles
and practices that have evolved during the last 20 years, as engineers,
social scientists, economists, and health specialists have shared
experiences and reached consensus on the reasons for past failures
and the recipes for future success. Wherever possible, the authors
have explained the reasoning behind the recommended approaches.
The intention is that professional staff in DFID and its partners will
gain by understanding the background to all of the disciplines, not just
their own speciality.
Chapter 3 is the operational part of the Manual, which it is expected
will be used by DFID staff involved with different stages of the
project cycle. It is arranged to follow the eight key stages of the
project cycle and to identify the key issues to be taken into account
during each stage. Regular reference back to Chapter 2 enables the
user to find the justification for the advice given in Chapter 3.
Appendices contain examples of the Log Frame analysis which is
used in DFID, specifically related to the WS&S sector.
The lengthy list of references and further reading indicates the broad
basis for the guidance. It should not, however, be taken as an
indication that the guidance is now definitive and unchangeable.
Concepts and approaches to sustainable community WS&S services
vi
are evolving continuously. The participatory approach that is at the

heart of these guidelines means that projects develop in line with the
expressed needs of partner communities. The learning process leads to
greater knowledge and to solutions for previously problematic issues.
DFID intends to take advantage of improving sector practices by
adapting the guidance periodically.
How to use the Guidance Manual
The guidance has been designed to help DFID staff involved in each
stage of the cycle, recognizing that some will be water professionals
whose primary need is to be able to incorporate the cross-disciplinary
issues of social development, health and hygiene promotion, and
economic and financial analysis. Other DFID staff, specializing in
related disciplines, need to understand the key issues of the sector and
how they relate to the project cycle.
The manual is also intended to help DFIDs project partners (national
and local governments, other donors, NGOs, and other external
support agencies) who need to understand DFIDs concerns, policies,
and procedures. Similarly, DFID contractors and consultants need to
be aware of the rules guiding DFID approaches and to understand the
key objectives of UK international co-operation.
Because of the need to cater for the different backgrounds of the
intended audience, specialists may find that they can skip sections
which detail their own field of interest for the benefit of others. The
participatory approach to project development does require, however,
that all those involved are aware of the needs of the other disciplines.
Readers are therefore encouraged to familiarize themselves with the
principles and approaches set out in Chapter 2 in respect of each of
the disciplines and the summaries in the left hand margin provide an
overview of each section.
Chapters 1 and 2 of the manual are seen as essential first-time reading
for staff who will be applying the guidelines in any stage of the
project cycle. They also offer a reasonably comprehensive background
to the WS&S sector for other readers. Chapter 2 is an important
reference source for users, as it provides the logic and justification for
the procedures outlined in Chapter 3.
Chapter 3 should be read once by all readers, to gain an understanding
of the interlinkages among different stages of the project cycle.
Different users will then concentrate on the section relating to the
stage of the project cycle which is their particular concern. Because
the guidelines cover a wide range of projects, from small village
latrine programmes to urban water supply and sanitation schemes
involving multiple partners from the private sector, NGOs, and local
government agencies, the guidance has to be equally wide-ranging.
After readers have an overall appreciation of the Guidance Manual,
they can read specific sections for guidance on the particular issues
they face. For example, if one is considering how to integrate hygiene
vii
promotion with technology at the project identification stage, the

sections to read would be:
Chapter 1 and Section 2.1 for the key overall issues
Sections 2.7 and 2.8 for specific approaches to technology and
hygiene promotion
Section 2.9 for guidance on maximizing benefits
Section 3.2 on specific issues to be considered at the project
identification stage
The Appendices for examples of logical frameworks for different
types of project.
To avoid repetition, Chapter 3 refers back regularly to Chapter 2. The
reader may also use the Index to look up particular topics and may
want to refer to the list of Acronyms and list of References in the
Appendices. The chapters are colour coded and the edges of pages are
flashed for easy reference.
The Guidance Manual details many factors which are important for
the success of WS&S programmes. In many circumstances, however,
it will not be possible, or perhaps appropriate, to follow all of these.
Compromises will have to be made, taking account of the partnership
approach and the priority of ensuring sustainable provision of basic
WS&S services to those in need.
viii
Contents
Foreword from the Secretary of State for International Development ........................................... iii
Preface ........................................................................................................................................... iv
About this manual ............................................................................................................................ v
List of tables .................................................................................................................................xvi
List of figures .............................................................................................................................. xvii
Introduction to water supply and sanitation projects
1.1
Definitions and scope of the Guidance Manual ..................................................................3
1.2
Why WS&S matters ............................................................................................................. 5

1.2.1
Impacts on the poor and powerless ......................................................................... 6
1.3
Historical development of the WS&S sector ..................................................................... 8

1.3.1
Ambitious targets for the 1980s ............................................................................... 8
1.3.2
Consensus on the way forward ................................................................................ 8
1.3.3
The sanitation challenge ......................................................................................... 9
1.3.4
Improvements have to be maintained ...................................................................... 9
1.3.5
Signs of hope ........................................................................................................... 9
1.4
Evolution of Guiding Principles........................................................................................ 10

1.4.1
The Dublin Principles ........................................................................................... 10
1.4.2
Global co-operation .............................................................................................. 12
1.5
Organization of the WS&S sector .................................................................................... 13

1.5.1
The nature of urban WS&S .................................................................................... 16
1.5.2
The nature of rural WS&S ..................................................................................... 17
1.5.3
Priority issues ........................................................................................................ 18
1.6
The programme and project process ................................................................................ 19

1.6.1
Building partnerships ............................................................................................ 19
1.6.2
Poverty eradication ............................................................................................... 21
1.6.3
Types of DFID assistance ...................................................................................... 22
1.6.4
The process approach ............................................................................................ 24
1.6.5
Developing the WS&S programme ........................................................................ 24
1.6.6
Managing the project cycle ................................................................................... 25
1.6.7
The project framework and the project cycle ........................................................ 26
ix
Principles and practices ..........................................................
2.1
Key issues and interlinkages ............................................................................................. 29

2.1.1
2.1.2
2.1.3
2.1.4
2.1.5
2.1.6
2.1.7
2.1.8
2.1.9
2.1.10
2.1.11
2.2
Water supply, sanitation, and hygiene promotion as a coherent sector ................. 29

Integrated water resource management ................................................................ 30
Sustainability, effectiveness, equity, efficiency, and replicability ......................... 31
Levels of service .................................................................................................... 34
Affordability, tariffs, cost recovery ........................................................................ 36
Stakeholder participation ...................................................................................... 36
Operation and maintenance, and community management .................................. 37
Technology choice ................................................................................................. 37
Demand assessment ............................................................................................... 37
Demand creation ................................................................................................... 38
Capacity building .................................................................................................. 40
Social development perspectives ....................................................................................... 41

Principles ............................................................................................................................. 41
2.2.1
Understanding the context .................................................................................... 41
2.2.2
Custom and culture ............................................................................................... 42
2.2.3
Local-level informal institutions ........................................................................... 42
2.2.4
Recognizing gender issues in water and sanitation .............................................. 45
2.2.5
Livelihoods, vulnerability, and the environment ................................................... 46
2.2.6
Achieving cost recovery and advancing equity ..................................................... 47
2.2.7
From participation to partnership ......................................................................... 49
Practice................................................................................................................................. 52
2.2.8
Conducting social impact analysis ........................................................................ 53
2.2.9
Methods ................................................................................................................. 55
2.2.10 Developing participatory practice ........................................................................ 58
Further reading ..................................................................................................................... 62
2.3
Health aspects ..................................................................................................................... 63

Principles ............................................................................................................................. 63
2.3.1
How water affects health ....................................................................................... 63
2.3.2
How sanitation affects health ................................................................................ 68
2.3.3
How hygiene affects health ................................................................................... 70
2.3.4
Epidemiological summary of WS&S interventions ................................................ 70
2.3.5
Health aspects of other components of environmental sanitation ......................... 71
Practice................................................................................................................................. 73
2.3.6
Think about health from the start .......................................................................... 73
2.3.7
Focus on quantity as well as quality of water supply ............................................ 74
2.3.8
Focus on changes at the household level .............................................................. 75
2.3.9
Seek improved health indicators, rather than improved health statistics .............. 76
Further reading ..................................................................................................................... 77
2.4
Environmental sustainability ............................................................................................ 78

Principles ............................................................................................................................. 79
2.4.1
Water quantity and resource management ............................................................ 79
2.4.2
Water quality and pollution ................................................................................... 83
2.4.3
Environmental impact ........................................................................................... 90
Practice................................................................................................................................. 91
2.4.4
Implementing integrated river basin management ................................................ 91
2.4.5
Pollution and water quality ................................................................................... 94
2.4.6
A Sustainable Rural Livelihoods Approach for arid and semi-arid areas ............ 97
Further reading ..................................................................................................................... 99
2.5
Economic and financial perspectives .............................................................................. 101

Introduction ........................................................................................................................ 101
Principles ........................................................................................................................... 101
2.5.1
The water sector .................................................................................................. 101
2.5.2
Demand for improved water and sanitation services .......................................... 102
2.5.3
Role of demand assessment ................................................................................. 104
2.5.4
Demand assessment and poverty ......................................................................... 104
2.5.5
Household benefits from water and sanitation .................................................... 105
2.5.6
Economic appraisal of water and sanitation projects ......................................... 106
2.5.7
Water pricing for economic efficiency ................................................................. 107
2.5.8
Use of public subsidies ........................................................................................ 108
Practice............................................................................................................................... 109
2.5.9
Demand assessment ............................................................................................. 109
2.5.10 Demand assessment: Water ................................................................................. 111
2.5.11 Demand assessment: Sanitation .......................................................................... 112
2.5.12 Subsidy analysis .................................................................................................. 112
2.5.13 Water: Cost recovery, tariff reform, and use of subsidy ...................................... 112
2.5.14 Meeting poverty objectives while restructuring utility cost recovery policy ....... 113
2.5.15 Sanitation: Cost recovery and use of subsidy ...................................................... 114
Further reading ................................................................................................................... 115
2.6
Institutional perspectives ................................................................................................. 118

Introduction ........................................................................................................................ 118
2.6.1
Why support institutional development in the WS&S sector? ............................. 118
2.6.2
Institutional options for rural WS&S .................................................................. 118
2.6.3
Institutional options for urban WS&S ................................................................. 120
Principles ........................................................................................................................... 123
2.6.4
Constraints to effective service provision ............................................................ 123
2.6.5
Key institutional issues ........................................................................................ 124
2.6.6
Opportunities and strategies ............................................................................... 125
2.6.7
Partnership approach: Sharing responsibilities .................................................. 130
xi
Practices ............................................................................................................................. 131

2.6.8
Scoping proposed sector and institutional appraisals ......................................... 131
2.6.9
Tools for appraisal .............................................................................................. 134
2.6.10 Assessment of critical success factors in water institution performance ............ 135
2.6.11 Institutional development .................................................................................... 139
2.6.12 Key elements of institutional development .......................................................... 140
2.6.13 Sector policy development and regulation .......................................................... 141
2.6.14 Structural and organizational development ........................................................ 143
2.6.15 Human resources development ............................................................................ 144
2.6.16 Management development ................................................................................... 145
2.6.17 Systems and procedures development ................................................................. 145
2.6.18 Physical and financial resources ......................................................................... 146
2.6.19 Translating institutional appraisal into project plans ........................................ 147
2.6.20 Institutional development approaches ................................................................. 147
2.6.21 Private sector participation (PSP) ...................................................................... 148
2.6.22 The implications of PSP on poor communities.................................................... 150
Further reading ................................................................................................................... 152
Key institutional terms ....................................................................................................... 154
2.7
Technical aspects .............................................................................................................. 157

General principles .............................................................................................................. 157
2.7.1
Water, sanitation, and hygiene promotion ........................................................... 157
2.7.2
Sustainable technology choices ........................................................................... 158
2.7.3
Design for operation and maintenance ............................................................... 159
2.7.4
Standardization ................................................................................................... 160
2.7.5
Replicability ........................................................................................................ 162
2.7.6
An incremental approach .................................................................................... 163
2.7.7
Least-cost solutions ............................................................................................. 164
2.7.8
Convenience ........................................................................................................ 167
2.7.9
Gender in technology .......................................................................................... 167
2.7.10 Construction ........................................................................................................ 168
Sanitation principles .......................................................................................................... 170
2.7.11 Reducing the cost of sewerage ............................................................................ 170
2.7.12 Sewage treatment ................................................................................................ 173
Water supply principles ...................................................................................................... 175
2.7.13 Quantity and quality ............................................................................................ 175
2.7.14 Levels of service .................................................................................................. 176
2.7.15 Metering policy ................................................................................................... 178
2.7.16 Demand management .......................................................................................... 179
2.7.17 Leakage control ................................................................................................... 180
2.7.18 Source selection and treatment ............................................................................ 181
2.7.19 Wastewater drainage ........................................................................................... 181
Practice............................................................................................................................... 182
xii
Sanitation practice.............................................................................................................. 182

2.7.20 On-site sanitation ................................................................................................ 182
2.7.21 Sewerage options................................................................................................. 185
2.7.22 Sewage treatment ................................................................................................ 187
Water supply practice ......................................................................................................... 192
2.7.23 Source selection ................................................................................................... 192
2.7.24 Choice of treatment ............................................................................................. 194
2.7.25 Water transmission and distribution systems ...................................................... 195
2.7.26 Defining and costing different levels of service .................................................. 198
Further reading ................................................................................................................... 199
2.8
A social marketing approach to hygiene promotion and sanitation promotion ......... 201
Principles ........................................................................................................................... 201
2.8.1
Definitions ........................................................................................................... 202
2.8.2
Why hygiene and sanitation promotion programmes need a social
marketing approach............................................................................................. 203
2.8.3
What happens in social marketing? .................................................................... 204
2.8.4
Targeting .............................................................................................................. 206
2.8.5
Political will ........................................................................................................ 207
2.8.6
Programme communication ................................................................................ 207
2.8.7
Hygiene promotion .............................................................................................. 209
2.8.8
Hygiene promotion in practice ............................................................................ 212
2.8.9
Sanitation programmes and the social marketing approach ............................... 214
Further reading ................................................................................................................... 218
2.9
Maximizing benefits of interventions ............................................................................. 220

2.9.1
2.9.2
2.9.3
Meeting needs and responding to demand .......................................................... 220

People, participation, and process ...................................................................... 222
Institutional linkages and partnership ................................................................ 222
Water supply and sanitation in the DFID programme

and project cycle
3.1
Stage 1: Policy development, sector planning, and programme formulation ............. 227
3.1.1
3.1.2
3.1.3
3.1.4
General considerations ....................................................................................... 230

Social development perspectives ......................................................................... 230
Water, sanitation, and health ............................................................................... 232
Environmental sustainability ............................................................................... 233
xiii
3.1.5
3.1.6
3.1.7
3.1.8
3.2
Stage 2: Programme and project identification ............................................................. 240

3.2.1
3.2.2
3.2.3
3.2.4
3.2.5
3.2.6
3.2.7
3.2.8
3.3
Economic perspectives ........................................................................................ 235

Institutional perspectives..................................................................................... 238
Technical aspects ................................................................................................. 238
Hygiene promotion and sanitation promotion ..................................................... 239
General ................................................................................................................ 241

Social perspectives .............................................................................................. 243
Environmental perspectives................................................................................. 249
Stage 3: Programme and project preparation ............................................................... 257

3.3.1
3.3.2
3.3.3
3.3.4
3.3.5
3.3.6
3.3.7
3.3.8
General ................................................................................................................ 258

3.4
Stage 4: Project appraisal and approval ........................................................................ 274
3.5
Stage 5: Programme and project implementation and monitoring ............................. 276

3.5.1
3.5.2
3.5.3
3.5.4
3.5.5
3.5.6
3.5.7
3.5.8
3.6
Stage 6: Programme and project operation and monitoring........................................ 285

3.6.1
3.6.2
3.6.3
3.6.4
3.6.5
3.6.6
3.6.7
3.6.8
xiv
General ................................................................................................................ 276

Hygiene and sanitation promotion ...................................................................... 284
General ................................................................................................................ 285

3.7
Stage 7: Programme and project extensions or next phase programme

and project identification ................................................................................. 292
3.7.1
3.7.2
3.7.3
3.7.4
3.7.5
3.7.6
3.7.7
3.7.8
3.8
General ................................................................................................................ 292

Environmental issues ........................................................................................... 294
Stage 8: Evaluation .......................................................................................................... 296

3.8.1
3.8.2
3.8.3
3.8.4
3.8.5
3.8.6
3.8.7
3.8.8
General ................................................................................................................ 296

Appendices
Sample Logical Frameworks .................................................................................................... 303
1.
2.
3.
Urban water, sanitation, and hygiene promotion project .................................... 304

Rural water, sanitation, and hygiene promotion project ..................................... 309
Institutional capacity building for developing participatory approaches
in the water and sanitation sector ....................................................................... 314
References ................................................................................................................................... 319

List of acronyms ......................................................................................................................... 330
Index ........................................................................................................................................... 333
xv
List of tables
Table 2.1.1
Table 2.1.2
Table 2.3.1
Table 2.3.2
Table 2.3.3
Table 2.3.4
Table 2.3.5
Table 2.3.6
Table 2.4.1
Table 2.6.1
Table 2.6.2
Table 2.6.3
Table 2.6.4
Table 2.7.1
Table 2.7.2
Table 2.7.3
Table 2.7.4
Table 2.7.5
Table 2.7.6
Table 2.7.7
Table 2.7.8
Table 2.7.9
Table 2.7.10
Table 2.7.11
Table 2.8.1
Table 2.8.2
Table 2.8.3
Table 2.8.4
Table 3.2.1
Table 3.2.2
Table 3.5.1
Table 3.6.1
Typical levels of service providing access to safe water supply and

sanitation in rural and urban areas
Demand assessment techniques: Water supply and sanitation
Summary of Feachem-Bradley Classification of Water-Related Disease
Inorganic drinking water contaminants of public health significance
Some orders of magnitude of the world-wide extent of
water-related disease
Sanitation-related disease, and the likely effects of interventions
Diarrhoeal morbidity reduction from WS&S
Effects of improved water supplies on non-faecal-oral disease
Common types of pollution
Indicative activity/responsibility matrix for the South African rural
water sector
Six basic management models of urban water supply organizations
Focus areas for institutional and sector appraisal
Performance indicators for typical urban water supply institutions
Comparison of construction and supervision costs of collector sewers in
Orangi, Pakistan
Example of average water supply consumption figures
Example of levels of service versus household incomes from
Jinja, Uganda
Options for excreta disposal
Options for secondary sewage treatment
Source selection for water supply
Water treatment processes for potable water
Options for rural water supply
Options for wastewater drainage from waterpoints and
domestic premises
Selection of pipe material
Cost data from the Policies and Guidelines of Ugandas Water
Development Department for Rural Towns and Sanitation Program
Examples of mobilization
Key steps in a hygiene promotion programme
Components of a communication plan
A social marketing plan for sanitation
Stakeholders in a water supply project with a participatory
approach and cost recovery dimension
A summary participation matrix for a water supply project
with participatory approach and cost recovery dimensions
DFID management and monitoring activities at the implementation stage
Indicators of progress in water and sanitation programmes
35
39
66
66
67
69
71
71
85
121
122
133
136
168
177
177
186
190
191
195
196
196
197
198
209
213
214
215
246
247
277
291
Sample Logical Frameworks

1.
2.
3.
xvi
Urban water, sanitation, and hygiene promotion project

Rural water, sanitation, and hygiene promotion project
Institutional capacity building for developing participatory approaches
in the water and sanitation sector
304
309
314
List of figures
Figure 1.6.1
Figure 2.3.1
Figure 2.3.2
Figure 2.3.3
Figure 2.3.4
Figure 2.6.1
Figure 2.6.2
Figure 2.7.1
Figure 2.7.2
Figure 2.7.3
Figure 2.7.4
Figure 2.7.5
Figure 2.7.6
Figure 2.7.7
Figure 2.7.8
Figure 2.8.1
Figure 3.1.1
Figure 3.2.1
Figure 3.3.1
Figure 3.3.2
The project framework in the project cycle

Transmission of disease from faeces
Water consumption vs travel time
Environmental priorities of city-dwellers
Environmental priorities of engineers and planners
Rural operation and maintenance models and tiers of responsibility
Organizational learning process cycle
Incremental improvements to sanitation facilities
A simple pit latrine
A domed slab
A VIP latrine
Pour-flush latrines
A schematic cut-away view of a sewered interceptor system
Condominial sewer layout in Petrolina, Brazil
Hand-auger drilling
The process of promotion
Sector strategy development an iterative approach
The project identification process
Project preparation outline process for WS&S technical option selection
Case study to illustrate technical aspects in the project cycle
26
64
74
75
76
119
140
165
171
171
172
172
188
188
194
214
229
242
259
271
xvii
xviii
DFID Guidance Manual on

Water Supply and Sanitation Programmes
he White Paper on International Development sets out

the Governments policy to seek to strengthen the
international commitment to meet the international
poverty elimination targets. Improved access to safe and
affordable water supply and sanitation is an essential
component of the strategy.
The Department for International Development
commissioned this Guidance Manual to assist staff and
partners to develop effective and sustainable water supply
and sanitation programmes. It represents collaboration
across a range of professions within my Department and
from key UK professionals in the sector. It details interdisciplinary approaches to planning and implementation
of partnership-based programmes.
Annual deaths per 1,000 people due to diarrhoea
12
Priority issues
integration
partnership
sanitation
the urban poor
Clare Short
Secretary of State for International Development
10
The Manual comprises three chapters and appendices.

These take the reader from an overview of the sector,
through specific development perspectives, to detailed
recommendations for each stage of the project cycle.
Chapter 1
Introduction to water supply and
sanitation projects
0
Under 5-14
4s
15-59 Over
60s
Asia and the Pacific

Middle East and North Africa
Africa
Latin America and the Caribbean
Bern et al, 1992
Child deaths due to

inadequate water and
sanitation is a particular
problem in Africa.
The first chapter sets the scene. It describes the WS&S

sector with particular focus on the development of services
for the poor in both urban and rural areas. Emphasis is
placed on the importance of co-operation and partnership
and the chapter also introduces the DFID programme and
project process.
The guidelines are

concerned with
household WS&S
with the emphasis on
meeting the
basic needs of
the poor in rural
and peri-urban areas,
inner city informal
settlements and
slums, and small
towns.
Chapter 2
Principles and practice
In order to achieve coherence within the WS&S sector,
strong interlinkages between different disciplines are vital.
Chapter 2 starts with an inter-disciplinary analysis of key
issues and then sets out recommended approaches under
seven perspectives:
One of the principal

features of the
Manual is the
integration of a
broad range of
perspectives
I recently received a copy of

your excellent guidance
manual on water supply and
sanitation programmes.
I have found the manual
comprehensive, thorough
and very well presented.
I work for a Peruvian NGO
which implements drinking
water and sanitation projects
in rural communities
Robin Papafio, CEDEPAS
Social development
Health
Economic and financial perspectives
Institutional perspectives
Technical aspects
Hygiene promotion and sanitation promotion
These are explored in some detail so that professional staff

in DFID and its partners will gain a better understanding
of all the aspects and not just their own speciality.
Chapter 3
Water supply and sanitation in the
DFID programme and project cycle
This is the How to part of the manual which
brings together the disciplinary perspectives at
each stage of the project cycle. The key issues to
be taken into account are set out in a helpful
question and recommendation format.
8
EVAL
Appendices
These include examples of logical
frameworks for water supply and
sanitation projects.
The 350 page Manual is attractively

presented in a colour format, including
many photographs, graphics, boxes
and summaries and a comprehensive
index. The thorough presentation of
recommended approaches will be
useful for DFID project partners in
national and local governments and
non-governmental organizations
(NGOs), and also for DFID contractors
and consultants working on
programmes supported by DFID. It will
also be of interest to other external
support agencies.
1
POL
7
NEXT
ID
PREP
APP
IMP
OP
NEXT
EVAL
2
ID
3
PREP
6
OP
POL
The Project Cycle
5
IMP
4
APP
Policy development, sector planning,

and programme formulation
Programme and project identification
Programme and project preparation
Programme and project appraisal and
approval
Implementation and monitoring
Operation and monitoring
Extensions or Next phase programme and
project identification
Evaluation
Chapter 1
Introduction to water supply

and sanitation projects
WaterAid/Jim Holmes
Every year, millions of the worlds poorest people die from

preventable diseases caused by inadequate water supply and sanitation
(WS&S) services. Hundreds of millions more suffer from regular
bouts of diarrhoea or parasitic worm infections that ruin their lives.
Women and children are the main victims. Burdened by the need to
carry water containers long distances every day, they must also endure
the indignity, shame, and sickness that result from a lack of hygienic
sanitation.
Impact on the poor
Over this decade the

proportion of people in
developing countries with
access to safe water has
improved.
Access to sanitation
services has not.
SAFE WATER
Billions of people
5
4
3
2
1
0
1990 1994 2000

Access
No access
SANITATION SERVICES
Billions of people
5
4
3
2
1
0
1990 1994 2000
The impact of deficient water and sanitation services falls primarily on

the poor. Unreached by public services, people in rural and peri-urban
areas of developing countries make their own inadequate
arrangements or pay excessively high prices to water vendors for
meagre water supplies. Their poverty is aggravated and their
productivity impaired, while their sickness puts severe strains on
health services and hospitals.
Apart from the overwhelming social arguments, there are also
powerful economic and environmental reasons for improving WS&S
services for the poor. Human waste is a major polluter of rivers and
groundwater resources. As water demand rises inexorably with social
and economic progress, scarcity of water becomes a major
consideration in development planning. Industrialization and food
security may both be threatened, unless water resources are protected
and conserved.
For all these reasons, improved WS&S services have been seen as a
high priority need by the development community for more than 20
years. So why is the suffering and the squalor virtually unabated in so
many countries? There are many reasons, and the problem is a
complex one because solutions depend on a mix of political, social,
technical, and institutional approaches, most of them involving
changing established practices. An indication of the type of
considerations that need to be taken into account can be gained from
WELLs own Guiding Principles, set out in the box on the next page.
There is no standard blueprint for a sustainable and effective WS&S
project. Each situation needs a co-ordinated approach by all of the
stakeholders to ensure that the installation reflects the true demands of
all sections of society. Discovering these demands can involve a lot of
preparatory time and effort, which has not always been provided in
the past.
Many committed professionals have been sharing experiences and

developing common concepts and principles which can be used to guide
the process of planning, implementing, and maintaining WS&S
improvements. That collective expertise provides a basis for optimism
that concerted efforts in the early years of the new millennium can make
a major impact on the current depressing situation in so many countries.
The WELL Guiding Principles
WaterAid/Jim Holmes
People matter more than science. Failures in environmental health in

developing countries are usually human problems of conflicting interests,
inadequate human resource development, or an inaccurate interpretation of the
needs and priorities of various stakeholders. Whether or not technology and
hygiene are promoted effectively has far more to do with specific institutional
players and interest groups and their interaction than with medical or technical
understanding. Despite lip service to gender awareness, all too often the
perspectives and roles of women are ignored or undervalued. We need to
understand demand for services from women, men, and children across all
social groups before selecting suitable approaches and technologies.
Child deaths due to

inadequate water and
sanitation is a particular
problem in Africa.
Annual deaths per 1,000 people due to diarrhoea
12
10
Under 5-14
4s
15-59 Over
60s
Asia and the Pacific

Middle East and North Africa
Africa
Latin America and the Caribbean
Bern et al., 1992
Software and hardware must go hand in hand. Many public health

engineering projects fail because the hardware has been provided but the
means to sustain the intervention beyond construction have not been
developed. An integrated approach is required to develop suitable
infrastructure by integrating the social, health, technical, economic, financial,
institutional, and environmental aspects and planning for sustainable
management, operation, and maintenance. The many demands on the time of
both female and male residents severely constrain what is sometimes naively
viewed as the limitless potential of community management. We also know that
efforts to improve hygiene are futile where the basic requirements of water,
sanitation, or drainage cannot be met.
Both public and private aspects of environmental health count.
Environmental health services often require both centralized resources (e.g.
water treatment works, trunk sewers, landfills) and distributed resources (e.g.
local public taps, house drains and street sewers, pit latrines, and street-level
solid waste collection). In addition, both public and private environments play
distinct roles in disease transmission. In times of structural adjustment, public
authorities have learned that they cannot manage both central and distributed
resources, and that there are benefits in devolving responsibility for the
distributed resources to local communities. Such an approach can improve
cost recovery and accountability to local residents, while reducing total cost.
Environmental infrastructure is about more than health. While improved
health may be a project goal for infrastructural or environmental projects, it is
not often a useful or complete indicator of success. On scores of occasions,
water and sanitation projects have commissioned epidemiological or
demographic evaluations of health benefits. Experience shows that, while
fascinating for academic researchers, such studies are time-consuming,
expensive, fraught with methodological defects, and frequently produce
misleading or ambiguous results. Moreover, they do not help to diagnose the
weaknesses of a project, or suggest ways in which its impact may be
strengthened. Operational evaluations of facility functioning and consumer use,
combined with studies of hygiene behaviour, are far more useful. Such studies
can also illustrate other benefits of water and sanitation that are valued highly
by the users, such as saved time, convenience, cost, and dignity, which are all
too lightly dismissed in a narrow medical framework.
Community WS&S in practice
A typical community water supply and sanitation project in most developing

countries will have both hardware and software components.
The water supply system may be:
a handpump raising groundwater from a borehole or dug well;
a standpost and tap connected to a pipe system (which may be supplied by
motorized pumping or by gravity, from a borehole, stream, reservoir, or spring
source, with or without any water treatment); systems may consist of only a
few standposts in a village, or may be part of a larger regional or city-wide
system; or
a water butt supplied by rainwater from a roof catchment.
A number of families share each handpump or standpost (water-point), and
family members (usually women and children) both collect water from it and
often wash clothes or dishes there.
Improved levels of service are provided by increasing the number of waterpoints, so reducing the time and distance to collect water. Most convenient is
the yard connection, where each family has a standpost on its own housing
plot, or the house connection, where water is supplied into the house at a
pressure which operates several taps in the bathroom and kitchen.
WaterAid/Jim Holmes
Safe excreta disposal for poor people usually involves the use of a family
latrine, which the family themselves keep clean. The latrine will use one of many
various designs of pit, slab, and superstructure, and may also include a lid,
vent pipe, or water seal to control flies and odour.
The software components will include such things as hygiene promotion and
the training of operatives, water committees, and caretakers.
Household water supply

and sanitation services
1.1 Definitions and scope of the Guidance Manual

The principles and practices set out in this manual apply to DFID
programmes and projects for improving access to household water
supply and sanitation services in developing countries.
Water supplies for agriculture, industry, power generation, ecosystem
protection, navigation, etc., involve different considerations which are
beyond the scope of these guidelines. There are, however, evident and
important links between domestic WS&S and the management of
water resources as a whole. Though water for domestic use accounts
for only about five per cent of water consumption, it is a proportion
that must be safeguarded in both quality and quantity as a basic
human need. At the same time, poor sanitation practices are the major
cause of surface and groundwater pollution.
Integrated water resources

management strategies
It is for these reasons that WS&S programmes need to be part of

integrated water resources management (IWRM) strategies in
developing countries. For the purposes of this manual, the discussion
is limited to the direct links between WS&S and IWRM, such as
water allocation and pricing policies; regulatory and legislative issues
in water conservation and pollution control; and the common
capacity-building needs of local institutions. For the broader IWRM
3
issues such as water resources assessment, river basin management,

and agricultural/industrial water use, readers are referred to other
information sources (e.g. EC, 1998).
These guidelines cover both rural and urban WS&S projects, but with
the emphasis on meeting the basic needs of the unserved or ill-served
poor in rural and peri-urban areas, inner city informal settlements and
slums, and small towns.
Wider issues of basic
infrastructure for poor
people have been reviewed
in an Occasional Paper
(DFID, 1998).
In terms of water supply, those basic needs include access to a safe

supply of water for domestic use, meaning water for drinking, food
preparation, bathing, laundry, dishwashing, and cleaning. In many
cases, domestic water may also be used for watering animals and
vegetable plots or gardens. Definitions of access (distance to the
nearest water-point and per capita availability) and safe (water
quality) may vary from country to country.
WEDC/John Pickford
There are many possible definitions of sanitation. For the purposes of

this manual, the word sanitation alone is taken to mean the safe
management of human excreta. It therefore includes both the
hardware (e.g. latrines and sewers) and the software (regulation,
hygiene promotion) needed to reduce faecal-oral disease transmission.
It encompasses too the re-use and ultimate disposal of human excreta.
The term environmental sanitation is used to cover the wider
concept of controlling all the factors in the physical environment
which may have deleterious impacts on human health and well-being.
In developing countries, it normally includes drainage, solid waste
management, and vector control, in addition to the activities covered
by the definition of sanitation.
The poverty-eradication goal of DFID established the focus of the
Guidance Manual. The target groups for DFID co-operation are rural
communities and poor people living in peri-urban areas, inner-city
slums, and small towns. To support them in their own efforts to
improve WS&S services, the approach has to be participatory and to
be based on partnerships which involve a wide range of stakeholders.
Participation and
partnership
These abbreviations have been

assigned only for the purposes
of this manual, as use of the
marginal icons helps to identify
the relevance of particular
sections later in the manual
The primary stakeholders in WS&S projects are the intended users

of improved facilities the householders in target communities. It is
worth noting right at the start that the partnership approach needs to
involve all sections of the community. Exclusion of groups on the
basis of gender, ethnicity, income level, or for socio-cultural reasons
leads to unsatisfactory projects which will usually prove unsustainable
in the long term.
Secondary stakeholders, in addition to governments and donors, will
typically include local NGOs, private sector entrepreneurs, local
government and water utilities, river management boards, consumer
groups, clergy, and schoolteachers.
The guidance in this manual covers the full programme and project
cycle, which is in eight distinct stages1 :
8
EVAL
1
POL
7
NEXT
6
OP
2
ID
3
PREP
5
IMP
4
APP
POL
Policy development, sector planning,

ID
PREP Programme and project preparation
APP Programme and project appraisal and
approval
IMP Implementation and monitoring
OP
NEXT Extensions or Next phase programme
and project identification
EVAL Evaluation
SCF/Alan Nicol
1.2
Why WS&S matters
Water is a precious resource and vital for life. Without it we would die
within days. Access to a safe and affordable supply of drinking water
is universally recognized as a basic human need for the present
generation and a pre-condition for the development and care of the
next. Water is also a fundamental economic resource on which
peoples livelihoods depend. In addition to domestic water use,
households use water for productive activities such as farming and
livestock rearing in rural areas, or horticulture and home-based microenterprises in urban settlements.
Water shortage, poor quality water, or unreliable supply have
profound effects on peoples well-being. Providing safe water alone is
not enough, however, as water can quickly become unsafe, and the
faecaloral transmission of diseases can occur in other ways. If people
do not have adequate and appropriate sanitation facilities or the
chance to develop good hygiene practices, diseases can be spread
through the contamination of water or through other pathways in the
home environment. At any one time around half of all people in
developing countries are suffering from one or more of the six main
diseases associated with inadequate water supply and sanitation:
diarrhoea, ascaris, dracunculiasis, hookworm, schistosomiasis, and
trachoma.
Assessing health impacts
Improving the health of the poor is a frequently cited goal of water

and sanitation projects. The relationship is difficult to establish in
practice at the project level, but over the longer term it can be
demonstrated that there are significant health-associated benefits from
improvements in water supply and sanitation provision, particularly
when these are associated with changes in hygiene behaviour. The
Water and Sanitation for Health programme (Esrey et al., 1990) found
5
that in the 144 epidemiological studies that it had reviewed, the health
impact of improved water supply and sanitation facilities was high,
measured by significant reductions in morbidity rates (sickness) and
higher child survival rates (see also Section 2.3).
The links between water use (and misuse), health impacts, and
environmental degradation are influenced not only by poverty but also
by affluence. Industrial development, economic growth, and
improvements in living standards lead to greater use, abuse, and
degradation of water quality, while water scarcity does not affect all
groups in society equally.
Water is an economic
and a social good.
The White Paper on International Development treats water as both an

economic and a social good in the context of the goals of sustainable
development. The benefits of safe water supply and sanitation
provision go beyond improvements to health, well-being, and quality
of life. Access to convenient and affordable water can save peoples
time and energy and enhance their livelihood opportunities.
Improvements in sanitation will improve privacy and retain human
dignity significant and legitimate social development concerns.
These less quantifiable benefits are among the advantages of water
supply and sanitation most often reported by people in low-income
communities.
1.2.1
Impacts on the poor and powerless
WaterAid/Jim Holmes
In rural areas poor people have to work hard for their water, often
fetching it from far-off sources and using it carefully and sparsely. The
time spent collecting water is a double burden, as it means less time is
available for the productive activities on which subsistence economies
depend. In cities, the urban poor suffer the indignities of inadequate
sanitation and frequently have to purchase water from private vendors.
Research in slum and squatter settlements in Jakarta showed that less
than a quarter of the citys population have direct connections to a
piped water system and 30 per cent depend solely on purchasing water
from vendors (Jarman, 1997). In Lima, Peru, a poor family paid a
vendor 21 times as much for water as a middle-class family with a
household connection paid for their water (Briscoe, 1986). Poor
households can spend up to 40 per cent of their total income on water
(UNICEF, 1995).
Poor slums and informal settlements are commonly found on lowlying, flood-prone, or low-infiltration-capacity land with a high water
table, leading to poor drainage and sanitation problems. Many poor
people rely for bathing, laundering, and defecation on drainage
channels, canals, and rivers which become clogged by garbage and
flood when solid waste management is inadequate. Research in So
Paulo, Brazil showed that only two per cent of slum dwellers have any
form of sanitation (Hardoy et al., 1990). Improved access to natural
sources of water or a piped water supply, along with appropriate and
affordable sanitation, are essential ingredients in facilitating the social
and economic development of poor rural and urban communities.
6
WaterAid/Caroline Penn
Children are the most

vulnerable.
Although improvements to water supply and sanitation are important

for everybody, children are the most vulnerable to the preventable
diseases which result from lack of water, dirty water, and lack of
sanitation. Over three million children die every year from diarrhoeal
disease and dehydration, and over half experience more than fifteen
attacks of serious diarrhoea before the age of five (Bern et al., 1992).
A lack of water also means that children cannot wash often enough
and so suffer from eye infections and skin diseases such as scabies.
Another extreme example of how a lack of water can affect children
comes from Huzi village in Tanzania. A mother there explained that
in the dry season she shuts her children in the house during the hottest
time of day because if they play outside they sweat too much and she
does not have enough water for them to drink to replace the loss of
body fluid (WaterAid, 1996a).
DFID/Dilshad Sheikh
There is also an important gender dimension. Improved water supply

and sanitation provides particular benefits for women and girls. Not
only do they do the bulk of the carrying of water, but they often suffer
harassment on the way to and from community defecation areas and
water sources. School sanitation facilities have a major effect on the
enrolment and attendance of teenage girls. Also, with their
responsibilities for family health, women are often the strongest
advocates in the community for change and improved facilities.
Improved water supply and sanitation can lead to significant and
tangible improvements in the way of life of many thousands of poor
people, and since the beginning of the International Drinking Water
Supply and Sanitation Decade considerable resources have been
channelled into water supply and, to a lesser degree, sanitation.
Unfortunately, however, not all people have benefited.
Poverty reduction through
improved WS&S
Poverty reduction through improved water supply and sanitation can

be achieved in a number of ways, for example by:
using enabling strategies such as promoting inclusive policy
dialogues and pro-poor policy frameworks;
addressing inequities by using city-wide approaches; and
directing activities at areas where poor people live or are
particularly affected by lack of safe and adequate water supply and
sanitation.
User participation
throughout the project
cycle
Whatever the means, good practice in water supply and sanitation

provision involves the active participation of communities or their
representatives in planning, construction, operation, and maintenance.
Insufficient attention has been paid in the past to providing economic
and other support to users in low-income communities and to their
involvement in activities which will ensure long-term and sustainable
services and supply.
Twenty years of
international efforts to
improve WS&S coverage
1.3
Historical development of the WS&S sector
Water supply and sanitation rose up the development agenda more
than 20 years ago. The 1977 UN Water Conference in Mar del Plata,
Argentina, recommended that the 1980s should be proclaimed the
International Drinking Water Supply and Sanitation Decade
(IDWSSD). In preparation for the launch of the Decade, the World
Bank and the World Health Organization (WHO) carried out rapid
assessments of the WS&S sectors in more than 100 developing
countries. These, together with WHOs five-yearly monitoring of
WS&S coverage, provided the baseline statistics against which
progress in the sector is generally measured.
The picture was a depressing one: 1.2 billion people out of a total
Third World population of 2.2 billion (China was not included in the
statistics at that time) were without access to safe drinking water; 1.7
billion had no proper means of excreta disposal. As a result, an
estimated 10 million people a year were dying from diseases directly
related to poor sanitation and half of the worlds hospital beds were
occupied by patients suffering from water-related illnesses.
1.3.1
Ambitious targets for the 1980s
The IDWSSD (1981-1990) was launched at the UN General

Assembly in November 1980, with all countries adopting the declared
target of achieving 100 per cent coverage in water supply and
sanitation by 1990. To reach the targets would have meant doubling
the rate at which new water supply services were then being provided,
and more than quadrupling the provision of sanitation/sewerage
facilities. Sector investments by governments and donors would have
to rise threefold.
DFID/Howard J Davies
The launch of the Decade gave WS&S a publicity boost and led to
concerted efforts to speed up progress. The economic climate of the
1980s, however, was not conducive to massively increased funding,
and anyway most sector institutions in developing countries did not
have the absorptive capacity to cope with the type of programmes
needed to come close to the 100 per cent coverage goals. Provision of
improved water and sanitation services did speed up in comparison
with previous years, though in the case of sanitation, it still could not
even keep pace with rising population, so the number of people
unserved continued to rise.
1.3.2
Consensus on the way forward
A major gain from the IDWSSD was the spur it gave to global cooperation in the sector. Regular consultations and workshops
encouraged sector professionals to share experiences and knowledge.
This in turn led to a growing consensus on both the causes of past
failures and the concepts and approaches which offered the best
prospects for future success. When the Decade came to an end with a
Global Consultation in New Delhi, India, in September 1990, the 600
WS&S specialists who gathered there were able to agree on guiding
principles for accelerated progress. The New Delhi Statement,
8
captioned Some for all rather than more for some drew together the
experiences of the Decade and updated the Mar del Plata concepts to
take account of the challenges of the 1990s.
1.3.3
2
The most recent figures from

the WHO/UNICEF Joint
Monitoring Programme were
published in 1996 and based on

the situation at the end of 1994.
They showed an estimated 2.9
billion people lacking adequate
sanitation and 1.2 billion without
access to safe water. By the year
2000 the number without
sanitation was predicted to
reach 3,300 million,
approaching 70 per cent of the
population of the
developing world.
The sanitation challenge
The challenges remain huge, and they continue to grow. This is

particularly true in respect of sanitation. WHO now estimates that
more than 3 billion people are without adequate means of excreta
disposal.2 The impact on the health, dignity, and quality of life of the
poor is shaming. Squalid surroundings and continuous health hazards
exacerbate the effects of poverty, particularly in the overcrowded
slums which surround all Third World cities. According to WHO, 3.3
million people die every year from diarrhoeal diseases and at any one
time there are 1.5 million suffering from parasitic worm infections
stemming from human excreta and solid wastes in the environment.
Increasingly it is recognized that neglect of WS&S services for the
poor affects all segments of society. On top of the costs of healthcare
and lost productivity, the contamination of rivers and aquifers by
untreated human waste hinders industrial progress, slows economic
growth, and deters tourism. The 1991 cholera epidemic cost Peru an
estimated one billion dollars in lost tourism and exports. That same
amount would have more than paid for all the water and sanitation
systems Peru needed to prevent such an outbreak from occurring.
1.3.4
Improvements have to be maintained
The dismal situation created by inadequate access to WS&S services

is aggravated still further by large numbers of broken down or
malfunctioning water and sanitation services. The health benefits of
an improved water supply can be destroyed overnight if people are
forced to revert to contaminated sources when the public supply fails.
Capital investment in new services is wasted unless there is adequate
provision for the reliable operation and maintenance of installed
facilities.
WaterAid/Jim Holmes
1.3.5
Signs of hope
The scale of the problems should not be underestimated, but the

picture is not entirely bleak. Developments in the later years of the
1980s and the early 1990s offer hope that damaging trends can be
reversed. During the IDWSSD, the development and demonstration of
low-cost water and sanitation technologies was a key strategy for
matching costs with affordability. The 1980s saw real progress in the
development of technologies and approaches for improving WS&S
services for low-income communities. Technological innovation
continues to be important in facing new challenges in urban
sanitation, waste management, and water conservation, where
conventional technologies are often unaffordable.
The 1980s showed too that properly motivated communities are ready
and able to devote considerable financial, material, and human
resources to water supply improvements which meet their own
9
aspirations and needs. It is also becoming apparent that, under the

right circumstances, the same motivation can be stimulated for
accompanying water improvements with better hygiene behaviour and
the construction of improved sanitation systems.
Rehabilitation can be an
economic way of deferring
investment in new facilities.
The Dublin Principles are

the basis of an international
consensus on development
in the water sector.
The legacy of disused and defective WS&S systems contains

important lessons too. Rehabilitating an old system can be an
economic way of deferring investment in new facilities, but only if it
is accompanied by the correction of previous operation and
maintenance shortcomings. It follows that remedial programmes must
be accompanied by full analysis of the reasons for past failure and by
planning, design, and implementation procedures which take account
of operation and maintenance needs.
1.4
Evolution of guiding principles
1.4.1
The Dublin Principles
As part of the preparations for the 1992 UN Conference on

Environment and Development (The Earth Summit) in Rio de Janeiro,
Brazil, an International Conference on Water and the Environment
was convened in Dublin, Ireland, in January 1992. The resulting
Dublin Statement and its accompanying four Guiding Principles have
remained the common basis for policy dialogues among donors and
partner governments, not just in the WS&S sector but in the wider
field of water resources development, management, and conservation.
The four Dublin Principles are quoted in full in the box on page 11.
The Conference Report (Dublin, 1992) also includes a 40-page Action
Agenda.
In June 1992 in Rio, world leaders endorsed Agenda 21. This
blueprint for sustainable development in the 21st Century contains 42
chapters setting development priorities under different headings.
Chapter 18 of Agenda 21 is entitled Protection of the Quality and
Supply of Freshwater Resources. The Dublin Principles are at the
heart of Chapter 18, and its negotiated text continues to be the basis of
global discussions on progress in all water resources areas.
Since Rio, a series of international meetings (most notably Noordwijk
1994, Harare 1998, and Paris 1998) have assessed the progress of
Agenda 21 and tried to put into operation its recommendations.
The UN mechanism for monitoring the implementation of all aspects
of Agenda 21 is the Commission on Sustainable Development, which
holds annual sessions in New York (CSD1, CSD2, etc., the name
relating to the number of years after Rio). The Noordwijk
recommendations were a basis for discussions on Chapter 18 at
CSD2, and the Harare and Paris meetings fed into CSD6, held in New
York in April 1998.
The CSD6 final text re-emphasizes the need for urgent government
actions to enable the unserved poor to gain access to basic water and
sanitation services. The recommendations reinforce the need for
participatory approaches, gender sensitivity, and the integration of
10
The Dublin Principles
1. Freshwater is a finite and vulnerable resource, essential to sustain

life, development, and the environment
Since water sustains life, effective management of water resources demands a
holistic approach, linking social and economic development with protection of
natural ecosystems. Effective management links land and water uses across
the whole of a catchment area or aquifer.
2. Water development and management should be based on a
participatory approach, involving users, planners, and policymakers at all levels
The participatory approach involves raising awareness of the importance of
water among policy-makers and the general public. It means that decisions are
taken at the lowest appropriate level, with full public consultation and
involvement of the users in the planning and implementation of projects.
3. Women play a central part in the provision, management, and
safeguarding of water
The pivotal role of women as providers and users of water and guardians of the
living environment has seldom been reflected in institutional arrangements for
the development and management of water resources. Acceptance and
implementation of this principle requires positive policies to address womens
specific needs and to equip and empower women to participate at all levels in
water resources programmes, including decision-making and implementation,
in ways defined by them.
4. Water has an economic value in all its competing uses and should
be recognized as an economic good
Within this principle, it is vital to recognize first the basic right of all human
beings to have access to clean water and sanitation at an affordable price. Past
failure to recognize the economic value of water has led to wasteful and
environmentally damaging uses of the resource. Managing water as an
economic good is an important way of achieving efficient and equitable use,
and of encouraging conservation and protection of water resources.
The Dublin Statement, January 1992
water projects into national water strategies. Specific

recommendations from the Harare meeting are quoted in Chapter 2.
WS&S issues are raised
on a wide range of
international platforms.
Other global meetings, while not directly concerned with water, have
had a significant influence on WS&S sector programmes and targets.
They include: the World Summit for Children (UNICEF) which gave
a high priority to achieving universal WS&S coverage as soon as
possible; the 1996 Habitat II Conference in Istanbul, Turkey, where
provision of basic WS&S services for the urban poor was highlighted
as a priority need; the 1995 Beijing Conference on Women, at which
the demand for greater influence of women in decision-making roles
was seen as especially important in the WS&S context; the Global
Conference on the Sustainable Development of Small Island
Developing States in 1994, which highlighted the vulnerability of the
small islands and the need to develop basic WS&S services as part of
an integrated water resources plan; and the World Food Summit in
11
1996, for which the plan of action stresses the role of water in food
security and poverty alleviation. The UK Government subscribes to
each of these Conference recommendations.
1.4.2
Global co-operation
A key development during the 1980s was the fostering of inter-agency

collaboration. One outcome was the formation of the Water Supply
and Sanitation Collaborative Council (WSSCC), which holds global
meetings attended by a wide range of participants, the majority of
whom are from developing countries. Although not a policymaking
body, the Council generates outputs through working groups and
networking and is becoming increasingly involved in global advocacy
for the sector. DFID (then ODA) was a founder member of the
Council and has continued to play an active role in its activities.
The World Water Council (WWC) was constituted in 1996 to cover
policy issues in the broad field of water resources management. Its
subscribing members include public and private sector agencies along
with UN agencies and donors. The WWC is currently spearheading
the preparation of a Vision for Water, Life, and the Environment with
four components, including one on water supply and sanitation.
The Global Water Partnership (GWP) was also formed in 1996 with
the aim of facilitating improved implementation of programmes in the
water resources field. It has been looking at gaps in sector knowledge
and capacity-building needs in the different sectors.
Concerted action on
sanitation by WSSCC and
GWP
Two recent initiatives by the WSSCC and the GWP are of particular
relevance to WS&S sector planning. The WSSCC is co-ordinating a
Global Environmental Sanitation Initiative, aimed at enabling
stakeholders to share information about ongoing sanitation
programmes and to develop common advocacy materials to raise the
profile of sanitation with decision-makers. The GWP is putting
together a programme on Urban Environmental Sanitation to address
technological and capacity-building needs in this critical area.
WaterAid/Jim Holmes
Some multilateral institutions have a primary interest and a strong

mandate in the WS&S sector. The objectives of their WS&S
programmes are as follows (taken from the UN Secretary-Generals
Report to CSD6 see the Appendices for a list of acronyms):
Co-operation and Co-ordination Mechanisms in Water Supply and
Sanitation: Habitat, UNICEF, and UNDP
Many multilateral agencies

are actively involved in
WS&S
Interagency Steering Committee on Water Supply and Sanitation:

DESA, FAO, IAEA, World Bank, INSTRAW, Habitat, UNICEF,
UNDP, ECA, ESCAP, ECE, ECLAC, ESCWA, UNESCO, UNEP,
UNHCR, UNIDO, UNU, WHO, and WMO
Joint Activities towards Universal Access to Water Supply and
Sanitation in Asia and the Pacific: DESA, World Bank, INSTRAW,
UNICEF, UNDP, ESCAP, and WHO
12
Joint Initiative on Participatory Methods for Hygiene Behaviour

Change and Sanitation: World Bank, UNICEF, UNDP, and WHO
Joint Initiative on Prevention and Control of Water-Related

Diseases in Europe: ECE, UNEP, and WHO
Joint Monitoring Programme (JMP), for Water Supply and
Sanitation: UNICEF and WHO
Memorandum of Understanding on Water and Environmental
Sanitation: World Bank and UNICEF
Promotion of Sustainable Water Supply and Sanitation Programme:
World Bank, UNDP, and WHO
Water Supply and Sanitation Programme: World Bank and UNDP
Water Supply and Sanitation Programme in Rural Areas: DESA,
UNDP, and UNCDF (United Nations Capital Development Fund)
Water Working Group of the System-Wide Special Initiative on
Africa: DESA, FAO, IAEA, World Bank, Habitat, UNICEF,
UNDP, ECA, UNESCO, UNEP, UNIDO, WHO, and WMO.
All these major actors and the donor community as a whole have
agreed to operate with a set of common guiding principles which are
the basis of sustainable progress in the delivery of improved WS&S
services to the unserved and under-served poor. The key elements of
those principles are summarized in Section 2.1 of this manual.
It is important to have a
clear understanding of the
institutional arrangements
for sector planning.
1.5
Organization of the WS&S sector
In the development of projects and programmes, it is obviously
important to have a clear understanding of the institutional
arrangements for sector planning. Larger countries, for example India
and Pakistan, may have a state government structure operating below
the federal level. This structure affects both the way in which overall
financial and human resources are allocated to sector programmes,
and also the mechanisms through which programmes and projects are
planned, implemented, and managed.
Matters are frequently made more complex by the large number of
institutions with a stake in different aspects of the WS&S sector in
most countries. This situation arises partly because old institutions are
rarely dispensed with at the same rate that new ones are created.
Historically too, responsibility for rural water and sanitation often
rested with health ministries, while urban WS&S was divided among
city administrations and central water ministries. Other aspects of
water resources management are sometimes the responsibility of
dedicated water ministries, or may come under the ambit of an
agriculture, energy, or industry department. This makes the job of
developing integrated programmes particularly difficult.
13
Increased
commercialization and
private sector participation
It has been fashionable over the last decade or more to create semiautonomous public bodies such as water utilities as a means of
increasing private sector participation. The arguments underlying this
are well known, and relate to effectiveness, efficiency, and distancing
service/infrastructure providers from what has been perceived as
undue political influence or budgetary restraints. While there are clear
benefits to this approach, an important side effect has been the
removal of powers from local government, particularly in the urban
sector. This is not automatically to the general good, as in practice it
distances service providers from direct accountability to both the local
political system and its consumers.
Utilities have paid little

attention to the poor, to
sanitation, and to small
towns and rural areas.
To date, utilities tend to exist only in large urban centres, and focus
primarily on water supply to middle- and high-income consumers,
with relatively little attention to the urban poor, who may as a result
be further marginalized. Also, they are much less successful in dealing
with and applying commercial principles to urban sanitation. In small
urban centres, it is mainly urban local governments which will retain
responsibility, and policy has to be directed at improving performance
within the context of their operational constraints; it is not an ideal world.
Planning ahead for O&M in Cuttack
DFID is funding an urban services improvement programme focused on the
urban poor in the Indian city of Cuttack. This includes improvements to water
supply and sanitation. Project preparation studies and previous experience
from DFID urban projects elsewhere in India indicated that operation and
maintenance of the assets created would be problematic, and that it was
essential to bring O&M to the fore. Common problems include:
Inadequate information and accounting systems make actual performance
assessment difficult.
O&M work programmes are not based on actual needs.
A lack of transparency in the subsidies being directed at the operation of a
small sewerage scheme which benefits the better-off residents; this has a
distorting effect because cost-recovery proposals for the urban poor are very
hard to justify unless these hidden sewerage subsidies for the better off can
be dealt with.
The set levels of cost recovery do not allow for adequate expenditure on
O&M.
The crucial point is that despite these weaknesses, the programme goes
ahead. The ideal policy and institutional environments exist only in theory. The
key issue is to identify the problems during project identification and
preparation and ensure that they are being addressed in the Project
Memorandum and Framework, as is the case in Cuttack.
This is currently being addressed as part of the main programme; a study is
underway to carry out a situation analysis and produce a phased development
plan for improving O&M over the lifetime of the project. Both institutional
performance and community perceptions of O&M are being investigated.
By the end of the project, actions will have been taken in conjunction with the
local project partners both at the city and state levels to improve the
performance of O&M. This will take at least five years to achieve.
14
Nevertheless, such situations offer important opportunities and

challenges for well-focused technical co-operation and investment in
the sector; careful problem analysis is required to ensure that the
project purpose and goal can be met, as the Cuttack experience shows
(see box left).
Other generic problems can arise where WS&S is handled by different
ministries and departments of local government and where rural and
urban responsibilities are different. The institution responsible for post
construction management, operation, and maintenance of the service
is often different from the one that planned and implemented it, and is
relatively poorly resourced. There is therefore a potential problem
with the sustainability of the service, which has to be anticipated and
overcome in the project development phase. In the same way,
communities which have not been involved in design and planning are
likely to have a low level of ownership and therefore they should be
brought in at these earlier stages and not just for O&M.
WEDC/Darren Saywell
The existence of different tiers of planning authority vested in the

federal, state, and local government systems creates difficulties with
regard to norms and standards used in planning. There may also be
various commissions and standing bodies of government who have
developed planning norms relating to matters such as per capita water
supply, public and private connections, sanitary guidelines, etc. This
raises two important issues:
Planning should be
demand responsive, based
on user choice from locally
appropriate levels of
service.
The planning mechanism needs to be demand responsive. This means

locally appropriate levels of service rather than the adoption of
universal norms and standards on an a priori basis. It is not helpful to
apply general classifications such as rural, middle-income, and the
like. Levels of service should not be fixed in this manner, but be
linked to the issues of demand, commonly expressed through user
willingness-to-pay for a particular level of service, rather than just
need (see Section 2.5 on the demand-responsive approach).
There is a strong case for

standardization in relation
to the choice of technology.
Engineering design standards relating to detailed technical design,

use of materials, and construction practice are often based on local
codes of practice, or in some cases national standards, and are used
routinely by local engineers. Some such standards may be
inappropriate, but it can be very difficult in practice to convince
people to go for wholesale change within the context of a
development assistance project. This is more of a problem than levels
of service, where there is usually more scope to move away from the
concept of planning norms. However, there may be scope for
innovation through developing standard details which are appropriate
for the project or programme but which are based on locally agreed
standards. Also, there is a strong case for standardization in relation
to the choice of technology, where this can simplify operation and
maintenance by limiting the range of spare parts and technical
expertise which need to be available. This is discussed in more detail
in Section 2.7.
15
1.5.1
The nature of urban WS&S
Urban water supply, and in some circumstances urban sanitation,

functions through a hierarchy of distribution (or collection) systems
known as primary and secondary networks. These feed the
neighbourhood-level tertiary distribution systems which are the
mechanisms of service delivery. The crucially important implication
of this is that the ability to deliver a particular level of service to the
consumer is dependent upon the capacity of the larger secondary/
primary network. Thus, in order to target improvements to the urban
poor, it may be necessary to augment the city supply system, which will
also benefit those outside the direct target group. Failure to appreciate
and act on this can result in yet more taps with no water coming out
of them. The concept and context of management at the lowest
appropriate level requires careful interpretation; the unbundling of
responsibilities can lead to piecemeal, unco-ordinated approaches.
WEDC/Rod Shaw
A related issue is the extent to which it is either possible or desirable

to decentralize city-wide infrastructure systems on a zonal basis. For
water supply, this is related to the nature of the water resources.
Groundwater in principle can be developed and supplied on a scale
ranging from city-wide down to individual on-plot wells. For
example, one-third of the population of Calcutta is served by street
corner handpumps on tubewells. This has greatly improved access to
water for the citys poorest, many of whom had previously had no
choice but to use cholera-infested canals. If sewerage is the means of
sanitation, it is again possible to envisage local collection and
treatment rather than single, centralized facilities. The guiding factor
is one of institutional capacity and capability to operate and maintain,
rather than one of technical feasibility.
Harnessing community
action
It is ironic that many urban poor people may be located quite close to
existing service lines, but the informal and unplanned nature of the
settlements frequently precludes access to services. Individuals and
community groups develop coping strategies to deal with the lack of
formal service provision; these are not always in a form which is
recognized in the conventional planning sense. The challenge is to
harness these actions through microplanning at the community level
and, most importantly, to look for ways in which these plans can
interact with city-level development plans.
There is a wide range of technical and management options available
for planning and procuring urban infrastructure. In particular, the
development of local solutions including on-site and on-plot
technologies can offer both affordable and sustainable long-term
solutions. For example, on-plot latrines should not necessarily be
regarded as a short-term solution which is conditional on a longer
term plan which includes upgrading to a sewered system.
There is good evidence to support the active role which urban poor
communities can take in infrastructure procurement, for example by
using community contracting. This brings in additional benefits of
income generation and enterprise development.
16
The Strategic Sanitation Approach to affordable

services for the urban poor
Unbundling is a way of
dividing investments and
service provision into more
realistic and manageable
components. These
separate components can
be relatively independent or
linked so that performance
of one is dependent on that
of others.
Horizontal unbundling
refers to the way in which
services in different areas
are provided by different
organizations and/or in
different ways.
Vertical unbundling refers to
the way in which services at
different levels in a
hierarchical system are
provided by different
suppliers, e.g. dividing
water supply into bulk
supply and water
distribution.
Unbundling should be
undertaken with caution
because it generally
requires good capacity and
the overall co-ordination of
the various components.
Rebundling may be
appropriate in some cases.
The UNDP World Bank Water & Sanitation Programme has developed a
theoretical basis for approaching urban sanitation problems, known as the
Strategic Sanitation Approach or SSA. This approach emerged as a response
to the perceived failure of the large, supply-driven investment programmes of
recent decades. In particular, its underlying principles are that sanitation
investments should be demand-based in operational terms, and the institutional
arrangements need to be incentive-driven. The operational implications of SSA
include:
providing technical support at the community level;

widening the technological options;
assessing sanitation demand;
unbundling sanitation investments to permit incremental improvements at
affordable costs; and
financing and cost recovery.
The unbundling of investments can happen in two ways.
Horizontal unbundling, in which services are subdivided geographically. In large
urban areas, this form of decentralization can be based on command areas in
relation to natural drainage patterns. It also provides opportunities for creating
competition in managing the services.
Vertical unbundling, in which programmes are divided according to the scale
and cost of components, for example at the trunk, secondary, and
neighbourhood levels.
Care is needed to avoid unco-ordinated and wasted resource inputs.
Incentives are required to stimulate the required behaviours from key actors.
SSA suggests the development tools which can be used to create the
appropriate enabling institutional environment, which must have:
rules governing interactions within and between enterprises;
referees who monitor and enforce compliance; and
rewards and sanctions in relation to compliance.
The crucial component in putting these concepts into operation is that there
needs to be clearly defined responsibility and capacity for overall planning at
the town or city level.
At the time of writing, DFID Engineering Divisions research programme is
currently funding work in conjunction with the UNDP/World Bank W&S
Programme in South Asia. The output from this work will be operational
guidelines for SSA, available in 1999.
A.M. Wright, Towards a Strategic Sanitation Approach, UNDP/World Bank
Water & Sanitation Programme 1997, the World Bank, Washington DC
1.5.2
The nature of rural WS&S
In rural areas the outreach of central government agencies is often

very limited, and based at best on rural district centres which may be
physically remote from communities in need. The situation is
aggravated by differing institutional responsibilities, for example for
water, sanitation, and health. Mobilizing programme support can be
17
problematic in terms of local institutional commitment, and staff are

frequently reluctant to spend time at remote locations and work under
very difficult conditions. The whole issue of managerial and logistical
support in the field requires close attention during project
identification and preparation.
WaterAid/Jim Holmes
In contrast to many urban situations, there is an obvious lack of

physical infrastructure. There is naturally a strong reliance on local
initiatives, and programmes need to build on what is already
happening. People themselves are at the centre of any actions, far
more obviously than in the urban sector. A key aim of local
government is therefore to support the existing village level
institutions, as these are likely to offer the most effective means of
sustaining any new facilities.
Where effective and accountable village institutions do not exist, the
task of creating and nurturing them is essential for sustainable
community infrastructure, and should not be underestimated.
The VLOM Approach

reflects the importance of
maintenance for
sustainable rural WS&S.
Operation and maintenance considerations predominate in the

planning and implementation of rural water and sanitation
programmes. The more traditional system of centralized maintenance,
using teams of trained technicians who travel out from a depot in
order to inspect and repair facilities, has been largely ineffective.
From the start of the water and sanitation Decade, attention has been
devoted to Village Level Operation and Maintenance Management
known as VLOM. Routine inspections and minor repairs are
carried out by trained people from the community, and the concept of
community management is virtually interchangeable with VLOM in
rural areas. There still needs to be an additional mechanism for
reporting and repairing major faults. Most rural programmes now
focus on VLOM, implying:
WEDC/Darren Saywell
the use of local resources;

solutions based on local capacity and technical capability; and
solutions which are sustainable through local human and financial
resources.
1.5.3
Priority issues
The list of common principles gets longer every year, and it forms the
basis for Chapter 2. It is worthwhile, though, to consider some generic
themes which should guide the approach to any future WS&S project
analysis.
The challenge is to make
the components work
together coherently.
18
Integration is one such theme. The challenge is not just to set up

multi-component programmes, but to make the components work
together coherently, so that the whole is greater than the sum of the
parts. It is a particular challenge when combined with decentralization
and management at the lowest appropriate level (two of the common
principles). On the other hand, the integrated approach is an intuitive
one for communities, who live on a daily basis with the links which
are at the heart of it.
Partnerships are the driving

force of sustainability.
Partnership is the next theme. Embracing the political,

governmental, and civil groups in society in relationships which are
inclusive and dynamic is the driving force for developing sustainable
programmes. There is a wide range of stakeholders who can
contribute to WS&S programme development. Some may need to be
motivated and equipped through capacity-building programmes if they
are to contribute their full potential. (For example, training and credit
facilities for private low-cost drilling contractors can speed up
implementation and reduce the costs of community borehole
programmes).
In addition to these themes, the evidence has been accumulating for
many years now that there are two important focus areas which need
priority attention.
Sanitation is the first

priority.
Sanitation is the first. National governments and the international

community have continued to ignore the clamour from sector
professionals for increased attention to sanitation for far too long. The
situation has been described as shameful and correcting it is now a
global imperative (Richard Jolly, Chairman of the WSSCC at its
conference in Manila in 1997). Change will require political
commitment and diversion of resources and it will take time to
achieve demonstrable results, but the longer it is delayed the worse
the crisis will become and the harder it will be for the poor to escape
the squalor and indignity they now endure.
Complexity is not an
excuse for inaction to
improve services to the
urban poor.
The urban poor make up the next focus area. The sheer complexity
of the urban and peri-urban scene can be an excuse for not getting
involved. It must not be so. Investments in improved basic WS&S
services can have a major impact on health and quality of life in the
squatter settlements. They can also be the trigger for income
generation and hence poverty alleviation. Failure to invest would
mean further degradation of soil and water resources and the living
environment, and a continuing brake on social and economic
development.
1.6
The programme and project process
The White Paper on International Development emphasizes the
partnership approach as the basis of UK co-operation in all
development sectors. The other key element is the focus on poverty
eradication. The identification and development of WS&S projects
and programmes will emerge from the partnership approach and that
approach will continue throughout the project cycle.
1.6.1
Building partnerships
In implementing UK Government policy on international

development, DFID will work closely with other donors and
development agencies to build partnerships with developing
countries. In establishing these partnerships, the aim will be to
strengthen the commitment to eliminate poverty and to mobilize the
political will to achieve international development targets.
19
Long-term partnerships, negotiation, and compromise

UNICEF WS&S programmes in India
UNICEF has been working continuously in WS&S in India since 1966. It has
established long-term partnerships with both central and state governments,
with much greater influence than its share of expenditure in the sector. An
evaluation found that it had made a major contribution in policy, design, and
standards at the national level, by supporting innovative elements and
pioneering approaches in both national and state programmes. UNICEF have
supported, for example, a range of options for hygienic latrines, and promotion
of sanitation through shops and demonstration sites; new hardware (for
example India Mark II and Mark III handpumps); work on information,
education, and communication; the involvement of NGOs; and the integration
of hygiene, sanitation, and water supply.
UNICEF also provided long-term partial funding with cash or material supplies
for established government programmes, and the evaluation found that these
gave legitimacy to UNICEF and its efforts to get innovative ideas incorporated
into government programmes. Without this financial commitment, UNICEF
might not have had any influence in the on-going programmes. Inconsistencies
were identified, however, between policies UNICEF was promoting centrally (for
example elimination of subsidies for household latrines) and programmes it
was supporting at state level (which still included latrine subsidies for the poor).
This is understandable in the context of a long-term relationship, which
provides support to partners while also advocating a change of policy, and
government representatives compared this approach to partnership favourably
with that of other donors. Weaknesses were also identified in the standard of
delivery of the programmes at village level by the state government partner,
which reduced the effectiveness and impact of the programmes.
Overall it is notable that UNICEF had a significant influence on national rural
water supply and sanitation policy, while contributing only 1 per cent of the
investment.
Smout et al., 1997
In pursuing its aim of

eliminating poverty in
poorer countries, DFID will
work in partnership with
developing countries,
multilateral agencies and
the private and voluntary
sectors.
Programmes will be developed to pursue these targets in co-operation

with poorer countries which are committed to achieving them. DFID
also intends to work closely with the UK private and voluntary sectors
and the research community in pursuit of the agreed targets. New
ways of working together with these UK partners are being put in
place. Among the targets is the goal to halve the proportion of the
worlds population living in extreme poverty by the year 2015, and the
UK Government wants to measure the effectiveness of its own efforts,
alongside others, in relation to this and other targets.
The approach is to be promoted through UK involvement in
multilateral development assistance and in the bilateral programme
through development partnerships. Among the criteria for
embarking on these long-term partnerships, involving all types of
assistance, are that partner countries will be low-income and contain a
large proportion of poor people. They will also be countries where the
UK is wanted as a partner, has the influence to play a positive role,
and has a comparative advantage in being able to make a strategic
contribution to poverty reduction.
20
Previous experience of partnerships for WS&S development may have

some lessons. The example of UNICEF in India (see box left) shows
slow but significant influence on policy over the medium term, which
could be seen as the result of mutual respect and understanding
developed through technical assistance and support for partners
programmes. In such circumstances policy and institutional reform
may be one of the outcomes from WS&S programmes followed over a
period of working in partnership, rather than a pre-condition for
partnership in the first place.
Partnership is not easy
careful negotiation and
compromise may be
required.
The issue of ownership is also important here. Whose programme is

it? The partnership approach and concern for sustainability suggest
that the programme should clearly be the host governments,
supported by DFID and other external support agencies. Practice is
more difficult. There may be several programme partners within the
host government, and possible competition or differences in interest
among them. Also where DFID-contracted staff or consultants have a
major technical co-operation role, there is a danger that they (and
DFID) may come to be seen as leading the programme. These issues
require careful attention, at the outset and throughout the programme.
The Gomti Project (see box below) describes some of the pitfalls and
suggests ways of avoiding them.
1.6.2
Poverty eradication
DFID (1998c) has adopted a Poverty Aim Marker (PAM) in its Policy
Information Marker System (PIMS). This identifies three types of
action against poverty:
Focused, inclusive and
enabling actions against
poverty
Actions focused predominantly on the rights, interests, and needs

of poor people. An example might be where a projects benefits are
targeted on low-income households, by restricting its scope to
deprived rural regions, or to slums and informal urban settlements.
Inclusive broad-based actions which improve opportunities and
services generally, and also address issues of equity and barriers to
participation of poor people. An example might be a project to
The Gomti River Pollution Control Project at Lucknow

Phase 1
The Gomti project originated in the DFID-supported Ganga Action Plan, which
was primarily concerned with river water quality. It included the previous
government partner and engineering consultant on a new project with an
additional objective improved cleanliness of the city of Lucknow and a
new management structure a Project Management Unit. The main difficulties
included partners different objectives and different communication and
decision-making channels, and a lack of focus on the agreed features of the
new Gomti project. Another partnership issue was that DFID and state
government had different expectations as far as preliminary studies were
concerned. Misunderstandings and frictions contributed to poor project
progress, and failure to proceed to Phase 2 as planned.
21
support reform of a utility to improve its overall performance, but

also to help it provide better services to low-income consumers, for
instance through reform of tariff structure to allow cross-subsidy
from high-income to low-income consumers, and through
provision of more public standposts.
Enabling actions, which support the policies and context for

poverty reduction and elimination. An example might be a project
to develop a national policy framework for water supply, which
aims for higher levels of cost recovery overall and a more
transparent use of public subsidy to be targeted on improving water
services for poor people.
1.6.3
Types of DFID assistance
The type of assistance which may be provided within partnerships

includes both the conventional capital aid (financial support for
specific projects or activities) and technical co-operation (transfer of
skills). There is also the option to provide resources more strategically
in support of sector-wide programmes. In WS&S, these types of
assistance may be managed through longer term development
assistance programmes, possibly following a multi-donor Sector-Wide
Approach (SWAp), or a Sector Investment Programme (SIP).
The following description of the SWAp process is taken from A Guide
to Sector-Wide Approaches for Health Development, WHO, 1997, by
Andrew Cassells.
Sector-wide approaches
involve medium-term
programmes of work based
on joint commitment to
shared goals.
Sector-wide approaches will only succeed if there is sufficient

commitment to shared goals on the part of government and key
players in the donor community. Also, in unstable macro-economic
conditions, no form of development assistance is likely to produce
sustainable benefits. Sectoral programmes therefore depend on sound
macro-economic policies and the need to form part of an overall
public expenditure framework.
At the heart of the sector-wide approach is a medium-term
collaborative programme of work concerned with the development of
sectoral policies and strategies; projections of resource availability
and expenditure plans; the establishment of management systems by
governments and donors to facilitate the phased introduction of
common management arrangements; and institutional reform and
capacity building, in line with agreed policies. In addition, structures
and processes need to be established for negotiating strategic and
management issues, and reviewing sectoral performance against
jointly agreed milestones and targets.
Implications
The most fundamental change is that some donors will give up the
right to select which projects to finance, in exchange for having a
voice in the process of developing sectoral strategy and allocating
resources. For these donors, becoming a recognized stakeholder in
22
negotiating how resources are spent replaces project planning, and

joint reviews of sectoral performance replace evaluation of discrete
projects.
In many countries, there is no clear policy or strategic framework,
budgets do not reflect spending priorities, and management
systems are insufficiently developed to allow for common
management arrangements. However, the components of the
programme of work are defined in terms of development objectives
setting out what is to be achieved over time, rather than as a set
of prerequisites which have to be in place before the form or
volume of external investment can change.
Components of the programme of work need to be implemented at
a pace which is appropriate to the country concerned, and in line
with local priorities. As confidence in both policies and
management systems grows, a wider group of donors will use
national systems for disbursing funds thereby decreasing the
reliance on separate projects. In the interim, project support must
be consistent with agreed policies and strategies.
Defining SWAps in terms of intent rather than eligibility does not
preclude donors from identifying the steps needed to overcome key
constraints to effective sectoral performance. Necessary actions
will form part of the agreed programme of work, rather than being
imposed as unilateral conditionalities.
Involvement in sector-wide approaches will require that donors
review the appropriateness of the forms, channels, and systems that
they currently use to provide development assistance. However, it
is important not to equate the attributes of a sector-wide approach
with the specific characteristics of the aid instruments used to
finance it.
Sector Investment
Programmes are similar to
SWAps and emphasise
strong partnerships and
local leadership.
The SIP is very similar in approach. The World Bank has identified
the six essential features of a genuine SIP:
It is sector-wide in scope and covers both current and capital
expenditures.
It is based on a clear sector strategy and policy framework.
Local stakeholders (meaning governments, direct beneficiaries,
NGOs, and private sector representatives) are fully in charge.
All main donors sign on to the approach and participate in its
financing.
Implementation arrangements should to the extent possible be
common to all donors.
Local capacity, rather than long-term technical assistance, should
be relied upon as much as possible.
23
1.6.4
WS&S projects will follow a

flexible process approach
rather than a fixed blueprint.
The logframe as a live

management tool
The process approach
Individual WS&S projects are likely to follow the process rather than
the blueprint approach. Process projects have agreed objectives, but
the exact modalities for achieving these may at the outset be unknown
and unknowable. As described in DFID Technical Note No.4,
implementation takes place in successive, defined, stages and future
stages are planned in the light of the outcome of initial interventions.
Instead of defining in the initial Project Memorandum the activities
and outputs necessary to achieve the objectives, the process of
identifying them is specified. This is usually done on an annual basis
with the setting of milestones, and the annual work programmes may
then include conventional inputs and outputs. Process projects are
therefore subject to more regular, thorough, reviews than conventional
projects, with greater scope for radical changes in project design
(ODA, 1996a).
The annual review cycle should be seen as an opportunity for
constructive learning and planning, rather than as a policing exercise.
It was found on the Gomti project in India that the logical framework
could be useful here as a live management tool. This needs to be
agreed with project partners, however, with the involvement of both
primary and secondary stakeholders. There is a related need for
regular review and planning workshops or events throughout the
programme and project cycle, but particularly early on in the life of
the programme, to foster commitment to agreed objectives. Again,
these can include a review of the programmes logical framework.
1.6.5
Developing the WS&S programme
Programmes are the outcome of partnerships, and can be seen as a

series of projects, covering an extended time period.
Many factors influence the
formulation of programmes
and projects, and their
progress.
Programmes and projects emerge from interaction between

stakeholders and external support agencies. There are milestones in
the process, but the route is only loosely defined and relies on the
judgement of the individuals involved, among partners and within
DFID. The resulting project may then reflect the professional and
personal interests of these individuals. Progress also depends on their
skills and power as project champions to find solutions to the various
problems which arise, and on the skills and power of other people
with differing views on the proposed programme or project. These
differences of opinion occur within host governments and within
external support agencies, as well as between them.
Project proposals often have a history, and it is important to recognize
this. Some have been around in one form or another for many years.
Similarly the stakeholders involved will have a past relationship with
each other and a record of work which may have a strong influence on
what they will be able to do in the future. It is unrealistic to assume
that projects start with a blank sheet, and important to recognize the
difficulties in introducing change.
24
The starting point is likely to

be an analysis of existing
WS&S policy and the
identification of constraints.
For future DFID programmes and projects the starting point is likely
to be an analysis of existing WS&S policy in the country and the
identification of constraints on reaching the poor with WS&S
services, coupled with studies of peoples current practices and their
views on options for the future. The negotiation of partnerships will
probably entail compromise on some issues, and difficult decisions on
whether differences in approach make partnership impossible.
Before going further it is important to ensure political agreement to
the basic principles or strategic framework required for meeting the
conditions of success. If there are to be some fundamental changes in
the way key institutions operate in the sector (e.g. much higher levels
of cost recovery, greater responsiveness to users demands, more
participatory planning and management, privatization) it will be
important from the outset to have strong political commitment to
change, and agreement on what the financial targets should be.
DFID
The complexities and interlinkages of WS&S could make it difficult

to get through this prior stage, which would be regrettable and
frustrate the political commitment to a substantial increase in
spending in WS&S. Policy-focused projects and process projects seem
to provide a way of travelling forward, learning, and strengthening a
partnership and then clarifying the route and endpoint during the
project itself.
In this case, a key step may be developing agreement among the key
stakeholders (donors, local government, utility, representatives of the
poor and of other users, etc.) on the purpose of a specific programme
or project.
8
EVAL
1
POL
7
NEXT
6
OP
1.6.6
2
ID
3
PREP
5
IMP
4
APP
Managing the project cycle
The DFID project cycle (see Section 1.1) is the basis for the guidance
in this manual. The cycle is described in more detail in the DFID
Office Instructions (ODA, 1996c), and is considered here as
comprising eight elements:
1.
2.
3.
4.
5.
6.
7.
8.
Policy development, sector planning, and programme formulation

Programme and project preparation
Programme and project appraisal and approval
Extensions or Next phase programme and project identification
Evaluation
To keep a continuing and consistent check on progress and the

achievement of project objectives, the logical framework (logframe) is
used in various forms by most external support agencies, including
DFID and the EU, though not the World Bank. It provides a
systematic way of developing and presenting the rationale of a project
and its key features.
25
1.6.7
The project framework and the project cycle
The diagram illustrates the conventional use of the logframe during

the project cycle, with a shifting focus from the Goal and the Purpose
at Project Identification stage, to the Outputs and the Activities during
the stages from Project Preparation/Design to Project Completion,
reverting then to the Goal, Purpose, and Outputs at the Evaluation
stage. Note however that DFID practice is now to retain a focus on the
Purpose throughout the project cycle, and this is particularly
important for the process approach to projects which is now being
followed.
WaterAid/Jim Holmes
Figure 1.6.1. The project framework in the project cycle
Considering DFIDs overall Aim and Objectives, a reasonable Goal

for DFID WS&S programmes and projects would be:
A sustainable improvement in health and
well-being for poor people
Suggested Purposes for
WS&S projects
Depending on the existing constraints to improvement, individual

programmes or projects to achieve this goal might include such
Purposes as:
Establishment of sound, sustainable environmental services for
N000 poor people in water supply, sanitation, and hygiene
promotion
Expansion of coverage (to N% of the poor urban population in X
town or city or N% of the rural population in Y district or region)
with adequate, safe, and conveniently located domestic water
supplies they are willing to use, at prices they are willing to pay
26
Expansion of coverage (to N% of the poor urban population in X

town or city) with appropriate household sanitation (and possibly
wastewater disposal and solid waste disposal services) at prices
they are willing to pay
Expansion of coverage (to N% of the rural population in Y district
or region) with appropriate household sanitation
Development of safer water, sanitation, and hygiene practices
among N000 poor people in X town or city or Y district or region
Increased involvement of N000 primary stakeholders (including
marginalized groups) in decision-making and management of
water supply and sanitation and other services
Provision and utilisation of improved, community-based and

sustainable water and sanitation services and hygiene practices in
(x) project villages, with successful approaches disseminated
outside the area.
Improved performance of institutions is often required to achieve the

project purpose, which necessitates institutional development of some
kind. This is particularly true where there are concerns about
operation and maintenance, cost recovery and sustainability. When
developing a logframe, it is then necessary to have institutional
development components at the output level such as:
cost recovery system developed, agreed and functioning;
HRD plan developed, agreed and implemented; and
management development programme designed, agreed and
implemented.
27
28
Chapter 2
Principles
and practices
2.1 Key issues and interlinkages
In keeping with the aim of this manual to promote and facilitate an
interdisciplinary approach to WS&S, the Principles and Practices of
WS&S programmes and projects are described in Sections 2.2 to 2.8
from seven different perspectives:
Section 2.2 Social development
Section 2.3 Health
Section 2.4 Environmental sustainability
Section 2.5 Economic and financial
WaterAid/Jim Holmes
Section 2.6 Institutional

Section 2.7 Technical
Improved water supplies,

adequate sanitation
facilities, and hygienic
behaviour are all vital and
interlocking elements in the
water supply and sanitation
sector. Investment in one
element without
complementary efforts in
the others carries a strong
risk that health benefits will
not be achieved.
The poor face the greatest
risk from faecal-oral disease
transmission. It follows that
sanitation and hygiene
promotion activities have to
accompany all povertyfocused water supply
interventions (recognizing
that there is a tension when
participatory studies reveal
a strong user priority for
water supply only).
Section 2.8 A social marketing approach to hygiene promotion

and sanitation promotion
First it is helpful to look at a number of key issues which apply to
several in some cases all of those perspectives.
2.1.1
Water supply, sanitation, and hygiene promotion as

a coherent sector
The WS&S sector has been described in Chapter 1, and it is important

to consider the sector as a whole. But in what sense do water supply,
sanitation, and their promotion constitute a coherent sector? Why do
sector professionals insist on considering these issues simultaneously,
even where implementation often reflects a higher priority for one
component than another? The history of the industrialized world and
current experience in developing countries do not show the individual
elements to be inextricably linked in the minds of the general public.
They will almost always see water supply as the highest priority.
There are several good reasons for considering WS&S as a sector:
Health aspects The main health benefits of improved water
supply lie in the reduction of faecal-oral diseases, as described in
Section 2.3. But faecal-oral diseases are spread through a multitude
of routes, most of which are best controlled through improved
sanitation and hygiene promotion. If water supply is intended to
improve health, it is critical that efforts to control this single route
of disease transmission are linked with control of the many others
29
2
2.1
2.1
through basic sanitation and hygiene promotion. The simple logic

of public health also suggests keeping drinking water clean by
isolating human wastes through sanitation.
WaterAid/Jenny Matthews
Technical aspects The widespread historical experience of piping

water into homes without sufficient attention to what subsequently
happens to the wastewater has taught sector professionals that they
need to consider both simultaneously. Environmental sanitation
becomes the mirror image of water supply, particularly where
water-borne sanitation is adopted.
Behavioural aspects Throughout both the industrialized and the
developing world, governments have seen the need to sell the
services together. Where sanitation is effected through sewerage,
the costs may be viewed logically as a consequence of water piped
to the home. It is then easier to capture willingness-to-pay for
water to recover the costs of sewerage too.
2.1
WaterAid/Jim Holmes
The need to consider promotion as a necessary accompaniment to

the provision of water and sanitation hardware also stems from
behavioural experience. It is the use of hardware that changes the
quality of peoples lives, not its mere construction/installation;
supplying hardware that people do not want is a waste of both time
and scarce resources. The bitter experience of so many projects in
the 1980s where newly installed facilities were not always being
used led to promotion being established as the third component
of the sector.
Safeguarding community
water supplies (quantity
and quality) depends on an
effective integrated
approach to the
management of national
and regional water
resources. World leaders
have endorsed the concept
of integrated water
resources management
(IWRM), most notably at the
1992 Earth Summit in Rio
de Janeiro. In practice
though, there is a danger
that irrigation, industry and,
latterly, ecological interests
dominate IWRM thinking,
with the WS&S sector
sidelined.
30
Participatory approaches may reveal a much stronger demand for

water than for sanitation. So, in the short term, it may seem expedient
to address only the water supply side of WS&S. This should be
resisted in a poverty-focused project, unless for some exceptional
reason the reduction of faecal-oral diseases is unimportant for the
project. After fifty years of learning lessons in the sector, the need to
link water, sanitation, and hygiene promotion has become clear to
those who have seen what happens when they are dealt with in
isolation.
2.1.2
Integrated water resource management
All the agenda-setting international meetings of recent years (New

Delhi, Dublin, Rio, Noordwijk) have led their recommendations by
urging the adoption of sector strategies based on integrated water
resources management (IWRM). The latest recommendations of the
Commission on Sustainable Development, CSD6, continue to urge
governments to accelerate moves to implement IWRM strategies. In
the case of WS&S, that means integrating demand forecasts into
national plans for allocating water resources nationally; it means
ensuring that proposals for sanitation and sewerage improvements are
consistent with national strategies for water conservation and
pollution prevention; it means institutional linkages to ensure
compliance with river quality objectives and other environmental
standards; and it means a role for communities in catchment
stewardship as well as the local focus of WS&S improvements. The

implications pervade many of the topics discussed in later sections of
Chapter 2 and particularly Sections 2.4 (Environmental
sustainability), 2.5 (Economic and financial perspectives), and 2.6
(Institutional perspectives).
2.1.3
Since the Rio Earth
Summit, sustainability has
been a prime criterion in
development projects.
Historically, the WS&S
sector did not have a good
record in achieving
sustainable projects. Many
broke down or fell into
disuse once the external
support came to an end.
The participatory approach,
more appropriate
technology choice, better
provision for access to
spare parts, and the
equipping of communities
for operation and
maintenance and financial
management have led to
significant improvements in
recent years.
In WS&S programmes
targeted at the poor,
sustainability is linked to
four more success criteria:
effectiveness; equity;
efficiency; and replicability
Sustainability, effectiveness, equity, efficiency,

and replicability
These concepts are linked together and need to be considered as a

package of issues, most importantly at sector-policy level, but also in
the planning and design of any project. There are tensions: financial
sustainability typically means charging users for services, but equity
emphasizes keeping charges to poor people affordable, which may
require public subsidy and which will restrict replicability, as
subsidies are limited.
Reaching a compromise between these conflicting objectives is a
political process. DFID should encourage stakeholders to conduct this
process in a transparent manner, making certain that decision-makers
are well-informed of the results of sound analysis, for instance on
levels of subsidy and cost recovery; on what people currently pay and
are willing to pay; and on the costs and benefits of alternative options/
levels of service and pricing regimes. DFIDs primary objective
should be to resolve these issues in a way which provides sustainable
and affordable basic services to the maximum number of poor people.
Sustainability
Sustainability has become the top item on many development agendas

since the Earth Summit, and rightly so. In sectoral terms, aiming for
sustainability means ensuring that WS&S services and interventions
continue to operate satisfactorily and generate benefits over their
planned life. In broader terms, it means ensuring that WS&S project
interventions support, rather than threaten, overall environmental
sustainability.
Sustainability has environmental, institutional, financial, technical,
and social dimensions which are considered in the corresponding
sections of Chapter 2. Fundamentally, it is about the operation and
maintenance of installed facilities, but it has to be considered from the
very start of a project, to ensure that the prerequisites for long-term
sustainability are in place. Strategies most likely to contribute to the
improved sustainability of WS&S programmes and projects
incorporate activities which ensure that the services provided reflect
the true demand, that the benefits are optimized, and hence that users
appreciate the value of the services. Those activities include:
Mobilizing and facilitating the active participation of both women
and men in decision-making around technology choice, siting,
O&M, and management processes.
Taking culture and context into account and understanding local
priorities and preferences for WS&S, as well as formal and
informal power structures and institutions.
31
2
2.1
2.1
Establishing an institutional framework which aims to provide the

levels of service that different sections of society want and will use
and pay for at the prices to be charged.
Setting charges for services at levels which will generate sufficient
income to cover the operation, maintenance, and replacement (i.e
capital) costs of infrastructure, and ensuring timely collection of
revenues due.
Ensuring that if subsidies are used, they relate to capital costs, with
O&M costs recovered in full from users.
Enhancing hygiene promotion programmes, which focus in turn on

men, women, and children, to stimulate demand for and use and
care of improved water supply, sanitation, and waste disposal
facilities.
2.1
Ensuring that the technical, institutional, and budgetary needs of

consultation and decision-making are catered for in the planning,
design, and implementation phases.
Matching capital investment with both information sharing and
capacity building at community level and corresponding training
and career development programmes for O&M staff, technicians,
mechanics, and caretakers.
Encouraging and equipping local water associations and water
committees to manage community WS&S systems, with technical
backup where required.
Establishing preventive maintenance schedules, leak detection
programmes, and regular quality surveillance, with formal
reporting and follow-up procedures.
Making optimum use of existing retail outlets and distribution
channels, strengthened where necessary, to assure the accessibility
of spare parts, tools, and materials for the operation and repair of
WS&S facilities.
Enabling private sector agencies to offer support services where these
can be provided more effectively than through public utilities.
By measuring effectiveness,
the concept of sustainability
is extended to ensure that
improved water and
sanitation systems deliver
the anticipated benefits to
the intended people. That
means coupling hardware
projects with hygiene
promotion, and ensuring
that all sections of the
community have access to
affordable and reliable
services.
32
Using demand management measures, including tariff structures,

to encourage water conservation and minimize waste.
Ensuring the continuing availability of a safe and adequate supply
of water, and protecting the environment against adverse impacts
from wastes, by following integrated water resource management
principles.
Effectiveness
Effectiveness is the degree to which WS&S services and interventions

meet their objectives. In the case of DFID programmes, that implies that
WS&S reaches poor people and that poor people use the services (see
Sections 2.2 and 2.7), that facilities and services are integrated as required
to deliver benefits (as described in Sections 2.3 and 2.8 for health
benefits), and are kept in good operating condition (Sections 2.6 and 2.7).
This last point is also

related to equity. Too many
WS&S projects benefit the
better off and further
marginalize the poor.
Subsidies enable higher
income users to use more
water, while the poor still
cannot afford basic
services. Women often
have the burden of paying
for, as well as carrying, the
water. It is vital that
charging systems and
choices of service levels
are designed to enable
women to obtain and pay
for convenient water
supplies, and to invest in
improved sanitation
systems. It is quite possible
to do so without
abandoning the concept of
water as an economic
good or the principle that
the full costs of WS&S
services should be
recovered from users.
The huge numbers of
people who lack access to
safe water and hygienic
sanitation will only be
served when investment
efficiency is related to the
number of people served
for every thousand dollars
invested. Right now, too
high a proportion of
government and donor
finance is directed towards
high-cost projects serving
urban lites. Even then, far
too much water is wasted
through leakage,
inadequate billing, or illicit
connections. Cutting
unaccounted-for water
needs to be an element of
WS&S programmes.
A crucial requirement for effectiveness is that programmes and

projects are designed from the start in an interdisciplinary way, so
that all the necessary components from the various disciplines are
integrated into the programme. Without this co-operation, early
decisions may preclude some important options being included later,
leaving inadequate preparation time for preparatory activities such as
data collection on existing practices and views, and training of
hygiene promoters.
Equity
Current provision of WS&S often fails to reach the poor and other
disadvantaged groups. Frequently it also fails to take account of the
particular needs of women, children, old people, the sick, and people
with a disability. Reaching these groups involves both practical
concerns (for example design issues which are considered in Section
2.7) and strategic issues of status, power, pay, etc. (see Sections 2.2
and 2.6). Gender issues in particular are crucial for the success of
WS&S programmes, therefore gender perspectives pervade all the
sections.
The real needs and potential contributions of disadvantaged groups
and presently unserved populations must be reflected in programme
planning, through an appropriate institutional framework.
Equity issues also arise when new approaches require communities to
pay when their neighbours or urban/rural counterparts previously
have not (see Section 2.5). The level of contribution of the poor is a
particular concern in situations where middle/high-income users in
the locality are paying tariffs which are well below the cost of
WS&S. Equity objectives may require mechanisms, such as targeted
subsidy or cross subsidy, to ensure that the prices that poor people
pay for basic services are affordable, even where the overall thrust of
sector policy is towards charging users the full costs of services
provided.
Efficiency
Efficiency represents the output produced per unit of resources

(water, staff, funds) and shortages of resources imply that high
efficiencies will be needed to meet the gap in WS&S coverage. Past
WS&S projects have been inefficient in a variety of ways. In
coverage terms, the focus on high-cost projects serving urban lites
has severely restricted the number of people served per unit invested;
neglect of sanitation and hygiene education has reduced benefits from
water schemes; and poor operation and maintenance has led to high
water losses and low cost recovery. Efficiency issues are considered
in Sections 2.5 and 2.7.
Replicability and transferability
The immediate challenge is to enable poor people to have access to

WS&S. This means keeping basic services for poor people
affordable, while aiming to recover a high proportion of capital and
recurrent costs from users. Available public subsidy can then be used
effectively to extend services to as many people as possible. National
33
2
2.1
2.1
2
2.1
The last extension of the

sustainability criterion is
replicability. So many
projects and programmes
are necessary to combat
the appalling backlog of
inadequate WS&S services,
that replicability (and
extendability and
transferability) needs to be
a key consideration in the
design of all individual
projects. High levels of
subsidy, institutional
complexity, and
dependence on long-term
external support are all
factors which make
programmes hard to
replicate.
Local manufacture,
community management,
skills development, and
standardization of hardware
and spare parts all
contribute to replicability.
The water supply service
level which can be provided
ranges from a communal
handpump shared by more
than 100 users to a house
connection giving 24hr
individual service.
Sanitation may be a simple
pit latrine or a flush toilet
connected to a sewer
system or septic tank.
The distant handpump may
be seen as a basic service
level, but it should not be
assumed that this will be
the preference of all poor
people. Yardtaps provide a
more convenient supply
than handpumps or public
standposts and this may be
reflected in the willingness
34
and international efforts in the 1980s and 1990s have improved

coverage, but much remains to be done (Section 1.3). In addition,
population growth, increased urbanization, and aspirations for better
WS&S levels of service, will necessitate continued expansion of
WS&S services for the foreseeable future.
Therefore it is essential that services and interventions can be
replicated to provide this expansion. Services which are heavily
subsidized, or not replicable for other reasons, fail to address the
challenge of coverage, and may make it more difficult by establishing
unrealistic expectations or standards.
Replicability should not imply rigidity. The model needs to be flexible
to meet demand for improved levels of service. Section 2.7 describes
technical replicability through standardization of a range of designs
from which choices can be made (handpump standardization is an
example). Similarly, approaches to tariffs and to hygiene promotion
are described in Sections 2.5 and 2.8. The empowerment of
community motivators to spread best practices features in Section 2.2.
An important consequence of the focus on replicability is that external
support agencies accept the national approaches and standards, rather
than insisting on their own. A focus on transferability highlights the
fact that technologies as well as development processes may need to
be adapted to local contexts and conditions, rather than simply
replicated. DFID is addressing this through the concept of partnership
(see Section 1.5).
2.1.4
Levels of service
Levels of service can be expressed in technical design terms (for

example, for sanitation, a simple pit latrine, a pour-flush latrine, or
piped sewerage; or for water supply, the quantity and quality of water
available within a given distance), or in performance terms (for
example with a stipulated measure of reliability). Typical levels of
service are shown in Table 2.1.1.
It may well be that a range of levels of service are available, and it is
clear that people have strong views on these, particularly where they
are asked to pay for the service (see Section 2.5). This is reasonable
enough, as the levels of service differ in terms of convenience and
health benefits as well as cost.
Technical departments often start with particular ideas about what
level of service may be appropriate for a given community, but under
a demand-responsive approach these need to be put to one side, and
instead a wide range of technically feasible options explored with the
primary and secondary stakeholders.
Basic needs for public health
A minimum level of service is vital to meet peoples basic needs for

water for drinking, washing, and cooking, and for disposal of excreta
and other wastes in a manner which is safe for them and the wider
community. The sustainability of this basic-needs level of service
1. Point sources include

collection from handpumps,
open wells, standposts/
tapstands, roof catchment,
protected springs and ponds,
and purchase from water
vendors.
2. Return travel time includes
queuing time
(see Section 2.3).
3. Sullage comprises all used
water, excluding toilet wastes.
Table 2.1.1
Typical levels of service providing access to safe

water supply and sanitation in rural and urban areas
Level of service
Water supply
(Deficient)
(Water source
unsafe or
inadequate or
return travel time
more than 30
minutes)
Minimum
Communal point
source with safe
and adequate
water and
appropriate
drainage, return
travel time less
than 30 minutes
Soakaway or other
drainage at public
waterpoint. Some
sullage disposal at
household level on
plot or onto field,
or, in urban areas,
gutter or open or
covered sullage
channel
Simple pit latrine

on householders
plot
Intermediate
Point source on
household plot with
safe and adequate
water supply
(usually metered)
and appropriate
drainage
Soakaway on
plot OR open or
covered drain
from plot to safe
disposal;
connecting
channels within
plot (made by
householder)
Improved pit
latrine or pourflush toilet on
householders
plot
High
Piped connection
(usually metered)
into house with
safe and adequate
water under
continuous
pressure
Open drain to safe

disposal OR pipe to
septic tank or
sewerage
Flush toilet with

septic tank OR
sewerage (if water
supply is
sufficient)
4. Improved pit latrines include

sealed lid, VIP, and pour-flush
pit latrines.
5. Safe water does not represent
a health hazard to the users
(see Section 2.3).
6. Adequate water means
sufficient to meet users
demands at the waterpoint,
and may be intermittent or
continuous supply.
of users to pay more for the

increased level of service.
However, designs and
charges need to reflect the
need to dispose of the
extra water used, including
safe disposal of sullage.
Sullage disposal
Sanitation
(Open defecation
OR dirty communal
latrine)
2
2.1
2.1
depends on users willingness-to-pay the recurrent costs, or failing

that, the governments willingness to subsidize the service over the
medium term. In some circumstances neither poor users nor the
government will pay. Further work is then needed to establish
conditions for sustainability (possibly focusing on policy and
institutions, maybe including cross-subsidy from richer or industrial
consumers), or to identify a different (possibly higher) level of service
which would be sustainable because users would be willing to pay for it.
DFID/Yang Xu Sheng
Convenience
Higher levels of service are often desired for convenience, and people
may be willing to pay for this, especially if the effective tariffs are no
higher this may happen for example with an intermediate level of
service (a yardtap) where they are purchasing water themselves
instead of through a vendor at a standpost. See Sections 2.5 on
willingness-to-pay and 2.7 for examples of costs. In addition, higher
levels of service can provide the conditions for greater health benefits
(see Section 2.3). Therefore programmes should aim to provide
people with the option of choosing a higher level of service, or
35
Appropriate technology may not be acceptable

Women do not always welcome appropriate technology which has the
approval of engineers. An example of this was from the Yucatan Peninsula of
Mexico, where pit latrines had been recommended by an engineer who was
normally well attuned to social considerations. Yucatan women did not want pit
latrines they wanted a flush latrine which they thought was more modern and
convenient. Instead of assuming that we know what people want we should
listen to them and find out what they really want and why.
Bingham, World Water, 1984
upgrading to a higher level in the future. The technical issues of

designing communal systems taking account of individual choices and
willingness-to-pay are discussed in Section 2.7.
2.1
2.1.5
The issue of water pricing
and cost recovery is
complex and is dealt with in
considerable detail in
Sections 2.5 and 2.6. The
big challenge is to enable
the poor to obtain basic
services at an affordable
price while still achieving
the full cost recovery
needed for sustainability. In
fact, the evidence is that
poor peoples willingnessto-pay for improved water
services is quite high (many
already pay high prices to
water vendors for
unsatisfactory supplies). On
the other hand, willingnessto-pay for sanitation
facilities depends on
promotion and motivation.
Community participation
has been accepted as a
principle for many years. In
the WS&S sector, and
particularly where DFID is
concerned, decisionmaking needs to involve all
stakeholders as partners.
And participation goes
beyond the involvement of
communities in decision-
36
Affordability, tariffs, cost recovery
Without adequate cost recovery, WS&S services will not be

sustainable or replicable. The concept of water as an economic good
is gaining currency, but it has to be read with the condition which was
attached to it at the Dublin Conference: within this principle it is vital
to recognize first the basic right of all human beings to have access to
clean water and sanitation at an affordable price. This basic right is
open to different interpretations. For this Guidance Manual it is the
right to a minimum level of service, for water supply, sullage disposal,
and sanitation, as described in Table 2.1.1. The affordable price
should be interpreted on a case-by-case basis, as described in Section
2.5, taking account of:
1. recurrent costs (which should usually be recovered in full, to
facilitate sustainability);
2. capital costs (in both financial terms, based on depreciation and
interest costs, and in economic terms, reflecting the long-run
marginal cost of new services);
3. users willingness-to-pay for the service;
4. users poverty; and
5. subsidy policy, (including on cross-subsidy opportunities) and the
likelihood that a higher degree of cost recovery may allow
available public subsidy to be used to extend coverage and meet
the basic rights of a larger number of poor people.
Safeguarding the poor from hardline economic approaches, while
pursuing the objective of full cost recovery, is a major challenge for
all countries (see Section 2.2). Tariff structures and subsidy policy are
discussed in Section 2.5, and cost recovery arrangements in Section 2.6.
2.1.6
Stakeholder participation
DFID is committed to the participation of primary and secondary

stakeholders and to ensuring that their perspectives and knowledge are
incorporated in any development. The full involvement of users in
decision-making is of special importance in WS&S services.
making. It is the
empowerment of
communities to manage
and control their own affairs
which can have the
greatest impact on poverty
and equity goals.
Participation may occur in project planning, environmental

assessment, monitoring, O&M, and evaluation. Participation may
affect effectiveness and efficiency goals. But DFIDs approach is also
concerned with participation as a process of empowerment, promoting
equity, and the sustained concern and involvement of primary
stakeholders with their living environment.
These issues are discussed in Section 2.2, with detailed
recommendations in Chapter 3 for each stage in the project cycle.
A related issue is the devolution of management responsibilities to the
lowest appropriate level a principle endorsed in Agenda 21 (see
Section 2.6).
2.1.7
Community management is
also the key to improved
operation and
maintenance, particularly in
rural areas.
The essence of a demandresponsive approach is that

users decide for
themselves what are the
most practical options to
meet their own perceived
needs. Those decisions
can only be taken after
participatory discussions
and analysis of available
options. The problem is
that planners and funders
need advance information
on the likely outcome of the
participatory process, so
that projects can be
properly appraised and
financed.
2.1
2.1
Operation and maintenance, and community

management
Operation and maintenance (O&M) is a crucial element of

sustainability, and a frequent cause of failure of WS&S facilities in the
past. Many failures are not technical ones. They may result from poor
planning, inadequate cost recovery, or the outreach inadequacies of
centralized agencies. Analysis has to seek out the causes as well as the
symptoms. For example, poor cost recovery may be down to poor
billing, or it may be caused by excessive waste through poor leakage
control, or it may mean that users will not pay for an unreliable or
inappropriate service.
2.1.8
Technology choice
The selection of a suitable technology is not an isolated activity, but

needs to be based on delivering the chosen level of service in a way
which will be effective, equitable, sustainable, efficient, and
replicable. This is a major consideration in Section 2.7, but also has
important implications on institutional development and financing
mechanisms. Crucially, the technology must be within the capacity of
the responsible institutions (government, utility, or community) to
manage, operate, and maintain it.
2.1.9
Demand assessment
Robust demand assessment is central to effective water supply and

sanitation services. It is necessary to inform decisions at the policy
stage of the programme and project cycle, as well as the project
preparation and appraisal stages. Without information from demand
assessment studies, it is harder to predict what the response of users
will be to service improvements, especially when they are
accompanied by tough cost recovery (see Section 2.5).
A demand-responsive approach to the water and sanitation sector
needs to ascertain what levels of service users are willing and able to
pay for and what mechanisms might ensure that poor people have
affordable access to services. At the centre of this approach is the
process of demand assessment itself. Demand assessment techniques
37
2
2.1
Assessing the likely

demand is an important
early activity, for which a
variety of analytical
techniques are available.
Choice of the right
technique depends on the
size and complexity of the
proposed programme and
the existing capacity in the
community for self
appraisal. If resources are
available, the Contingent
Valuation Method is the
most reliable. In different
circumstances, less costly
options can yield
worthwhile results.
are discussed in Sections 2.2 and 2.5. Some examples of key

techniques and their possible application are summarized in Table
2.1.2.
General points to take into account when considering demandassessment techniques are:
The assessment techniques highlighted represent examples along
a continuum of quantitative and qualitative research methods; a
combination may often be appropriate.
The wider the range of technically feasible levels of service, or
the more complex the existing situation, then the more thorough
the demand assessment should be.
Economic techniques such as the contingent valuation method
(CVM) may be more relevant for utilities planning larger
investments and where overall programme or project expenditure
is high.
Participatory rapid appraisal (PRA) methods are both more
flexible and less costly, and are particularly appropriate where
significant community consultation and management is required.
Demand assessment studies of different scale or depth may be
needed at different stages of policy, programme, and project
development. In larger and more complex systems, there will be a
need to develop institutional capacity for continuing demandresponsiveness.
2.1.10 Demand creation
Lack of demand for

sanitation is not a signal to
do nothing. Nor is it right to
go ahead with sanitation
improvements which the
community has indicated
are not wanted. Hygiene
and sanitation promotion
should be the starting point
(even preceding the
demand assessment,
where possible).
38
In some poor communities there may be little demand for hygienic

forms of sanitation. People may be satisfied with their existing
practices, or not familiar with alternatives. Nevertheless there may
be substantial scope for a poverty-focused WS&S project. The
appropriate approach for a project to increase sanitation coverage in
these circumstances is not to provide facilities for which there is
little demand, but rather to focus first on hygiene and sanitation
promotion as described in Section 2.8. This should create demand
for improved facilities, to which the project can respond at a later
stage.
Similarly, some poor communities may show little demand for an
improved clean water supply, especially if their existing water
source is convenient and tastes good and they would have to pay for
an alternative system. Again, hygiene promotion is the appropriate
focus of a WS&S project until there is effective demand for a new
system. One of the startling findings of the Evaluation synthesis
study of rural water and sanitation projects (White, 1997) was the
large number of new water facilities which were in good order but
were not used for lack of demand. It is important not to repeat this
mistake by confusing need with demand.
Table 2.1.2
Demand assessment techniques: Water supply and sanitation
1. Elicit relative
demand between
different services *
2. PRA option
selection:
Internally
facilitated *
3. PRA option
selection:
Externally
facilitated *
4. Revealed
preference
surveys (RPS)
5. Contingent
valuation
method
(CVM) *
6. Real detailed
options considered
by community
groups or ballot
Description Improvements to a
of technique wide variety of
different services
such as water,
drainage, roads,
etc., are considered
by the communities,
who express their
relative demand for
these services. Total
funds available for
each community
area should be
reasonably fixed.
Community
volunteers are
encouraged and
trained to
undertake a
participatory
survey in their own
community.
Preferences and
commitments are
then agreed in
meetings.
A variety of PRA
techniques are
used by trained
researchers or
facilitators to
triangulate and
confirm the
preferences of
different
community
groups, who are
also involved in
the analyses.
RPSs estimate
time and financial
costs of current
household
behaviour, (e.g.
payments to
water vendors)
and time saved in
collecting water.
A questionnaire
survey to determine
the maximum
willingness-to-pay
of individuals for
various options for
level of service
(including improved
reliability), payment
arrangements,
within the context of
the current or
specified
institutional regime.
Detailed options
and their
implications (costs,
O&M, institutional,
etc.) are considered
by communities
using PRA or ballot.
Potential
benefits
very good
community sense
of ownership
good community
sense of
ownership
enhances
empowerment
extension staff
can assess
appropriate time
to elicit demand
can provide
reasonably
accurate estimates
of current time and
cost expenditure
and hence possible
willingness-to-pay
for service
improvements
simple and easily

understood
expresses real
demand if only in
relative terms
preferences can be
refined during
micro-planning
inexpensive
useful if demand
assessment
involves on-going
negotiation
can be used in
changing
institutional
environment
compatible with
PRA work
Potential
risks and
constraints
Typical
usage
can enhance
empowerment
possible group or
strategic bias
possible group
bias
possible group
bias
WTP for different

service levels not
readily known
liable to lack
technical/financial
rigour
process can be
manipulated by
extension workers,
who do not use
sufficient technical
or financial rigour
reliant on skills
being in the
community
process can be
manipulated by
extension
workers, who may
not use sufficient
technical/financial
rigour if
not adequately
supervized
suitable for village

or slum general
improvement
projects. NGOs
often use this
technique
data and analysis

requirements are
modest
suitable in most
situations,
possibly
complemented
by other
methods
* estimated costs of technically viable options are needed for these techniques
can guide tariff

subsidy and costrecovery policy
institutional charging
of O&M implications
can be thoroughly
assessed
can be used in a
changing
institutional
environment
good baseline data

similarity to public
for impact
opinion polls means
assessment
results conceptually
compatible with
easy for nonPRA
specialists and
politicians to
understand
cannot estimate h/h
response to price
increases (including
for new levels of
service options)
poverty may
constrain ability of
poor people to
convert time
savings resulting
from service
improvements into
cash payment for
them
requires
substantial
flexibility by
extension
external funding
agencies and local workers with
support institutions good facilitation
skills are required rarely useful for
sanitation projects
more suitable
where low-tech,
low-cost solutions
are definitely
viable, e.g.
handpumps and
latrines
2.1
2.1
provides good data more precise cost

for Project Appraisal estimates lead to
good data on WTP less confusion
and potential
revenues for
different service
levels, assuming a
thorough survey is
undertaken
suitable where
substantial water
supply problems
exist. To be used in
conjunction with
say PRA methods
risks inhibiting
community decisionmaking and
ownership, for
instance by raising
expectations about
particular options
risk of key decisions

being based on
misleading results
from an unrepresentative group unless
care is taken to avoid
group bias
relatively high cost

and requires
specialist consultant
for reliable results
requires detailed cost

information, so earlier
demand assessment
may need to use
other methods
inaccuracies may
occur in a changing detailed work on
institutional
some options can be
environment
redundant
requires flexibility by
funding agency
suitable for
informing strategic
decisions on levels
of service, costrecovery policy, etc.
in large investment
programmes, e.g.
urban systems, or
policy framework
for small rural
supply schemes
suitable where
difficult choices are to
be made between
different options
39
2.1.11 Capacity building
2
2.1
The demand-responsive
approach is new to many
stakeholders in WS&S. The
concept is appealing, but
unfamiliar. Different skills are
needed in all phases of the
project cycle. Capacity
building is needed, so that
communities and their
partners can continue the
participatory process in the
long term, as well as on the
initial project.
40
If partners change their approach to WS&S (for example by moving to

a demand-responsive approach with choices) there will be a need for
institutional capacity building. This will involve empowerment of
primary stakeholders and the development of peoples capabilities at
local level. It will also involve developing institutional mechanisms
and capacity within and among secondary stakeholder organizations,
to enable them to respond to demand in a more flexible manner than
that with which they may be familiar. The requirements of institutions
which are involved in programme and project identification and
design will be different from the capabilities required of implementing
agencies. Each of the Sections 2.2 to 2.8 has implications for capacity
building, and the requirements for institutional development and
human resource development (HRD) are particularly addressed in
Section 2.6.
DFID/Eric Don Arthur
2.2 Social development perspectives

The days of solving water supply and sanitation problems with
concrete and pipes alone are over. Integrated approaches to WS&S
now have people at the centre. A social development perspective,
which supports this approach, means understanding and involving
users and responding flexibly towards their concerns.
Participatory approaches to
WS&S planning and
implementation are very
different from the supplydriven, technology-based
approaches of the past:
Their inclusive nature
ensures that the voices of
the poor and
underprivileged are
heard.
They empower people to
take responsibility for
their own services.
They respect the
traditions and cultures of
different societies and
use them to develop
appropriate solutions.
They recognize that
women have a beneficial
influence on key
decisions, and that
gender considerations
matter.
They mobilize public and
private resources and
create partnerships to
make optimum use of all
stakeholders.
They make user demand,
demonstrated by
willingness-to-pay, a
primary criterion for
selecting levels of service
and technologies.
Social development objectives in WS&S include ensuring that

dialogue and interventions: are responsive to demand; reach poor or
disadvantaged populations and socially excluded groups; promote
empowerment, local voices, and ownership; and recognize the
different needs and contributions of women and men. A social
development perspective is supported by social analysis and by
incorporating social issues and participatory approaches into
development planning.
Principles
The response to WS&S which evolved during the 1980s was the basic
services approach. It identified lack of access to basic services such as
water, healthcare, and education as both a cause and a symptom of
poverty and therefore a basic right (Jarman, 1997). The World Summit
for Social Development held in Copenhagen in 1995 persisted with
the point that over one billion people in absolute poverty live lives
characterized by deprivation of basic human needs, including those of
safe drinking water and sanitation facilities. The Social Summit urged
that in formulating strategies for eradicating absolute poverty,
governments and the international community should implement the
commitment to meet basic needs including providing on a
sustainable basis, access to safe drinking water in sufficient quantities
and proper sanitation for all (UNICEF, 1995). The DFID White Paper
supports this commitment, along with an emphasis on demand
responsiveness and participatory approaches.
2.2.1
Understanding the context
The priorities of donors and governments do not always coincide with

those of primary stakeholders women and men in rural and urban
communities, particularly the poor. Prior to the 1980s, the practice of
WS&S provision hardly ever involved consumers in decision-making and
management. Recipients of WS&S projects were referred to as
beneficiaries and to the extent that assessments were made of felt needs,
they were not made on the basis of wide consultation and participatory
methods. As a result, the services provided often did not reflect user
preferences, were not maintained, and were used inappropriately or not at
all, reducing potential benefits. It is now accepted that, for reasons both of
equity and efficiency, programmes and projects need to be responsive to
peoples felt needs and based on genuine demand. Assessing demand
before project preparation and design whether it is expressed or latent
demand helps to achieve interventions which are socially acceptable.
It is also a way of starting out with a genuine commitment to partnership
and empowerment.
41
2.2
2.2
In summary, participatory
approaches put people at
the centre of the
development process. The
implications are wideranging. Government
agencies, NGOs, donors,
and communities
themselves need new ways
of working, new skills, and
new attitudes. There is no
doubt that the change is
worth making; the legacy
of past failures is reason
enough. The challenge is
to equip and empower
people to take rational
decisions for themselves,
and to ensure that
government and donor
practices are able to
respond effectively to
consumer choice.
2.2.2
Custom and culture
Just as customary water and sanitation sources existed prior to WS&S

projects, so the people involved do not come to projects as blank
sheets. People have existing notions of health and well-being, they
have long-standing hygiene practices, and they operate within
complex webs of formal and informal institutional arrangements and
local power relationships. These include very specific arrangements
for the management of common property resources. People generally
act rationally and consistently, although often not in accordance with
the expectations of engineers, planners, or officials.
A vivid example is that many villagers will not share Western notions
of the germ theory of disease. They almost certainly have some other
explanation of disease, and may regard pollution of a water source by
animals, for example, with as much horror as would a medical officer
of health but for different reasons (ODA, 1995). When people are
ignored and the local context is not taken adequately into account,
WS&S schemes fail. So, as well as being technically appropriate and
financially sound, WS&S projects need to pay particular attention to
cultural factors and to the social and organizational context in which
the schemes take place.
For instance, in countries with large Moslem populations it is
essential to take account of purdah, the seclusion and/or veiling of
women, in the design and siting of rural water supplies and sanitation
facilities. In South Asia, waste and sanitation services cannot be
designed without recognizing notions of ritual pollution and social
relations influenced by caste. To illustrate the point, there is often
great resistance to efforts to encourage community participation in
waste and sanitation projects in contexts where the maintenance of
these systems is seen to be the ancestral occupation and birthright of
particular groups or castes (Beall, 1997b).
In recognizing culture it is important to be alert to two critical factors:
first, culture is context specific; and second, it adapts to changing
circumstances. So for example, caste taboos around water use are
often more strictly observed in rural than in urban areas of India,
while in Pakistan the pressure of unemployment means that castebased jobs around waste removal are being taken on by other groups
(Beall, 1997c).
2.2.3
Local-level informal institutions
WS&S is not just an individual or household issue. It is a collective

concern and requires the active involvement of communities in
planning, construction, or operation and maintenance. In any
community, there are customary networks which form the basis of
individual trust and co-operation, currently being referred to in broad
terms as social capital. They also underpin the way in which
communities organize collective activities and pool resources such as
water sources and communally owned land. In South India and parts
of Africa, for example, entire villages manage community-based
42
irrigation systems and have developed monitoring systems to

discourage water theft.
On the other hand, it cannot be assumed that people living in the same
neighbourhood or village constitute a single community. They may be
divided by caste, ethnicity or political factionalism, and do not
necessarily possess institutions to resolve conflicts between those
divisions and to reach and implement decisions, or to decide whose
authority will be accepted.
It is not always easy for
engineers to accept the
validity of community
decisions which seem to
contradict their professional
judgement. They may not
appreciate the priorities
related to land tenure, local
power bases, or sociocultural conditions. Only by
working through existing
local structures and
recognizing the efficacy of
community preferences,
can development agencies
design projects which are
equitable and sustainable.
The priorities of user groups may well differ from those engaged in
project design or implementation. Engineers or government officials may
be concerned with providing water of an acceptable quality, but rural
communities will choose their source for different reasons. These may
indeed be based on the perceived quality of the source (often based on its
taste), but also on factors such as the time, distance, and effort involved in
collection. Other important factors may be who owns the land on which
the source is located, the nature of the route leading to the source, or the
others who use it. To appreciate these priorities and preferences it is vital
to recognize who owns, controls, or has rights of access to land, and to
understand how this relates to local power structures and arrangements
for the use of common pool resources.
Attempts to speed up a community development process by
circumventing existing or customary institutions and investing in new
externally designed organizations have frequently failed in their aims.
They also carry the danger of undermining and being sabotaged by
local power brokers, and so diminishing the ability of community
Different approaches to care of water in Tanzania
In the varied ethnic groups and natural environments of East Africa, attitudes to
and care of water differ within the family circle and of the wider community.
Concepts of ownership and attitudes towards community or individual
responsibility for water sources are important. Where there is sharing of sources
there is usually some feeling of responsibility for keeping the facilities clean and
in working order. The strongest tradition of co-operation is found among the
Chagga in Tanzania, with their long record of irrigation from the streams of
Kilimanjaro. Among other groups work crews and periodic cleanup operations
tend to be informal and established in response to the initiative of concerned
households. The Gogo do not improve sources much and there is no strong
organization for this purpose. Among the Lango a group of women will dig and
clean a small hole which constitutes a well. They will not prevent other women
from using the well but will make remarks about their laziness in failing to build
their own or to maintain the common one.
Where sharing of water sources has been the custom, the introduction of piped
supplies serving only part of the population may cause a problem. At Karuri, one
resident complained that people who own supplies are prevailed on by
neighbours for water. Some owners of piped supplies solved this social
dilemma by selling water to their neighbours by the tin, or by collecting rainwater
from the roof in drums and letting their neighbours use this freely.
White et al., 1972
43
2.2
members to co-operate and organize effectively. Community-based

programmes need to use and build on existing stocks of social capital
and, where possible, to work through existing power structures and
organizations. Examples of successful new organizations are those
which draw upon what is already in place and are as much the
creation of members as organizers. Working with existing leaders and
building on indigenous principles of organization is the approach
adopted by the Orangi Pilot Project (OPP) in Pakistan. OPP has taken
an incremental approach to challenging local power relations and to
developing womens empowerment in its work helping local people to
attain sanitation services.
There are times, though, when creating new groups or structures is the
only means of promoting the participation of disadvantaged people.
Projects that wish to challenge highly inequitable social organization,
which specifically target poor communities, or that have gender equity
goals face this dilemma. After the first democratic elections in South
Africa in 1994, it was recognized that new institutional arrangements
were necessary to redress historical imbalances in the distribution of
infrastructure and services. The Department of Water Affairs and
Forestry (DWAF) in Eastern Province realized the structural
limitations it faced in working with diverse communities at local
level. Therefore it has developed an effective partnership with the
NGO Mvula Trust. The NGO works at community level, both forming
and building the capacity of local organizations to participate in
district-level indabas or consultative fora.
2.2
The lifestyle of a young girl in Ethiopia

Elma Kassa is a thirteen-year-old girl from Addis Ababa, Ethiopia. Her father is
a labourer and her mother is a washerwoman. She has one younger sister and
a brother.
I go to collect water four times a day, in a 20-litre clay jar. Its hard work! When I
first started collecting water I was about seven years old. In those days we used
to have to walk for over a mile to fetch water. Now there is a tapstand about 10
minutes from my home, which has made life easier.
Ive never been to school as I have to help my mother with her washing work so
we can earn enough money. I also have to help with the cooking, go to the
market to buy food, and collect twigs and rubbish for the cooking fire.
Our house doesnt have a bathroom. I wash myself in the kitchen once a week,
on Sunday. At the same time I change my clothes and wash the dirty ones.
When I need the toilet I have to go down to the river in the gully behind my
house. I usually go with my friends as were only supposed to go after dark
when people cant see us. In the daytime I use a tin inside the house and
empty it out later.
If I could alter my life, I would really like to go to school and have more clothes.
WaterAid, 1996b
44
DFID/Lorraine Chittock
2.2.4
Gender is a vital issue in

WS&S programmes. It is
not just a question of giving
women a voice, though that
is important. Nor is it right
to make women more
influential by increasing
their workload that is
counterproductive.
Fetching and carrying water
for their families is a huge
burden for millions of
women. Relieving them of
that burden is a laudable
aim. Filling the time thus
saved with other duties,
such as hygiene education
or community work, is a
gender-blind approach
which can undermine the
benefits of improved WS&S
facilities.
It is the decision-making
role of women which can
have the greatest impact
on the sustainability of
WS&S programmes, and
that needs to be brought
into play at all levels, not
just community level.
Recognizing gender issues in water and sanitation
Women and men use water and contribute to water management in

different ways. For example, it is mainly women and girls who use
water for domestic purposes, while men and boys may compete for
water from the same sources for farming and livestock purposes.
What is meant by a gender approach is that the different
responsibilities and needs of both women and men are taken into
account in the design and management of projects. Gender relations
need to be understood as context specific and efforts need to be made
to ensure the fullest possible participation of both women and men in
programme and project processes.
For millions of women around the world, fetching and carrying water
is part of their daily routine. Water containers typically hold about 20
litres of water and weigh 20 kilograms. Carrying such a heavy weight
on the head, back, or hip has severe health implications for women,
who commonly experience backache and joint pains. In extreme
cases, curvature of the spine and pelvic deformities result, creating
complications in pregnancy and childbirth (WaterAid, 1996b).
Collecting water is not only physically stressful but also time
consuming. Women in rural Africa often walk ten miles or more every
day to fetch water. As well as travelling these long distances, women
have to wait in line to collect water, sometimes for hours. In the dry
season, customary water sources are depleted and it can take up to an
hour for an East African woman to fill her bucket (White et al., 1972).
Children and particularly girls are required to help their mothers with
water collection and other domestic tasks. This means they are not
able to attend school and often have little time left for play.
With regard to sanitation, women often have different privacy
requirements from men. For example, in densely populated urban
settlements without adequate sanitation, they are required to use
public spaces by cover of darkness in the early morning and late
evening, and can suffer health problems related to urine retention as a
result. In a project in El Salvador it was found, for example, that
women would not use the communal latrines designed by male
engineers, because the toilets had been designed with a gap at the
bottom of the door which exposed their feet and offended notions of
privacy (Moser, 1989).
Although women play a major role as custodians of water sources and
in the management of environmental hygiene and sanitary services at
the household and community level, they have rarely been consulted
in WS&S programmes and projects. A survey of 300 women in 30
villages, conducted in 1989 with the support of the NGO the SelfEmployed Womens Association in Gujarat, India, found that:
42 per cent of women said they were never consulted about the site
of the borehole or the water supply standpost;
63 per cent of women showed readiness to learn skills of water
harvesting, drip irrigation, afforestation, and desalination; and
45
2.2
in most projects women were not consulted on decisions

concerning the site, budget, formulation of the scheme, and its
operation and maintenance.
2.2
In the poorest communities

where sanitation is
inadequate and water
supplies are sufficient only
for the bare necessities of
life, decision-making, for
both women and men, may
come down to hard choices
between water needs for the
household and for
income-earning activity
outside.
These most hard-pressed
groups are perpetually at
greater risk of health
problems and are often
suffering from chronic poor
health, impacting on their
ability to earn a living.
Frequently, these conditions
go hand-in-hand with poor
environmental surroundings
and such fragile existences
are correspondingly more
vulnerable to the exceptional
climatic conditions that
produce floods or drought.
46
It is now recognized that the success of programmes and projects

depends on the active involvement of women, because it is they who
fetch and store water, dispose of domestic waste and childrens
excreta, teach hygiene habits to children, and provide much of the
healthcare in the family. Women are thus invoked to participate in
hygiene education schemes and are recruited as community
mobilizers and healthworkers (see also Section 2.8). This can have a
negative effect on women themselves however, as they are already
busy with childcare, domestic tasks, and often income-generating
activities as well. Time savings through improved water supply can
easily be undermined by the opportunity costs and increased
workload of ill-conceived and gender-blind efforts at involving
women in community participation. Thus attention needs to be paid in
project design not to over-burden women or to make them
environmental custodians under conditions over which they have little
control. The best way to do this is to involve women directly in
decision-making from the outset, and for implementing agencies to
employ women in positions where they can influence programming
decisions.
2.2.5
Livelihoods, vulnerability, and the environment
There is a substantial literature attesting to the impact of poor living

and environmental conditions on people in poverty. As Douglass
argues in the case of Asia, When viewing environmental distress and
poverty together, the major conclusion to be drawn is that the
consequences of environmental deterioration fall heaviest on the
poor (Douglass,1992: 11). Suffering comes as a consequence both of
the environmental health risks associated with inadequate
infrastructure and services, and because environmental degradation
impinges negatively on livelihood strategies. Nowhere is this more
evident than in the case of water supply and sanitation.
The health impact of absent or inadequate WS&S is discussed in
Section 2.3. The impact on livelihoods results in part from the toll on
the health of household breadwinners, dependants, and carers, and in
part from the competition for scarce water resources between
domestic and income-earning activities. For example, in rural areas
decisions sometimes have to be made between water for domestic use
or for keeping livestock alive. Such choices are often intricately tied
up with gender relations and the gender division of labour.
Balancing the roles and relationships that make up household
livelihood strategies is made all the more difficult in times of scarcity
and risk. In relation to water supply, seasonality is an important factor.
In rural areas, customary sources may disappear during the dry
season, involving women in longer journeys to fetch water. In urban
areas, water shortages can affect some sanitation options such as
pour-flush latrines, or can reduce the availability of water for some

income-generating activities, leading to more hard choices.
In the wet season food is often in short supply because the harvest is
not yet in, there is often more illness (especially malaria), and rural
womens time may be in high demand for planting and weeding crops.
If it is not feasible to provide improved water supplies nearby on a
year-round basis, wet season wells and rainwater catchment may be
more useful in these circumstances than they might seem.
This manual does not cover water supply and sanitation in emergency
contexts. However, it is important to note that beyond poverty, some
households or communities can be at particular risk. For example,
households or settlements may be vulnerable to floods due to their
location, or communities may be at risk through being prone to
drought. In such cases, the natural and man-made components of such
disasters need to be factored into both environmental (Section 2.4)
and social impact analysis.
2.2.6
In such circumstances the
obvious WS&S needs may
be accompanied by the
expressed willingness of
households or communities
to pay for improvements,
but the ability to contribute
to the associated costs will
be strictly limited. The
principle of cost recovery,
bringing recognized
benefits in terms of
sustaining community
interest in a programme,
can still be pursued, but the
charging regime must be
carefully tailored and
balanced with the assessed
means of the users.
Making this assessment
and linking household or
community incomes to an
affordable level of service
improvement that meets
community demands and
aspirations can only come
from early and ongoing
discussion with these
intended users.
Achieving cost recovery and advancing equity
Experience world-wide shows that water supply and more particularly

sanitation programmes face sustainability problems if they are not
based on genuine demand, conventionally expressed as willingnessto-pay. It is assumed that cost sharing reflects a commitment to the
project in question, and in recent years cost recovery has become a
feature of most WS&S programmes. It is further argued that while
sharing capital costs fosters ownership, recovering recurrent costs
helps programme sustainability. This is true, but there are caveats.
A causal relationship between cost recovery on the one hand, and
project ownership and sustainability on the other, is by no means
automatic. An influential study of rural water supply conducted in
Lesotho during the 1970s (Feachem et al., 1978) demonstrated that
the level of cash contributions collected from villagers was so modest
and the administrative costs so high, that cost sharing had a negligible
effect on project sustainability. Also, rather than instilling in villagers
a sense of ownership and responsibility, contributing cash, labour, and
local materials towards construction convinced them that they had
already paid their fair share and that the government should take on
the longer term responsibility of operation and maintenance.
This example serves to underscore the importance of on-going
consultative processes and the development of a mutually agreed and
shared agenda from the outset. It does not imply that water supply and
sanitation services should be free to users. Some contribution from
users is certainly desirable.
Cost-recovery policies can improve the position of poor people in a
number of ways. For example, if collected revenue improves the
sustainability and reliability of water supply systems, this benefits the
poor, who are least able to cope with bad system performance. Costrecovery mechanisms can also be used to charge higher income
47
2.2
consumers, determined by area, for example, according to the number

of taps in a dwelling or by metering water use, so as to cross-subsidize
lower income households and communities. Section 2.5 addresses this
issue in more detail.
2.2
Private input has

traditionally played an
important role in service
provision. It carries the
danger that vulnerable
groups may be sidelined
for several reasons
including poverty,
geographical location, or
local prejudices. If
programmes are alert to
these difficulties local
private input can lower
project costs and, where
extended into operating
and maintenance activities,
can offer the additional
benefits of increased
activity and opportunity in
the local work environment.
For the poorer

communities a degree of
subsidy will nevertheless
sometimes be necessary.
Setting the level of subsidy
needs care, not least
because of the movement
towards cost recovery in
current and more recent
programmes. This can
lead to inequities in
48
There are various means of pursuing cost recovery while at the same
time being alert to issues of affordability. For example, the developing
of financing mechanisms built on customary practices such as
revolving funds can play a useful role. Affordable appropriate
technologies, which accord with local demand and can be operated
and maintained by local users, have a vital role to play (see also
Section 2.7). Private entrepreneurship currently plays a significant
role in service delivery to people in poverty and building capacity in
the private sector can improve both affordability and livelihood
opportunities, particularly when it includes local level and informal
sector enterprises.
However, it should also be noted that risks and problems of equity are
associated with private provision. While many low-income
households and communities are able and willing to pay for the
services they want, some remain vulnerable. In poor rural
communities, for example, vulnerability may result from being cut off
from existing or proposed sources of water or from sanitation
services, due to social invisibility or distance from centres of
decision-making and investment. In urban areas certain households
and communities may be excluded from services as a result of poverty
or for reasons of social identity, for example ethnic marginalization.
Thus cost recovery from very poor households and communities must
take into account their ability to pay. This is often different from
expressed willingness-to-pay. For example, in low-income urban
communities where people are reliant on vendors for their water, they
may be willing to pay a relatively high price for water, so long as it is
below the vendors rates. However, this may result in them keeping
their consumption at minimal levels, with increasing health risk. Even
then, water payments may still absorb a disproportionate and far
larger share of household incomes than the cost of water and
sanitation to better off households (see also Section 2.5). Whereas the
better off households can sacrifice non-essential expenditure to pay
their water bills, poor families have little choice but to reduce their
food budget, with obvious implications for their nutritional status.
A balance has to be struck when determining charging policy. The
charging structure needs to take into account peoples poverty as well
as information from willingness-to-pay studies. It also has to be
recognized that the higher the level of cost recovery, the more public
subsidies can be directed towards extending basic services to more
poor people, instead of subsidizing existing consumers.
Additionally, people need to know and agree to exactly which aspects
of water supply and sanitation they are willing and able to pay for. It
may be easier for members of low-income communities to reconcile
charges between these and

earlier projects where costreflective charging was not a
common feature.
The implications of this can
be seen, for example, in
established urban areas
where the piped water mains
and sewers of the central
zone, laid some years ago
under conditions of heavy
subsidy, will typically serve
higher-income families.
Newer investments in the
peri-urban zones, which will
be seeking cost recovery, will
usually be directed towards
lower-income groups.
themselves to paying user charges for on-plot sanitation, for example,

rather than for communal latrines, or for secondary or primary
infrastructure where the benefits might not be immediately apparent.
Members of low-income households also need to know how often, in
what manner (for example weekly, monthly, or annually) and for how
long they are expected to pay. Willingness-to-pay is not only tied to
issues of household budgeting, which in themselves have important
gender dimensions, but is closely linked to the legitimacy and
effectiveness of the agencies and organizations responsible for service
delivery. How people pay, and to whom, therefore influences how
much they are willing to pay.
Subsidies are not a magic cure for poverty. Indeed, they do not
necessarily reach poor households or communities. They can be both
socially and politically motivated and have often been channelled to
services rather than people. Urban areas may benefit from subsidized
water supply at the expense of rural areas. Within urban areas,
subsidized centralized water and sanitation systems reach only a
minority of city dwellers, as mains water and sewerage are
concentrated in middle-class and better-off areas. Moreover, new
Setting a charge that is
investments often tend to be in existing serviced areas. In developing
affordable and equitable to
countries, those who receive services are estimated by the World Bank
all can be achieved by a
to pay on average 35 per cent of the costs and, in effect, governments
system of cross-subsidies,
heavily subsidize urban lites (Black, 1994). As cost sharing and user
using the increased revenues
charges usually characterize new investment in WS&S in low-income
from higher charges in the
areas, inequities may be further compounded (Jarman, 1997) unless
higher income communities
careful attention is paid to technology choice and means of cost
to aid cost recovery in the
recovery.
less favoured areas, with an
appropriate lowering of
service charges to these
households.
In the terms of the DFIDs
Poverty Aim Marker (PAM),
actions targeted on specific
areas of low-income
households can be
described as focused
actions.
In order to avoid this inequity, policy approaches can target efforts

specifically at low-income households, for example by discrete areabased interventions in deprived rural regions or in slums and informal
urban settlements. In terms of DFIDs Poverty Aim Marker (PAM)
(see Section 1.5), this would constitute focused action.
In urban systems in particular, when services are being extended into
low-income areas, steps must be taken to ensure that the unit cost of
water to poor people does not exceed what better-off consumers pay.
Mechanisms for doing this are discussed in Section 2.5.
2.2.7
From participation to partnership
During the 1990s it was recognized that extending access and

sustaining service provision would demand a lot of human energy,
including the efforts of local communities and local private sector
actors. The role of governments in actual service provision is on the
wane, their emphasis changing to the development of economies of scale,
the co-ordination of wide coverage and multiple sectors, and building
partnerships of service providers and service users. UNICEF (1995) also
sees the public sector as having a role in ensuring equity, and in situations
where local institutions and the private sector are weak, it sees
government service provision as of continued importance.
49
2.2
2.2
In tandem with moves

towards cost recovery, the
1990s has seen a transition
in the respective roles of the
various parties to WS&S
improvements. Except in
particular situations, perhaps
where local government
structures are lacking or
weak, national governments
have tended to distance
themselves from service
provision in favour of a
broader co-ordinating and
planning role.
The role of the private sector is discussed in Section 2.6 and

elsewhere but it is important to make two observations here. First,
private involvement in water supply and sanitation spans a broad
range of activities, which includes households and communities
engaging in the private informal provision of infrastructure and
services, in the absence of public or formal private sector provision
(Batley, 1996; Beall, 1997b). Second, the private sector is not
monolithic and embraces an informal economy, which is involved in
construction, production, and service provision (Beall, 1997c). This in
turn provides both services and livelihoods for low-income people.
Civil society organizations are diverse in both structure and

motivation, from community-based organizations (CBOs) engaged in
self-help activities or procurement (Cotton and Sohail, 1997), to nongovernmental organizations (NGOs). NGOs are involved in activities
ranging from service delivery, for example of low-cost water supply
and sanitation, to intermediary activities such as negotiating with local
The private sector, formal
government on behalf of communities. They can take on broader
and informal, is therefore
advocacy activities as well, such as issues related to poverty
playing a bigger part and at
reduction, equitable service provision, or public health. It is not
the same time users, now
required to contribute money unusual for NGOs to establish themselves to perform one kind of
as well as labour and time to activity, and to find themselves inexorably drawn into others, so that
one organization may be active across a spectrum of activities.
improvement enterprises,
have increasingly come to
be recognized as
programme partners rather
than beneficiaries.
Where this leads to user
input at the earlier stages of
project preparation it has the
positive result of relating
project content more closely
to community requirements.
The increased involvement
reinforces user commitment
to the project and
encourages a more
questioning user relationship
with the participating
agencies more demands
are made on the successive
layers of contributing groups
and organizations CBOs,
NGOs, local, regional, and
national governments.
The agencies most closely
involved with users are
therefore having to adjust
50
Many national and international NGOs provide an important

intermediary function, whether it is channelling development
resources to community-based organizations, providing them with
services and technical assistance, or helping them to strengthen their
capacity to make demands on government.
NGOs have a number of advantages as intermediaries, not least
because they are usually familiar with low-cost techniques and local
innovations, and have field presence and good rapport with local
communities. NGOs do not always solve the problem of linkages, but
some try. The Orangi Pilot Project (OPP) model involves a multitude
of small informal organizations, each of which takes responsibility for
tertiary services in its own lane or immediate neighbourhood.
Government, through a local government department or the
appropriate line agency, continues to be responsible for external
services to use the OPP terminology. The OPP acknowledges that it
has experienced difficulties in establishing linkages between internal
and external services (Hassan, 1997).
Local and international NGOs have demonstrated that they are often
well placed to reach low-income communities and households in
terms of commitment, location, relationships, and planning
methodologies. However, there are also a number of risks and
assumptions relating to NGOs. The case of the World Banks JAKPAS
project in Nepal is instructive. Up to 1996 this project provided funds
to NGOs to organize the construction, operation, and maintenance of
schemes with villagers, but experience showed that NGOs tended to
their roles and answer new

questions arising from this
evolution towards
partnership arrangements
that look beyond the base
practical details of WS&S
improvements and seek to
integrate them with the
associated aspects of
social development.
This can present some
difficulties for the partnering
agencies. They now have
to forge stronger links with
users. The CBOs, NGOs,
and local governments in
particular must extend their
interest beyond the initial
focus on the technologyoriented needs of
interested users and seek
also to address gender
issues and other aspects of
culture and established
social and hierarchical
order in the target
communities.
Only in this way can the
welcome movement
towards integration of
social issues into WS&S
programmes be expanded
to the point where it
becomes accepted as the
norm.
take over the implementation (with diversion of funds) rather than to

facilitate the process as intended.
In the end, there is no substitute for strong user involvement whatever
the institutional mix. User participation has played a central role in
meeting the challenges of the water and sanitation sector. Consulting
and involving users in the design and preparation as well as
management and maintenance of WS&S provides a means of
revealing both expressed and latent demand and of ensuring that
services match what people want, are able to pay for, and will strive to
maintain. Participatory approaches can also help to resolve conflicts
over water resource allocation among competing uses, and to ensure
that choices are anchored in demand and not unduly influenced by
contractors, consultants, or other secondary stakeholders.
Conventionally, participation in rural water supply has been through
the development of village water committees, which in turn mobilize
and manage people in providing contributions of cash and labour in
self-help initiatives during the construction and maintenance phases of
a project. Best practice examples also involve users in design, and
work synergistically with existing formal and informal institutions and
political structures. Previously the focus has been on the contribution
The Self-Help Rural Water Supply Programme in Malawi
The Malawi gravity-fed rural water supply scheme was one of the earliest
examples of popular participation in large-scale, government-sponsored
development projects in Africa, and it delivered sustainable benefits over a wide
area. Forty-seven piped water schemes supplying over one million people have
been completed since the Programme was first developed in the late 1960s.
The popularity of the project lay in the fact that the piped water was brought to
villages from a year-round source such as a spring or stream, located above
the line of habitation, making the water both pollutant free and reliable.
New schemes were only undertaken at the request of local communities who
were involved in system design and planning. Appropriate technology was
developed that matched local needs and local resources. Sharing responsibility
between the government and local communities, based on their respective
comparative advantages, meant that communities were expected to perform
only the tasks they could manage, given appropriate training, resources, and
organizational and technical support. They were required to supply nearly all
the labour for construction and to carry out continuing maintenance after
construction.
The Programme devised appropriate institutional solutions. Working with
existing patterns of organization appropriate to local conditions and with
recognized local leadership, both traditional and political, enabled the
programme to expand quickly and yet leave behind effective local management
capacity. Political backing was an important factor. Initially the Malawi Congress
Party was a constructive force at village level, providing a bridge between
traditional leaders and the self-help committees. In later years the Party became
alienated from its roots and its actions undermined the spirit of self-help,
providing a reminder that the role of politics cannot be discounted.
Krishna and Robertson,1997
51
2.2
of peoples participation to the efficiency and effectiveness of projects

(Narayan, 1995), but increasingly it is recognized that asking people
to contribute towards the costs of improved services means they will
make more demands on the project. They will ask what benefits they
will obtain from the investment of their time, energy, and money into
the development, improvement, and operation and maintenance of
WS&S services. The greater the contribution from users, the less they
can be treated as beneficiaries, and the more they must be seen as
partners (Evans, 1992), and as partners, communities are likely to make
more demands on governments and agencies. This poses new issues.
While projects such as the Self-Help Rural Water Supply Programme

in Malawi were able to scale out horizontally with much success,
existing institutional relationships were not tested beyond the
community level. Moreover, just as there are risks and assumptions
associated with NGOs, so there are with CBOs as well. Inequities and
power relations within a locality can mean that communal rubbish
bins are never placed outside the homes of high status families, while
handpumps may very well be located next to the headmans
homestead. Within a partnership approach, developing appropriate
linkages between users and providers of services remains a challenge.
It is often low-level field staff or workers who provide entry points for
developing linkages.
2.2
Socially sensitive partnerships depend, in the end, on the attitudes and

capabilities of local government to understand and undertake social
development processes. This is a difficult problem given the limited
capacity of local government departments and the technical
orientation of most training provided to professionals involved in both
rural and urban water supply and sanitation. An example of an
organization trying to change is provided by Shrestha and Pyakural
(1996).
Practice
How do the principles of social development translate into practice?
How can they become an automatic part of good practice in WS&S?
A social development perspective is supported by two key
methodologies: social analysis, and the incorporation of social issues
and participatory approaches into the process of development
planning. Social analysis is particularly important in the
identification, preparation, and appraisal of WS&S programmes and
projects. It also provides socio-economic baseline data for on-going
monitoring and subsequent evaluation. A social development
perspective in development planning includes:
responding to the demands and needs of those affected by projects
and policies;
reaching poor and disadvantaged populations;
recognizing the roles and needs of women, as well as men;
52
encouraging participation of all stakeholders in the development

process; and
creating an enabling environment for inclusive partnerships.
Adopting a social development approach is not a once and for all
exercise, but a process which informs policy dialogue, programme
and project formulation, design and implementation, as well as
management and evaluation.
2.2.8
If a social dimension is to
be included in a project it
must be introduced to all
the partner groups at the
outset (project identification
stage).
It must be founded on a
comprehensive baseline
study (a social impact
analysis) of social
conditions applying at
household, community, and
local institution levels in the
populations concerned.
The study should classify
information according to
sex, age, class and, where
appropriate, language,
ethnicity, and religion.
Key outputs must include
analysis of:
cultural beliefs and
sensitivities, particularly
as they apply to water,
water sources, and
sanitation;
community power
structures and
hierarchies; and
current rights and
practices concerning
existing water sources
and supplies, including
water vending activity.
Conducting social impact analysis
For reasons of equity and effectiveness and to avoid risks, attention to

social issues needs to be built into programme activities as early as
possible, ideally at the identification stage. This is particularly
important in the context of a partnership approach. If DFID is to
introduce and gain acceptance for social objectives and participatory
approaches among all programme partners (including other donors
and the private sector as well as government, NGOs, and
communities), this has to be introduced before the appraisal stage
when negotiations are usually already well advanced.
Primary and secondary data which describe socio-economic
conditions and analyse social relationships in a proposed project
location are collected at an early point in the project cycle, so as to
provide benchmarks and indicators for planning, monitoring, and
evaluation. Known as situation analysis, baseline studies, or the
term used by DFID social impact analysis (SIA), studies are
conducted during sector reviews and at the identification stage of all
projects.
In social impact analysis, information collected should include
general demographic information about the population, disaggregated
according to sex, age, class, and settlement, and, where appropriate,
religion, ethnicity, and language. Cultural issues with regard to water
and sanitation are especially sensitive and may differ among different
groups or on the basis of socio-economic status; gender, age and the
life-cycle; and according to physical ability. Particularly important
are: perceptions about the healing and health properties of traditional
water sources; preferences around the taste and smell of water;
customary hygiene practices and perceptions of clean and unclean
water; customary sites for bathing, washing clothes, and ablution for
women, men, and children; and issues of privacy with regard to
sanitation. Analysis of social customs and norms will permit better
dialogue about the siting of new water installations and sanitation
facilities, for example, as well as facilitating appropriate hygiene
promotion.
The household
Information about households should include residence patterns, their

average or typical size, composition, and organization. There should
be a solid understanding of the gender division of labour in the
household, the tasks undertaken by children, and the hierarchies and
53
2.2
power structures within the household. Livelihood systems and

strategies should be understood, including patterns of migration and
who contributes to and controls different assets and areas of
household budgeting. This information is crucial for understanding
key water uses. It is also helpful in assessing how much time and
resources different household members have for participating in
WS&S provision, and whether all household members are willing and
able to pay for it.
The community
Jo Beall
2.2
Socio-economic data on the community should include information on

whether the community is rural, urban, or peri-urban, whether it is
large or small, homogeneous or heterogeneous. Customary approaches
to cross-subsidization within communities need to be understood
along with the way in which care and social safety nets are provided.
Economic information should include the type and size of enterprises
and employment opportunities. This also provides an opportunity for
understanding competing water uses at household and community
level, as well as the impact of water supply projects on traditional
water sellers or owners of traditional sources of water. They may
stand to lose income or status in the community and they may play a
dominant role in consultation processes as a result. Where possible,
groups with a special relationship to existing water sources should be
involved in the planning and possibly management and maintenance
of proposed WS&S projects.
Local-level institutions
Time spent on the initial

study is time well spent. As
well as describing current
conditions it forms the
basis for assessing user
demand, defining
appropriate improvements
and estimating likely user
participation and outcome
benefits. Finally, when
those benefits, the impacts
of the improvements on
user livelihoods, are
evaluated, it provides the
benchmark for doing so. In
all these areas the results
are directly affected by the
quality of the initial analysis.
54
Participatory approaches need to be built on a thorough understanding

of the leadership and organization of the community, including both
formal and informal groups and structures. It is crucial, for example,
to discern the importance of traditional leaders and other hierarchies,
including informal power structures. These issues are important for
identifying and analysing natural resource management, use of
common resources, and the customary operation and maintenance of
infrastructure. Understanding of community organization and informal
institutional arrangements may influence the siting of installations,
technological options such as pour-flush versus simple pit latrines,
and cost-sharing arrangements.
Monitoring and evaluation
Establishing both good baseline information which feeds into

benchmarks and indicators for monitoring and evaluation allows for
better social impact assessments when the project is finished.
Traditionally assessment of improved WS&S provision was made
against construction targets and the percentage of people with access
to improved services. Then water supply projects came to be
measured against the criteria of quantity, quality, accessibility, and
reliability, using indicators such as distance to old and new sources of
water, and time and energy saved in collecting water. It is only quite
recently that evaluations have assessed the impact of WS&S provision
on poverty, understood through the perceptions of poor people
themselves. Combining participatory approaches with other methods
not only deepens understanding but also provides the conditions for
developing inclusive processes and responsive projects. Indicators are
discussed further in Section 3.5.2 and also in Narayan (1993). See the
further reading at the end of Section 2.2.
2.2.9
Methods
Social analysis includes a range of methods which help to assess

whether a community, sets of communities, or groups within a
community, want a project or are likely to participate in and benefit
from it. The extent of the investigation required will depend on how
much is already known, for example from existing socio-economic
studies or previous projects. The methodologies employed will depend
on the size of the proposed location and budget, as well as the nature
of the problem and the project. However, a combination of methods is
often advisable so that robust benchmarks are identified. Indicators
should be relevant, measurable, and comprehensible to all
stakeholders and should be developed, probed, and checked with
primary stakeholders.
Some of the following research methods may be useful:
review of available information and previous projects
formal surveys
semi-structured and conversational interviews with key
informants
observation
group interviews with households, occupational groups, or
segments of communities
life, work, and organizational histories
public meetings
The strengths and
weaknesses of the three
methods commonly used
for demand assessment
revealed preference,
contingent valuation, and
participatory rapid
appraisal are referred to
in Section 2.1.9 and Table
2.1.2. Participatory rapid
appraisals, as well as being
quick to implement, have
the prime advantage of fully
involving users in both
information gathering and
analysis, thereby promoting
local capacity building and
strengthening partnering
attitudes.
workshops
participatory rapid appraisal (PRA) methods
A general rule of thumb is that quantitative methods are best suited to
exposing what and how much, while qualitative methods are more
appropriate for their explanatory value and answering the question
why?. They are also good for answering the question what next?
and feed well into policy decision-making processes.
Social impact analysis can be used to explore attitudes to water such
as quality and taste, its use in domestic and livelihood activities, and
whether water from certain rivers or sources is imbued with magical
or spiritual qualities. Social impact analysis can also reveal whether
water is considered a free good in a particular context, and whether
people are willing and able to pay for new or improved services. This
is invariably related not only to issues of affordability, but to existing
water supply or sanitation facilities and the improved options on offer.
Three main types of demand assessment are used within DFID. First,
revealed preference (RP) methods measure demand indirectly by
55
2.2
examining current behaviour, such as time spent fetching water or the

price paid to water vendors. Second, contingent valuation (CV)
methods ask people directly what they would be prepared to pay for
different or improved services in the future (see Section 2.5). Both
direct and indirect assessments of demand can also be undertaken
through a third approach, that of participatory rapid appraisal
methods. These usually constitute a number of qualitative research
methods used in combination and triangulated or cross-checked
against one another. They usually take a participatory form and
include indirect methods of assessing the services and practices
people already have, what they currently pay for water and to whom,
and what their perceptions are of proposed changes to services and
charges.
In conducting demand assessment, different methods have different

strengths (see Section 2.1.9). Large-scale CVM surveys of randomly
selected households can give a reliable indication of what proportions
of people might be willing to pay various prices for different levels of
service, but focus groups might better tell you why. Care needs to be
taken in drawing strategic-level conclusions from focus group or
community meeting discussions, however, because the participants in
these discussions may not be representative unless they are randomly
selected (see Davis and Whittington, 1997).
2.2
Participatory rapid appraisal
Often resources and time do not permit extensive social research.

Instead, participatory rapid appraisal (PRA) methods are used as a
quick and clean means of conducting social analysis and of
ascertaining social impact. The advantage of including participatory
methods of enquiry is that when they are well done, the research itself
The Community-based Environmental Management
Information System (CEMIS) Project
On the basis of pilot work in Indonesia, the Community-based Environmental
Management Information System (CEMIS) project advocates that communities
themselves assess effective demand. The approach is to train communities to
assess their own demand for services through self-survey of needs and
community workshops. It uses community leaders and volunteers, uses locally
available information and resources, and leads to local-level empowerment and
self-determination.
At the beginning of the process local people are consulted at a community
meeting held to prioritize environmental problems. If water supply tops the
agenda, for example, the community may decide to determine effective
demand. During the research, workshops are held with community volunteers
to familiarize them with the methodology and develop a plan for the self-survey
which they would then conduct. After the data is collated and analysed, the
results are presented back at a community meeting. There consensus would be
reached on the commitment of individual households to contribute to the
provision, operation, and maintenance of the service.
UNCHS, 1996
56
belongs to local people, who contribute to its analysis as well.

Facilitators help them to analyse and understand their situation in
relation to a wider context, so that they can plan their role in projects
and assess the impact on their future. In this way, PRA not only
contributes to the process of information exchange but also to the goal
of developing a shared agenda and to local capacity building.
PRA draws on the following menu of sources and activities:
use of secondary data, maps, and reports for background
information
direct observation
case studies, work, and incident histories from local experts
semi-structured interviews with key people
transect walks: systematically walking through an area with local
guides, observing, asking, listening, and learning about water
sources and uses, sanitation provision, settlement patterns,
technologies, etc.
group discussions of different kinds (casual, focus, community)
mapping and modelling to show local world views
matrix scoring and ranking exercises to compare preferences and
conditions
well-being grouping to establish local criteria for deprivation and
disadvantage
time-lines and trend and change analysis to show chronologies of
events and to analyse local trends and causes of change
seasonal calendars and daily time use analysis to show work
patterns and activities
Information from PRA should be made available to all stakeholders as
early as possible in order that it can feed into and facilitate
participative processes. Further reading on PRA techniques is
included in the references at the end of this section.
Stakeholder analysis and gender planning
Gender-separated statistics
are an important output of
the impact analysis,
assisting the planning and
implementation of WS&S
improvements around the
separate needs, functions,
and responsibilities of men
and women in the
community.
Stakeholder analysis as outlined in DFID planning guidelines (ODA,

1995a; 1995b; 1995c) provides a means of identifying those groups
who may directly or indirectly be affected by projects, both positively
and negatively. It also ensures that not only users or primary
stakeholders are recognized as having vested interests in the project
and the planning process, but secondary stakeholders also, such as
donors, governments, and project staff.
Once people as well as pipes are recognized in WS&S planning, it is
easier to disaggregate all categories of stakeholders on the basis of
gender or other important categories such as ethnic groups and rural
urban distinctions. Gender planning techniques include the use of sexdisaggregated statistics, task analysis in which the activities of men
and women are defined, relational analysis which explores the relative
position of women and men in society, and gender planning checklists
57
2.2
for project planning. Together these help respond to the different

responsibilities and needs of women and men, and allow for gender
differences in the way women and men engage in the planning,
implementation, and management of programmes and projects.
2.2.10 Developing participatory practice
2.2
Participatory practice as
now envisaged is a step
forward from earlier
examples where user input
was usually limited to
practical matters centred
on the construction and
subsequent operation and
maintenance stages.
More recently, as costrecovery has become an
important element of WS&S
programmes, financial
input has been added to
the user side of the
participation equation.
These arrangements are
valuable as aids to project
affordability and
sustainability, but fall short
of giving users a full role in
the earlier planning and
design decisions on
matters that can
significantly impact on their
future lives.
Correcting this by
developing user
participation into
meaningful partnerships is
a slow process demanding
patience and, in many
instances, changed
attitudes and new skills in
the secondary stakeholder
groups, such as CBOs,
NGOs, and local
governments.
For a long time the case for community participation in WS&S was
made simply on the grounds of cost effectiveness and efficiency.
Participation provided the opportunity of incorporating indigenous
technical knowledge into planning and design, of devolving
responsibility for operation and maintenance to the level where there
was most at stake, and of relying on community self-help in the
context of increased emphasis on cost sharing. In this case,
participation was advocated on the grounds of long-term project or
programme sustainability and this rationale remains valid.
However, in WS&S provision as in many other sectors of
development, there is a growing emphasis on building both individual
and community level empowerment. This involves approaching the
development process from below and increasing peoples role in
shaping their own development. It is closely linked to the shift away
from supply-led to demand-responsive approaches, which
advocate the active involvement of primary stakeholders at all stages
of the project cycle. Empowerment is also linked to strengthening
civic engagement and government responsiveness. There are a
number of examples of WS&S projects, such as WAMMA in
Tanzania, highlighted in the box at right, which are actively
attempting to incorporate demand into their project planning, usually
through the use of PRA methods.
Building capacity and shared agendas
Sometimes local groups or secondary stakeholders need help to raise

levels of awareness and sensitivity. For example, professionals may
need gender training or capacity building in participatory research and
planning techniques. At community level capacity building may
involve skills training and confidence building to ensure participation
in project fora and partnerships.
Linking demand and participation
Demand is concerned with defining what is done: participation concerns
how it is done. Responding to demand is an important first step but does not in
itself create a sense of primary stakeholder ownership. Even where project
interventions are welcomed by and appropriate to the needs of primary
stakeholders, their exclusion from continuing decision-making and planning
processes often prevent community management or maintenance systems
from working effectively, and prevent poor people from developing and
sustaining any sense of control over their own lives.
Derbyshire and Vickers, 1997
58
WAMMA: Empowerment and partnership in practice

WAMMA is an example of how, during the five years up to March 1996, an
evolutionary partnership between the government of Tanzania, an international
NGO (WaterAid) and Tanzanian villagers helped attain sustainable water and
sanitation services among 86 communities in the Dodoma region of Tanzania.
In that same period, the villagers concerned raised the amount of money in
their village water funds from nothing in 1991 to UK25,000 (US$40,000) in
1996.
Professionals and workers

in these groups must
adapt, sometimes with
(additional) training, to the
increased interactions with
users that must become
the norm. These will extend
into areas of the
programme cycle not
previously exposed to
consultation processes.
More consultation and
interaction should ease the
path to shared agendas,
for example enabling
professionals to illustrate
and promote the
substantial medium-term
benefits seen to arise from
a certain WS&S
improvement which
householders, with
pressing daily concerns,
might not see as an
immediate priority.
Today the WAMMA programme has become a model of an integrated

participatory approach to community water supplies. The four multisectoral
teams at the heart of the programme were formed principally from junior staff in
three departments (Water, Health, and Community Development). Most were
unskilled and demotivated by low pay, poor job satisfaction, and a lack of
practical experience. As fieldworkers and agents for change, they have become
dynamic and committed teams, respected by the villages they work with and by
the managers and directors of their departments.
Integrated, participatory partnerships require patience, flexibility, and long-term

commitment and cannot be achieved from a rigid blueprint. WaterAid has been
working in partnership with the Tanzanian government in Dodoma Region for
more than a decade. Relationships involving government officers at national,
regional, and district level, WaterAid staff, and local community representatives
have progressed from cautious suspicion to mutual respect, but not without
significant difficulties on the way. Throughout, approaches were modified in
response to local conditions and attitudes. The end result was teamwork.
Government staff, WaterAid, and the villagers share common goals and
recognize the benefits of collaboration.
2.2
Jarman & Johnson, 1997
In WS&S projects a balance has to be struck at times between an

objective assessment of aggregate need by professionals and the
prioritized demands of communities themselves, not necessarily
supported by all local people. An illustration is that sanitation
provision is not always a prioritized demand among the urban poor,
who may be more preoccupied with earning a daily income than with
long- or even medium-term health risks. One approach to developing
a shared agenda is to try and stimulate demand, for example through
social marketing components of hygiene promotion, which might
emphasize issues of dignity, status, and improved property values as
much as health (see also Section 2.8). Another is to hold communitylevel or multi-stakeholder workshops. Whatever techniques are used,
raising awareness to stimulate change in behaviour and attitudes is a
long-term process which requires skill, resources, and time to work
interactively at community level.
The demands of partnership
Not all stakeholders can or want to participate equally at all stages of

a programme or project. Pretty et al. (1995) identify seven different
types of participation ranging from low-level passive participation
where people are simply told what is going to happen and what to do,
through to functional participation and self-mobilization where people
take initiatives themselves. DFIDs guidelines (1995a) on enhancing
59
It should be borne in mind

that increased participation
does not mean continuous
participation on the part of all
interested partners.
Programmes are fluid and
can be complex and multifaceted. They therefore
require inputs from and
interactions between different
partners at different stages of
the project cycle.
2.2
stakeholder participation provide a useful model to assist in thinking

through at which points in the programme cycle information,
knowledge, and decision-making processes might be shared.
This is particularly important in projects concerned with water and
sanitation, where a shared agenda needs to be developed around
several issues such as technology choices, the level and location of
services, and the deployment of different kinds of expertise. DFIDs
participation matrix illustrated at the end of Section 3.2.2 (Figure
3.2.1) recognizes that the specific circumstances and purposes of
primary and secondary stakeholder participation can shift over the
project or programme cycle. For example decisions around the
structure and involvement of community-level organizations at
various stages, or the procedures for operation and maintenance,
require on-going clarification and negotiation. Beyond the
information-gathering exercise of many PRA methods, these can
extend into decision-making processes and prioritization. Planning
for Real (Gibson, 1996) is a version of participatory planning
particularly well suited to projects concerned with physical
infrastructure and urban services, and it accommodates the steps
towards successful partnerships elaborated below.
The starting point for successful partnership is for all participating
groups to know that:
WaterAid/Jim Holmes
they are recognized and valued;

they can do some things alone but also need the help of others; and
they are included in decisions that will affect their work or lives.
60
Seven steps towards successful partnerships in

Professionals and officials look

to the ground
5. Agree division of
responsibilities with
community
representatives
6. Explain your
limitations and lines
of accountability
7. Be accountable to
partner communities
and stay in regular
contact with them
Learning from
experience of other
projects
and sectors
5. Negotiate for respect

for contributions of
money, time, and
energy
CATALYSING ROLE
OF
SOCIAL DEVELOPMENT
FACILITATION
4. Negotiate options
for technology, siting
of installations, cost
sharing, and
operation and
maintenance
6. Agree on a division
of responsibility with
professionals and
officials
Learning from experience

of other projects
and other sectors
Capacity building towards
participation
for empowerment
Linking local groups
and agreeing agendas
4. Learn from the

knowledge and
experience of
professionals and
officials
3. Share local
knowledge with
professionals and
officials and
understand their role
2. Develop local-level
skills, selfconfidence, staying
power and credibility
1. Involve everyone in
assessing needs,
resources, and
assets within the
community involving
everyone
3. Explain what you

are doing and break
down big plans to
show local details
and how they fit in
Capacity-building
in
public and private
institutions
2. Learn from the

knowledge and
experience of local
actors and respond
to their views
Changes
in
Professional Training
7. Be accountable to
partner professionals
and officials and
explain to them who
else you are
accountable to
1. Learn about
communities and
the different groups
within them, and
learn how to relate
to them
Local communities
set their sights higher
61
2.2
Further reading
Introductory texts
Cairncross, S., Carruthers, I., Curtis, D., Feachem, R., Bradley, D. and Baldwin, G.
(1980) Evaluation for Village Water Supply Planning, Wiley, Chichester.
Feachem, R., Burns, E., Cairncross, S., Cronin, A., Cross, P., Curtis, D., Khalid
Khan, M., Lamb, D. and Southall, H. (1978) Water, Health and Development: An
interdisciplinary evaluation, Tri-Med Books Ltd., London.
White, G.F., Bradley, D. and White, A. (1972) Drawers of Water: Domestic water
use in East Africa, University of Chicago Press, Chicago and London.
These three books represent early examples of interdisciplinary studies of rural
water supply, which include a social development perspective. They were
pioneering studies and continue to stand the test of time.
Poverty and social development
2.2
Beall, J. (1997a) Introduction to J. Beall (ed.) A City for All: Valuing difference
and working with diversity, Zed Books, London.
Jarman, J. (1997) Water supply and sanitation in J. Beall (ed.), A City for All:
Valuing difference and working with diversity, Zed Books, London.
A useful introduction to social development issues in an urban context. The
chapter by Jarman examines the relationship between poverty and water supply and
sanitation in the city, providing best practice examples of interventions.
Gender issues
FINNIDA (1993) Looking at Gender, Water Supply and Sanitation, Finnish

International Development Agency, Helsinki.
SIDA (1996) A Gender Perspective in the Water Resources Management Sector,
Swedish International Development Agency Department for Natural Resources
and the Environment, Publications on Water Resources No.6, SIDA, Stockholm.
Together these provide a good overview of gender issues as they pertain to WS&S.
The SIDA publication is particularly useful in that it provides a checklist in relation
to gender at each stage of the programme cycle.
Participation
Dudley, E. (1993) The Critical Villager: Beyond community participation,

Routledge, London.
Evans, P. (1992) Paying the Piper: An overview of community financing of water
and sanitation, IRC Occasional Paper No.18, IRC International Water and
Sanitation Centre, The Hague.
Narayan, D. (1993) Participatory Evaluation: Tools for managing change in water
and sanitation, World Bank Technical Paper No.207, World Bank, Washington DC.
These texts are recommended for their analysis and application of participatory
approaches in the context of infrastructure projects and water supply and sanitation
respectively.
62
In the developing world

inadequate water supply
and sanitation facilities are
the prime cause of
widespread and serious
health problems, but
improvements in these
services show few health
benefits unless they are
coupled to improved
hygiene behaviour.
Inadequate water supply,
poor sanitation, and poor
hygiene all offer routes for
transmission of faecally
contaminated matter, the
source of diarrhoea and
many other diseases.
The main health benefits of

both water supply and
sanitation interventions lie
in the reduction of faecaloral diseases, of which
diarrhoea, estimated to kill
over three million people a
year, is by far the most
important.
2.3 Health aspects

Health is one of the most important reasons for investing in water,
sanitation, and hygiene. While the measurement of health
improvements is extremely difficult, rigorous studies (Esrey et al.,
1985, 1991) have demonstrated conclusively that well-designed
projects can make important contributions to health. Experience
shows that the provision of water and sanitation technology alone,
without changes in hygiene behaviour, will usually achieve little or no
significant health improvement. On the other hand, water and
sanitation improvements can be the spur to changes in hygiene
behaviour (see Section 2.8).
Principles
2.3.1
How water affects health
Water affects health in the developing world mainly through helping or

hindering the transmission of communicable diseases such as diarrhoea,
scabies, schistosomiasis, and malaria. These diseases are characterized by
an infectious agent (e.g. bacteria or parasites), a human or animal host
containing these agents, and transmission routes from old hosts to new
hosts. Bradley (1972, 1977) and Feachem (1977) developed a useful
classification of such communicable diseases affected by water (see Table
2.3.1). The system looks at the ways in which water affects infectious
disease transmission, and thus the ways in which water interventions may
reduce the burden of disease.
Faecal-oral diseases
This group includes cholera and other diarrhoeal diseases, typhoid,

hepatitis A and E, and many other diseases which are spread by people
swallowing faecally contaminated matter containing the organisms which
cause these diseases. The main health benefits of both water supply and
sanitation interventions lie in the reduction of faecal-oral diseases; of all
of these, diarrhoeal disease is by far the most important.
Diarrhoea is estimated to kill over three million people every year, the
overwhelming majority of whom are children. The toll is not just in
mortality, but also in heavy morbidity (sickness); the median
frequency of diarrhoea is 2.6 episodes of diarrhoea/child/year for
those under five, while the median frequency among infants is five
episodes/child/year (Bern et al., 1992). These are median rates, and
vulnerable communities will experience much higher rates of attack.
Many of these attacks are serious, and all demand time, care, and
often money from the family.
Faecal-oral transmission can follow a number of routes as shown in
the F-diagram (see Figure 2.3.1). Water and sanitation affect
transmission in a variety of ways. Sanitation, with good hygiene, acts
as a fundamental primary barrier by ensuring that faecal matter is
disposed of safely, and does not spread in the environment. Once in
the environment, however, there are many ways in which infected
faecal matter can be spread. Good water supply can support a number
63
2.3
2.3
Figure 2.3.1. Transmission of disease from faeces
of the secondary barriers, which prevent the further spread of

contamination and infection to new hosts.
There are two ways in which water can affect faecal-oral disease
transmission. One is through water-borne transmission, in which
faecally contaminated water transmits the disease-causing organisms
directly to the new host. Contaminated drinking water can lead to
dramatic epidemics, in which large numbers of people are
simultaneously exposed to infection. The second way is through
water-washed transmission, that is, transmission encouraged by poor
hygiene due to insufficient quantities of water for washing. Where
water is scarce, it is very difficult to maintain clean hands, clean food,
and the clean household environment essential to control many of the
other routes of faecal-oral transmission.
Water-washed transmission is not as dramatic as water-borne
transmission, as it does not often affect so many people at the same
time. On the other hand, the conditions for water-washed transmission
are common, and exact their toll every day, whether or not an
epidemic is in progress. Water-washed transmission probably
contributes more to the endemic (continuous) toll of diarrhoea than
does water-borne transmission.
The distinction between water-borne and water-washed is important,
because while improving the quality of drinking water can reduce
64
Good water quality is

important as a faecally
contaminated water supply
can lead to direct ingestion
of disease-causing
organisms by many,
possibly causing an
epidemic. An adequate
quantity of water, however, is
more important in controlling
non-epidemic disease,
which in fact exerts a higher
toll. Increasing the quantity
of water available allows
better hygiene and can thus
prevent disease
transmission from faecal
contamination of hands,
food, or household utensils.
Washing hands and utensils
in dirty water can still reduce
contamination, and is better
than not washing them at all.
water-borne transmission, increasing the quantity of domestic water

used is the most important way to reduce water-washed transmission.
Where water use is low, water-washed transmission is widespread,
and simply increasing the quantity of water used, regardless of its
quality, can be expected to reduce the transmission of faecal-oral
disease. Put very simply, washing faecally-contaminated fingers and
utensils, even with dirty water, is better than not washing at all.
Increasing the quantity of water used by households is probably more
important than increasing the quality to reduce the day-to-day nonepidemic toll of disease. Of course, increased water use is not a goal
in itself, but an indicator of changes in hygiene behaviour. Under
certain conditions it will result directly from improved access to water
(see Section 2.3.7). On the other hand, hygiene promotion efforts need
to be directed at specific behaviour changes, rather than at an increase
in water use per se (see Section 2.8.4).
Strictly water-washed diseases
These are the diseases, apart from the faecal-oral diseases, which can
be reduced through increasing the quantity of water available to
households, regardless of its quality. Skin infections (e.g. scabies,
body lice, tropical ulcers) and several eye infections (e.g. trachoma,
conjunctivitis) fall into this category. Thus, in addition to reducing
faecal-oral disease, increasing the quantity of water used in the
household will also reduce these infections. Improved sanitation
would not be expected to have any effect upon strictly water-washed
Adequate quantities of water diseases, except through the control of flies, which have been
are relevant to many other
incriminated in the transmission of eye diseases.
diseases. No mortality is
generally associated with a
range of skin and eye
infections but some millions
are blinded by the eye
infection trachoma; many of
these diseases can be
reduced by increasing water
quantity.
Water-based diseases
These are parasitic infections of humans in which the parasite spends

a part of its life cycle in an intermediate aquatic host. The two most
significant diseases within this category are schistosomiasis
(bilharzia) and guinea-worm. Improvements in water supply can
significantly reduce these infections; indeed, water supply is a major
focus of the effort to achieve world-wide eradication of guinea-worm.
Water-related insect vector diseases
These consist of a number of insect-borne diseases where the insect

(known as a vector) spends a significant portion of its life cycle
breeding or biting around water. These diseases include malaria,
filariasis, yellow fever, dengue, and onchocerciasis (river blindness.)
Domestic water and sanitation projects are unlikely to influence such
diseases, with the possible exception of filariasis. These diseases,
however, should be considered in the planning, development, and
execution of large-scale water-resources projects. Good management
of urban infrastructure (e.g. solid waste management, drainage, and
construction site management) can also can be significant in reducing
urban breeding sites for malaria, yellow fever, and dengue vectors.
Chemical contamination
As stressed in the WHO Drinking Water Guidelines, many chemical

water quality standards (such as those for salinity, iron, and hardness)
have evolved in response to such real consumer concerns as taste,
65
2.3
Table 2.3.1
Type of water
related infection
Examples
Water-related
control measures
diarrhoea, typhoid,
hepatitis, cholera
increase water quantity

used
improve water quality
Strictly water-washed
scabies, trachoma,
conjunctivitis
increase water quantity

used
Water-based
(intermediate host)
guinea-worm,
schistosomiasis
restrict contact, provide

alternative sources
Water-related insect
vectors
malaria, filariasis,
river blindness
focus on insect breeding

sites (not much scope in
domestic water supply)
Table 2.3.2
2.3
Summary of Feachem-Bradley Classification of WaterRelated Disease (after Cairncross & Feachem, 1993)
Substance
Inorganic drinking water contaminants of public

health significance
Maximum guideline concentration (mg/l)
arsenic
0.01 (P)
cadmium*
0.003
chromium*
0.05 (P)
cyanide*
0.07
fluoride
1.5
lead*
0.01
mercury* (total)
0.001
nitrate (as NO3)

selenium*
*
P
50
0.01
contamination likely to be from artificial source.

provisional guideline
staining, and excessive soap requirements. These are important, as

they will have a significant effect upon the consumer choice of water
source, but they are not directly related to health.
The number of chemicals which are both widely distributed and
which constitute a significant health threat is fortunately small.
Nevertheless, natural contamination by such chemicals as arsenic and
fluoride can contribute to very serious health problems.
The main inorganic chemical contaminants of public health concern
are shown in Table 2.3.2, although the reader is referred to the WHO
66
As noted in the WHO

Guidelines for Drinking
Water Quality,
microbiological
contamination is by far the
most widespread and
serious threat to health
from poor water quality. In
some cases (e.g. where
levels of arsenic and
fluoride are naturally high)
there may be chemical
dangers to which
programme planners must
be alert, but in most cases
a good water supply will
benefit users without the
need for refined chemical
analysis.
An obvious example of the
need for balance in this
area is the interest in trace
carcinogens that can be
produced by the
chlorination of some source
waters; the protection
chlorine affords against the
deadly faecal peril far
outweighs any hypothetical
increase in cancer risk.
Guidelines for Drinking Water Quality (1993a) for a complete listing.

Those marked with an asterisk are unlikely to be found in these
concentrations in natural waters, and usually occur only as the result
of artificial contamination (e.g. industrial leachate, lead pipes).
There can be little general guidance on the vast variety of possible
organic contaminants from agricultural herbicides and pesticides.
Where these are suspected to be a problem, analysis is a worthwhile
investment. Where there is no reason to suspect a problem, however,
such analysis is unwarranted and far from routine. This point holds in
general for chemical hazards. It is not realistic or worthwhile to
propose chemical testing of all water sources, especially in rural areas,
for possible contamination.
Most pesticides are insoluble emulsions, and tend to sink to the

bottom of surface water bodies. They accumulate in the food chain,
particularly in bottom-feeding fish. Long before pesticides reach
concentrations which constitute a health hazard in water, therefore,
they will have reached far greater and more hazardous levels in the
fish, and in those who eat them.
Over the past twenty years there has also been growing concern in the
engineering community about the formation of trace amounts of
carcinogenic organic compounds (for example, carbon tetrachloride)
Table 2.3.3
Some orders of magnitude of the world-wide extent of

water-related disease
Morbidity
Mortality/year
diarrhoeal disease
1,000 million episodes/year
3.3 million
cholera
>300,000
>3,000
enteric fevers
>500,000
>25,000
roundworm (Ascariasis)
2040% rate of infection in

developing countries
1. Faecal-oral
2. Strictly water-washed
trachoma
6-9 million blind
skin infections
very common, millions
3. Water-based intermediate
host (parasitic)
schistosomiasis
200 million
guinea-worm
1989: 890,000
1996: 35,000 (and still
dropping!)
>200,000
4. Water-related insect vector

malaria
300-500 million cases
filariasis
128 million
dengue
30-60 million infected/year
1.5-1.7 million
67
2.3
from the chlorination of drinking water. The risks from such

compounds pale into insignificance compared with those from
drinking water which is not reliably disinfected, and any claim that an
alternative disinfectant to chlorine is safer on these grounds should be
treated with suspicion.
2.3.2
2.3
The cycle that leads to

faecal-oral disease
transmission begins with
poor sanitation.
Failure to dispose of
human excreta safely can
contaminate the
environment and new
victims through a variety of
routes. While contaminated
water supplies are one
route, poor personal and
household practices can
spread disease in other
ways. Even where
acceptable sanitation
facilities are installed, the
risks are not eliminated, as
poor hygiene can still
spread disease through a
variety of faecal-oral routes.
How sanitation affects health
Sanitation, defined in these guidelines as the safe management of

human excreta, naturally has its greatest impact on excreta-related
diseases. The chosen definition of sanitation rightly includes both
hardware and software components, as effective interventions need
to stimulate both the construction of sanitary facilities for excreta
management, and their hygienic use.
Understanding the health aspects of sanitation requires some
understanding of the types of diseases involved, how they are
transmitted, and how sanitation hardware and hygiene promotion are
likely to affect them. The classification described below was
developed by Bradley and Feachem (Feachem et al., 1983), and this
summary follows closely that of Cairncross and Feachem (1993).
These diseases, described earlier by the F-diagram (Figure 2.3.1),

are among the most obvious targets of sanitation for health; they are
endemic throughout the developing world. The effectiveness of
sanitation as an intervention in reducing faecal-oral diseases can vary
substantially with the required dose for infection. Bacterial infections,
such as cholera, often involve large infective doses, and these are
naturally more susceptible to control through sanitation than other
diseases, such as polio or hepatitis, which require only a small dose to
spread the disease. Many of the faecal-oral diseases (e.g.
salmonellosis) involve transmission cycles that can pass through
animal hosts, which therefore limits the benefits of controlling only
human excreta. Controlling human wastes will do little good if the
disease can be spread by the excreta of chickens in the household.
Soil-transmitted helminths
Sanitation alone has its

greatest impact on
parasitic worm infections.
These diseases, like the
faecal-oral group, are
endemic in the developing
world and can be
significantly reduced by
eliminating excreta or
sludge disposal on the
ground around habitations,
including areas accessed
by pigs and cattle.
68
These are parasitic worm infections where the eggs, passed in human
faeces, require some time in favourable conditions, usually moist soil,
to mature and become infective. These diseases include roundworm,
whipworm, and hookworm, which are debilitating diseases that can
contribute to malnutrition and can become severe conditions in their
own right. These diseases are widespread throughout the developing
world. Good sanitation facilities, which are regularly cleaned, can
make a significant contribution to the control of these diseases; a
poorly maintained latrine, however, can actually become a focus of
infection.
Beef and pork tapeworms
These tapeworms require a period in the body of an animal host

before they re-infect humans when the animals meat is eaten without
being cooked sufficiently . Any system which prevents pigs and cattle
from eating untreated excreta, or grazing on soil contaminated by

fresh sewage or sludge, will therefore control the transmission of
these parasites.
Water-based helminths
This group is the same as the water-based intermediate host group

described for water, with the exception of guinea-worm, which is
unrelated to excreta management. The most important member of this
group is schistosomiasis. Since one worm can multiply in the snail
host to produce thousands of larvae each day for over a year, faecal
contamination must be practically eliminated to reduce transmission.
Under these conditions, restricting human contact with water (e.g.
through provision of convenient water supplies) is likely to be far
more effective than sanitation alone.
Excreta-related insect vectors
There are two groups to consider. Firstly, culex mosquitoes, which do

not transmit malaria but can transmit filariasis, breed extensively in
septic tanks and flooded latrines. Secondly, flies and cockroaches
often thrive on excreta and have been implicated in some transmission
of faecal-oral disease. Mosquitoes, flies, and cockroaches all
constitute a great nuisance, and poor urban households have
consistently been shown to spend substantial amounts of their scanty
household income on using control coils and nets.
Table 2.3.4
Sanitation-related disease, and the likely effects of interventions

(after Cairncross & Feachem, 1993)
Category
Examples
Dominant
transmission
mechanisms
Likely effect
of sanitation
hardware alone
Likely effect
of hygiene
promotion
alone
Faecal-oral
(non-bacterial)
Hepatitis A
Amoebic dysentery
Rotavirus
Giardiasis
Person-to-person contact
Domestic contamination
Negligible (as very low

infective dose required)
Moderate
Faecal-oral
(bacterial)
Cholera
Salmonellosis
Shigellosis
Many forms of diarrhoea
Person-to-person contact
Domestic contamination
Water contamination
Crop contamination
Slight to moderate
Moderate
Soil-transmitted
helminths
Hookworm
Roundworm
Whipworm
Yard contamination
Communal defecation areas
Crop contamination
Great
Negligible
Tapeworms
Beef tapeworm
Pork tapeworm
Yard contamination
Field contamination
Fodder contamination
Great
Negligible
Water-based
helminths
Schistosomiasis
Water contamination
Moderate
Negligible
Excreta-related
insect vectors
Filariasis
Some faecal-oral diseases
Insects breed or feed in

sites of poor sanitation
Slight to
moderate
Negligible
69
2.3
2.3
Experience shows that

WS&S hardware
improvements, without
effective hygiene
promotion, are not enough
to improve health
significantly among poor
communities. Making water
available in or near the
house leads to a natural
increase in washing, but
other beneficial changes to
hygiene behaviour require
other forms of promotion.
In 1992, an informal WHO
working group reviewed
epidemiological literature
and field experience in
hygiene promotion, and
identified three areas where
particular attention should
be focused:
the safe disposal of
childrens stools;
the washing of hands
with soap after defecation
and before touching
food; and
the safe storage of water
in the household.
WHO, 1993b
The above classification summarizes the various ways in which

sanitation can affect health. The faecal-oral group exacts by far the
heaviest toll in human health of all the sanitation-related diseases,
followed by the soil-transmitted helminths. While the above
discussions only promise moderate success in their control, this is
far more significant than much greater success in controlling much
rarer diseases.
2.3.3
How hygiene affects health
Hardware by itself cannot improve health very much; what matters is

the way in which it is used, and the ways in which it may promote
changes in hygiene-related behaviour. In some cases this change is
fairly automatic; people across the world need little encouragement to
increase the amount of water they use for washing once it is readily
available at the household level. In other cases, however, a significant
amount of time and effort is required to alter hazardous practices
which are considered safe, or are simply not thought about.
Even after substantial investments have been made in water and
sanitation hardware, hygiene behaviour in these areas often remains a
substantial risk to health. In many cultures, for example, the excreta of
young children are considered safe, and are thus not treated with the
same hygienic concern as the excreta of adults. In fact, as children are
the main victims of faecal-oral diseases, they are consequently the
main reservoir of infection. This means that the faeces of children are
more infectious than those of adults, as they are more likely to contain
the disease-causing organisms.
The practice of washing hands with soap after defecation is another
example of a behaviour that does not follow automatically from the
provision of hardware, and yet which has major health implications. A
classic study by Khan (1982) in Bangladesh showed that the simple
practice of washing hands with soap after defecation was sufficient to
reduce the secondary attack rates of dysentry within participating
families by 85 per cent. Similarly, B.C. Deb et al. (1986) examined
transmission within families with one proven case of cholera. Some
families were provided with a traditional sorai water storage container
with a small diameter inlet and outlet which does not permit users to
dip into the storage container; control families used the more
widespread practice of dipping into a common bucket. The rate of
cholera transmission within the families with the sorai was 75 per
cent lower than that in the families using conventional water storage
and dipping. While such an intervention may not have much impact on
transmission between families, it is a simple, effective, and low-cost
intervention to reduce transmission within the family (see Section 2.8.7).
2.3.4
Epidemiological summary of WS&S interventions
Esrey and colleagues (1985, 1991) have been involved in a number of

reviews of the epidemiological literature of water and sanitation.
These reviews have demonstrated a wide range of results for
superficially similar interventions. Some discrepancies may arise from
70
poor study design and an inability to control for such variables as

hygiene and socio-economic status, while others may stem from the
very complexity of the problem and the variety of transmission routes
and disease-causing organisms. Esreys results for the relatively few
rigorous studies which were felt to be relatively free of
methodological error are summarized below.
Table 2.3.5
Diarrhoeal morbidity reduction from WS&S

(Esrey et al., 1991)
Rigorous studies
Type of intervention
No. of studies
Median % reduction
Water and sanitation
30
Sanitation
36
Water quality and quantity
17
Water quality
15
Water quantity
20
Hygiene
33
Looking at the effects of water supply improvements on other

diseases, Esrey found the following:
Table 2.3.6
Disease
Adding good hygiene to

WS&S interventions is not
the end of the story. Lack of
attention to other aspects of
community environmental
health can detract from or
nullify the intended benefits.
Poor solid waste
management encourages
rats, flies, cockroaches, and
other vectors of disease.
Uncontrolled waste tips in
poor areas often contain
faecal matter and are fertile
breeding grounds for pests.
Indiscriminate rubbish
dumping can lead to
blocked drains and
overflows.
2.3
Effects of improved water supplies on nonfaecal-oral disease

No. of rigorous
studies
Median reduction in
morbidity
Range
Guinea-worm
78%
75-81%
Schistosomiasis
77%
59-97%
Trachoma
27%
0-79%
Note that guinea-worm is the only one of these water-related diseases

where water-quality was significant to the intervention; the benefits of
water supply improvements in reducing schistosomiasis stem from
reducing contact with infected bodies of surface water, and the
reduction in trachoma resulted from increased quantities of water
allowing better personal hygiene.
2.3.5
Health aspects of other components of

environmental sanitation
There is more to environmental health than water supply, sanitation,

and hygiene. In developing countries, the other main environmental
health measures include drainage of surface water and sullage, solid
waste management, and vector control. These will only be discussed
in these guidelines as they relate to water and sanitation interventions.
Drainage
No sanitation system can be considered safe if the area it serves is

poorly drained. Any sanitation system (sewer, septic tank, pit latrine,
or other) can become a source of faecal contamination when flooded,
as the flood waters will mix with the excreta and spread the
71
In adequate drainage of
surface water and sullage
can lead to local flooding
and spread of waste from
foul sewers, septic tanks or
latrines.
2.3
Sometimes the best

investment in drainage is
better solid waste
management.
Where improving
community health is a
major objective for a WS&S
intervention, appropriate
health specialists need to
be involved from the
beginning. Unless health
issues are properly
reflected in the project
design from the start,
technical planners are
unlikely to achieve
significant improvements in
community health.
contamination wherever the water flows. Sullage consists of

domestic water exclusive of toilet waste, but this does not mean that it
is safe; water used for cleaning clothes and nappies can be heavily
contaminated with the same disease-causing organisms that sanitation
is intended to control. Runoff consists of the portion of rainfall that
runs off the surface during or after a storm. Sewers are often designed
to drain all three liquid wastes (toilet wastes, sullage, and runoff) but
they can be very expensive. Regardless of the technical option chosen
for sanitation, both runoff and sullage need to be disposed of safely if
a sanitation system is to be considered complete.
Solid waste management
Piles of rubbish in the streets or at dump sites can provide a habitat for
rats and flies, and thus contribute to the spread of a number of
diseases; rats are major vectors of plague, leptospirosis and other
infections, and flies are one of the transmission routes in the Fdiagram for faecal-oral disease. In addition, tin cans and tyres can
contribute a significant breeding ground for Aedes mosquitoes, which
transmit dengue and yellow fever. Apart from these direct health
impacts, solid waste is also linked to the faecal-oral transmission
route in a number of ways.
First, where sanitation is poor, faecal matter can often be a significant
fraction of solid waste. In Lucknow, for example, DFID-funded
studies of sanitation and solid waste estimated that the contents of
dry latrines contributed 30 to 40 tonnes/day or five per cent of the
total mass of the solid waste chain; this excludes the faeces discharged
to the small and large drains of the city. Given the lead time required
for replacement of dry latrines with more sanitary options, it was clear
that attention had to be directed to the solid waste system in the short
run to address the inherent health risks.
Secondly, unmanaged solid waste usually ends up blocking surface
water drains or sanitary sewers, and thus contributes to flooding and
the faecal contamination described earlier. Sometimes the best
investment in drainage is better solid waste management.
Vector control
Many municipalities have a group that is responsible for pest and

vector control. These operations are primarily aimed at reducing the
hazards from mosquito-borne and rat-borne diseases. As mentioned
earlier with regard to excreta-related insect diseases, septic tanks and
flooded latrines can become a focus of Culex mosquito breeding, and
construction sites can become temporary (but dangerous) breeding
grounds for malaria-carrying Anopheles mosquitoes. Consultation
with the vector control staff at the municipal level can help to
establish how serious these problems may be on a given project, and
may forestall the possibility of water and sanitation improvements
actually making the situation worse.
Public and domestic domains
In thinking about environmental health, it is helpful to distinguish

between the public and domestic domains of transmission. The
72
domestic domain is defined as the area normally occupied and under

the control of a household, while the public domain includes public
places of work, schooling, commerce, and recreation, as well as
public infrastructure, streets, and fields (Cairncross et al., 1996).
Whereas transmission in the public domain can allow a single case to
cause a large epidemic, transmission in the domestic domain, while
less dramatic, can account for a substantial number of cases and a
significant fraction of endemic disease. Infection in the public domain
is relatively widespread and indiscriminate, whereas infection in the
domestic domain is characterized by clustering around those
households where sanitary conditions, for whatever reason, are poor.
Work done in Brazil (Moraes, 1996) studying ascaris (roundworm)
and other worm infections found that the provision of drainage (which
also acted as sanitation) reduced the overall level of infection. The
work also suggested that as the infection level dropped, it tended to
become more clustered by household. The results thus suggested that
drainage made wastewater contamination of the streets less common,
and reduced infection in the public environment. Once the public
transmission had been reduced, however, the residual transmission
between household members in the domestic environment became
relatively more important.
There is a temptation when dealing with public services and public

health to focus on the public domain, and this may well be a suitable
first priority. The studies showing the benefits of hygiene in
improving health, however, illustrate the critical role of promoting
health at the household level as well as in the public environment.
Practice
How do the above principles translate into practice? What are the
aspects of water and sanitation projects and programmes that are most
important to consider in practice to maximize health? As shown
above, the requirements for improved health involve good hardware
and good software; providing reliable, effective, and low-cost
hardware are described in Sections 2.5, 2.6, and 2.7, while the
application of health principles to hygiene and sanitation promotion is
described in Section 2.8. Given the detailed coverage in these specific
areas, there are only a few fundamental points of practice to
reiterate here.
2.3.6
Think about health from the start
A common difficulty in any multidisciplinary activity is the

temptation for members of one discipline with a strong interest to
develop most of the project, while involving the other disciplines only
in the later stages of the work. This can be particularly troublesome
when activities with a substantial lead time (such as the data
collection and training of hygiene promoters, or the establishment of
systems to develop and market low-cost sanitation options) are
invited into the project only in the later stages, when fundamental
decisions about the level of service and the types of intervention have
73
2.3
already been made by the lead stakeholders. If health benefits are

likely to be a major justification of the project, it is critical that
competent public health specialists be involved from the outset to
assess the scope and plausibility of these health benefits. These
specialists can then contribute to the development of relatively lowcost project or programme activities which can ensure that such
benefits are maximized. As with any discipline, it is easier to
contribute when involved from the beginning than if added in as a
bolt-on.
2.3.7
Quantity, as well as quality
of water must be a focus of
attention.
2.3
When water is brought

within easy reach of the
household water use
increases dramatically.
When water is further away
or involves a return trip
travel time exceeding half
an hour water consumption
drops off. (Note that
queuing can be a
significant contribution to
this time.) Between these
two extremes, however,
water consumption is
surprisingly constant and
does not vary substantially
when the return trip travel
time is in the approximate
range of three to thirty
minutes. Reducing tap
spacing in this range
reduces drudgery and work
and saves time but will not
lead to increased water
consumption and resultant
health benefits.
Focus on quantity as well as quality of water supply
It is intuitively clear that the quantity of water a household will actually

use must somehow be related to its distance from a water source; we
would all expect households with house connections to use more water
than households an hour away from the nearest source of water. While
this intuitive perception is certainly true, detailed water use studies
carried out in the 1970s and 80s have reached a surprising consensus on
water-use patterns between these extremes. Cairncross (in Cairncross &
Feachem, 1993), developed the diagram below as a summary of the
results of these water-use studies in East, West, and Southern Africa,
Nicaragua, India, Sri Lanka, and Bangladesh. (While the exact levels of
the graph vary from site to site, the shape and turning points are similar
at all sites. It has been noted e.g. by Thompson (1998) that the
water consumption versus tariff graph is conceptualy similar, and in fact
has been observed to have a similar shape.)
Schemes which increase the number of public taps, in either rural or
urban settings, but only move residents along the plateau of the
consumption vs. travel time graph, will not increase water
consumption at the household level, regardless of how much water is
available at the tap. Such an intervention cannot be expected to reduce
water-washed transmission of disease, and therefore can claim
relatively few direct health benefits. By contrast, schemes which
permit more house connections, or which reduce long travel times to
below half an hour, can be expected to lead to increased water
Figure 2.3.2. Water consumption vs travel time
74
consumption, and a reduction in water-washed disease. This principle

is reflected in the policies of a number of organizations; WaterAid, for
example, has as one of its main criteria for appraisal of rural water
schemes the reduction of travel times from very distant sources.
2.3.8
Programmes intended to
improve environmental
health must be driven by
the impact they have at the
household level. This is
where most people
(especially children) spend
most time, and are most
vulnerable to
contamination. Unless
improvements can be
shown to have an impact at
the household level, they
are unlikely to improve
health.
Focus on changes at the household level
Changes to centralized infrastructure are unlikely to improve health

unless they reduce contamination at the household level. People are likely
to be most at risk from contamination when it is present in places where
they spend the most time. One way to see this in an urban context is to
think about the environmental priorities of many city-dwellers. The first
environmental priority for most families is a clean and pleasant
household, followed by a better environment in their street, followed next
by a cleaner neighbourhood; only after these are all satisfied can there be
much real concern over the city-wide environment and beyond (see
Figure 2.3.3). This ranking is similar to the priorities from a public health
perspective, which stresses the need for a clean and hygienic environment
where people spend most of their time. In particular, the age distribution
of sickness and death associated with poor water and sanitation stresses
the need to look at where children become infected, and where children
spread infection.
The health benefits of sanitation also reflect a household focus. A
number of studies have shown that health benefits accrue to families
who have latrines, even where neighbours do not. So, there is no
minimum threshold of coverage required to achieve health
improvements. The improvements are synergistic, however; additional
benefits will accrue if the whole community is covered. Coverage
here, however, refers to household sanitation. Communal or public
latrines are invariably either poorly maintained or else too costly to
attract the most vulnerable; poorly maintained public latrines are a
definite health hazard.
Home
Peri-domestic
Ward
City
River and environs
Figure 2.3.3. Environmental priorities of city-dwellers
75
2.3
Home
Peri-domestic
Ward
Central treatment works
City
Primary mains
Street mains
House connections
Figure 2.3.4. Environmental priorities of engineers and planners
This focus on the household can seem odd at first glance to the
professional engineer, who may see instead that the whole system is
dependent upon the centralized treatment works, or the functioning of the
primary mains or sewers (see Figure 2.3.4). It is fair to say, however, that
unless investments in such centralized resources reduce risk at the
household level, they will not contribute to health. Investing in a water
treatment system where intermittent distribution could result in recontamination before water reaches the household, for example, offers
little hope of improving health. A focus on the need to change practices at
the household level also means that more effort must be spent on hygiene
and sanitation promotion, and on ensuring that the services offered are
what individual householders want (see Section 2.8.2).
2.3
2.3.9
Health impacts from WS&S
interventions are
notoriously difficult to
assess. There are too many
random variables to gain
reliable information from
statistics-based surveys.
Better results come from
observing practical
outcomes such as the use
and maintenance status of
facilities, or improvements
in hygiene practice.
Seek improved health indicators, rather than

improved health statistics
Esreys studies cited above, and earlier work by Blum and Feachem
(1983), stress the enormous difficulty of managing rigorous studies
that prove a health improvement is attributable to a water and
sanitation intervention. Seasonal effects, the community-wide nature
of the intervention (variations between health statistics in villages may
well be due to chance), the difficulty in establishing controls, the
epidemiologically short timeframe of most development projects, and
the ever-present risk of confounding, make the epidemiological
proof of health benefits a far larger task than should be reasonably
attempted in a development project. (For example, what kinds of
people build latrines? Those who are more concerned about hygiene.
It may not be surprising that they are therefore healthier than those
who do not.)
Instead, it makes sense to look for practical indicators that point the
way to changed health. Are the facilities in good order? If so, are they
being used? If they are being used, have they contributed to changes
in hygiene? The answers to these questions are much more reliable
76
and sensible than most health statistics, especially where most

diarrhoea goes unreported, and variations between seasons and years
(with the odd epidemic) may contribute too much confusion to the
analysis.
The logical frameworks for urban and rural projects in the Appendices
include appropriate proxy indicators for health.
Further reading
Cairncross, S. and Feachem, R. (1993) Environmental Health

Engineering in the Tropics, 2nd edition, Wiley, Chichester.
The first chapter of this book presents, in clear and simple terms, the
basic issues of environmental health in developing countries,
particularly those associated with water and sanitation. The remainder
of the book describes the variety of engineering interventions
developed to control these problems, and makes the necessary link
between engineering intervention and health. Practical issues of
management, institutions, and cost are also described.
2.3
Feachem, R., McGarry, M., and Mara. D.D. (eds.) (1977) Water,
Waste, and Health in Hot Climates, Wiley, Chichester.
Although slightly dated, this book still has much to offer in its broad
interdisciplinary perspective, and its realistic recognition of the
financial, institutional, and economic constraints upon the
improvement of water and sanitation in developing countries.
Hardoy, J.E., Cairncross, S. and Satterthwaite, D. (eds.) (1990) The
poor die young, Earthscan, London.
An integrated review of the relationship between housing,
infrastructure, and health among the poor in urban areas of the
developing world. The book explores both the housing and health
conditions in which the urban poor find themselves in different parts
of the world, and the types of interventions most realistic for
improving these conditions. The book is written for the general
interested reader, and no previous technical knowledge is assumed.
Webber, R. (1996) Communicable Disease Epidemiology and Control,
CAB International, Wallingford.
A clear and complete introduction to the issues of communicable
disease control from the perspective of a public healthworker.
Although this book was principally written for doctors working in
rural areas in developing countries, the approach, text, and drawings
are clear enough for the interested non-specialist; no engineer should
be afraid to read it! The roles of water and sanitation are clearly
recognized and explained.
77
2.4
Threats to water
sustainability revolve
around quality and quantity
issues. Increasing
demands from industry,
agriculture and from the
domestic sector place an
increasing strain on natural
water bodies. Also the
proportion abstracted but
not consumed contributes
a similar threat. Untreated
or poorly treated return
flows to water bodies lower
quality and reduce the net
availability.
The inherent self-cleansing
capabilities of surface
waters and unsaturated
ground layers above
aquifers have, in the past,
allowed them to cope with
and degrade the wastes
they have traditionally
received. Increasing
population, urbanization
(concentrating polluting
inputs), and industrialization
( more wastes and less biodegradable wastes) have
stretched these powers to
their limit.
2.4 Environmental sustainability

Chapter 18 of Agenda 21 gives a high priority to the protection of
water resources from depletion, pollution, and degradation. The
emphasis given to the protection and conservation of water resources
reflects a growing recognition that freshwater is becoming more and
more scarce and that neglect of pollution control threatens the
sustainability of future resources. Environmental resources may also
need protection for their own intrinsic value (e.g. protection of
biodiversity), and also because they represent an important economic
commodity (e.g. lagoon/coral reef areas are opportunities for tourism
which represent significant employment opportunities in many
developing countries).
There are therefore issues of water quantity and water quality. The
case for the integrated management of water resources is
unchallengable. This means that WS&S programmes have to be
considered alongside plans for water use in agriculture (irrigation is
the major user of water resources in developing countries) and
industry, and for the protection of water ecosystems.
The environment, and particularly the water environment, has been
used as a disposal site for waste products for generations. Water can
dilute and disperse a high volume of potential pollutants, and the
aquatic environment can treat some wastes (water courses, for
example, have a reaeration capacity). However, it is important that
this capacity for self-treatment is not exceeded, and as communities
grow and develop, the natural capacity for self-treatment will be
limited. It is important that the environmental impact of
developments, the management of water resources, and pollution
control measures are addressed at early stages of developmental
projects.
DFID programmes and projects are normally subjected to
environmental appraisal in order to confirm that they meet the
requirements for environmentally sustainable development. General
procedures for undertaking appraisal are set out in the Manual of
Environmental Appraisal (ODA, 1996b), and this appraisal is often
carried out at the same time as social impact analysis (see Section
2.2).
The objective of this section of the Guidance Manual is to highlight
environmental perspectives which are specifically relevant for WS&S
projects. To provide a framework for discussion, environmental
sustainability is initially discussed in terms of water quantity and
water quality, although in practice of course these issues need to be
considered at the same time for resources to be used sustainably.
78
These threats allied to the

increases in demand from
all sectors intensify the
competition for water.
Governments must
therefore take decisions on
allocation and can only do
so rationally by associating
demand with availability in
an overall strategy, usually
termed an Integrated Water
Resource Management
plan.
Within these plans
allocation of water for
drinking and personal
hygiene is usually afforded
top priority, but may still be
threatened by high levels of
overall demand.
The commended
integrated water resources
management approach
extends to community level
too. Communities live with
the multi-purpose nature of
water and can be
motivated to protect
catchments from pollution
and look after water
intakes. They must be
encouraged too to
conserve and not waste the
water they are allotted.
Principles
2.4.1
Water quantity and resource management
Water in the earths hydrosphere is part of a very active natural

recirculation system with a relatively small available reservoir. Solar
energy is the driving force behind the various reactions which occur in
the cycle. If the water balance is to be sustainable in a river basin or
sub-basin and its underlying aquifer, then the competing demands on
the use of the available resources need to be managed.
In planning for the management of water resources, the demand for
water must be balanced with the water resources available. Water
resources need to be considered holistically and these
considerations are often brought together in an Integrated Water
Resource Management (IWRM) plan or strategy (also known as a
catchment management or river basin plan). See Section 2.4.4.
Water uses and allocation
There are many demands on water resources. These may be consumptive

(WS&S, agriculture, industry, and ecosystem maintenance), as well as
non-consumptive (hydropower generation, fisheries, and navigation).
Governments have to allocate water resources among competing users
and, in many cases, this task is made much harder by a lack of
knowledge of the true yields of rivers and aquifers. That is why water
resources assessment is a key element in IWRM strategies.
The quality of individual water resources will influence their potential
uses. Both allocation strategies and river water quality objectives are
influenced by the need to match quality with purpose.
When allocating water resources a water use classification scheme is
helpful. Such a classification may vary from one country or region to
another depending upon location-specific factors, but a typical general
use classification, in decreasing order of water quality requirements,
would be:
1.
2.
3.
4.
5.
6.
7.
public water supply

fishing
industrial water supply
irrigation
recreation and amenity
navigation and power generation
wastewater disposal
The ranking of importance of individual uses will change with

circumstances, but public water supply is usually seen as the most
demanding in quality. This is not because highly polluted waters
cannot be treated to provide a potable supply, but rather to emphasize
the value of providing multiple barriers between potential
contaminants of a water source and its use for potable supply.
Abstraction of highly polluted water for potable supply will
necessitate complex and costly treatment processes which could fail
and allow contaminated water into the distribution system.
79
2.4
DFID/C J Oxlee
In developing countries, agriculture is by far the biggest water

consumer, accounting for as much as 90 per cent of total consumptive
use. The rest is about equally divided between industrial and domestic
consumers. The total consumption of all three elements is increasing.
While it may be appealing to WS&S proponents to say that the greatest
potential for savings is in the irrigation sector, the fact remains that
inefficient water use, wastage, and pollution have to be tackled by each
sector. No-one disputes that water for human consumption has to be the
top priority in allocating resources, but that does not remove the need to
manage it efficiently and avoid waste.
Irrigation, the prime area for
water savings, is also a
matter for national
governments to address.
Food imports and bulk
storage provision are seen
as a favourable alternative
to reliance on local
production in high waterloss irrigation systems.
2.4
The allocation priority of a water supply is crucial for WS&S

programmes in situations where water shortages occur at some time of
the year. Increasingly, the growing demand for domestic water supply
will necessitate reducing existing allocations of high quality water to
irrigation systems where it has a relatively low economic value per
cubic metre. The relative amounts involved are illustrated by the fact
that a flow of 1 litre/second is needed to irrigate just one hectare of
land, but sufficient to provide domestic water supply for 1000 people.
There are strong vested interests in existing irrigation systems,
however, and these will need careful political handling (government
departments, commercial farmers and businesses, and large numbers of
small farmers who rely on irrigation). Food security is a high political
priority in many countries, but there is a growing belief that where
water is scarce, security is best achieved through food imports and
storage facilities (the term virtual water imports is being used for this
alternative to heavily subsidized irrigation).
In relation to specific community WS&S systems, the critical point is
that the community or the water utility has the right to abstract the
required amount of water, which should be recognized in the overall
planning and management of water resources. The amount may be
small, but it is a priority and must be protected.
Governments and utilities

can promote community
efficiencies with
appropriate charging
systems.
Governments in turn may
promote utility attention to
leakage prevention and
other aspects of water
saving by appropriate
charging for bulk
abstractions.
80
Water pricing issues arise in water allocation and also in demand

management. Demand management plays an important role in reducing
inefficient consumption of water (for example leakage from pipes and
excessive use by some consumers) and encouraging water conservation.
There are also very good reasons why water utilities need to
demonstrate efficient use of potable water, including the need to
recover costs from consumers. Note however that WS&S programmes
should generally be trying to increase water consumption by the poor,
for the important health reasons described in Section 2.3.
Water availability
The water resources which provide supplies for all the uses given in the
previous section may be summarized as:
surface waters in streams and rivers, village ponds, lakes, and reservoirs
groundwater in aquifers and rocks, and emerging to the surface in
springs
rainwater, recharging both surface water and groundwater, but also a
resource itself in roof catchment and water harvesting systems
There is clear evidence that

the dwindling availability of
renewable water per head
of population is bringing an
increasing number of
countries into conditions of
such scarcity as to limit
their potential for economic
development. Better
allocation and increased
attention to efficiency in all
sectors is vital; it is also
essential that, whatever the
pressures, the priority given
to public water supply is
maintained so that the
extension of water supplies
to the poor is not hindered.
In the end economic

development depends on
increasing industrialization.
Developed countries have
learned that this puts a
double strain on water
resources: rising demands
for process water and more
discharge of polluting
wastewater. The adverse
impacts of these trends,
falling aquifer levels and
dried river beds amongst
them, have become
evident and are belatedly
being addressed. For these
reasons water re-use and
recycling practices have
progressed rapidly in the
industrialized world. There
is a need for similar
approaches as part of
demand management and
water conservation in the
developing countries.
These resources are not uniform or static. They vary in quantity and
quality over the annual cycle and from place to place. Quantity also
varies from year to year and over longer time periods, and climatic
change is predicted to increase variability and uncertainty.
A rough measure of water scarcity in a country is the total amount of
renewable freshwater per person per year. Hydrologists say that water
stress starts to occur when the average is below 2,000m3 per person
per year (about the UK figure). Scarcity becomes evident at 1,000m3
per person per year, which is the figure in a growing number of
countries in sub-Saharan Africa.
As the stress gets more intense, so does the competition for water and
the need to use it efficiently and protect it from contamination. The
stress is growing all the time. In the 1997 Comprehensive Assessment
of the Freshwater Resources of the World, the UN Secretary-General
summarized the position as follows:
There is clear and convincing evidence that the world faces a
worsening series of local and regional water quantity and
quality problems, largely as a result of poor water allocation,
wasteful use of the resource, and lack of adequate
management action. Water resources constraints and water
degradation are weakening one of the resource bases on
which human society is built.
2.4
Water use has been growing at more than twice the rate of the
population increase during this century, and already a number
of regions are chronically water short. About one-third of the
worlds population lives in countries that are experiencing
moderate to high water stress partly resulting from increasing
demands from a growing population and human activities. By
2025, as much as two-thirds of the world population will be
under stress conditions.
Water shortages and pollution are causing widespread public
health problems, limiting economic and agricultural
development, and harming a wide range of ecosystems.
The long-term growth in water consumption has arisen from irrigation
development, industrialization, urbanization, tourist development,
population growth, and increased per capita demand. Associated
wastes also pollute water resources, reducing the quality and hence
the quantity of freshwater available for WS&S.
Groundwater abstractions which are greater than the natural recharge
inevitably cause a continuing fall in groundwater levels. Surface water
abstractions which are greater than the natural flow cause dry river
beds downstream, but disturbance to natural ecosystems, including
fisheries and wetlands, will occur long before the withdrawals become
so large. These are examples of non-sustainable use of water, and are
like the mining of any non-renewable resource. At a time of climate
change it is difficult to estimate long-term replenishments with
confidence, and a factor of safety needs to be applied in critical
81
Groundwater sources are

to be preferred for water
supply; compared to
surface sources they are
cleaner, and in some cases
may be useable without
treatment. If the community
is encouraged to protect
the borehole or well
catchment zone from
pollution the source will
remain clean.
The safe disposal of waste
on the household plot
prevents the pollution of
adjacent areas and
streams.
Saline intrusion
Saline intrusion can occur in aquifers which outcrop into a body of saline water
(usually the sea, but possibly a saline lake). An interface is formed in the aquifer
between freshwater and salt water. The position of the interface depends on the
water table depth, and pumping at a higher rate than the aquifer is recharged at
will lower the water table, forming a hydraulic gradient which moves the salt
water interface inland. This can lead to wells becoming saline and unusable.
Therefore it is particularly important in coastal areas to monitor abstractions,
groundwater tables, and water quality (electrical conductivity).
circumstances such as where over-abstraction would cause saline

intrusion to an aquifer.
WS&S water management
Any WS&S system needs to have a sustainable supply of clean water,

and a safe means of disposing of wastes. For WS&S projects in rural
communities, local groundwater is the most widely used source of
clean water supply, often replacing traditional surface water sources.
Wastes are disposed of on the household plot (e.g. in latrines),
replacing traditional use of nearby fields or streams.
As Section 2.7 makes clear, these are likely to remain the most costeffective solutions for poor people, so it is important to ensure that
they are also environmentally sustainable, by taking care to prevent
pollution of the groundwater resource. A major factor favouring
groundwater as a source for drinking water is that in its natural state it
is more protected than surface water and it can generally be used
without treatment.
2.4
WS&S services for the urban poor may follow the same pattern as for
rural communities, especially in peri-urban areas and small towns. In
many cases however (e.g. inner-city slums) water may need to be
supplied from a city-wide utility which abstracts large quantities of
water from major surface water or groundwater sources. Similarly,
wastes may be removed by drains and sewers connecting to major
systems and discharged to surface water bodies with or without
treatment.
One other key experience
is that conventional waterborne sewerage is
expensive, in both money
and water. It may be an
enforced option for WS&S
projects in inner-city areas,
but in rural locations and
wherever possible
elsewhere, on-plot
sanitation is the favoured
cost-effective choice.
82
Most of the water abstracted for WS&S will be returned, although with
some deterioration in quality and not necessarily to the same basin.
Using water to carry human and industrial waste discharges through
sewerage systems places heavy demands on water resources. Its
almost universal use in developed countries does not mean that it
should be an automatic choice in all situations, and it will rarely be a
cost-effective solution for the poor.
Water and wastewater treatment processes are themselves heavy water
users, and this needs to be taken into account. So does the potential
for leakage in water distribution networks. A water treatment plant
may use up to 10 percent of its throughflow in process operations,
and leakage from large distribution networks in developing countries
Conventional sewerage and sewage disposal

The conventional industrialized-country approach to sanitation is to provide
conventional sewerage and off-site treatment. This has several disadvantages:
It uses potable, treated water in large quantities for a use where it is not
required.
By using water as a carriage medium away from the source of defecation it
changes the fundamental nature of sanitation from what can be a localized,
dry-disposal problem to a remote and very much larger one.
Conventional remote treatment does not use the resource potential of the
sewage rather than seeing the nutrients and water as a resource, it treats
them as a problem.
It is expensive.
There are a lot of advantages of on-site sanitation. From a health perspective

the important aspect is to have any form of usable and reliable sanitation facility
to separate humans from excreta. From an environmental perspective, the
implications of a malfunctioning or inoperative centralized system are worse
than the implications of on-site sanitation.
However, there will be situations where on-site sanitation is not possible or
desirable. Alternative sewerage systems which optimize water conservation
(such as small bore or shallow sewers), systems which use non-potable water
(such as seawater) as the carriage medium, and which optimize recycling and
re-use, are available and should be considered. See Section 2.7.22.
2.4
may be as high as 50 per cent of input (though this should be seen as a

signal for action, not a basis for design!).
Planning: Integrated Water Resource Management (IWRM)
Catchment zone protection

is an integral part of river
basin management
generally and, in turn, of
Integrated Water Resource
Management (IWRM).
WS&S user groups must
be engaged in the local
implementation of plans,
but effective IWRM
demands a powerful
organization capable of
ensuring equity in
abstraction allocations,
enforcing anti-pollution
measures, and devising
and implementing
strategies that prevent
waste and guarantee the
primary objective of water
sustainability.
The complex interactions between the uses of land and water in a

river basin are often difficult to specify with precision, but without a
proper understanding of these interactions it is almost impossible to
manage the basins water resources effectively. In areas where water
resources are ample the need for their positive management may not
be obvious, but with growing demands some form of management
will become inevitable in most river basins.
The effective management of water resources requires a powerful and
properly funded impartial organization which is able to assess the
available resources and balance the various demands on them using a
rational and open policy. All abstractors need to be licensed and
regularly inspected to ensure that over abstractions are not taking
place. In the absence of such arrangements water shortages and
conflicts between users are likely. It is important that all abstractors
are subject to some degree of demand management so that excessive
and/or wasteful uses can be curbed. The practice of IWRM is
discussed later in this section.
2.4.2
Water quality and pollution
Pollution is a major environmental concern, and needs to be

approached from a wider perspective than just WS&S. Industrial
wastewater discharges, for example, have a major impact on the
quality of rivers passing through cities. In some instances, pollution
83
from one citys factories may contaminate the water to such an extent
that it cannot be used as a resource downstream.
In this manual we confine our attention to the two water quality areas
which are important for WS&S programmes:
the protection of water supply sources from pollution; and
controlling pollution from sanitation systems.
Before addressing these issues, it is instructive to look at common
types of pollution, and the sources.
Types of pollution and their effects
The effects of pollution can be detrimental both to human health and

to the natural living environment. Often, in developing countries, the
major concern will be with protection of human health. Section 2.3
highlights two aspects:
Poor sanitation combined with a lack of safe water and poor
personal hygiene leads to the transmission of pathogenic
organisms. These are the cause of immense disease and suffering
throughout developing countries.
Water which is contaminated with chemical pollution may be
unsuitable for domestic water supply due to a direct threat to health
(e.g. from heavy metals and organic substances from industrial
processes and agro-chemicals) or to its unacceptability to users
(because of taste, staining, hardness).
2.4
As part of WS&S
programmes users can be
educated and encouraged
to protect the aquatic
environment. They have a
direct interest in doing so
and they also have direct
control over pollution from
their own activities. It is
beyond their control to
stem pollution from
outside the immediate
locality, for example, in a
river polluted by wastes
from upstream.
Although the main worry in many situations will be human health,

increasingly environmental pollution is of concern as the holistic
nature of environmental issues means that the implications of a poor
quality of any aspect of the environment can have serious widespread
and/or long-term effects.
Many low- and middle-income communities depend on fragile
ecosystems and marginal lands. Any pollution or degradation of these
environmental resources can have serious consequences on the
livelihoods of local inhabitants. It is also important to consider the
environmental effects of development on long-term issues such as the
maintenance of global biodiversity.
Table 2.4.1. offers a classification of the more common types of
pollution. This is a big subject in itself and the table is only a
summary guide to the main issues, which are covered in depth in
textbooks on pollution control, such as Rhoades (1997) or Tebbutt
(1998).
A natural watercourse in an unpolluted state has a balanced chemical
composition and usually supports a wide variety of living organisms.
This balance is largely dependent on the presence of sufficient
dissolved oxygen, which is essential for most of the aquatic life.
Pollutants in water behave differently in different circumstances and
this must be taken into account when formulating control measures.
84
Environmental protection in coastal areas

Many coastal areas are associated with fragile ecosystems, such as coral reefs
or mangroves. Protection of these resources is important for several reasons.
Such ecosystems contribute to development and poverty alleviation through
their role as a tourist attraction (and hence employment creation) and also as
an important fishing area. They also play a vital environmental role by naturally
protecting coastal communities from the ravages of the sea.
The need to protect such important habitats means that pollution-control
indicators other than those associated directly with human health are important.
For example control of phosphorous is vital, as an excess will lead to
eutrophication which could mask the penetration of sunlight on to corals, and
hence lead to die-off.
This may present a problem in low-income communities, as the protection of

resources from pollutants which are more difficult to control and which cause
damage in small quantities is a costly process. Standards and controls which
are stricter than the basis required for human health protection may be
required. Local economies may have difficulty affording such a level of
protection, although from an environmental point of view it may well be needed.
Without it, the fishing and tourism industries may be affected, and peoples
livelihoods threatened.
The dilemma is who should pay for the control and protection?
2.4
Table 2.4.1
Common types of pollution
Type of pollution
Reason for importance
Typical identifier
Pathogenic material
Health problems for those in

contact with the polluted
water (often severe)
Indicator organisms such as

faecal coliforms
Readily
biodegradable
organic matter
Oxygen depletion in water

course resulting in die-off
of aquatic life and loss of
natural recuperation capacity
of a water body
Dissolved oxygen level.

Indicator of organic load (such as
Biochemical Oxygen Demand
(BOD), Chemical Oxygen
Demand (COD) or Permanganate
Value (PV)
Solid material
Several problems: harmful to

aquatic life; often pathogenic
material will attach to solid
material; turbidity problems;
aesthetic problems
Suspended solids concentration
Nutrients
Algal growth (eutrophication)

leading to taste and odour
problems and problems with
operation of water abstraction
and treatment facilities
Nitrogen and phosphorous are the

main nutrients of concern
Toxic material
Inhibit or totally destroy

aquatic biological life. Can
have serious accumulative
effects in the food chain
Heavy metals and complex

organics are often thought of as
typical examples, but ammonia is
also very toxic to fish life
Dissolved salts
Colour, taste, health

problems (see WHO Drinking
Water Guidelines for
recommended acceptable
levels in potable supplies)
Salts of particular chemicals

produce particular problems, e.g.
fluoride affects teeth and bone
structure; iron affects colour and
taste of water supplies, etc.
85
Provided the pollution is not excessive, most organic substances,

including micro-organisms, and some inorganic substances are
degraded by the natural self-purification processes which occur in a
healthy watercourse. The implication of this for water supply
abstractions from rivers is that water quality may vary considerably
along the length of a river depending on pollution inflows and selfpurification, so water supply intakes should be located accordingly.
Biochemical Oxygen Demand (BOD) and dissolved oxygen (DO)
measurements should be taken at possible sites as a simple indicator
of the pollution load, bearing in mind that the situation may change
seasonally, especially if agricultural runoff adds fertilizers and
pesticides in the irrigation seasons.
Heavy metals and many other inorganic substances are relatively

stable in solution and are not affected by self-purification processes,
so the amount of material in the receiving water does not change with
time. Most are also unaffected by conventional water and wastewater
treatment processes. The concentration in a watercourse or aquifer
will only be reduced if uncontaminated dilution water is added, from
an unpolluted source for example.
In developed countries much of the concern about pollution is related
to its effects on dissolved oxygen levels or to the possible toxic effects
of pollutants on aquatic life. There is, however, growing concern
about the presence of low concentrations of complex organic
substances in water sources which may not be readily removed by
conventional water treatment processes.
2.4
In both rural and urban

areas of developing
countries it should be
borne in mind that
pathogens are likely to
remain as by far the most
dangerous threat from
water pollution.
Properly used on-site
sanitation prevents this
form of pollution.
Communities are also
vulnerable to industrial
pollution and to pollution
from diffuse off-site
sources such as
agriculture, or storm runoff
from highways or
contaminated land.
86
Where abstracted water receives only limited treatment, the primary

concern in relation to pollution must be with the potential hazards
arising from the presence of pathogenic micro-organisms in the water
and the consequent risks of outbreaks of water-borne disease. In such
circumstances concerns about possible long-term health hazards
which may arise from the presence of minute concentrations of
potential carcinogens in drinking water are not justifiable.
Sources of pollution
Pollution may be from human activities or from natural processes.

Sanitation systems may pollute the environment if not properly
designed and maintained. Lack of sanitation is a primary cause of
river water pollution. In many situations in developing countries,
sanitation systems may be based on off-site collection systems
(sewerage, typically), but without subsequent proper treatment or
disposal of the collected wastes. The generally accepted estimate is
that less than 2 per cent of the domestic and industrial wastewater
generated in developing countries receives any kind of treatment
before being discharged to the surrounding land or water. This has
resulted in serious degradation which environmental programmes
need to address.
On-site sanitation systems which are used and maintained can make a
major contribution to pollution alleviation.
Point and non-point sources of pollution

Point or local sources of pollution such as pipes, channels, and overflows are
usually seen as the primary causes of contamination, and most control
measures have in the past been directed towards such sources. This is
normally justifiable in relation to potentially heavy pollution but increasing
concerns about trace contaminants in the aquatic environment mean that nonpoint or diffuse sources are growing in importance. Non-point sources of water
pollution include runoff from agricultural land and urban areas, and can include
aerial contamination, such as from acid rain.
Typical point sources of pollution include discharges from:
sewage treatment plants;
rural sewerage;
industrial wastewater treatment plants;
farms and agricultural activities;
solid-waste disposal sites;
storm water overflows on combined sewers;
surface water drains in urban areas from roads and paved areas, industrial
premises, and transportation facilities; and
power generation stations and cooling water equipment.
Non-point sources of pollution are more difficult to identify but include:
surface water runoff from agricultural land;
land drainage from agricultural land;
surface water runoff from contaminated land; and
surface water runoff from roads and paved areas.
2.4
Industrial processes are a significant source of pollution, particularly

for chemical pollution (dissolved salts, heavy metals, and complex
organics).
Pollution may be also classed as point or non-point, as described in
the box above.
Community-level measures
that can be taken to protect
surface sources include:
preventing access by
users or animals;
guarding against inflows
from polluted spillages
(good intake design and
construction helps);
avoiding upstream
bathing, clothes washing,
animal watering, and
defecation; and
abstracting from an
adjacent well or borehole
rather than direct from
the river or lake.
Protecting sources from pollution
Water supply systems for small communities generally use

groundwater from wells, boreholes, or springs, or surface water from
small streams or reservoirs. The most important safeguard for the
future quality of this water is to protect the source itself from
contamination by keeping users, animals, and dirty buckets out of the
water source, and to prevent spilled water draining from the surrounds
into the source. This requires good design and construction of the
abstraction facilities, combined with hygiene promotion and
community action to maintain good practice.
Then pollution inflows to the source water need to be controlled. With
surface water, the main risk is faecal-oral contamination (and in some
areas guinea-worm). It must generally be assumed that surface water
is faecally polluted. Though people who drink the water may develop
resistance, babies and children are still vulnerable. Surface water
treatment requirements can be reduced by minimizing the pollution.
Again the community can establish good practice and maintain a
clean area upstream in which people do not bathe, defecate, or water
87
animals. In some situations abstraction facilities from surface water

can be designed to provide some safeguards against pollution for
example by abstracting from a well or borehole beside a reservoir or
river rather than directly from the open water source, in order to
benefit from the cleansing due to filtration and travel time.
2.4
Groundwater sources are

much less vulnerable and
can have their quality
protected by:
filling in or covering
disused wells that could
give a direct pollution
route through the
protective unsaturated
zone above the water
table;
siting landfills and
soakaways well away
from the borehole and in
a location that takes
downward percolation
away from the well; and
prohibiting any polluting
activities in a 10m zone
around the well.
The soil above an aquifer provides a natural physical and biological

filter to keep groundwater protected. That is why groundwater
supplies rarely require treatment. Normal surface activities are not a
threat to groundwater; the danger comes either from concentrated
pollution loads, or from short-circuiting the natural filtration by
contaminating the area around a borehole or dug well.
Although it has natural protection, most groundwater has little
capacity for self-purification if it does become polluted. This is
because of its inability to replenish oxygen by re-aeration. As a result
even relatively small amounts of organic matter reaching the
groundwater can produce anaerobic conditions, leading to unstable
end products like methane and hydrogen sulphide, which may render
the water unacceptable for potable supply purposes.
Hence, it is important to take appropriate steps to protect existing
groundwater sources (and those which may be used in the future)
from pollution. A simple example at a local level is to cover (or fill)
disused open wells to prevent them from becoming filled with rubbish
and a direct pollution route into the aquifer.
The implication for WS&S programmes is that water resources used
for potable supplies (now or potentially in the future) need to be
protected against future degradation by an effective control system for
hazardous pollutants.
Pollution from sanitation systems
Sanitation systems may themselves pollute the local environment, the

underlying aquifers, or the surface water bodies, estuaries, or coastal
waters into which they discharge.
Maintaining a clean living environment is important from the health
point of view, and environmental sustainability is a development goal.
Hence the need to adopt design and maintenance measures which
prevent pollution risks.
Aquifers can be contaminated by downward percolation, drainage
soakaways, solid waste landfill, and miscellaneous wastes such as
engine oil. In most soil conditions the filtration effect and long travel
time before the percolating water enters the aquifer will be sufficient
to remove the pollutant. The best safeguard is the appropriate siting of
landfills and other waste disposal facilities, with registered facilities
for disposing of hazardous wastes. Particular attention is needed to
protect both vulnerable and key aquifers for potable water supply. The
risk of groundwater pollution by on-site sanitation is generally low
and should not prevent sensible low-cost sanitation projects. See for
example, the literature review by Lewis, Foster, and Drasor, (1980).
Minimum distance rules (for example 10m) can protect
88
Aquifer vulnerability
The vulnerability of an aquifer to contamination can be assessed from the
composition of overlying deposits;
nature and thickness of the unsaturated zone; and
speed with which water flows through the zone.
A thick layer of clay and a deep water table indicates a well protected aquifer.
An example of a very vulnerable aquifer would be a fractured limestone with a
thin soil cover and a shallow water table.
Downing, 1998
Appropriate effluent discharge standards

Often one of the first measures in controlling pollution is to set effluent
discharge standards. In many developing countries, there will be no history of
such standards, and so they are often based on practice in industrialized
countries.
Just as WS&S
improvements must be
protected against external
environmental impacts so
must they make no adverse
impacts on their
surroundings. In particular
discharges resulting from
sanitation improvements
must comply with relevant
standards.
It may be necessary to go
further if a discharge
complies with set
standards but leaves the
receiving water in a state
that impacts on potential
downstream uses. This is
more likely if standards are
of the fixed emission or
end of pipe type. The
preferable alternative,
based on water quality
objectives, generally
obviates this risk.
The problems in the developing world, however, are very different from the
industrialized situation, as:
differences in climate mean that the impact of pollutants is different (e.g.
rivers can re-aerate themselves more quickly);
there will be different priorities in terms of control of pollution parameters
(e.g. pathogenic material is the major concern in developing countries, but
in industrialized countries the main concern has been with biodegradable
organic pollution); and
monitoring and enforcement capabilities are often poor in developing
countries
There is a need to be realistic, and to:
base standards on real local problems;
implement standards incrementally (start small); and
ensure standards are realistic and attainable, and enforceable otherwise
they are virtually worthless.
Parr and Horan, 1994; Johnstone, 1994.
groundwater sources from latrines. In case of conflicting demands,

off-site water supply is a much more cost-effective solution than offsite sanitation.
Control of pollution
Again, text books such as Rhoades (1997) or Tebbutt (1998) are the
source of detailed information about specific pollution control
measures. Only the main features are highlighted here.
Setting standards
It is important that new WS&S programmes support improvements

rather than worsen the situation. New sewerage and treatment systems
need to comply with national water quality standards and to consider
the impacts on downstream users and ecosystems. If there are no
national standards, assistance might be provided in developing these
in a wider environmental or water resources framework.
89
2.4
There are two types of water quality standard in relation to pollution:

Ambient water quality objectives for the river or lake, set in
relation to the intended uses and the protection of the freshwater
ecosystem. Such standards take into account the dilution and
dispersion capabilities of a water body.
Requirements for effluent discharges may take the form of fixed
emission standards (in which the quality standards for discharges
are not related to the location of the discharge or to the dilution
available) or more flexible effluent discharge permits, based on
what is necessary to maintain the ambient water quality objectives.
Fixed emission standards are easy to apply but they make no

allowance for the environmental conditions at the discharge and the
usage of the receiving water. As a result they tend to be economically
and technically inefficient.
Effluent discharge permits based on ambient water quality objectives
are more flexible in approach but require more work to determine on
a case-by-case basis. Such an approach can result in a more costeffective use of resources, but problems can arise later if additional
discharges are made to the water. Water quality objectives may exist
in the form of advisory information used for management purposes, or
they may have legislative backing in the form of statutory standards.
2.4
Sullage drains should have no problem meeting discharge

requirements, and any resulting pollution should be removed by the
self-purification process. For sewage, however, treatment may be
necessary to meet the standards, and various options are available
(preliminary, primary, secondary, or tertiary levels of treatment, using
a range of technologies). These provide different degrees of removal
of pollutants. Normally the cheapest option which will provide
effective and sustainable compliance with national water standards
(considering both capital and recurrent costs) should be adopted.
Appraisal of any proposed further treatment will need to include
economic analysis of costs and benefits.
2.4.3
To prove sustainability the
impact of all WS&S
interventions must be
measureable and
monitored. Monitoring is
expensive; it must therefore
be selective, with a focus
on important parameters
such as faecal coliform
counts in drinking water
supplies or dissolved
oxygen levels in receiving
waters.
90
Environmental impact
The Manual of Environmental Appraisal (ODA, 1996b) provides

guidance on procedures to be followed when analysing impacts. A
project may need to include additional components to mitigate against
these, possibly including, for example, improvements to a water supply
system downstream to protect it against pollution from the project.
Environmental Impact Assessment (EIA) and Environmental Auditing
are standard practices which are explained in specialist literature.
Monitoring requirements
If WS&S projects are to be sustainable, then their environmental

impact needs to be monitored. There is a need to measure and monitor
only then can problems be identified, and preventive or remedial
action taken. Analyses need to be made and records need to be kept of
water and environmental quality. While some analytical procedures
are easier and cheaper than others (and visual sanitary surveys can
convey much information) monitoring requires resources. It is
important that resources are optimized to achieve the best results. It
will not be possible to analyse for all parameters, for example, so
efforts should concentrate on highlighting the parameters of main
concern (such as faecal coliform counts in potable water supplies, or
dissolved oxygen levels in surface water courses, or indicators of
chemical pollution where there is known to be a problem). It is
beyond the scope of this section to go into detail of how a monitoring
programme should be undertaken, but see Canter (1996) or Gilpin
(1995) for guidance.
Sustainable management
of the natural water
environment is conveniently
based on the river basin as
a unit. Integrated river basin
management has as its
primary objective the
balancing of ground and
surface water resources in
the catchment with the
competing demands made
upon them.
To meet this aim the river
basin management
authority must have
influence in pollution
control matters and be
aware of agricultural,
commercial, and industrial
activities in the basin.
An effective authority will be
independent of but consult
fully with all parties in the
formulation of a basin
strategy that has mediumand longer term
perspectives and
embraces environmental,
social, and economic
concerns.
Interested parties are not
limited to abstractors. Valid
interests include other
sectors such as leisure and
wildlife groups.
Practice
2.4.4
Implementing integrated river basin management
The river basin provides an obvious management unit for water

resources for small rivers but with larger systems it may be more
appropriate to establish a hierarchical management structure with
overall policies for the whole basin supplemented by more detailed
policies at sub-basin level.
2.4
Roles and responsibilities China

Co-ordination between sectors and government departments at all levels
remains central to the planning process in China. The Water Law (1988),
defines responsibilities and mandates of ministerial and government
departments, including specifying lead and co-operative agencies. This aims to
prevent over-lapping responsibilities and duplication of effort.
The primary function of the Ministry of Water Resources is to organize and
enforce implementation of the Water Law, Soil Conservation Law, and other
water-related laws and regulations on behalf of the State Council. The ministry
has a wide range of responsibilities ranging from policy formulation, strategic
planning, economic regulation measures, and implementation of the water
permit system, as well as arbitration in water-related disputes and conflicts.
River Basin Conservancy Commissions are responsible for planning and
management along the main river courses, but Provincial Water Resource
Bureaux take responsibility for development along the tributaries. Co-ordination
between the Conservancy Commissions and Provincial Water Resource
Bureaux is therefore critical.
Planning for water pollution prevention and wastewater discharge sites is
undertaken in close collaboration between the Environmental Protection
Bureaux and the Provincial Water Resource Bureaux and, if necessary, the River
Basin Conservancy Commission.
Although there are clearly defined roles and responsibilities, a critical factor
remains one of co-ordination of the large number of authorities involved at the
national, river basin, provincial, and local levels. In addition, lack of financial
support can also hamper the effective implementation of key responsibilities
within the various authorities.
DFID (1998b) Water Resources Occasional Paper No.5
91
Development of water policies and strategies

In Pernambuco, North-eastern Brazil, DFID is helping the State Environmental
Agency and municipal institutions to collaborate in the production and
implementation of a Sustainable Development Plan for the Pirapama catchment
area. This Plan will define those measures and decision-making criteria needed
in order to ensure the sustainable supply of freshwater from the Pirapama
catchment area. This involves a multi-disciplinary approach to balance the
different, and potentially conflicting, objectives related to economic growth,
environmental management, and social development.
Use of groundwater for irrigation and water supply in

South Asia
Both the public and private installation of boreholes for irrigation has facilitated
a major expansion of wheat and rice production in the alluvial plains of South
Asia since the 1970s. As a result, water table levels drop much lower than
previously in the dry season, recovering in the wet season. Shallow handpumps
for water supply may then need to be replaced in some areas with deeper
boreholes and handpump models suitable for the deeper water tables. If this is
done, a new, sustainable, and effective development of the water resource has
been achieved, but note the severe inequity if pumps are not replaced.
2.4
A more local problem occurs when a powerful farmer installs a private

motorized pump close to a village borehole, drawing the water table down in its
vicinity so that the handpump can no longer deliver water.
Integrated river basin management requires a full appreciation of the

natural characteristics of the system and of the interactions between
the system and the various users. This should enable the establishment
of both a water budget and an allocation and regulation policy to
ensure that uses and demands are prioritized and that appropriate
measures can be taken to augment resources if necessary. Because of
the vital importance of water to many users it is essential to involve
all interested parties in the formulation of river basin management
strategies and to ensure that an agreed conflict resolution mechanism
is in existence.
A basin management strategy focuses on a river and its associated
corridor to analyse the issues which affect the river basin and to
suggest solutions to resolve problems and conflicts. Many of the
issues can only be addressed with the co-operation and assistance of
other bodies, organizations, or industries, but it is essential that the
organization responsible for river basin management has the necessary
resources and powers to operate in an independent manner.
The purpose of a river basin management plan is to produce a vision
for a healthy and diverse water environment managed in an
environmentally sustainable way, balancing the needs of all users of
water. Sustainable development of water systems must embrace
environmental, social, and economic concerns for it to be a workable
concept. Integrated river basin management planning should:
92
Basin management plans

are the building blocks
underpinning national
IWRM strategies, a concept
which the UN Commission
for Sustainable
Development
recommended to all
national governments
following the advice of the
1998 Harare meeting of the
Expert Group on Strategic
Approaches to Freshwater
Management.
focus attention on the water environment of a specific river basin;

involve all interested parties in planning for the future well-being
of the basin;
balance the competing requirements and interests of all users;
agree a vision for the basin which helps to guide activities over the
next 10 to 20 years; and
establish an integrated strategy and plan of action for managing
and improving the river basin in the future.
Effective enforcement arrangements are needed, taking account of any
possibility that these may be subverted by corruption.
National IWRM strategies
The Expert Group Meeting on Strategic Approaches to Freshwater

Management in Harare in 1998 recommended that each country
prepare a comprehensive national water policy to ensure efficient and
equitable allocation of water resources, and to protect freshwater
ecosystems, water quality, and human health. That recommendation
has been transmitted to all governments by the UN Commission on
Sustainable Development (CSD). A Harare Working Group made
detailed recommendations on the elements of any such policy:
1. Research, monitoring, and information management programmes
for understanding the quantity and quality of the resource base
and its variability in time and space, and the social and economic
forces affecting them.
2. The principles for allocation of the resource, taking into account
the principle that access to safe drinking water and sanitation is
essential for satisfying basic human requirements, and that other
allocations should be based upon consideration of economic
efficiency and equity, and that allocations should be based on both
the sustainability of the resource base and on ecosystem and
environmental protection.
3. Incorporation of health concerns into the freshwater management
process through the adoption of explicit health objectives in
planning, the use of health indicators in routine monitoring, and
the assessment of health outcomes in evaluation.
4. Protection of the aquatic environment, including wetlands, from
local and diffuse pollution sources and from threats posed by
exotic influences to maintain physical and chemical balances and
biological integrity.
5. Management of demand should be a key part of the policy,
focusing on water conservation through recycling and re-use and,
where appropriate, driven by pricing policies and by adopting best
practices and appropriate technologies.
6. Management of water supply to deal with annual and inter-annual
variations, to support food security and other purposes.
93
2.4
Integrated management of catchments and water

resources
As part of a regional environmental management project in Region II in Chile, an
assessment of the water supply and demand showed that the existing use was
unsustainable and was seriously contaminating ground- and surface water
resources. The project enabled the regional institutions to integrate water
resources management into their planning processes, identify environmental
improvements and investment priorities, and raise the awareness of the other
institutions, communities, and industries.
7. Providing appropriate mechanisms for the management of land

and water resources on an integrated basis within natural
hydrological and hydrogeological units (river basins and
aquifers), and providing for necessary interaction with
administrative organizations where provincial, municipal and
district boundaries do not coincide with basin or aquifer
boundaries.
8. Provision for coping with hydrological extreme events and
disturbances, particularly droughts, floods, and erosion, through
the implementation of programmes of drought preparedness,
flood protection, and mitigation including adequate monitoring
and early warning systems.
2.4
9. Substantive co-operation with neighbouring countries in the

integrated management of shared surface and groundwater
resources within river basin or aquifer system frameworks
10. Development and sustenance of appropriate institutions, including
cross-sectoral water councils, and recognizing needs for capacity
building, public information, and education.
2.4.5
Pollution and water quality
Sound engineering practice based on holistic approach
As discussed earlier, good design and construction of water-points and

sanitation systems is important to safeguard against the direct
pollution of water sources. A sustainable system means that it will
have addressed all the elements of infrastructure intervention as
described in this manual.
A common approach may be suggested for preventing pollution from
WS&S interventions (Parr and Horan, 1994):
Define the problem: identify sources of pollution (point and nonpoint), and their characteristics (volume, quality, and frequency).
Identify areas at risk (environmental and health risks).
Establish what type and how much pollution one is trying to
remove, and why.
Identify the constraints on the development of a pollution-control
94
Making the polluter pay is

an important principle of
pollution control. It is a
concept of the developed
world, typically applied to
piped sewage or industrial
effluent discharges.
Sewerage systems are high
users of water and money;
they are rarely the best
sanitation option for the
worlds poor. Requiring the
better-off to pay the full cost
of pipe-borne pollution
therefore serves the poor
well.
In current thinking the
principle is carried further
into pollution prevention
pays it is better for an
entity to save costs by
cutting its polluting output;
by the same token society
in general benefits from
less pollution in the
environment.
strategy (e.g. what are the resources available, and what is the
ability to pay for services, or to operate and maintain them).
Set monitoring and control procedures (which are attainable,
realistic, and enforceable).
Select the control options which meet the requirements.
The polluter pays principle places the cost of remedial action on the
producer of the pollution. This is an important principle to establish
and uphold, for sewage as well as for industrial effluent. The costs of
sewerage and treatment should be passed back to the households
producing the wastes. In general the poor will not be connected to
such systems, and any subsidy will in effect reduce the resources of
the utility to provide services to other consumers, including the poor.
The high financial and environmental cost of sewerage systems

reinforces the point that sewerage cannot make much contribution in
the near future to providing for the three billion people who lack
adequate sanitation.
Increasingly, there is a realization that much can be done to prevent
water pollution in the first place. There is a move away from the
concept that the polluter pays for the pollution caused, to one which
states that pollution prevention pays. This means that control of
pollution in the first place (by industry for example) will reap benefits
for the industry in terms of lower penalties for the cost of pollution
and increased process efficiencies, and for society as a whole in terms
of reduced polluting loads in the natural environment.
Associated with this is what is sometimes termed the 4Rs principle:
Reduce
Recycle
Recover
Re-use
Industrial pollution control in China

An electroplating enterprise in a village near Beijing in China discharged
dangerous industrial wastewaters without treatment, polluting groundwater over
an area of approximately 50km2. Most of the working areas were unpaved, and
liquids drained both into the ground and into a nearby river bed. Water use was
wasteful, with no attempt made to limit the volumes of water used. A village
downstream from the electroplating enterprise, where the groundwater was very
acid and contained dangerous concentrations of chromium, was forced to find
an alternative source of water.
The local Environmental Protection Bureau began fining the enterprise for
causing pollution. The regular fines were substantial, and the polluter was
made, reluctantly, to pay for the pollution caused, although not for any remedial
work. Economic pressure caused the owners to consider provision of
wastewater treatment.
The enterprise received advice on wastewater management, and financial
assistance to buy treatment equipment, under a DFID project. Water
consumption was reduced, working areas were paved, and treatment facilities
were installed. As a result, the wastewater discharges were contained and
treated prior to discharge.
95
2.4
WEDC/Michael Smith
Effective management of sanitation facilities should encompass the 4

Rs to ensure that effective use is made of increasingly precious finite
resources.
On a wider scale, UNICEF (1998) points out the importance of
monitoring groundwater conditions, developing capacity for longterm management, and focusing efforts in areas where serious
problems are emerging. The following instruments are recommended:
Comprehensive information systems about the resource base.
Setting of water quality standards Standards should reflect
national priorities and technical capabilities. The strict adoption of
standards set in the industrialized world may not be attainable,
enforceable, or in some cases even desirable in developing
countries.
Establishment of protected areas Rather than attempting an
immense task to protect at once all groundwater resources it
is better to focus on the creation of protected areas for key aquifers.
In cases of critical water supplies, water systems above and below
the surface need to be efficiently protected and monitored.
Integrated management of groundwater resources In Colombia,
DFID is working with research institutions and regional authorities
to establish pilot systems for the control, mitigation, and protection
of groundwater resources. Working in two pilot catchment areas,
the objectives are to develop and implement groundwater
protection measures that can be replicated at a regional level
throughout Colombia.
Pollution control Pollution sources, especially in groundwater
protected areas, should be carefully identified and removed.
Extraction control Based on the average recharge of a given
aquifer, it may be necessary to set legal limits on pumping or to
motivate more efficient use of groundwater by charging extraction
fees.
Control of subsurface waste disposal Limitations or a complete
restriction also need to be placed on the location of underground
waste disposal and on the quantity and content of waste material,
both liquid and solid.
Land-use regulation The use of certain toxic materials may be
prohibited or restricted. Controls may be placed on the pollution of
the ground from landfills, sewage treatment plants, and
underground storage tanks. Other helpful regulations might include
controls on housing density, use of chemical fertilizers and
2.4
Integrated management of groundwater resources

In Colombia, DFID is working with research institutions and regional authorities
to establish pilot systems for the control, mitigation, and protection of
groundwater resources. Working in two pilot catchment areas, the objectives
are to develop and implement groundwater protection measures that can be
replicated at a regional level throughout Colombia.
96
pesticides, and limitations on clearing vegetation in groundwater

protection areas.
In some specific regions of

the developing world where
there is great need for
WS&S interventions there
are compelling reasons for
caution in the uncontrolled
extension of water
availability. These are the
arid and semi-arid areas
populated by wandering
herdsmen.
Culture inclines these
groups to give livestock the
priority over household use
of scarce water supplies.
More water could mean
more stock, overgrazing,
local erosion, and possible
terminal degradation of a
fragile environment already
under severe water stress.
WS&S must in such cases
be integrated with and give
precedence to other forms
of intervention. Sustainable
livelihood improvement
must be the objective. It
might be achieved by
educating to give an
understanding of the
dangers of immediate
water supply
improvements. Earlier
steps might include
improvements in animal
welfare or hygiene and
sanitation promotion.
Environmental sustainability is a multi-faceted problem and involves

the integration of many aspects of development, including
potentially conflicting stakeholders and users. Institutional
responsibility is often not clear and is usually shared between many
agencies. The need for a rational co-ordinated response is vital. The
tools and principles of Integrated Water Resources Management and
integrated environmental pollution control are important contributions
to a more sustainable environmental future.
2.4.6
A Sustainable Rural Livelihoods Approach for arid

and semi-arid areas
A high proportion of people living in arid and semi-arid lands (ASAL)

have pastoral livelihoods. They frequently give a higher priority to the
water demands and health of their livestock in comparison to
themselves. The fragile nature of their environment also needs to be
borne in mind; for example, the provision of a new, plentiful water
source could result in extensive overgrazing and erosion around that
new source. Hence the provision of water and sanitation services, in
such areas has to be placed in a wider integrated framework.
2.4
The interrelated nature of these problems would suggest that a

Sustainable Rural Livelihoods Approach would be appropriate. The
approach is inherently responsive to peoples own priorities for their
livelihoods, without compromising the fragile environment. The
purpose of such a project could be to:
Contribute to sustainable improvements in the livelihoods of
pastoralists and communities in the selected district.
A framework for project development could include:
a) A participatory analysis of livelihoods, stakeholders, the
environment and the effectiveness of potential project options.
b) Help for those concerned with supporting Sustainable Rural
Livelihoods to understand and manage the complexities of
livelihoods in arid and semi-arid areas, enabling the
complementarity of interventions and the trade-offs between
outcomes to be assessed.
c) Support for community organizations and other implementing
organizations (including NGOs, the private sector, and local
government) in developing and implementing integrated project
proposals, using piloting as appropriate.
d) Water supply could be used as an entry point, but interrelated
interventions to be considered based on community priorities could
include:
97
improved access to water supplies;

animal health services;
marketing of livestock products and livestock management;
hygiene and sanitation promotion;
environmental assessment and management;
supporting income-generating opportunities;
capacity building; and
support to the development policies and legislation for ASAL
areas.
An area-based approach in a limited area may be appropriate to

enable a good understanding to develop between stakeholders.
Water and sanitation in semi-arid areas in Kenya
Arid and semi-arid lands (ASALs) comprise over 80 per cent of Kenyas land
area, sustain 20 per cent of the population and 60 per cent of the livestock.
These are water-stressed areas with large disparities between seasons as well
as within the region. Over 70 per cent of the population in ASALs do not have
access to safe water and in many of these districts more than 70 per cent of
households do not have access to safe sanitation. In most ASAL districts
people take an average time of more than 15 minutes to collect water in the dry
season. In some districts, more than 50 per cent of households take, on
average, more than one-and-a-half hours to walk to the nearest source.
2.4
The districts with the highest percentage of people suffering hard-core poverty
are mainly ASAL districts, ranging from 30 to 60 per cent. There is also reported
to be a higher level of willingness-to-pay in these areas compared to other
parts of Kenya, although this would need to be confirmed.
Advantages of the Sustainable Rural Livelihoods Approach (Strengths and
Opportunities):
It conforms to DFIDs poverty focus.
ASAL communities are reported to have a high need and demand for water
and other services.
An integrated approach reduces the risk of making the situation worse in a
fragile ASAL environment.
Disadvantages (Weaknesses and Threats):
The areas are generally sparsely populated resulting in interventions being
generally more expensive.
There are security problems in many of the ASAL districts, so if the situation
deteriorates, project achievements could be lost and plans abandoned.
It can be difficult to get well-qualified outside people to work in these areas.
The complexity of having a number of different interrelated project
components can result in slow progress.
98
Further reading
Bailey, R.A. (ed.) (1996) Water and Environmental Management in
Developing Countries, CIWEM, London.
Bailey, R.A. (1997) An Introduction to Sustainable Development,
CIWEM, London.
Canter, L.W. (1996) Environmental Impact Assessment, 2nd edition,
McGraw-Hill International, Singapore.
An excellent reference book for policy methodology and
implementation of assessments (based on different components of the
environment)
DFID (1997) A Guide to the Regional Environmental Action Plan for

the Antofagasta Region of Chile, Department for International
Development, London.
DFID (1998b) Case Studies of Water Resources Planning in
Developing Countries: Lessons learned, Water Resources Occasional
Paper No.5, HR Wallingford, Oxfordshire.
ERM (1996a) UK Environmental Best Practices Study, Environmental
Resources Management, ODA CNTR/95/5171A, London.
ERM (1996b) Environmental Standards for Water, Environmental
Resources Management, ODA Ref. 3274, London.
Gilpin, A. (1995) Environmental Impact Assessment: Cutting edge for
the 21st Century, Cambridge University Press, Cambridge, UK.
This book provides useful checklists for assessment of different types
of projects and also case studies from an international perspective.
Hammerton, D. (1996) An Introduction to Water Quality in Rivers,
Coastal Waters and Estuaries, CIWEM, London.
Johnstone, D.W.M. (1994) Standards, costs and benefits: an
international perspective, JIWEM Vol.8 No.5 pp.450-8.
This article discusses the rationale behind the setting of effluent
discharge standards, using case studies.
NRA (1992) Policy and Practice for the Protection of Groundwater,
National Rivers Authority, Bristol.
NRA (1994) Water Quality Objectives, National Rivers Authority,
Bristol.
Newson, M. (1992) Land, Water and Development, Routledge,
London.
Nicholson, N. (1993) An Introduction to Drinking Water Quality,
CIWEM, London.
ODA (1993), A Fresh Approach to Water Resources Development,
Overseas Development Administration, London.
99
2.4
ODA (1996b) Manual of Environmental Appraisal (revised edition),

Parr, J. and Horan, N. (1994) Process Selection for Sustainable
Wastewater Management in Industrializing Countries, Research
Monographs in Tropical Public Health Engineering No.2, University
of Leeds, Leeds.
This booklet discusses the issues behind the implementation of a
wastewater management strategy, based on experiences in the Indian
Ocean region.
Price, M. (1996) Introducing Groundwater, 2nd edition, Chapman and

Hall, London.
A good general book on the principles of groundwater easy to read,
not too technical or detailed; good for those who know little about the
subject and want to find out more.
Rhoades, J. (1997) An Introduction to Industrial Wastewater
Treatment and Control, CIWEM, London.
Rodda, J. C. (1995) Guessing or assessing the worlds water
resources, JCIWEM, Vol.9, p.360.
Tebbutt, T. H. Y. (1983) Relationship Between Natural Water Quality
and Health, Technical Documents in Hydrology, UNESCO, Paris.
2.4
Tebbutt, T.H.Y. (1998) Principles of Water Quality Control, 5th

edition, Butterworth Heinemann, Oxford.
This book covers the principles of water pollution the
fundamentals of water chemistry and biology and the control
measures, including treatment processes.
United Nations (1997) Comprehensive Assessment of the Freshwater
Resources of the World, Report of the Secretary-General to
Commission on Sustainable Development Fifth Session, United
Nations, New York.
A valuable review of the availability and use of water resources, and
the related issues and challenges.
World Bank (1991) Operational Directive OD4.01 Environmental
Assessment, World Bank, Washington DC.
World Bank, Environment Department (1991) Environmental
Assessment Source Book: Volumes I, II, and III, World Bank,
Washington, USA.
These books provide detail on methodology for assessment in general,
and on different types of methodology specifically.
World Bank (1993) Water Resources Management, World Bank,
Washington DC.
A useful overview of water resources management issues and World
Bank perspectives.
100
2.5
Economic and financial perspectives
Introduction
This section looks at the economic and financial principles that should
underpin domestic water supply and sanitation policy, programmes,
and projects; the role of economic and financial appraisal throughout
the programme and project cycle; and recommended analytical
approaches and techniques.
Economic and financial analyses have an important role to play in
informing decisions at the policy stage of the cycle, at national or
utility level. Key areas for analysis are the demand for different levels
of service, the use and targeting of public subsidies, and how to
reform tariffs and improve utility finances (e.g. in the context of a
privatization programme).
Economic and financial analysis can inform decisions at the project
identification and preparation stages by contributing to strategic
choices for offering specific levels of service. At the appraisal stage
the economic justification for water projects is typically based on
cost-benefit analysis. In contrast it is usually much more difficult to
quantify the benefits of sanitation projects, and the economic
justification is more usually based on cost-effectiveness analysis. The
financial appraisal should define financial viability, and hence project
or programme financial sustainability. Both economic and financial
appraisal are vital parts of project monitoring and evaluation.
Principles
2.5.1
The water sector
At the many international conferences, regional workshops, and other

gatherings of water specialists in recent years there has been a
growing consensus on the economic and financial principles that
should underlie the formulation of a national water policy:
Past failure to attach a true

value to water as an
economic good or to
implement cost-based
charging policies for water
and sanitation services has
been a major factor in
downgrading the financial
viability of public service
providers and discouraging
private sector investment.
WS&S is a basic need Many people still lack access to safe drinking
water and sanitation. The cost of under-provision is revealed in
disease and in the human and financial costs of people making their
own alternative arrangements. Enabling the unserved to obtain access
to a basic water supply and safe sanitation should be the first priority
of any countrys water policy. As we saw in Section 2.4, domestic
water use accounts for less than five per cent of total water
consumption in developing countries, compared with agricultural
consumption of around 90 per cent.
Water is an economic good In a large and growing number of
countries, water is becoming scarce, in the sense that at its prevailing
price demand is fast approaching supply. Scarce commodities and
services have economic value. An appreciation of the economic value
of water is essential to reduce waste and loss, encourage conservation,
and move consumption towards higher value uses.
101
2.5
Correcting these failures by

robust financial and
economic analysis and
monitoring at all
appropriate stages of
WS&S improvement
programmes can
contribute significantly to
better progress in
extending service
coverage.
A crucial corollary to these
failures, impacting
adversely on sustainabilty,
is an unnecessary boost to
demand water is seen
as cheap and there is no
incentive to cut waste.
Financial self-sufficiency Shortages of funds because of poor cost

recovery are widespread in all kinds of water systems, at every scale.
This is due to a combination of reluctance to charge fully for water,
inefficiency in collecting amounts due, failure to control water losses
and wasteful use, and a continuous growth in the demand for services.
Financial viability is vital for system efficiency.
Sustainability This has technical, environmental, financial, social, and
economic dimensions. Economic sustainability requires that users pay
the full cost of their actions, including environmental costs and the
full cost of replacing supplies in future. Financial sustainability
requires that the system is able to meet its capital, operating, and
maintenance costs.
2.5.2
Demand for improved water and sanitation services
No community can exist without a source of water. In rural and periurban areas households often have a variety of water sources available
to them, each with different characteristics. Different sources may be
selected for different domestic uses (e.g. drinking, cooking, bathing,
and clothes washing), and they may vary seasonally. The demand
curve for water is therefore an aggregation of individual demand
curves for different purposes, which is considerably more complex
than in developed countries.
A new water supply project is never the only water supply available. It
simply changes the range of options available. Such an intervention
may increase the quantity of water available to a community, the
reliability, the convenience of the service provided, and/or the quality
of water available. These changes in quantity, reliability, convenience,
and quality may range from significant to modest. The economic
value of a water supply project depends largely on the magnitude of
these changes.
2.5
Programme planners
should be aware that:
The poor will not
necessarily make use of
newly installed facilities,
for a range of reasons
quite unconnected with
their ability to pay for
them.
Householders commonly
have more than one
existing option or water
source and will not
automatically switch to a
newly installed cheaper
supply.
102
People can have very strong views on what standard of improved

service they want, and are willing to pay for, and will use in
preference to existing water sources (and sanitation facilities). It
cannot be assumed that households will switch to a new water or
sanitation system. This will depend on the combined effects of three
Why willingness-to-pay (WTP) for rural water supplies varies
Poor households without good alternative supplies are often willing to pay
much more for improved water supplies, in both absolute and relative terms,
than richer families pay for their existing supplies.
Time and monetary costs of obtaining water from alternative sources is a key
influence on WTP for improved supplies.
Family characteristics, such as level of education and family size thought
to be related to the opportunity cost of time will also influence the
perceived attractiveness of improved supplies and affect WTP for different
standards of service.
Where people believe government should provide free water, WTP is very low.
Poor householder
willingness and ability to
pay for service
improvements is not, as
often assumed, limited to
the 3 per cent to 5 per
cent range of income. In
some circumstances
WTP is effectively zero;
where the service is
closely associated to
demand WTP can be
over 10 per cent of
income.
Poor householders without
good alternative supplies
are often willing to pay
much more, in relative and
absolute terms, than richer
householders currently do
for the good quality
services they enjoy.
The best take up and use of
new facilities is achieved if
provision corresponds to
what householders want
after consultation on a
range of cost-related
options. The principal
factors influencing demand
for water improvements,
particularly in rural settings,
are the perceived cost or
time savings.
Since health benefits are
frequently not understood
there is typically a lower
demand for sanitation than
for water supply. Initial
subsidies are one route to
promoting a change in
thinking and realizing
benefits for the individual
and the wider community.
Variations in willingness-to-pay (WTP)

In Chihota District in Zimbabwe, where water is relatively easily available from
traditional wells, WTP is very low (0.5 per cent of income).
In Newala District in Tanzania, where water is far away in the dry season, WTP
is quite high (8 per cent of income).
In Ukunda, a small market town in Kenya, most households prefer to spend
over 10 per cent of their income buying water from vendors rather than
fetching free water from a well, because of the high value they attach to their
time.
In rural Thailand, villagers were willing to pay 8-9 per cent of their income for
yardtaps, but were unwilling to pay small amounts for maintenance of
communal supplies.
sets of factors: characteristics of the supply, socio-economic

characteristics, and attitudes to government policy (see box on
previous page).
Nor can it be assumed that householders will automatically switch to a
cheaper source of supply. There may be (a) reluctance to make a firm
commitment to pay a water utility (or users committee) a fixed sum
every month, especially where demand will fluctuate seasonally; (b)
mistrust of governments ability to provide a reliable supply; and (c)
unwillingness to upgrade a rented property. It may also be that the level of
service offered may not meet the aspirations of the intended users.
Income is therefore not the only determinant of willingness-to-pay
(WTP). Poor householders without good alternative water supplies are
often willing to pay much more, in absolute and relative terms, than
richer households currently do for the good quality services they
enjoy. The widely used rule of thumb that a households ability to pay
for water is some 3-5 per cent of income is simplistic and inaccurate
(see box above).
Where the standard of service provided is not what people want, they
soon abandon new facilities. The implication is that successful
projects depend on matching supply to demand. Crucially, people
should be given a choice over the type and standard of services
offered. Water and sanitation systems should allow for a range of
facilities to be made available, such as public standpipes, private
house connections, different types of toilet, and sewage disposal
facilities.
Demand for water reflects perceived benefits. These are primarily cost
or time savings. People typically do not perceive health benefits.
Improved sanitation is therefore often low on the list of rural peoples
priorities (it may be higher in crowded urban areas, where dignity and
status are important criteria). Initially, to create demand, it may be
necessary to subsidize sanitation services and/or facilities (but see also
Section 2.5.15). In addition to meeting individuals needs, domestic
water and sanitation may also have public health benefits for the
population as a whole.
103
2.5
Assessing demand by
gauging willingness and
ability to pay helps the poor
by eliminating assumptions
and misconceptions in
these areas. Reliable
assessment provides a
sound basis for installing
an affordable service that
aims for cost recovery and
thereby service
sustainability.
2.5.3
Role of demand assessment
The importance of adopting a demand-responsive approach to water

and sanitation projects has been demonstrated in the previous section.
At the centre of a demand-responsive approach to the WS&S sector is
the process of demand assessment, used to ascertain what levels of
service users are willing and able to pay for. As we saw in Section
2.5.2, this varies much more widely than has been traditionally
assumed. Demand assessment is important to inform decisions at both
the policy stage of the programme and project cycle, and at the project
identification, preparation, and appraisal stages. Detailed guidance on
how to carry out demand assessment studies is provided in the
Guidance Notes for DFID Economists on Demand Assessment in the
Water and Sanitation Sector (see DFID 1998 in Further Reading).
2.5.4
Demand assessment and poverty
Despite the focus of most demand assessment work on WTP (by

which economists mean willingness and ability to pay), demand
assessment studies can help with poverty reduction in several ways.
Firstly, it cannot be assumed that all poor people are unwilling and
unable to pay for private connections (see box below), and the
strategy of providing communal water facilities and latrines (some
for all not all for some) may benefit the poor less than providing
them with the level of service that they want. Evidence shows that
unless people see the new facilities as providing on balance a more
attractive service than the present one, they will not switch to them.
2.5
Secondly, cost recovery based on demand assessment can help to

improve the financial, and thus the technical, sustainability of water
supply systems. Where existing public systems offer a poor standard of
service, characterized by low water pressure or irregular and unreliable
supplies, it is usually the poor who are most adversely affected.
Targeting the poor
Lessons learned from the DFID evaluation Synthesis study of rural water and
sanitation projects:
At the appraisal stage of the Aguthi rural water supply project in Kenya,
Danida found that demand for private connections was high but, to protect
the poor, chose to supply a mix of water kiosks and private connections.
Their ex-post evaluation found that all the kiosks had gone out of use, and
more than 90 per cent of households had private connections.
At the appraisal stage of the Sri Lanka rural water supply programme, Danida
forecast demand on the basis of assumed ability to pay. At evaluation it was
found that people were unwilling to pay their share of O&M costs for
communal waterpoints. Many poor consumers had acquired house
connections, independent of the project, and were limiting their consumption
to within the level of the lowest tariff, so making it affordable.
UNICEF reviewed 54 sanitation projects and concluded that success is
determined principally by consumer demand, and that it cannot be assumed
that demand will universally be for low cost sanitation.
White, 1997
104
Water vending
Interventions to improve water supplies for the urban poor need to take
particular note of the role of water vernding, as summarized below:
WEDC/Sarah Parry-Jones
Probably 25 per cent of the population of most Third World cities buy water
from vendors.
They spend typically 10 to 20 per cent of their income on water, and this
money comes out of their food budget.
The income elasticity and price elasticity of demand are very low, with the
result that the poor pay the highest proportion of their income for water, and
the price is very sensitive to change in supply.
Vendors charge high prices, but rarely get rich; their prices reflect the high
cost of their means of transporting water.
In this situation, any interventions which reduce the cost of water to the poor are
likely to improve their nutrition and hence their health. These include:
more accessible piped water for the poor (standposts);
reduced queuing time for vendors when filling up; and
credit schemes to help more vendors to enter the market.
Cairncross and Kinnear, 1988
Tariff structures and

subsidy policy are
formulated on demand
assessment information,
ideally allowing
incorporation of
appropriate payment
mechanisms for the poor
which may include cross
subsidies from better-off
households.
Cost recovery policies informed by demand assessment studies can

also be structured to provide cross subsidy to low-income or lowvolume consumers.
Thirdly, demand assessment studies can help in the design of payment
mechanisms that are appropriate for poor people by identifying, for
example, their preferences for weekly as against monthly payments, or
for credit arrangements to spread over time the capital costs of
connection fees. They can also indicate the WTP of better-off
households to pay the full costs of metered private connections.
Allowing such households to on-sell water may improve the access to
water of poor people who would otherwise have to buy water from
vendors or from public taps. And by demonstrating peoples WTP for
different levels and types of water and sanitation services, demand
assessment studies can help to obtain political endorsement for
pricing reform and greater cost recovery. This can facilitate improved
services for the poor, as described above, and attract new investment.
2.5.5
Householders can benefit

from WS&S improvements
by, amongst other things,
saving time and/or money,
and enjoying better health
and a more convenient
service.
Household benefits from water and sanitation
The main benefits to households from improved water and sanitation are:
Financial savings Households can spend less money on water
supply (e.g. from vendors) or on storage tanks.
Time savings Households spend less time collecting or queuing
for water.
Convenience Water supplies are more reliable and accessible, and
sanitation arrangements provide adequate privacy.
Health benefits Increasing the quantity of water used, and
combining better water access with sanitation and hygiene
105
2.5
promotion is usually more important than improving water quality.

We saw in Section 2.3.7 that unless the return-trip time to fetch
water is less than three minutes or more than 30 minutes, the
quantity of water used (and hence the health benefits felt) varies
little. Some potential health benefits are unperceived by
households, and some are external in the sense that they depend on
others actions too.
Consumer surplus Benefits may arise when households consume
more water because it is available much more cheaply from the
improved supply than previously.
2.5.6
Economic appraisal of water and sanitation

projects
Health
The exception to the rule

is guinea-worm, for which
reasonable estimates exist
for the reduction in
incidence which improved
water supplies can offer,
and for the economic value
of such disease reduction.
1
2.5
Health is the benefit most commonly used to justify drinking water

and sanitation projects. But there are serious practical and theoretical
difficulties in measuring the health benefits that may arise from an
individual project,1 although health impact studies, taken as a whole,
provide firm evidence of a link (see Section 2.3). The key policy
implication is that expected health impacts are not an operational tool
for the fine tuning of interventions, or for ex-post evaluations.
Results from individual studies are too unpredictable.
An alternative approach is to try to maximize health benefits, without

attempting to quantify them. Broad patterns of disease, and their
Economic justification for
projects is commonly based associated economic and social costs, should help guide the overall
strategy. Health benefits can be expected to be maximized where
on health benefits. They are
existing water sources are furthest away and water consumption is
difficult to quantify. For rural
lowest, and people are most likely to feel a need for improved (that is
water projects an indirect
assessment can be made by more convenient) water. Those who would benefit most in terms of
allotting a monetary value to convenience that is where time savings are greatest are the most
likely to switch to the improved water supplies, with potential health
the time saved in water
carrying, for example, when a benefits. Typically, the economic value of time savings in these cases
is high enough to justify the cost of rural water schemes, and give a
source is provided closer to
positive economic rate of return. (See Briscoe & de Ferranti, 1988 and
dwellings.
Churchill et al., 1987).
The difficulty of measuring health benefits from improved water and
sanitation has led to the development of proxy indicators, for use in
monitoring and evaluation (see WHO, 1983). As Section 2.3 makes
very clear, the likelihood of health benefits occurring is significantly
diminished where there is no reason to believe hygiene behaviour will
change.
Cost-benefit or cost-effectiveness analysis
Assessments for water

projects in general are
preferably derived from cost
benefit analysis.
106
The preferred method for assessing economic justification for a water

project is cost-benefit analysis. Demand assessment surveys using
Contingent Valuation (CVM) and/or Revealed Preference (RP)
methods should form the basis for benefits estimation for most water
projects. Table 2.1.2 compares these with other assessment methods.
The basic steps in using CVM and RP surveys are outlined in the
Guidance Notes for DFID Economists in the Water and Sanitation

Sector (DFID, 1998). Traditionally, tariffs have been used to value
water benefits for urban piped water schemes, but typically these
seriously underestimate benefits. For rural water supply projects,
estimated time savings, converted to a monetary value based on the
assumed economic and social value of time, can be used as a measure
of benefits. For both urban and rural schemes, financial cost savings
may also be an important additional component of project benefits.
The costs and benefits that should be included are not only the capital
and running costs of the project and the direct benefits, but also those
which are external to the project (see the following sections on Water
pricing for economic efficiency and on use of public subsidies).
Sanitation projects, where
economic benefits are hard
to measure, more usually
depend on costeffectiveness analysis. The
same technique is used for
water and sanitation
projects where there is no
demand assessment study.
Cost-effectiveness analysis is an alternative approach where benefits

cannot be estimated. It involves comparing the costs of meeting the
assumed demand for water or sanitation and identifying the least
cost option. Conventionally, sanitation projects have been justified in
economic terms by cost-effectiveness analysis, because of the lack of
satisfactory measures of the economic benefits of improved
sanitation. This method is still recommended for both water and
sanitation projects where demand assessment studies are not justified.
2.5.7
Water pricing for economic efficiency
Leaving aside for the moment questions of income distribution and

poverty, economic theory argues that setting the price of water to
reflect its full cost will give incentives to use water in the most
efficient way for the economy. The full cost should be estimated in
economic prices (reflecting the impact on the economy as a whole)
rather than in financial prices (which may not be the same, for
instance because of tax and subsidy arrangements).
There are several very
good reasons for basing
water pricing on full costs.
The results of under pricing
are that:
public utility service
providers are left short of
funds;
the private sector will not
invest;
users take and waste
more
there is a lack of incentive
to prioritize water
allocations to the higher
value uses.
The full cost of water has three components:

(i) Long-run marginal costs of supply They are long-run because
they include capital as well as running costs. They are marginal
because they are based on the cost of expanding the supply.
(ii) External costs These are external to the water users main
concern. The main components are:
Economic externalities These are where water use has an impact
on others upstream or downstream. Examples are the cost of
disposing of wastewater (where pollution of other water sources
leads to higher costs for downstream producers), or the cost of
over-extraction from an aquifer or lake (which may raise the
water salinity levels, and costs, of downstream water supplies).
Externalities may be positive too (for example where irrigation
leads to the recharge of an aquifer and reduces salinity).
Public health externalities These are health costs imposed on
others because of polluted wastewater.
Environmental externalities These are costs imposed on
ecosystem health.
107
2.5
2.5
(iii) Opportunity costs These are the costs to the economy when
scarce water used in one way pre-empts its use for a higher value
purpose elsewhere. Typically domestic water has a high value
relative to other uses, so the opportunity cost to be applied in
calculating the cost of domestic water is zero. (The opportunity
cost concept can be very important, however, for policy
discussions about intersectoral allocation of water. The
opportunity cost of water used in agriculture can be high when
this pre-empts domestic use.)
Pricing must encourage the
most efficient use of the
resource for the national
economy as a whole.
Prices must reflect true
economic cost, accounting
for both the external
impacts and opportunity
costs of specific uses as
well as the current capital
and operating costs and
those needed to expand
the supply system.
International recognition of
the realities of the growing
scale of WS&S needs
means a move to cost
recovery and away from the
heavy subsidy policies
currently built into charging
systems.
Subsidies may still be
necessary to aid the poor,
rectify price inequities, and
encourage service
expansion. A justifiable
case for subsidy can be
made where individual and
community health benefits
are not apparent to
householders but are
apparent to those
competent to make
judgements from a wider
perspective.
Where water is under-priced, public sector agencies responsible for

the operation and maintenance of water supplies will typically be
short of funds, and the private sector will be discouraged from
investing in water utilities. The likely result will be a decline in the
quality and reliability of water supplies.
In addition, where water is under-priced, little incentive is created for
users to avoid excessive use and wastage of water, which may lead to
over-investment, as new projects are brought forward to prevent
demand outstripping supply. Finally, under-pricing will not encourage
the allocation of water to more essential and valuable purposes, such
as domestic use.
2.5.8
Use of public subsidies
Public subsidies are used extensively to meet both the capital and the
running costs of water and sanitation schemes. In practice, subsidies
have often been allocated primarily to reflect political objectives.
From the economic viewpoint the main justifications for using
subsidies are on income distribution grounds, that is to reduce
poverty, and where significant external benefits are expected.
For water supply schemes, any proposed subsidies should normally be
justified on income redistribution grounds, not on direct health
benefits, because the link with water investment is very complex.
Subsidies can be used to provide water at a lower cost, either by
charging a lower tariff or by providing a water source which is closer
to home, or more reliable.
For sanitation schemes, subsidies may be needed to correct for
market failure which arises because inherent demand (the market)
does not to lead to the level of investment in and use of sanitation
services which would be most efficient for the economy and society.
Market failure occurs because people do not know that their own
health and welfare could be improved by better sanitation facilities
and hygiene practices (and potential providers of products and
services do not know that there is market potential in this sector); and
because improved sanitation and hygiene practices in individual
households can contribute to improved health in the wider
community.
Typically, public financial resources for the water and sanitation
sector are scarce compared to need, so a higher level of subsidy per
capita is possible only at the cost of subsidizing fewer people. This
108
It is essential that subsidies

built into any pricing
strategy are transparent
and have clear objectives
and targets. They must be
sustainable by being
covered through other
elements of the charging
structure.
highlights the importance of a transparent subsidy policy so that there

is clarity about the objectives of the use of the subsidy; the targets for
cost recovery and/or financial performance of the utility; the criteria
for deciding where and how much subsidy will be allocated and for
what purpose; including definition of the target group of consumers;
and the procedures to ensure accountability on the use of the subsidy.
Scarcity of public financial resources also emphasizes the need to
avoid subsidizing consumers who are willing to pay the full costs of
the service proposed, and where there is no compelling social reason
for subsidy. Lastly, it argues for action to attract more private sector
investment into the water and sanitation sector, and to aim for higher
cost recovery from users who are willing and able to pay for the
services provided.
It is important that subsidies are sustainable, for example covered by

surpluses generated elsewhere by the utility, or funded from
earmarked revenue sources. See also Sections 2.5.12 and 2.5.13.
Practice
2.5.9
The importance of making
WS&S interventions
effective by associating
them closely to user
demands and preferences
is a central theme of this
manual. There are
established and recognized
methodologies for
assessing demand, of
which the two most
recommended are
Revealed Preference and
Contingent Valuation (CVM).
Between these two the
latter has some major
advantages but it has the
serious disadvantage that,
unless an experienced
CVM expert is involved in
the design, implementation,
and analysis of the study,
the outputs can be biased
and misleading.
Two approaches not
recommended are the
benefit transfer and
affordability rule of thumb
methods.
Demand assessment
Advantages and disadvantages of different methodologies
Two common approaches to demand assessment which are not

recommended are:
An affordability rule of thumb, which is the widely used
assumption that people will be willing to pay three to five per cent
of their income on water has been shown to be a poor guide to
WTP for service improvements. One of the key findings of demand
assessment studies to date (undertaken by the World Bank Water
Demand Research Team) is that income is only one among several
determinants of WTP for improved water (see box Why WTP for
rural water supplies varies in Section 2.5.2). Differences in
characteristics (quality, cost, reliability, etc.) between the improved
and alternative sources of supply are very important, as are socioeconomic characteristics of the household and attitudes to
government policy. Households WTP as a proportion of cash
income consequently varies widely, from effectively zero to over
10 per cent.
Benefit transfer, under which results in one location are used to
estimate benefits in a similar location. This can lead to seriously
erroneous conclusions as WTP varies considerably even between
apparently very similar locations. The conditions under which
benefit transfer is valid are rigorous, and rarely met.
Demand assessment is best undertaken by:
Revealed Preference methods, which measure demand indirectly by
examining current behaviour, for example the price paid to water
vendors, other expenditure on water services such as private pumps,
storage tanks, or boiling water, and time taken fetching water.
109
2.5
Contingent Valuation methods (CVM), in which people are asked

directly what they would be willing to pay for different water and
sanitation services specified in a carefully designed and realistic
hypothetical scenario.
Choice of method depends
on project-specific criteria.
In some instances different
approaches may be
preferable at different
stages of a programme.
Criteria affecting choice of
method are summarized in
the boxes on pages 110
and 111.
2.5
Either method can be used for focus group discussions, for small, nonrandom surveys, and for large surveys on randomly selected samples.
CVM has two big advantages over Revealed Preference. Firstly, it can
assess demand for a variety of possible improvements (i.e. different
standards) to water and sanitation services, for example, individual
yardtaps versus public standpipes, pit latrines versus indoor toilets, as
well as demand for improved reliability to existing water supplies.
Secondly, it can accurately estimate what proportion of households are
likely to switch to improved service levels at given tariff levels.
A serious disadvantage of CVM is that unless an experienced CVM
expert is involved in the design, implementation, and analysis of the
study, the results are likely to be biased and misleading. Using CVM
adds significantly to the cost of (and time needed for) focus group or
small survey demand assessment studies, but the incremental costs of
a CVM approach will be relatively modest if a large random sample
survey is to be undertaken in any case. CVM household surveys may
not give a full picture of demand where money decisions are taken by
men, but the views of women are important, as women bear the time
costs of water collection and have gender-specific needs or views in
relation to sanitation. CVM may need to be complemented by other
investigations, such as focus group discussions with women or men.
It is important that options presented under CVM hypothetical
scenarios are based on sound engineering advice of what is technically
Small rural water projects
DFID/R Lokanadham
Where there are few levels of service options and costs are low:
The cost of a large survey and a CVM expert may not be justified for projectlevel decisions.
Care still needs to be taken to ensure schemes respond to demand. Many
rural schemes have been abandoned because their designers failed to do
this. In villages where there is no water vending, and households spend little
time, effort, or money on collecting or storing water, improved water services
are not a high priority, and supply-driven water supply projects are likely to fall
into disrepair through poor cost recovery. Providing water supply to these
communities is likely to be a poor use of public funds.
Full community participation is vital in the selection of technology and
location; in determining arrangements for operation and maintenance; and in
meeting O&M costs and at least a part of capital costs, in order to ensure
that schemes match demand.
Proxy measures for demand such as village size (population to be served),
return trip time to existing water source(s), and price paid to vendor, may be
useful to assess where demand is likely to be highest.
110
Urban or large rural water schemes

The case for using a CVM approach at some stage rather than just revealed
preference studies is stronger where:
there is a range of different, technically feasible levels of service options
which can be made available to consumers, for which there is likely to be
some demand, even if charged at full cost, but which have significantly
different implications for project design, e.g. whether to plan only for public
standposts or for a growing proportion of private connections. The drainage
infrastructure needs and therefore the costs of some level of service options
are likely to be high, because of high density of housing and water demand
(i.e. water volume supplied per hectare);
the charges that users will be required to pay for some service-level options
are likely to be high. In such cases, the financial viability of the utility and the
economic justification for the project may be heavily dependent on how
people respond to the options at the prices to be charged, for example, how
many people opt for private connections and how much water all those with
private connections will use;
there are middle-income and commercial and industrial users with
significantly higher WTP than poor people, and who might have the capacity
to cross-subsidize the latter. Since poor people, particularly those served by
standposts, use less water, this is likely to require only a marginal increase in
the tariff for the larger consumers; and
there is scope for providing private connections to households WTP full costs
in areas where they are likely to sell water to poorer neighbours. This can be
a useful component of a strategy to improve access to safe water among
poor people.
feasible, and at what cost. In the case of water supply improvements

the cost of associated drainage must also be taken into account.
Indeed the capital cost of the latter can be as high as that for water
supply, where water consumption per unit area is high.
2.5.10 Demand assessment: Water
An important factor to consider in all water demand assessment work

is how far demand changes seasonally. In particular, it is important to
identify all wet and dry season traditional water sources, since women
often resort to wet season sources, when these are close, in preference
to improved water supplies that are further away. Changing seasonal
patterns of demand also influence households willingness-to-pay on a
regular basis for improved water supplies.
In the course of developing sector policy and then project
identification and design, it may be appropriate to use more than one
demand assessment approach. Which approach is most appropriate
depends on circumstances. For policy-related studies to inform
politically contentious decisions such as tariff structures and levels,
cost-recovery levels, and the structure and targeting of subsidies, it is
likely to be important to conduct a large randomly selected survey in
order to produce results which are statistically robust. Results from a
small survey or focus group discussion, though much cheaper, will
111
2.5
carry much less weight. The factors that will influence the decision on
the appropriate demand assessment approach at project level are
summarized in the boxes on the previous two pages.
2.5.11 Demand assessment: Sanitation
2.5
Decisions on subsidy
require a quite separate
assessment and analysis
and, given the financially
weak state of many
developing world utilities,
are not infrequently tied into
wider discussions covering
essential tariff reforms and
financial restructuring
designed to give the
company a viable,
sustainable future.
Some key findings from
experience in these areas
are:
Inadequate cost recovery
breeds low standards
and prevents system
expansion.
Recovery of O&M costs
from users aids
increased reliability of
existing systems.
Water coverage to the
poor could be increased
by using public subsidy
for capital costs in
conjunction with full cost
recovery from existing
users willing to meet
them.
Communal facilities make
cost recovery difficult.
112
As part of the formative research for a hygiene promotion and

sanitation promotion programme (see Section 2.8), Revealed
Preference approaches will be important to ascertain current
expenditure and time spent on sanitation. But it will be useful to
complement this with a CVM approach to assess preferences and
WTP for new sanitation options which can be offered. CVM has been
successfully used in this way, using descriptions of the characteristics
of unfamiliar options (privacy, convenience, etc.) rather than of their
technical design options (Altaf and Hughs, 1994). It should be noted,
however, that using CVM to estimate WTP for sanitation is likely to
understate the full economic benefit because of both public health
externalities and respondents misperceptions about the links between
sanitation and family health.
2.5.12 Subsidy analysis
Subsidy analysis can inform policy dialogue, and lead to clearer

subsidy objectives and criteria for use. The first issue to consider is
the scale, purpose, and direction of fiscal subsidies. Here it is useful to
distinguish between the source of the subsidy (domestic budget or
donor financed), the end-user (utility, municipality, or other agency),
and what is to be subsidized (capital and/or running costs). Secondly,
who will benefit from the financial subsidy, and by how much? This
requires comparing, for different classes of users, the financial cost of
supply with how much they pay. Thirdly, what are the economic
subsidies? This requires comparing the full cost of supply in
economic prices for different classes of users with how much they
pay.
2.5.13 Water: Cost recovery, tariff reform, and use
of subsidy
Weak cost recovery is the root cause of both low standards and low
coverage of water systems. The reliability of existing systems is more
likely to be increased if users meet operation and maintenance (O&M)
costs. Greater coverage of safe water supply to many more poor
people could be achieved if available public funds were used to
subsidize capital costs, and if full costs (including capital costs) were
recovered from existing users who were willing to meet them. Note,
however, that cost recovery from consumers taking supplies from
communal standposts is a more difficult or expensive, than costrecovery from those with yardtaps or home connections. This is
especially true in rural areas where weak local institutions may have
no sanctions they can apply to non-payers.
For small rural schemes for water supply, simple cost-recovery targets
may be appropriate, such as requiring communities to provide labour,
materials, and a fixed cash sum as their contribution towards
construction costs, and to meet O&M costs subsequently. These may
In urban schemes
variations in service levels
and types of consumers
introduce new
possibilities and
complexities into cost
recovery.
In summary poor
households and
communities are unlikely to
benefit from an expansion
of existing water systems
where utilities are in need of
the reforms described
above; and those reforms
must be accompanied by
better billing and collection
systems and more
widespread metering of
supplies.
or may not include occasional, major, maintenance costs, depending

on public subsidy policy.
In urban schemes, especially where a range of water and sanitation
services is provided to a variety of customer types, cost-recovery
policy is more complex. Often many existing customers are middleand upper-income households and commercial and industrial
businesses who would be willing and able to meet the full cost of
supply. Typically only a small proportion of system costs are
recovered, and sometimes not even O&M costs, so the utility is
financially weak, and the standard of service to existing consumers is
very poor.
In this situation poor people are unlikely to benefit from system

expansion to cover (more) low-income areas, unless steps are taken to
tackle the financial and operational weaknesses of the utility as a
whole. Investment to improve the sustainable access of the poor to
safe water must therefore be complemented by comprehensive reform
of the utility to make it financially self-sustaining. The aim should be
to meet all capital and O&M costs, except those met by transparent
public subsidy (targeted, for example, on expanding the system to
low-income settlements).
Improved cost recovery will usually require the setting of clear
objectives for cost recovery and the use of subsidy; reforming of the
tariff structure and levels to meet revenue objectives (and provide
incentives for consumers to conserve water); greater attention to
billing, collection, and enforcement; and more extensive metering of
consumers.
The basis for tariff reform should be an analysis of the utilitys financial
costs and the economic costs of supply (and of necessary wastewater
collection, treatment, and disposal), complemented by an analysis of
consumers WTP for water, and a financial analysis of existing and future
subsidies. General guidance on public enterprise pricing and financial
management is given in DFIDs Technical Note No.5, (1992), and more
detailed guidance on tariff systems and the accounts of water enterprises
is contained in Appendix 3 of the Manual for the Appraisal of Rural
Water Supplies (ODA, 1985). On-Lending Guidance is contained in
DFIDs Technical Note No.6 (1992). Revenue projections should be
based on analysis derived from WTP studies which assess how
existing users will respond to tariff rises and how many new
consumers will connect to the system.
2.5.14 Meeting poverty objectives while restructuring
utility cost recovery policy
Full cost recovery from all water consumers is not necessarily in

conflict with reducing poverty. Many studies have found that poor
people in some circumstances are willing to pay high prices and a
significant proportion of their income for water supply. The full cost
charges of the water supply from the utility may be less than they
currently pay anyway, for example if they buy water from vendors.
113
2.5
2.5
When reforms are in hand

policies can be tailored to
accommodate the essential
water needs of the poor
and not necessarily by
compromising the aim of
cost recovery.
There are more
complexities involved in
justifying the need for
sanitation projects than for
water supply
improvements, and also in
justifying the need for and
level of subsidies.
User demand for sanitation
is less because, without
understanding of health
issues, the perceived
benefits are less or even
absent.
There may be good
grounds for subsidized
sanitation on public health
grounds but special care
must be taken with
sewerage. Sewerage
systems often serve the
middle- and high-income
sections of the community
best able to pay the cost of
the service. In addition,
treatment works should not
be subsidized for public
health unless their
contribution to this goal is
clear; most sewage
treatment is for
environmental protection,
not public health benefit.
Ways should be sought, however, to ensure that the poor have access
to a minimum volume of water necessary to meet their basic needs at
an affordable price. Possible approaches, ideally within the context of
reform of a utilitys cost-recovery policy, are shown in the box below.
However, lifeline tariffs and rising block tariff structures will work to
the detriment of the poor in certain circumstances, as the following
example from Accra in Ghana demonstrates. In Accra, most low-income
households do not have private connections, so they do not benefit from
the social tariff (for consumption below 3000 gallons per month). They
have to buy water from vendors or neighbours. The vendors charge high
prices for water, not only because of scarcity, but because as wholesalers
of large volumes of water, they have to pay high rates themselves under
the rising block system. As a result, households that purchase water
from vendors pay between 2.5 and 6 times more for their water than those
with private connections. (See also Section 2.6.17.)
2.5.15 Sanitation: Cost recovery and use of subsidy
For sanitation improvements, subsidy may be justified on the basis of

significant external benefits, that is on public health grounds. Where
to concentrate sanitation subsidy should be determined by examining
the pattern of disease and hygiene practices, and assessing the likely
benefits from sanitation and hygiene promotion programmes.
Decisions on whether to subsidize sewerage schemes should take into
account that every 1 spent on subsidy for sanitation is probably 1
less subsidy for water supply.
If a sanitation scheme is to be subsidized, it is better to subsidize the
overheads of the project, particularly the promotion activity, rather
than subsidizing the construction of facilities themselves. In that way
Meeting poverty objectives within utility full costrecovery policy
Options include:
cross-subsidy charging better-off users more than the cost of supplying
them;
avoiding reverse cross-subsidy ensuring poor people are not charged
more for their water than better-off users;
lifeline tariff charging a low (often a flat) rate for low-income, or lowvolume, users. Low-income users may be classified by type of supply, e.g.
shared rather than individual connection, or by location, e.g. township or
slum location. To identify low-volume users requires metering. A typical
ceiling for the lifeline tariff would be 6-8 litres per capita per day (0.9-1.2 cubic
metres per month);
rising block tariff structure charging higher rates for larger volume users;
and
easing the cost of individual connections for low-income households by
subsidizing connection costs, or by allowing connection fees to be spread
over a longer period, and included in monthly water bills.
114
the number of families who can benefit is not limited by the size of
the subsidy budget.
Households can gain health benefits from following sound sanitation and
hygiene practices themselves, regardless of what other households do
(see Section 2.3.8). Sanitation has significant convenience benefits (for
example privacy) which people are willing to pay for if suitable products
and services are made available. It may be more appropriate and
sustainable to subsidize the start-up costs of small businesses to provide
products and services than to subsidize the products directly.
When considering sewered systems it is important to distinguish
wastewater collection from its treatment. The economic benefits for
these two stages may differ greatly, for instance when disposal or
treatment is distant from population centres, so that public health
risks from non-treatment are low. Treatment may not be economically
justified, even if collection is.
If there is a subsidy to the O&M costs of the water and sewerage utility, it
will usually be inequitable for this to go to the sewered customers, who
typically are middle- and upper-income households and commercial and
industrial users who can afford to pay full costs. If the sewerage network
is being expanded, sewered customers should pay at least the long-run
marginal cost of the network. The usual cost-recovery method is to add a
sewerage surcharge to the water bill, rated on water consumption, which
has the added benefit of discouraging excessive water use.
2.5
Further reading
Core references
Relevant chapters of Planning Development Projects by G. Bridger

and J. Winpenny (HMSO, 1983) and Values for the Environment by
J. Winpenny (HMSO, 1991).
Papers marked with
an asterisk are available
to DFID staff from the
Development Economics
Research and Enterprise
Department. They include
papers presented at a
DFID seminar on the use of
demand assessment in the
water and sanitation sector
held in London
15-16 December 1997.
*
*DFID (1998), Guidance notes for DFID economists on demand

assessment in the water and sanitation sector, Department for
International Development, London.
*Pearce, D. (1997) Demand assessment in the water and sanitation
sector in developing countries.
A clear summary of water valuation issues and techniques.
*Griffin, C.C., Briscoe, J., Singh, B., Ramasubban, R. and Bhatia, R.
(1995) Contingent valuation and actual behaviour: Predicting
connections to new water systems in the State of Kerala, India, World
Bank Economic Review Vol.9 No.3, pp.373-95.
Demonstrates the reliability of CVM by ex-post comparison of
behaviour with predictions based on CVM survey.
*The World Bank Water Demand Research Team (1993), The demand
for water in rural areas: Determinants and policy implications World
Bank Research Observer, Vol.8 No.1, pp.47-70.
Draws general conclusions from careful fieldwork in several countries.
115
*Whittington, D., Davis, J., and McClelland, E. (1998) Implementing a demanddriven approach to community water supply planning: A case study of Lugazi,
Uganda, Water International (forthcoming).
Compares results using CVM in surveys and community meetings.
Winpenny, J. (1994) Managing Water as an Economic Resource, Routledge for ODI,
London.
A readable book written from a water economics perspective making the case for
water demand management and for integrated water resource management.
White, J. (1997) Evaluation Synthesis of Rural Water and Sanitation Projects, DFID
Evaluation Report EV 596, Department for International Development, London.
Reviews experience of DFID and other donors projects.
Evans, P. (1992) Paying the Piper: An overview of community financing of water and
sanitation, IRC Occasional Paper No.18, IRC International Water and Sanitation
Centre, The Hague.
Kamminga, E. (1991) Economic Benefits from Improved Rural Water Supply: A
review with a focus on women, IRC Occasional Paper No.17, IRC International
Water and Sanitation Centre, The Hague.
WHO (1994) Financial management of water supply and sanitation.
Other references
Warford, J. (1994) Marginal opportunity cost pricing for municipal water supply,
Economy and Environment Program for Southeast Asia,
2.5
Good review of economic principles to underpin pricing rules.

*Pearce, D. (1997) Rapid Appraisal Techniques: Benefit Transfer,
A note on the formal requirements which must be met for benefit transfer to give
reliable results.
Rogers, P., Bhatia, R. and Huber, A. (1996) Water as a social and economic good: How to
put the principle into practice. Draft Paper prepared for the meeting of the Technical
Advisory Committee of the Global Water Partnership in Namibia.
Presents general principles and methodologies for estimating costs and values in the
water sector, discusses prices and tariff setting, and provides a summary of best
practice in water demand management.
Winpenny, J.T. (1997a) Water Policy Issues, Occasional Paper No.2, DFID
Engineering Division, Department for International Development, London.
Winpenny, J.T. (1997b) Draft DAC Guidance on the treatment of aid financed
projects in the water sector, DCD/DAC/FA, Development Assistance Committee,
OECD, Paris.
Whittington, D. and Swarna, V. (1994) The economic benefits of potable water
supply projects to households in developing countries, Economics and Development
Resource Centre, Asian Development Bank.
Discusses the concept of economic benefits in the water supply sector and presents
several approaches which can be used in their estimation.
116
Whittington, D., Lauria, D.T. and Mu, X. (1991) A study of water vending and WTP
for water in Onitsha, Nigeria, World Development Vol.19 No.2/3, pp.179-98.
Case study demonstrating that reliability is a key factor in WTP, and how tariff policy
can satisfy equity and efficiency objectives.
Whittington, D., Mu, X. and Rock, R. (1989) The Value of Time Spent on Collecting
Water: Some estimates from Ukundu, Kenya, World Bank Policy Planning and
Research Staff Paper, Report INU 46, World Bank, Washington DC.
Case study showing that most households spend 10 per cent of their income
purchasing water, in preference to fetching free well water, as they value time highly.
Whittington, D., Lauria, D.T., Wright, A.M., Kyeongae, C., Hughes, J.A., and
Swarna, V. (1992) Household Demand for Improved Sanitation Services: A Case
Study of Kumasi, Ghana, UNDP-World Bank Water and Sanitation Report No.3,
UNDP-World Bank, Washington DC.
The use of WTP to elicit demand for different levels (and costs to consumers) of
sanitation services.
Altaf, M.A. and Hughs, J.A. (1994) Measuring the demand for improved urban
sanitation services: Results of a contingent valuation study in Ouagadougou, Burkina
Faso, Urban Studies, Vol.31 No.10.
Briscoe, J. and de Ferranti, D. (1988) Water for Rural Communities: Helping people
help themselves, World Bank, Washington DC.
Reflects the state of the art before WTP studies. Argues that project success depends
on giving people what they want and are willing to sustain, and that time savings
provide insight into likely response of users to project.
Churchill, A. et al. (1987) Rural Water Supply and Sanitation: Time for a change,
World Bank Discussion Paper No.18, World Bank, Washington DC.
Examines reasons why a high proportion of rural water supply projects failed to meet
their objectives. Advocates economic appraisal of projects to be based on cost-benefit
analysis which quantifies time savings, but not health benefits.
WHO (1983) Minimum Evaluation Procedure (MEP) for Water Supply and
Sanitation Projects, WHO, Geneva.
Narayan, D. (1993) Participatory Evaluation: Tools for managing change in water
and sanitation, World Bank Technical Paper No.207, World Bank, Washington DC.
Guidelines for evaluation using proxy indicators for health benefits based on
community use of facilities and associated changes in hygiene behaviour.
Yining, L., and Warford, J. (Co-Chairmen) Natural resource pricing in China: Water
supply, coal and timber, Working Group on Resource Accounting and Pricing
Policy, China Council for International Cooperation on Environment and
Development.
A detailed review of how to meet the multiple objectives of economic efficiency,
social equity, and sustainability in policy reforms.
117
2.5
2.6
The central lesson learned

from too many WS&S
interventions of the last
twenty years is that simply
building new facilities does
little to help the poor.
Projects that end with the
construction phase
inevitably fall into disrepair
and disuse.
Experience has proved that
benefits are only achieved
when hardware installation
is fully integrated with
properly planned and
implemented arrangements
for the long-term operation,
maintenance and financing
of an improved service.
A successful programme,
therefore, requires the
active participation of a
number of agencies from
the public and probably the
private sector, as well as
professional input from a
range of disciplines. Above
all it requires that these
many partners to a
programme be properly coordinated, with clearly
identified roles and
responsibilities. Achieving
this is difficult in a country
where there is no strong
institutional framework;
deficiencies in this area are
at the root of many past
WS&S failures.
For rural projects a multilayered, centrally-controlled
management hierarchy is
not helpful. Devolving
management responsibility
118
2.6
Introduction
If we are to maximize the impact and the prospects for sustainability

of WS&S programmes, institutional aspects need to be addressed
comprehensively, as part of a collaborative approach with project
partners. Key professionals working in the sector therefore need to
understand institutional issues and their implications.
In this section we consider why support for institutional development
is important, and look at the key issues and opportunities in the
context of a poverty-focused approach and typical constraints in the
sector. Under the heading of Practices, we examine what is entailed in
Institutional and Sector Appraisals and Institutional Development, and
learn how to support these. To put the discussion in context, we look
briefly first at management options that are in use and worthy of
further consideration in the rural and urban sectors.
A glossary follows this section with definitions of some common
institutional terms.
2.6.1
Why support institutional development in the

WS&S sector?
Rapid population growth and the inadequacy of water supply and

sanitation services led to a strong emphasis in the 1980s and 90s on
the construction of new facilities. Considerably less attention was paid
to the sustainable management of services. Among examples of
poorly managed services are the high percentage of handpumps that
are not working in rural areas and the high leakage rates in urban
water distribution systems. Host governments and donors usually
advocate sustainability, but in practice they have often withdrawn
support soon after the facilities have been constructed and then
handed these facilities over to local institutions.
Poorly managed facilities lead to declining service levels. This in turn
reduces the chances of good cost recovery in terms of both
willingness-to-charge and willingness-to-pay. One consequence is that
investment in the sector cannot keep pace with demand. It is clear that
in many developing countries scarce resources such as water are
allocated unfairly, with preference given to those who have power and
influence, and the poor further marginalized.
Institutional Development (ID) work that leads to improved and more
transparent management practices results in more effective and
equitable use of resources, which is central to DFIDs main aim of
eliminating poverty in poorer countries.
2.6.2
Institutional options for rural WS&S
Management models for rural WS&S facilities vary from centralized

government systems to localized community management, with
several models between these extremes (see Figure 2.6.1). Some
countries have central, state, district, and village administration
involvement in the sector, amounting to four tiers. The activity-
to the community via

partnership arrangements
with key agencies is more
effective. It allows for
appropriate skills inputs,
particularly important for
the up-front promotion
programmes generally
needed to engender
demand for sanitation
works.
responsibility matrix for South Africas rural water sector (Table

2.6.1) demonstrates the overlapping or fragmentation of
responsibilities, which is also common elsewhere.
Centralized management often contributes to operation and
maintenance (O&M) failure because of:
over-dependence on limited government resources;
user expectations that government provides everything;
user non-payment of water charges; and
a lack of user involvement in decisions concerning their water
supplies and sanitation.
(Davis and Brikke, 1995)
Under such circumstances, adapting centralized management by just

incorporating community participation is unlikely to be successful.
2.6
Figure 2.6.1. Rural operation and maintenance models and tiers of responsibility
119
A fundamental change towards community management using a

partnership approach involving the community and the key agencies
offers a more effective solution (see Section 2.6.7).
Rural sanitation
This sector presents a particular challenge because of the general lack

of facilities, combined with limited initial demand for sanitation
services, that is experienced in many areas. A comprehensive social
marketing approach is advocated and explained in Section 2.8, as an
effective means to promote sanitation and its use.
2.6
What are appropriate means of managing sanitation programmes from

an institutional point of view? Collaboration between the various
departments and stakeholders is possible for specific integrated
projects, but long-term co-ordination is difficult to achieve.
The devolving down

principle of management
responsibility is equally
applicable to urban
programmes, as is the
reduction of overlapping
responsibilities to ensure
accountability. The proviso
is that the more complex
nature of WS&S systems in
large towns and cities,
possibly including
treatment works, and other
major engineering
elements, lends itself to
and may benefit from an
unbundling of management
functions. Bulk supply of
water and the associated
river intakes and well fields
may, for example, be
regionally managed, while a
municipality is responsible
for the distribution network.
One clear advantage of
municipal management at
the end-user level is the
potential for integrating the
expertise of other municipal
departments, such as
health or education, into the
programme.
120
Where such institutional problems exist, issues such as clarification or

reallocation of responsibilities, options for an integrated approach,
and HRD requirements should be addressed during the process of
project development. A partnership approach involving NGOs and the
private sector will also enable the introduction of much-needed skills
to sanitation promotion and implementation.
2.6.3
Institutional options for urban WS&S
Six basic management models of urban water supply are set out in
Table 2.6.2. Models 1 and 2 can present problems associated with a
lack of organizational autonomy, with substantial government
involvement in matters that are often best left to competent managers.
There are variations on these models in some developing countries.
For example, in some states in India there is a combination of Model
1 and Model 2, where both municipal and state government are
involved in the management of water supply and sanitation. Such
overlapping responsibilities can often create problems of
accountability. In South Africa there are combinations of Model 1 and
Model 3, where municipal departments are partially corporatized or
commercialized this may offer a suitable route for development for
other countries. Some countries unbundle functions such as bulk
supply and water distribution for reasons of economies of scale and to
maximize the use of available expertise. Models 1 to 4 may also have
varying levels of private sector participation as a means of introducing
more incentives for effective service provision.
Models 5 and 6 include ownership by private shareholders and may
raise concerns of equity where a high percentage of the population is
poor. Model 4 a public owned/public limited company with staff
recruited from the private sector can offer an acceptably balanced
arrangement such models are used successfully in the Netherlands,
the Philippines, and Chile.
Municipal management
While the management of WS&S services by a municipality (Model

1) can present problems such as a lack of organizational autonomy for
Table 2.6.1
Indicative activity/responsibility matrix for the South African rural water sector (in a Transitional Policy Environment).
Activity
Responsibility
Involvement
Legislation
& dispute
resolution
Policy
development &
implementation
Sector
Strategic
Planning
Subsidy
decisions
capital
recurrent
Financial
Allocation
Budgets
Water
Resource
Allocation
Project
Identification
Project
Planning
& Design
Project
Implementation
Water
Quality
Management
of Community
Involvement
Tarrif
setting
Management
of O&M
HRD
Training
of
community
CBOs
Monitoring
& Evaluation
Research
National Government
Parliament
DWAF
DCD (MIP, EMIP & CMIP)
Other financiers1
(National public water utility)**
(Natural Resources Court)
Water Research Commission
Provincial Government
Responsibility
DWAF2
Local Government
District Councils
TRCs3
Private Sector
Water Boards
Consulting Engineers
Contractors
BoTT contractors
Training institutions
NGOs4
CBOs5
Project Steering Committees
(Statutory Water Committees)
Community Water Committees
Consumers
121
** Proposed institutions in parenthesis
e.g. DBSA, IDT. international funders
Catchment Management Agencies
Transitional Rural Councils
Non-Government Organizations
Community-based Organizations
2.6
Table 2.6.2
Organizational
model
Six basic management models of urban water supply

organizations
Who owns the
infrastructure?
Who operates Legal status

infrastructure? of operator
Who owns the

shares?
1. Direct public/
Local (municipal) Municipal
local (e.g. Kenya) government
administration
Municipal
department
Not applicable
2. Direct public/
supra-local
(e.g. India)
National or state National or

government
state
government
administration
National or
state
government
department
Not applicable
3. Corporatized
utility
(corporation/
authority/board)
(e.g. Ghana)
Government or
utility
4. GovernmentGovernment or
owned public
PLC
limited company
(PLC)
(e.g. Netherlands)
Corporatized
utility
Parastatal,
Not applicable
usually
defined
by special law
A PLC as
Public limited
permanent
company
concessionaire
Local/provincial
government
5. Delegated
private
(e.g. France)
Any combination Government

of government
and temporary
agencies
concessionaire
Public limited
company
private
shareholders
6. Direct private
(e.g. UK)
Private agents
Public limited
company
Private
shareholders
Private
company
Source: adapted from EUREAU (1992)
2.6
effective management, it also offers a number of advantages. For

example, local municipal management with potentially better
accountability to consumers is a key reason for the growing trend of
decentralization of powers to municipalities. If this is to lead to
substantial improvements in service levels, however, it requires
politicians and key staff to be prepared to make difficult decisions
regarding aspects such as cost recovery and efficiency improvements.
Another advantage of municipal management of WS&S is the good
potential for collaboration with other concerned departments in the
same municipality, such as the Health, Public Works, Planning, and
Slum Improvement Departments, where they exist. Unfortunately,
such potential is not always exploited.
Close collaboration is particularly advantageous when considering
sanitation improvement programmes. A box in Section 2.6.6 (page
128) discusses the management of sanitation programmes in urban
local government as well as the strategic approach to sanitation.
This approach differs from the existing supply-driven agenda through
two underlying principles: it is demand based, and incentive driven
(with appropriate rules, referees, and rewards). (See the box on the
strategic sanitation approach in Section 1.5.)
The approach, as described in Cotton and Saywell (1998a), involves:
122
Wider choices concerning technologies and service levels

Comprehensive information about technologies must be made
available, support provided in determining appropriate levels of
service, and flexibility shown in applying appropriate technologies
and service levels within the wider context of municipal sanitation
programmes.
Step by step actions Levels of service need to be disaggregated, or
unbundled both vertically and horizontally (see page 17). This
implies that sector delivery systems are broken down into separate but
technically integrated systems and the most efficient solutions are
designed at the most appropriate level (household, community, city).
Financial sustainability Key to the Strategic Sanitation Approach

(SSA) is the full recovery of investment, operations, and maintenance
costs, including financing and transaction costs.
Responsive institutional arrangements Links between departments
and institutions need to be developed to allow users to participate in
the decision-making process and management of services within the
context of the overall municipal sanitation programme.
Small towns
A general problem for rural
and small town projects, and
one which will test the
strength of institutional links,
is establishing sustainable
mechanisms for drawing on
the professional expertise
which tends to be
concentrated in regional and
large municipal
organizations. In many
developing countries the full
spectrum of necessary skills
is not available at central
government level or in lower
level agencies.
WS&S for small towns can present its own particular problems. Often
towns require more sophisticated forms of water supply systems than
villages, including distribution networks, reservoir intakes, and treatment
plants. Many small towns, however, do not have sufficient capacity to
manage all aspects of such WS&S services. Larger towns and cities
attract the more able management expertise in the sector, so the skills
shortages become most apparent in small towns.
Some countries have a system of national or state water authorities
Models 2 and 3 in Table 2.6.2 which serve some or all of the towns
and cities in their defined region. These models are a means of
maximizing the use of expertise in the sector. However, in resourcescarce countries, such national/state boards or authorities have often been
unable to achieve the outreach to provide customer-orientated services,
particularly to low-income groups. Fragmentation of responsibilities
exacerbates this situation. Again, unbundling may offer a solution. Then
the municipality (with support in capacity building) can manage the
distribution system and collect charges itself or contract it out to the
private sector. The bulk supply may then be managed by a regional water
authority, or they too may seek private sector participation. Decisions
need to be made where bulk supply costs are high, as to whether there
will be cross subsidies or an average bulk supply cost applied across a
region.
Principles
2.6.4
Constraints to effective service provision
Experiences vary both between and within countries, but WS&S

institutions typically have to contend with a multitude of constraints
which have varying degrees of severity, including:
123
2.6
2.6
Participatory approaches
are undoubtedly vital in
WS&S programme
development and
implementation. The
problem is that they require
new skills and experience.
Few WS&S agencies have
ready access to the social
scientists and other
specialists needed. In
addition resource
constraints are widespread
and there is an everpresent risk of political
interference to obstruct
movement towards costreflective charging.
Progression towards
pricing structures that allow
full cost recovery must be
the central focus of
institutional reform. The end
objective of a sustainable
water and sanitation
service can come only
within the framework of an
integrated water resources
management strategy in
which tariff structures are
formulated to cover the full
costs of maintaining
existing systems and
financing planned
expansions.
124
fragmented and overlapping responsibilities between different

organizations and stakeholders;
a lack of clear direction and vision;
poorly defined financial and physical objectives/indicators;
a lack of capable trained staff at all levels and particularly in
decentralized agencies taking on responsibility for WS&S
operations;
inadequate management information systems a lack of
transparency;
no comprehensive O&M procedures;
bureaucratic controls that inhibit effective management;
ineffective staffing policy and job definition;
lack of resources;
political management and interferences and lack of willingness to
charge higher water and sanitation tariffs; and
a lack of incentives to make improvements.
In the case of rural and peri-urban WS&S, many government
institutions have not been able to provide adequate services to these
widespread communities. Some form of community-based approach
has been adopted in most developing countries with varying degrees
of success. Problems arise when institutions have limited awareness
and capacity to elicit peoples real demand for service improvements,
based on their willingness-to-pay, and then to support community
management. The social mobilization and participatory approaches
described in Section 2.2, the hygiene promotion recommended in
Sections 2.3 and 2.8, and the willingness-to-pay studies outlined in
Section 2.5 all require skilled staff with specialist knowledge. These
people are rare in most developing countries. Even central
government agencies have limited outreach and lack the capacity to
implement programmes in distant communities.
2.6.5
Key institutional issues
The institutional framework for WS&S has to meet major challenges

in achieving both sustainable and equitable service provision. Central
is the improvement of cost recovery to generate the resources for
maintaining and improving services, to meet both existing and future
demand. This requires a sustained effort and long-term commitment
to addressing key issues that require greater emphasis, such as:
water resources allocation and management;
improved integration of water supply, sanitation and hygiene
promotion;
a commercial orientation including improved financial
management, investment planning, and tariff setting;
improved organizational autonomy, transparency, and
accountability as well as decentralization and delegation to the
lowest appropriate level;
improved equity and gender perspectives through dialogue with
low-income communities and well-targeted subsidies, seeking to
minimize perverse subsidies;
Good finance and resource

information is a basic
necessity; establishing
adequate management
strengths in this area is an
ideal starting point for
reform. Subsequent
capacity building should
encompass moves towards
the decentralization of
decision-making and
downward devolvement of
management
responsibilities. It should
lead to an integrated
institutional structure
responsive to and focused
on user demand.
demand responsive approaches including participatory methods

and the provision of appropriate marketing and customer services;
private sector participation and regulation with appropriate
incentives;
management of operation and maintenance (O&M); and
human resources development (HRD) and management
development that supports improved capability in all these aspects.
WS&S strategies and

interventions should seek
to have a positive impact
on policy in the host
country.
In recent years, many countries have begun the process of

decentralizing sector activities and some are making efforts to follow
the principle of devolving management to the lowest appropriate
level. This is a challenging process, particularly as it has to be
combined with the other key principles of involving all stakeholders
in decision-making processes and adopting an integrated approach to
water resources management.
Opportunities for
institutional development
can exist at all levels in
national management and
organizational structures
and should be sought
around the starting point of
a viable poverty-focused
WS&S programme.
At a very basic level

sustainability of small
community-managed
projects can be impaired
by the lack of a reliable
system for obtaining spare
parts or technical
assistance for occasional
repairs. The problem may
be solved by developing
links between
community managers and
relevant public or private
An institutional set-up capable of addressing these issues in an

integrated and comprehensive way improves the prospect for adequate
and sustainable services. Institutional Appraisal and Development as
described in the remainder of Section 2.6 provides a framework for
assessing how such a set-up may be achieved.
WS&S institutions in developing countries are usually orientated

towards constructing new infrastructure and the crisis management of
existing facilities. They need support in developing their institutions
to bring about improvements in the key aspects identified above. A
common starting point is improving management information and
transparency in the management of physical and financial resources.
2.6.6
2.6
Opportunities and strategies
Past projects of DFID and other agencies offer lessons for developing
new water sector programmes and projects, and reinforcing current
policy guidelines. All strategies and interventions should seek to have
a positive impact on policy in the host country. Opportunities and
appropriate strategies for institutional development need to be placed
in the context of potentially viable poverty-focused water and
sanitation programmes. The elements of such programmes are:
Integrated water supply, sanitation, and hygiene promotion
programmes aimed at maximizing health benefits at the local
level, using a demand-responsive and a process approach (DFID
Technical Note No. 4, 1992), and targeting poor communities in
rural and peri-urban areas. All projects are likely to involve some
form of institutional development, particularly in the areas of
Human Resource Development (HRD), information systems, and
improving linkages among stakeholder institutions.
Programmes in rural areas supporting management at the
lowest appropriate level will usually entail some form of
community management. Even where Village Level Operation and
Maintenance Management (VLOM) is achievable, the institutional
responsibilities between community organizations, local
125
partner agencies.
At a quite different level
appropriate specialist input
might be used to strengthen
national or regional resource
management planning or to
develop a water allocation
policy.
government, and the private sector, will need to be agreed and the
necessary support provided to achieve sustainable service
provision. Ensuring the availability of spares is often a key issue,
as is technical backup for major repairs. No less important is
institutional backup to fragile new local institutions.
Addressing local water resource management (WRM) issues
offers substantial potential benefits, particularly in areas where
there are water scarcity and water allocation problems between
different users. Any significant improvements to WRM will
involve some institutional development or strengthening. Support
could be in terms of building policy frameworks, including
assessment and modelling, legislation on water rights, and
appropriate environmental standards (ODA, 1995d). Water
allocation can be a sensitive issue and can generally only be
addressed where there is a clear willingness to collaborate by the
host government. Experience shows that properly informed
communities will themselves become the best caretakers of local
water resources, providing they are given the rights and the means
to do so.
Cairo Wastewater: Support to deprived areas
DFIDs support to the Cairo Wastewater project (since 1978) has primarily
concentrated on the construction of trunk sewer tunnels and large pumping
stations on the East Bank of the Nile. While the large investment in these works
has clear benefits for the city drainage system as a whole, it is more difficult to
identify targeted benefits particularly in relation to low-income groups in the city.
2.6
With the major part of the trunk infrastructure complete, the logical way of
addressing this issue is to extend sewerage to deprived areas which fall within
the catchment of the new trunk sewerage. The cost is marginal compared with
the cost of the trunk infrastructure already provided.
An additional project has subsequently been formulated which provides an
opportunity to develop participatory planning of local improvements with
communities, extending services to 60,000 people. The procurement and
contracting process will be structured so that labour-intensive methods can be
used for income generation within the local economy.
There are complementary projects offering institutional development support to
the responsible city authority.
There are also lessons here about the timing and planning of investments in
relation to trunk and local neighbourhood infrastructure.
Firstly, it is clear from the framework of the 1997 DFID White Paper that the
potential benefits to the urban poor can and should be appraised at the outset,
with clearly targeted interventions as opposed to trickle down assumptions of
benefits.
WEDC/Keith Pugh
Secondly, such clearly targeted interventions cannot be made in isolation from

the city-wide infrastructure context. The benefits of the Cairo deprived areas
project are only realizable because the trunk infrastructure exists. In the effort to
demonstrate the direct impact on the poor, it is important not to lose sight of the
wider picture.
126
Programmes with a primary

focus on the urban poor
can derive positive benefit
from parallel institutional
strengthening of the utility
service provider. An
improved or expanded
service to target groups
might, for instance, be
better assured by
improving the management
of billing and charge
collection and thereby the
overall financial position of
the utility.
Capacity building within the
utility should concentrate
on the human resource
element rather than on
financial aid which might be
misdirected. Improved
engineering expertise, for
example, might save
money by identifying areas
for strategic infrastructure
repairs as an alternative to
major renewals.
Private sector management
of urban systems has
proved its worth but must
be regulated to protect and
ensure attention to the
interests of poor
communities.
Where WS&S
improvements are only one
element of an integrated
poverty alleviation project a
management system has
to be developed around the
municipality and CBOs.
Technical support to
strengthen WS&S
institutions at the higher,
policy formation, level must
be well targeted and
depends on a degree of
Working in poor areas allied with support to urban water

utility management offers the opportunity of a clear poverty focus
together with collaboration on improving the effective and
equitable management of water and sanitation services, without
which the long-term service provision to the poor is threatened. By
addressing service provision to poor areas as well as utility
management, there is potential for synergy in terms of project
effectiveness. For example, improved services to poor areas can be
indicators of better utility management. Institutional development
interventions need to be well targeted and enabling in nature, to
avoid expensive overall development of the water supply
organization (new offices, vehicles, computers, etc). The
possibility of providing funding for the provision of strategic
infrastructure to remove bottlenecks, as well as provision of
support on leakage control, should be considered where
appropriate. Projects that are dominated by the provision of
substantial trunk infrastructure can create difficulties in achieving a
poverty or sustainability focus, as has been experienced on DFIDs
Lucknow project in India (see box in Section 1.6). Provision of
trunk infrastructure, however, can facilitate development of
secondary and tertiary infrastructure for poorer areas, as the box on
the DFID Cairo Wastewater project (left) illustrates.
Privatization in its many forms raises special issues of concern in
relation to services for the urban poor. Unless there is protective
legislation or regulation, the commercial approach can mean that
resources are focused on those who can afford to pay for high-cost
services, at the expense of the poor. These issues are discussed
later in Section 2.6.21 on Private sector participation.
Working with urban slum communities in developing
integrated infrastructure provision, including roads, community
halls, lighting, etc., in addition to water and sanitation services, has
been found to be successful in DFID urban poverty projects in
India, where slum communities are able to express their relative
demand for each type of infrastructure service. Close collaboration
is required with municipalities and community organizations,
particularly in developing appropriate institutional arrangements
for operation and maintenance.
Institutional development of WS&S institutions requires welltargeted technical assistance programmes such as the DFID
projects in Swaziland (where a Corporate Planner and Finance
Expert were provided). In South Africa DFID is supporting the
development and implementation of new rural WS&S policies (see
box in Section 2.6.13). Such programmes generally require good
capacity and commitment to institutional issues within the host
organization. The impact on equity or poverty needs to be
demonstrated in each case. Institutional support seeks to foster the
participatory approach and real involvement of stakeholders. The
right gender perspective is also important. The increased
127
2.6
current capacity and

commitment to key
institutional issues in the
host organization.
2.6
Urban sanitation
programmes for the poor
can demand a singular
management approach,
working through local
government bodies which
are typically responsible for
non-sewered sanitation
while a specialist utility
manages piped
infrastructure services.
Small local community
projects may be led or
supported by NGOs.
Opportunities for
institutional strengthening
include capacity building in
the local government
organizations and in NGOs,
and the development of
stronger links between the
two. Project sustainability is
best achieved by
establishing robust links
between the community
and local government.
involvement and influence of women in sector institutions is one of

the key principles guiding the WS&S sector (see also Section 2.2.4).
Sanitation and hygiene promotion programmes or subprogrammes offer the advantage of providing sufficient focus on
sanitation issues without the preoccupation with water supply.
However, sewerage programmes should only be considered where
potential water supply problems will not adversely affect the
operation of the sanitation facilities. Institutional considerations in
such programmes include: optimizing subsidies and incentives in a
demand-responsive approach, roles for formal and informal
institutions, and capacity building as part of a Strategic Sanitation
Approach (see box in Section 1.5).
Programmes led by international and local NGOs that work
with local communities also require institutional inputs in terms of
encouraging local government collaboration, capacity building,
Sanitation programmes in urban local government
While large-scale urban water supplies, and to a lesser extent sewerage, are
increasingly managed by specialized utilities, the provision of unsewered
sanitation, which will cater for the majority of urban poor in the foreseeable
future, is frequently the responsibility of urban local government. It requires a
careful understanding of the role, functioning, and constraints of local
government.
One of the most important institutional problems in urban sanitation is that there
may be several different pro-poor sanitation programmes instigated at national,
state/district, and city levels, and these may be channelled through different
departments within local government. This leads to widespread confusion; the
underlying question is who should be responsible for overall planning at the city
level, and how can this be achieved?
While the strategic approach to sanitation (in Section 1.5) envisages
unbundling of responsibilities as a key issue, there may also exist situations in
municipal government where the need is to set up an effective co-ordinating
group of the various concerned line departments to promote convergence
among the different sanitation programmes. The need for this is illustrated by
the situation in Cochin, India.
The different skills for sanitation implementation are: health-related promotion
and education; community development and negotiation; and technical issues
around construction. In Cochin, India, these skills lie respectively in the Health
Department, the Poverty Alleviation cell, and the Engineering Department.
Different programmes of the state and central governments come through
these departments. The problem is lack of communication between
departments with a lack of convergence as different programmes are
implemented in different ways.
DFID work on a strategic approach to urban sanitation is currently underway
with the aim of developing an adaptable strategic macro-framework which
sketches out the overall direction for sanitation service provision in a project
area. It is clear that in small towns, it is necessary to put in place some
directional role from the higher level state or district institutions, as well as
internal co-ordination.
128
and developing longer term support to community organizations.

This form of project is particularly advantageous in developing
approaches and systems for working with local communities, and
tends to be more suitable for smaller projects. The development of
NGO capacity should also be considered.
Demand-responsive projects working through government
institutions that maximize the use of local skills in government
and in the private sector is the preferred approach for sustainability
reasons, with support provided from NGOs and consultants as
appropriate. Strategic technical assistance needs to be carefully
planned and to begin sufficiently early in the project development
cycle to influence the direction of the programme.
Encouraging host countries
towards an institutional
structure capable of
supporting an expansion in
WS&S provision for the
poor can be effectively
advanced by co-operation,
collaboration, and
dialogue. Learning is a twoway process.
Where major institutional
reform is called for support
may be directed towards
one or more specific
aspects of sector
organizational policy such
as mechanisms for private
sector participation. A
possible alternative, used
in other sectors, is to
support general
development across the
sector. It is an approach
that is subject to some
important pre-conditions
and one that might not be
applicable in the water
sector.
Collaboration with project partners to influence policies needs

to be carefully planned too, and to take advantage of opportunities as
they arise. This can be done through such measures as: promoting
DFID approaches to project development; developing national water,
sanitation, and hygiene promotion policies and guidelines;
encouraging governments to use development projects as pilots for
replication elsewhere; introducing institutional development project
components; promoting and supporting civil society institutions;
supporting HRD institutions; holding policy review workshops;
disseminating examples of best practice from elsewhere; arranging
study tours, strategic consultancy inputs, and the well-designed
dissemination of lessons, manuals, and successful systems; working
with other donors; ensuring appropriate project conditions; and
participating in an ongoing dialogue. Opportunities for collaboration
on policy are often easier to develop with larger projects, where the
donor is seen as a more important stakeholder. It has to be
remembered too, that influence is a sensitive topic and learning is a
two-way process. DFID staff need to see themselves as supporters of
national policies and programmes (the compatibility of such policies
with the agreed principles will be established in the very early project
phases).
Promotion of substantial institutional reform may be
appropriate in many cases and could include providing support to a
variety of initiatives in the WS&S sector, such as:
decentralizing;
commercializing or corporatizing of institutions;
unbundling or rebundling of functions;
organizational restructuring;
changing roles of government from service provider to
regulator and facilitator;
appropriate forms of public private sector partnerships; and
instituting agreeing targets performance between different
organizations or levels of government.
Substantial reforms are usually led by the host governments and
would often benefit from the support of the major donors in the
sector. DFIDs involvement in such reforms needs to be carefully
129
2.6
assessed in terms of the likely size of the DFID programme in the

sector and the perceived risks.
The Sector-Wide Approach (see Section 1.5) is a promising
alternative way to support development in the sector that avoids
the problem of a project being an island of success in a sea of
failure. The aim of this approach is to develop Sector Investment
Programmes (SIP) that cover all sector expenditure, both
recurrent and capital, as described in Section 1.5. An SIP has to be
based on a clear sector strategy and policy framework, and local
stakeholders such as government, direct beneficiaries, and private
sector representatives have to be clearly in charge. All main donors
must sign on to the approach and participate in its financing. There
are specific macroeconomic pre-conditions for SIPs to be
considered (Harrold and Associates, 1995). To date this approach
has mainly been used in the health and roads sectors. Opportunities
should be explored in the WS&S sector, although where there is a
high degree of decentralization or significant institutional
complexity, it may prove difficult.
2.6.7
2.6
The balance of
responsibilities and powers
between project partners
must be capable of change
as capacities are
developed. The balance
will initially be governed by
the technical complexity of
the installed facilities and
by the relative capabilities
and finances of the partner
bodies. Both may change;
skills development in the
community might allow a
transfer of O&M
responsibilities it should
then bring a corresponding
transfer of powers for
charge collection and
service financing.
Partnership approach: Sharing responsibilities
A partnership involving rural or peri-urban communities and

government agencies should be seen as a flexible and evolving
process requiring continual dialogue. NGOs and the private sector
should normally also be part of such partnerships, with NGOs
commonly having a facilitatory role. The sharing of costs and
responsibilities within a partnership will vary according to a variety of
factors, including the:
choice of existing or proposed technologies;
capacities of the various stakeholders; and
type and stage of development of the partnership.
More complicated technologies such as multi-village regional piped
water schemes require more substantial government agency inputs.
Simpler technologies such as handpumps are likely to require only
back-up support from agencies. Work is continuing world-wide on the
development of VLOM (Village Level Operation and Maintenance
Management) pumps and systems that need minimal external inputs.
As partnerships develop, management agreements between the
various key parties should be considered as a means of clearly
allocating responsibilities. Such agreements have been used on DFIDsupported multi-village piped water schemes in Maharashtra, India.
Further guidance on community-based operation and maintenance is
set out in a box in Section 2.6.8.
If a village institution such as a Village Water Committee is expected
to take on a key role of managing O&M, it is preferable that it also
collects water charges and manages O&M finances. Such an
arrangement balances accountability with empowerment, although
capacity-building requirements need to be addressed.
130
The private sector could have a key role to play, particularly in

corrective maintenance and the supply of materials and spares. If it
can provide the flexible responses required, an enabling environment
is established. The box below describes how project partners in
Karonga, Malawi supported the long-term supply of handpump spares
to communities by local wholesalers and village shops.
Practices
2.6.8
An appraisal of host
country institutional
structures and of individual
institutions in the water
sector is a necessary
preliminary to DFID
involvement at programme
and project level.
Scoping proposed sector and institutional

appraisals
Determining the scope of Institutional Appraisals is an iterative

exercise which depends on the realistic potential for achieving DFIDs
objectives and the likely size of the country programme in the water
sector. The DFID Institutional Adviser dealing with the concerned
region should be consulted at an early stage. Institutional Appraisal is
essentially a two-fold process. The first stage entails considering the
whole sector that is the broader institutional arrangements in which
services are planned and delivered while the second stage
examines the internal environment and functioning of individual
organizations. Before moving to the project identification stage there
should be a well-documented institutional appraisal of the WS&S
sector and a broad understanding of the institutional arrangements in
typical WS&S institutions, as well as the external environment within
the country concerned.
VLOM: Karonga, Malawi: Facilitating the provision of
Afridev handpump spares by the private sector
2.6
The Danida-supported Karonga integrated groundwater supply project on the

northern shores of Lake Malawi evolved from having a construction target focus
to being a project where priority was given to setting up a sustainable operation
and maintenance system.
In 1992 arrangements were agreed with 15 existing village shops in the project
area. This entailed the project supplying fast-moving spares such as o-rings
and u-seals to the village shops, who received a 10 per cent commission on
sales. An agreement was then reached in 1993 with two wholesale stores, who
received a years supply of pump spares (initially on commission). It was
agreed that in future the stores would obtain the spares from local producers.
With the introduction of the wholesale link, shopowners were required to
purchase their supply of pump spares from the wholesalers. Realizing that the
shopowners could not afford to invest in stock, the project delivered an equal
amount of fast-moving spares to all 15 shops. This functioned as start-up
capital or a revolving fund.
Handpump committees are generally satisfied with the new system, apart from
having to travel to the wholesalers for the slow-moving spares. The village
shopowners felt that stocking the spare parts is mainly a community service
because of the small profit margins, but all expressed a willingness to continue
to stock the fast-moving spares.
D. Noppen, 1996
131
Table 2.6.3 identifies a range of key focus areas to consider in

conducting appraisals under four main categories:
Institutional Appraisal
extends to an overview of
the general conditions and
structures in the country. It
is an ongoing, continuous
exercise, in which detail is
added at succeeding
stages of a project but the
initial complexity and scope
is defined by the size of the
intended programme and
the complexity of existing
institutional structures.
Water and sanitation sector

External environment
Appraisal of water and sanitation institutions/municipalities
Appraisal of community organizations
In many countries, good information may already be available from

the government, other donors, and academic institutions. It can be
advantageous to conduct appraisals in conjunction with other donors
and host governments. Decisions will need to be made on the focus
areas to be included in an appraisal. For example, should the complex
issue of water resource allocation and management be examined?
More detailed appraisals of WS&S institutions and of community
organizations that are intended to participate in a programme are more
likely to be required at the project preparation and appraisal stages,
but Institutional Appraisal should never stop. Implementation is a
Sustaining community-based operation and
maintenance
Implications for practice
Participatory methods of working are centrally important, and not simply
participatory contributions of labour and money in response to agency
instruction, but continual processes of shared decision-making between the
agency and primary stakeholders at all stages of the project cycle, with the
aim of developing the community members sense of responsibility for and
control over the local operation, maintenance, and management system.
2.6
Increase as far as possible the room for manoeuvre that community

members have in relation to aspects of the service design choice and
location of service, and operation, maintenance, and management of the
system.
Where community management is required, capacity building should be a
project output, especially the development of skills in management, planning,
analysis, decision-making, and problem solving. The time scales for
construction work and capacity building are different. Capacity building
requires separate resources of time, resources, and personnel.
Provision for the transfer of responsibility should be built in from the
beginning of the project, with clear recognition that this is a process not an
event.
Recognition that tackling the problem of non-payment of recurrent costs is
not simply a matter of adjusting payment levels, but addressing all aspects of
effective community management, including institutional and technical.
As far as possible, make change pay, that is by creating paid jobs in service
operation and management wherever possible and reducing or eliminating
reliance on volunteer labour.
Keep technology very simple to maintain and repair, where possible, with a
reliable supply of spare parts and technical assistance available locally.
Derbyshire & Vickers, 1997
132
Table 2.6.3
Focus areas for institutional and sector appraisal
Appraisal categories
Focus areas
1. Water and sanitation sector
Regional allocation of water between user groups

Water pricing and subsidy distribution
Allocation of responsibilities between WS&S
institutions
Government policies, strategies, and regulation in
the sector
Actual service levels, particularly for the poor
Sector performance against key indicators
Cost recovery, transparency, and lending terms

HRD for the sector
Private sector participation (PSP) in water and
sanitation
Climate for change and change champions
2. External environment
Social, technical, economic, and political

environment
Government policies and progress on reform
Employee conditions of service and recruitment
policy
Opportunities and constraints for PSP
Formal and informal structures
Absorbtive capacity
Consumer and media pressures
3. Appraisal of water supply

and sanitation institutions
Organizational performance against key indicators

Actual service levels, particularly for the poor
2.6
Organizational autonomy
Leadership
Commercial orientation
Consumer orientation
Management and administration
Technical capability
Developing and maintaining staff including training
needs
Organizational culture, formal and informal structures
Interactions with key institutions/departments
Availability of financial resources
Priority areas for improvement often include:
Management of O&M, cost recovery, customer
services, demand assessment, and investment
planning
4. Community organizations
Demand for improved water and sanitation

services
Capacity/willingness to manage service provision
and recover costs
Representation of different community groups in
the community organization
Social cohesion within the community
Linkages with government/water utility/NGOs, etc.
Training needs
133
The key stages in appraisal,

applying equally to national
structures/policies and to
those of individual sector
organizations are:
establish current policies,
objectives, and
programmes;
evaluate actual progress

against programmes; and
assess policies/plans
against fitness for
purpose' and against best
or recommended practice.
2.6
A more detailed
understanding of national
policies and their
effectiveness/equity can be
obtained by examining
subsidies and their
outcomes and by clarifying
the functions and
responsibilities of sector
organizations from national
to local level.
Within individual
organizations existing service
and financial performance is
measured against key
indicators, allowing
comparisons between similar
organizations.
SWOT and STEP techniques
are useful analytical tools.
134
further opportunity for learning the project cycle should not be a

linear process (DFID Technical Note No.14, 1995).
2.6.9
Tools for appraisal
For Sector Institutional Appraisals, the governments policies, plans,

and progress against those plans provide a useful starting point. It is
important to consult widely using participative techniques such as
semi-structured interviews, workshops, stakeholder analyses (DFID
Technical Note No.13, 1995), and problem tree analyses to develop a
common understanding of the interlinkages of problems and potential
solutions. After developing a good understanding of the existing
situation, a key question is: are the current or proposed institutional
arrangements appropriate? Some of the key institutional appraisal
techniques and considerations are summarized below with a brief
discussion of their applicability.
Activity/Responsibility matrices are a particularly useful tool in the
water sector for establishing the actual allocation and fragmentation
of responsibilities between the various institutions. An example
matrix is shown in Table 2.6.1.
Assessment of apparent and hidden subsidies is a means of
determining if there are perverse incentives that could distort demand
and equity on any proposed projects. Hidden subsidies can be in the
form of capital grants, inter-sector subsidies, electricity subsidies, etc.
Single-entry accounting, which is common in some government
departments, does not reveal hidden subsidies as well as commercial
double entry accounting. (For more detail on subsidy analysis, see
Section 2.5.)
SWOT analysis is a technique for diagnosing key institutional issues
by looking at S(trengths), W(eaknesses), O(pportunites), and
T(hreats). Although it can be used by DFID staff for their own
analysis, it also lends itself to a workshop approach, facilitating selfdiagnosis by the institution concerned. It encourages not only
diagnosis of internal issues but also of the external environment
(DFID Technical Note No.14, 1995).
Key performance objectives and indicators are the quantitative
means of assessing how an organization is managing its service
provision. A number of widely applicable indicators for a water utility
are summarized in Table 2.6.4, under categories of water production
and delivery, efficiency, water consumption, sanitation, and
productivity. Indicators generally have three distinct levels: process
and performance indicators within water sector organizations and
impact indicators in the external environment. There are risks that
some indicators can be misinterpreted, for example coverage implies
the percentage of people receiving water, but in India, for example, it
is the percentage of people within the water distribution command
area. In the project context, it may be worth confirming some data by
surveys, such as the consumption of water per capita in poor areas,
particularly in the dry season.
Other organizations, such as an agency responsible for hygiene and

sanitation promotion, would have different indicators, mainly related
to behavioural change (see Section 2.8).
Financial objectives and indicators are a key means of determining
an institutions priorities and capacity. Typical financial objectives
could be: to meet O&M costs, to break even, to make a profit, to
achieve a specified percentage return on fixed assets, marginal cost
pricing, to achieve social equity, or to achieve a combination of these.
Some selected financial indicators for the urban water sector are
shown under the bottom five headings of Table 2.6.4. Progress
achieved against such indicators can be used as comparators among
similar institutions.
STEP analysis can be used to assess the external environment by

examining the S(ocial), T(echnical), E(conomic), and P(olitical)
environment that an institution or sector has to operate within. These
factors can then be considered in terms of the potential threats and
opportunities for the institution/sector concerned.
Assessment of organizational structures
Different situations call for different organizational forms and this is

generally true for urban and rural water supplies in developing
countries. Some of the key factors to consider when examining an
organizational structure are:
organizational levels
chain of command
grouping of functions and objectives of those groups
responsibility and authority limits
job descriptions
formal and informal structures
2.6
Analysis will include a focus on the structure of the organization, with a

view to determining the extent to which its formal processes and systems
are actually followed in practice, and how the informal culture of the
organization exerts a dominating influence on actual practice.
Assessment of roles, policies, and strategies
As part of the Sector Appraisal, the roles, mission, policies, and

strategies of key stakeholder institutions should be assessed. DFID
Technical Note No.14 (1995) provides a checklist for assessing these
aspects.
A good overall assessment

of an institutions strengths
and weaknesses can be
2.6.10 Assessment of critical success factors in water
institution performance
gauged by looking at nine
A methodology for diagnosing institutional deficiencies in the water
critical aspects of its
management philosophy and sector emerged from the WASH (Water and Sanitation for Health)
project that was funded by USAID. The methodology is described in
operational capacity. The
Guidelines for Institutional Assessment for Water and Wastewater
method is described in
Institutions, Cullivan et al., (1986). Other documents in the WASH
literature of USAID's Water
series provide useful further reading. The methodology involves
and Sanitation for Health
making rating assessments against a number of indicators within each
(WASH) programme.
135
Table 2.6.4
Performance indicators for typical urban water supply

institutions
Formulae
Water
production
Quantity of water
produced
S Asia
E Asia
SE Asia
270mld
128.7mld
1,189mld
75%
na
Quantity of water
Energy/Chems%
Op Costs
Target population
2,800,000
1,079,000
3,057,000
Connections
190,000
32,064
799,049
Service coverage
90%
34%
100%
Connections/
Standposts
55%
70%
100%
Service timing
1-4 hrs
12-24 hrs
24 hrs
Population density
165.7/ha
varies
48.3/ha
Efficiency
Unaccounted for
water
40%
35%
8%
Water
consumption
Quantity water
consumed (av.)
45lpcd
Water
delivery
35.4%
168lpcd
Water consumed in
slum areas
Sanitation
Metered
consumption
26%
100%
Quality of water
delivered
na
100%
100%
Service coverage
Treatment
10%
50%
100%
4.2
na
na
Customer surveys
na
na
na
Connections/
employee
55
5 - 24
417
Population/employee
720
325 - 536
1,566
Percentage staff
costs
51.7%
Socio-economic
GNP pc
$330
$170
$14,210
WTP to vendors
$0.5
$2 - $8
na
Average domestic
tariff
$0.09
$0.2 - $0.3
$0.44
20%
100%
22%
43%
Effectiveness Water related

diseases
Productivity
2.6
Marketing
($US)
Financial
sustainability
($US)
per thousand
population
na
$0.68
Community tariff
Sewerage
sustainability
Operating ratio
total cost
total revenue
96.4%
84%
Return on fixed
assets
profit after
depreciation
net fix assets
0.16%
2.42%
Liquidity
Current ratio
current assets
current liabilities
na
6.7
Creditworthiness
Debt equity ratio
long-term loans
equity
na
Financial
efficiency
Days receivable
ratio
365 x accounts
286 days
242 days
33 days
na
55%
na
Profitability
receivable
annual billed revenue
Bill collection
efficiency
136
% of bills
collected
of the nine Critical Success Factor or Performance Categories listed

below. The relevance of these factors have been found to be high in
many ID projects in the water sector.
Organizational autonomy is critical in terms of an organizations
ability to manage and respond to its customers needs. Municipal
water departments, for example, which are not able to hire staff or
raise tariffs to meet their projected costs, have insufficient
autonomy to manage effectively. Effective organizational
autonomy can be categorized as the authority to make decisions
about budgets, tariffs, revenues, hiring levels, pay and incentives,
control of personnel, institutional policies and systems, planning of
projects, and organizational goals. There are also regulatory
functions that need to be performed by governments, such as
setting and monitoring objectives and targets, to balance the
autonomy provided.
Leadership is the capability to inspire key stakeholders to develop

and understand the institutions mission/objectives, to commit
themselves to that mission, and to work towards its fulfilment.
Effective leaders/change agents serve as positive role models and
are required at all levels of an organization. Leaders are essential
for agreeing and implementing institutional change programmes,
but over-reliance on one leader in development projects can be a
problem, particularly if they are then transferred, as happened at
the DFID Water Authority Assistance Project in Lesotho. It is
generally better to have Core Groups plus a Steering Committee,
if the long process of change is to be sustainable.
Effective management and administration is demonstrated by
the capacity to get the most out of the resources available (human
and other) in a deliberate or planned manner. Good managers have
a clear sense of objectives and priorities; they know who to rely on
to get a job done and how to delegate to them the means to do it.
An effective management climate is characterized by team-work,
co-operation, and good communication among staff. To enable
managers to perform effectively an efficient administrative system
is required. This includes the policies and procedures which
regulate, guide, and facilitate the actions of managers. A mature
organization has effective sub-systems such as personnel,
budgeting, accounting, financial management, procurement,
contracting out, and management information.
Commercial orientation is the degree to which actions in an
institution are driven by cost effectiveness and operating efficiency.
The performance should be guided and disciplined by a strategy to
achieve financial self-sufficiency at an appropriate stage of growth.
Commercial orientation can be viewed at both operational and
policy levels. At the policy level, commercially oriented
institutions structure and stage investments, expenditures, and
revenues to achieve financial equilibrium annually. At the
operational level, everyday activities are guided by quality
137
2.6
standards and by constant attention to cost. The institution strives

to establish a reputation as a financially well-run business in the
eyes of its consumers (to promote the payment of tariffs) and in the
financial and political community in order to obtain financial
support for growth and to maximize financial and operating
autonomy.
Customer orientation is organizing and directing the services and
output of the organization towards the demands and desires of the
customer. Staff of a successful WS&S institution see serving
consumers as their primary function. All work, including all
programmes, and projects, are directed towards greater efficiency,
effectiveness, and equality of service to all consumers. Every effort
is made to inform and educate customers about the role of the
institution and the means it is using to achieve its (and the
customers) objectives. The marketing of differentiated services to
poorer communities can lead to reliable service provision at
affordable prices.
Technical capability is the measure of the institutions

competence in conducting the technical work required to carry out
the responsibilities of the institution. Most of the technical work is
performed directly by skilled, qualified employees, as well as
outside specialists supervised by the institutions own staff.
Human resources development includes an assessment of
training needs and the capacity to meet those needs, as well as
employee incentives and motivation. DFID Technical Note No.14
(1995) provides brief checklists for Human Resources
Management and Human Resource Issues. There will usually be
HRD requirements at all levels of sector institutions.
2.6
Organizational culture is the set of values and norms which

inform and guide everyday actions. An unhealthy organizational
culture is likely to be highly resistant to change, and will protect
narrow interests (such as graft or petty bureaucratic authority). A
more positive culture has a clear sense of mission and identity. In
the water sector, the institutional culture is often bureaucratic and
supply driven. The box opposite briefly describes how Hyderabad
Metro Water Supply and Sewerage Board is changing to a more
consumer and commercially orientated working culture. An
organizations culture can be assessed by means such as an
Attitude Analysis (refer to DFID Technical Note No.14 (1995)
for a checklist) and an appraisal of the level of transparency.
Corruption has a deleterious, sometimes devastating effect on
administrative performance, although a distinction should be made
between speed money taken by very low paid staff and
substantial misappropriations. Klitgaard considers that:
Corruption = Monopoly + Discretion - Accountability - Transparency
There are various anti-corruption measures that can be undertaken
by host governments, including professionalizing staff and
improving transparency and hence accountability.
138
Hyderabad Metro Water Boards changing organizational

culture in India
The Hyderabad Metropolitan Water Supply and Sewerage Board was
constituted in 1989 as an autonomous institution to serve the city of Hyderabad,
with a population of 4.3 million in 1991, that is expected to rise to 6.2 million in
2001. Successive managing directors have provided a continuity of leadership
in change management away from the previous supply-driven engineering
culture, towards a more commercial and customer orientation. This has been
achieved through measures such as:
agreeing a corporate plan and an HRD plan;
redesignating engineers as managers, encouraging then to be multidisciplinary, revising the staff structure with increased delegation and
agreeing new job descriptions;
increasing accountability by making area managers responsible for O&M of
water and sewerage, billing, and customer service, within a distribution zone.
Targets are then set and monitored for improvements in cost recovery. This
provides the incentive for improving services to customers;
improved communication with customers and community groups, particularly
with the single window local Customer Service Offices;
HRD and management development in collaboration with a local university as
part of an institutional strengthening programme; and
Despite all the improvements, much work remains to be done in Hyderabad,
particularly in developing new water sources and increasing tariffs.
Interactions with key external institutions are judged by the

capacity to influence positively and strategically those institutions
which affect its financial, political, and legal ability to perform
effectively. An adequate legal and regulatory framework (both on
the statute and in practice) is an enabling factor in this respect. The
The aim of institution building
multiplicity of institutions in the water sector means that positive
is to create the skills, working
interaction and the influencing of external institutions, such as state
environment, and systems
and national government departments, is generally a priority for a
for self-sustaining
water institutions managers.
development. The appraisal
process may identify
2.6.11 Institutional development
weaknesses in one element
The aim of institution building is to create the skills, working
of institutional structure but
environment, and systems for self-sustaining development.
changes there will impact to
The basic strategy for achieving sustainability is a twofold process of
varying degrees on the
improving institutional performance (showing results) and training at
remaining five key elements.
the same time (Edwards, 1988). Performance against objectively
Strengthening must therefore
verifiable indicators should improve over the life of a project.
be an integrated and
Promoting the ideas of ID should preferably be a natural process
continuing process with
arising out of analyses by key stakeholders, supported by facilitators
adjustments made as
and experts as appropriate.
implemented changes are
Institutional Development (ID) is a learning process, both for the
evaluated. The six key
individual and for the organization. The figure below shows the
elements are described in
learning cycle used by the National Irrigation Administration in the
Sections 2.6.13 to 2.6.18.
139
2.6
2.6
Figure 2.6.2. Organizational learning process cycle

(Korten and Siy, 1988)
Philippines as part of an ID programme that enabled them to become

a more participative and effective institution (Korten & Siy, 1988).
The feedback loops within the cycle are as important as each step.
The overall process was managed by a working group.
2.6.12 Key elements of institutional development
Building on the Institutional Appraisal (where are we now?) options

for ID can achieve sector/organizational objectives, using best
practice locally and elsewhere (where do we want to be?). The agreed
Institutional Development/Strengthening Programme should evolve
from discussions with key stakeholders, including staff at all levels.
There are six key elements of ID that need to be comprehensively
integrated:
Sector policy development and regulation
Structural and organizational adjustment
140
Transformational and transactional analysis

The Burke-Litwin Model distinguishes between two categories of institutional
change factors: transformational and transactional change.
Transformational factors operate at a more strategic level, providing the
environment within which the institution operates a strategic direction and
impulsion for change. They include the External Environment, Leadership,
Mission, and Culture. Any fundamental change has to be associated with
change in them.
Transactional factors may be equally important in particular circumstances but
are more operational and incremental. They include structure, management
practices, systems, work-unit climate, task requirement, individual needs and
values, and motivation. For change at the transactional level to be effective and
sustainable, it needs to be consistent with the transformational factors. In turn,
however, energy at the transformational level needs to have an impact at the
transactional level to overcome specific problems, such as systems or
motivation.
based on DFID (1995a) Technical Note No.14
Human resources development

Management development
Systems and procedures development
Physical and financial resources
Previous experience has shown that ID programmes need to be
comprehensive; deficiencies in one area can subvert the best efforts to
improve one sub-system alone. Emphasis on each element would
depend on the programme objectives and priority areas identified.
Further discussion of each element is set out below.
In contemplating support of ID work, the transformational factors (for
example external environment and organizational culture) that are
described in the box above, need to be borne in mind.
Transformational change is difficult to bring about, so there is a need
to be opportunistic in detecting a climate for change in the state,
country, and institution being considered.
The objective is an enabling 2.6.13 Sector policy development and regulation
framework of policies and an
Governments need to develop and implement agreed water, sanitation,
encompassing regulatory
and hygiene promotion sector policies and legislation that provide an
regime. Governments need
enabling framework for adequate and sustainable service provision.
not take an active role in
There are opportunities for DFID to support such a process as the box on
service provision but may
the next page on experiences in South Africa shows. Some countries have
beneficially play a part in
policies that seem worthy but they are not always so in practice. Recent
aiding capacity building in
thinking on the role of governments in the water sector has favoured the
service provider
concept of an enabling environment, with governments concentrating
organizations. For effective
on setting up the right legal and institutional framework, and stepping
regulation the regulatory
back from actual operation (Winpenny, 1997a).
body must be fully informed
A clear role for government is regulation, which is often neglected
in all spheres of service
due to the preoccupation with service provision. There is a strong
provider activities.
141
2.6
Development of water and sanitation sector policy in

South Africa
DFID is supporting policy development and its implementation in rural
community WS&S programmes, in conjunction with DWAF (Department for
Water Affairs and Forestry). The programme focuses on community
management, staff development, institutional frameworks, strategy
development, data management, and research. Collaboration occurs through a
number of relatively small linked projects including:
1. DWAF capacity building

Project purpose: Institutional framework and capacity to support community
WS&S established in two provinces
2. Development of a national sanitation programme
Project purpose: Develop and implement the start-up phase of the national
sanitation programme at national, provincial, and local levels
3. Human resource development support
Project purpose: Establishment and development of an HRD service in DWAF
While such projects can have relatively high staff inputs in relation to aid
expenditure, they offer potential benefits in terms of widespread sustainable
poverty-focused government initiatives. In South Africa good progress has been
achieved in terms of developing policy documents, although some problems
have occurred in implementing the policies, in terms of capacities at the local
level. DFID is now supporting a follow-on project to DWAF Capacity Building,
which is aimed at operationalizing the Water Services Act, especially at local
government level.
However, there is a genuine risk that efforts to promote community participation
can be circumvented by ambitious construction programmes, which is also a
common occurrence elsewhere.
2.6
Such policy-focused projects are more likely to be successful where there is a

shared agenda between the donor and the host government, as in South Africa,
as well as good potential capacity for policy development and its
implementation.
based on Harvey & Kirk, 1997
argument that regulation should be separated institutionally from

service provision. Otherwise regulation will be weak, as shown for
example by UK experience before the setting up of the National
Rivers Authority.
Key areas which government should consider in customer protection
and regulation are:
responsiveness to customers;
service standards and service levels achieved;
water availability, use, and allocation;
safety net for the poor;
tariffs, prices, and value for money;
asset serviceability and efficiency;
environmental and health standards;
142
infrastructure development for future needs; and

performance-related incentives (particularly for substantial private
sector participation).
To regulate effectively requires good management information in
these areas. Where there is insufficient organizational autonomy or
fragmentation of responsibilities, regulation is more problematical
because it is difficult to hold any one institution accountable. In many
developing countries, the government also undertakes serviceprovider functions, particularly in the areas of training, staffing
policies, and capital investment. For water supply institutions which
need to improve their capacities, the government needs to undertake a
facilitatory role using incentives where appropriate. For example,
public capital loans can be conditional on water supply institutions
addressing cost-recovery issues.
HUDCO in India uses such conditionality on loans to municipalities

for water supply projects. Useful references in this area are contained
in the further reading section.
The example given in the box opposite highlights some key lessons
from DFID policy-focused projects in South Africa.
2.6.14 Structural and organizational development
Beware of seeking change
by creating new institutions.
Where possible, good
institutional development is
achieved by patient building
around the best of existing
capacity.
The answer to the question what are the most appropriate

institutional arrangements?, may suggest a new organization. The
NWSDB Sri Lanka: Decentralization and ID
Indicators
1984
(before ID project)
Piped water produced (Mm 3/y)

Billed connections (000)
Billed connection to employee ratio
Billing lag time (days)
Collections (Rs. million)
Collection efficiency (% of billings)
155
79
13
180
56
25
2.6
1990
(end ID project)
218
185
26
30
442
87
The impressive improvements against these key indicators have been achieved
with the assistance of an ID project supported by USAID. The most significant
initiative was decentralization or deconcentration within the National Water
Supply and Drainage Board (NWSDB). This entailed the development of five
Regional Support Centres which became responsible for many of the
organizations functions. Regional operational autonomy and delegated
financial authority increased significantly, and resulted in both a more
responsive service to customers and improved financial performance.
Substantial management development and HRD supported this process.
The positive trends against key indicators have continued. Further
improvements, however, are considered to be dependent on greater autonomy
and role clarity for the NWSDB as service provider, and the government as
regulator.
based on Franceys, 1998 and Tillekeratne, 1993
143
case for the creation of new institutions, whether they are new village
water committees or a corporatized water board/company, needs to be
carefully assessed in terms of prospects for sustainability. Issues such
as the degree of financial and managerial autonomy, legal status,
incentives, capacity-building requirements, and pressures from the
external environment, need to be weighed against alternative
arrangements, including the perceived risks. There is also a danger
that new institutions take over all or part of the functions of existing
ones, but the old ones remain in being, increasing the bureaucratic
complexities of the sector.
An institution need not always reorganize to develop itself, but most

institutional development efforts involve adding and dropping
functions, moving towards decentralization or amalgamation, or a
combination of both (Edwards, 1988). Historically, many institutions
are centralized, with power concentrated in the hands of a few. Since
no one person can do the job of everyone, this arrangement usually
does not work very well.
Structures often need to be set up to delegate authority combined with
the development of management skills, in order to respond to
consumer needs. This was undertaken at the National Water Supply
and Drainage Board in Sri Lanka, where substantial improvements
were achieved (see box on previous page). Structural changes take
time to implement and require a careful process of developing and
communicating new roles and procedures, with adequate training and
involvement of those concerned.
2.6
2.6.15 Human resources development

Sectoral moves to
programmes driven by user
demand and to the
partnership approach
require personnel at all
levels and in all agencies to
adapt their attitudes and
thinking. Building capacity
in this area is therefore
likely to occur in almost all
WS&S interventions. Many
staff will need
multidisciplinary training to
equip them to adopt
participatory approaches
and to guide communities
on economic, social,
environmental, and
technical issues. Training
curricula have to respond
to the changing demands.
144
The development of human resources is likely to be a key intervention

in DFID WS&S sector programmes. While there is no standard
approach to training design, the training cycle can be considered to be
four inter-related activities:
identification of training needs

training development/planning
training implementation
assessment/evaluation
Refer to the Guide to human resource development and training in

developing countries (DFID, 1997b), for a discussion of the overall
training process and what is entailed in the four stages listed above.
As part of a project it may be appropriate to support the development
of the capacity of a local training institution. A useful reference in this
respect is Edwards and Salt, 1990.
Where project partners are expected to adopt new approaches, training
will be required for those concerned. Decisions will need to be made
relatively early in the project cycle regarding training needs and
specifications, who will be trained, and how, when and where will the
training take place. Overseas training may be appropriate for changing
attitudes and developing an open-minded, professional approach,

particularly when it is undertaken with a broad range of other
international participants.
HRD focus areas
Successful demand-responsive water and sanitation projects require

project partners to have the requisite skills and motivation to
implement their component of the project and integrate effectively.
Much of the guidance given in the other specialist sections of this
manual implies a need for new skills and more trained people. HRD
programmes need to take into account each of these new demands and
to develop appropriate capacity building components covering:
hygiene and sanitation promotion; social development; economics;
environmental issues; and technical aspects.
HRD focus areas for institutional aspects HRD in this area needs to
address the content of the various aspects involved in ID work, as well
as the process of change. Competent facilitators are required to
oversee the process. For effective integration of different disciplines,
it is preferable to train change managers in the relevant related
subjects. For example, senior engineers engaged on improved O&M
and cost recovery would benefit from training in subjects such as
finance, communication skills, management, customer care, etc.
2.6.16 Management development
WEDC-IHE/Richard Franceys
A management development programme is not merely a management

training course, although management training is an element of it
(Edwards, 1988). A well-conceived programme will aim to change
managerial behaviour to achieve agreed objectives. This component
should coincide with the development of new systems (delegation of
financial authority, improved procedures, performance review, etc.).
The objective is to instil in

managers the changed
attitudes needed to
effectively implement new
policies. Development
programmes should begin
with top management and
work down to all levels.
Staff must work to set

procedures, and within
established and recognized
systems, as a basis for
maintaining acceptable
standards of performance.
One approach is to engage managers in proactive problem analysis;

this will open minds to solutions and best practice used elsewhere and
facilitate the consideration of potential solutions. A Management
Development Strategy needs to start with the top level of management
and should then be developed with staff consultations at all levels. A
useful reference is Edwards and Salt, 1989.
An important aspect to consider is the incentive structure for staff in
terms of job satisfaction, conditions of service, and working
environment. Improvements in incentives are likely to be incremental
in nature. Very low salaries in comparison to the private sector are a
key constraint and over-staffing in some job categories may be a big
problem. DFID is supporting a retrenchment programme in the health
sector in Tanzania, as a means of enabling the sector institution to
develop.
2.6.17 Systems and procedures development
Some initial identification of potential new systems can arise out of

the Institutional Appraisal (Section 2.6.8). The objectives of
developing systems and procedures are twofold: to develop a needed
145
2.6
Block tariffs to subsidize the poor?

Many urban water utilities use a block system of tariffs for metered households.
The principle is that families using less water pay less per cubic metre up to a
threshold consumption per month. More affluent households who use more
than the threshold pay more per cubic metre of water consumed above that
threshold, in accordance with the next tariff slab. This is in recognition of the
fact that water is a social as well as an economic good.
Problems can arise in developing countries where a number of poor families
use the same metered connection, illegally or otherwise, and they use more
than the threshold amount, thus paying more for their water. Under such
circumstances poor families can pay more with a block tariff system than if
there was a flat tariff per kilolitre consumed. Such disparities can encourage a
climate of not paying.
In Santiago, Chile, they have dealt with this problem by not subsidizing the poor
through lower water charges like block tariffs, but instead providing separate
well-targeted subsidies. Other cities which suffer water shortage problems will
wish to retain the block tariff system to send economic signals to consumers to
conserve water. In those cases, they will need to carefully design and market
service options and tariff levels to ensure equity for multi-family pipe
connections. (See also Section 2.5.13.)
2.6
Satisfactory development is
best achieved from within
the organization with
maximum design input from
staff. Externally designed
systems are not
recommended.
controllable standard of excellence to carry out the work of the

institution; and to train staff to develop and carry out their own
procedures. It is tempting to try and implant a system by having
outside consultants introduce or impose them. This rarely works.
Systems and procedures are most effectively developed by working
together with staff. Common systems to be developed in water supply
institutions include: management of O&M, billing, financial
management, and customer services. Systems for cost recovery,
including metering and block tariff design, can present problems in
terms of achieving equity as is illustrated in the box above.
Computerization is often seen as a way of solving all sorts of
problems in organizations. But it should follow, not precede, the
redesigning of business processes. Great caution should be taken in
introducing computerized information systems.
Useful reference documents for various systems are included in the
further reading section.
New hardware is often a

necessary component of
institutional strengthening
but it is rarely the key
component and its priority
in the scheme of things
should be allocated
accordingly. Since long lead
times on delivery and
commissioning are
frequently involved, the
146
2.6.18 Physical and financial resources
The provision of physical resources (computers, vehicles, maintenance

equipment, etc.) is an important part of institutional development, which
needs to be clearly related to the objectives of the programme. If there are
limitations on the funding of such resources, equipment sufficient for
demonstration purposes only may be provided, or a donor who is
collaborating (e.g. the World Bank) may offer loans for equipment.
Decisions need to be made concerning how critical the equipment is and
how critical the timing of its provision. Situations where a whole project
is delayed because certain items of equipment have not been provided
would hopefully be avoided. It has been observed that as a rule of thumb
need for and timing of

critical hardware should
be carefully assessed.
it takes twice as long as estimated to procure and commission

equipment! A procurement strategy and plan should be drawn up to
avoid such problems.
Local conditions and

influences external to
the WS&S sector in the
host country may
present major
impediments and risks
to making significant
institutional reforms.
The needs identified
from an appraisal may
therefore not be
achievable.
A process approach
may then offer the
better route to effective
programme
management, obtaining
the commitment of
local staff and partner
agencies by fully
participatory processes
that allow them to guide
the direction and extent
of change on the basis
of their experiences
and knowledge.
2.6.19
Translating institutional appraisal into project plans
An appraisal that has been reasonably participatory should lend itself

to a natural development into project plans. However, information is
critical to WS&S management, and frequently the information
required for more detailed problem analysis and planning is not
available without further data collection, which can take considerable
time. This is one reason why a Process Approach, where project
activities are not specified from the start, is appropriate for ID work.
Another reason is that managerial staff working in the sector are often
more orientated towards crisis management, and may be reluctant to
commit themselves to very specific institutional development plans over
a long period. There may also be specific local reasons why things are
done in a haphazard manner, and it is worth discovering these reasons
before alternatives are suggested. In summary, a process approach allows
project partners to apply the lessons they have learned, thus gaining
confidence and a sense of ownership of the programme.
In order to obtain strong commitment from project partners, the
process of developing the logframe and plan needs to be worked out
jointly. This is likely to involve the use of independent facilitators
with key stakeholders actively participating. Various ways of working
together should be considered, including workshops, study tours,
dialogue with change champions, working groups, etc.
The quality of government in the external environment is a key
determinant of institutional performance and the prospect for change.
If, for example, politicians expect to exert influence over matters of
detail, or corruption is rife, or the project partners do not recognize the
need for accountability and good management information, then it
will be difficult if not impossible to achieve significant change.
InstitutionaI Development is usually risky and requires careful
analysis and management of risk. If a project proposal includes ID,
the project preparation team must be able to argue convincingly that it
can be achieved (DFID, 1995).
2.6.20 Institutional development approaches
Wherever institutional
development is
proposed as part of a
project there are
several approaches
that are recommended
and several that should
be avoided.
There are several rights and wrongs in approaches to institutional

development, and it is helpful to bear these in mind:
Change management: Approaches to encourage
Explain and promote Institutional Development where it is a

potentially viable objective.
Promote a programme sequence as if it were a training project,
where learning, systems development, and inputs should dovetail
and build upon one another. Use pilot projects where appropriate.
Encourage the collection and use of management information at an
early stage information is power.
147
2.6
At the start of a project, seek a project area or pilot project where

early success can be achieved in order to raise confidence in the
approach.
Encourage the use of local consultants where they have the
requisite skills.
Allow sufficient time for institutional development, including time
for stakeholders to make the necessary changes, using a flexible
approach. Four to seven years is the minimum time for institutional
renewal of a substantial organization.
Champions of change who proactively support change (e.g. senior
government officials) should be identified, while avoiding overreliance on them.
Working groups of people committed to change from the various
departments/disciplines should be encouraged to plan and manage
the implementation of change programmes.
Support local and SouthSouth networks/study tours for
experience sharing.
Change management: Approaches to avoid
Patching up organizations that are in need of more fundamental

reorganization.
The sacred cow pilot project: where lots of time and resources
are devoted to a small project that it would not be possible to
replicate elsewhere.
Flying in a lot of experts for brief visits fewer consultants, and
developing mutual understanding with project partners, is
preferable.
Rushing the formation of working groups and committees to meet
targets.
Adopting the role of a diplomat by using guarded language and
avoiding commitments. Effective collaboration on development
projects usually involves open, genuine, and polite dialogue, with a
willingness to learn.
Over reliance on voluntary inputs.
Emphasizing that the project is the responsibility of the local
government but then not allowing it to influence the management
of the project and its consultants.
2.6
2.6.21 Private sector participation (PSP)

There is a strong push,
driven powerfully by the
World Bank, for city water
utilities to privatize, or at
least to engage with the
private sector in various
forms of partnership
contracts.
148
PSP in the water and sanitation sector offers the potential benefits of
introducing private sector incentives and management skills, and it
can act as a catalyst for change. There is a continuum of different
types of contracts that can be used; from basic service contracts
through to complicated concession contracts where the management
of a whole citys water and sanitation is let to a private operator for
25-30 years. The different types of contract are briefly described
below in order of increasing scope and complexity (Sansom and
Franceys, 1997). Specific contracts can also be developed with
features from two or more types.
Service contracts are the simplest form of PSP. The public authority
retains overall responsibility for operation and maintenance of the
system, except for the specific system components that are contracted
out. The contractors responsibility is limited to managing its own
personnel and services efficiently. Typically, service contracts are used
for maintenance in components such as pumping stations and meter
reading. Payment is usually on a lump sum or schedule of rates basis.
A typical contract duration is one to three years. Similar arrangements
may apply on a small scale in community-managed projects. In such
cases, the village water committee or other management body enters
into contracts with local entrepreneurs for items such as deepwell
pump maintenance and repair.
Management contracts are a more comprehensive arrangement,

where the public authority transfers responsibility to a private
contractor for the management of a range of activities such as the
O&M of a water supply distribution system or major sub-system.
Terms of remuneration can vary, but the inclusion of appropriate
success incentives and penalties for poor performance offer better
potential for service improvements. The public authority usually
finances working and investment capital and determines cost recovery
policies. A typical contract duration is three to five years.
Lease contracts, also known as affermage, are used where a private
operator or lessor rents the facilities from a public authority and is
responsible for operating and maintaining a complete system and
collecting the tariffs. The lessor effectively buys the rights to the
income stream from the utilitys operations and thus assumes a
significant share of the commercial risk associated with those
operations. The lessor generally provides the working capital and the
public authority deals with the capital investment. The duration of a
lease contract can be from five to 15 years.
BOT contracts, (build, operate, and transfer) is a form of concession
whereby a private firm or consortium agrees to finance, construct,
operate, and maintain a facility for a specific period, before
transferring the facility to a government or other public body. BOT
arrangements are attractive for new plants that require large amounts
of finance, such as large water treatment plants, but they are not
suitable for water distribution or wastewater collection systems. The
contract period is normally greater than 20 years, sufficient for the
private contractor to pay off loans and achieve a return on investment.
These contracts often require high tariffs and/or subsidies to meet the
BOT operators costs.
Concession contracts are very substantial in scope, where the private
sector company takes on full responsibility not only for the O&M of
the utilitys assets, but also for investments, often for a whole city.
Asset ownership remains with the government. Frequently the
concessions are awarded according to price the bidder who
proposes to operate the utility and meet the specific investment and
performance targets, for the lowest tariff, wins the concession. The
149
2.6
contract, which is usually over a period of 25 to 30 years, sets out: the

main performance targets; the mechanism by which prices can be
adjusted over time; and arrangements for arbitration of disputes
between the project partners. Concessions generally require tariffs to
be at a sufficiently high level at the start of the contract to meet the
full costs of service provision. There is a danger that such contracts
can only be taken on by a small number of experienced international
companies, who are only likely to bid on favourable terms to cover
the cost and risk of their involvement in a small distant country.
Each type of contract has its own potential benefits and disadvantages,
which must be assessed when selecting an appropriate form of
contract for a particular situation.
Many lower-middle-income countries are opting for the more
comprehensive forms of contracts such as lease, concessions, and
BOT contracts. Toolkits for private participation in water and
sanitation (World Bank, 1997), was produced with DFID support and
provides detailed guidance in selecting which type of contract to use
and how to develop such forms of contract.
2.6.22 The implications of PSP on poor communities
2.6
While there is clear

evidence that the
commercial approach leads
to greater efficiency and
reliability of services,
concern for the poor is by
no means automatic.
Concessions need to
include enforceable
requirements that
affordable services will be
available to all sections of
society.
The lesser forms of private
sector participation, service
and management
contracts, do not generally
threaten the poor, because
they are limited in scope
and duration. BOT
contracts are also usually
risk-free because they apply
on the whole to discreet
items of infrastructure.
The risks come from longterm, all-encompassing
lease and concession
contracts where the
150
A key question is what type of contracts are appropriate for lowincome countries (LICs) in the water sector? The World Bank and
others advocate substantial PSP in LICs, perhaps using simpler forms
of contracts such as management contracts in the interim, before
moving on to longer term lease and concession contracts. There is
increasing concern about how such long-term PSP contracts will
provide water and sanitation services for very poor communities,
particularly those communities that are established during the course
of a contract.
Many LICs already use service contracts, but in general neither
service nor management contracts should pose a threat to the poor.
This is because these contracts are usually small, with the contractors
taking on only very limited commercial risks, so these contracts can
be easily amended to ensure that the poor are not being marginalized.
BOT contracts are not likely to have a direct adverse effect on
services to the poor because this type of contract is normally for
discreet items of infrastructure such as water treatment plants and
transmission mains. If, however, the water utility over-commits itself
in paying the BOT operators charges, this could indirectly affect the
poor.
There is resistance in some countries to more substantial forms of
PSP, such as concession contracts, because the provision of water is
seen as primarily a social good and the private sector may be viewed
as profiteers. In such circumstances a more incremental approach
may be appropriate, particularly where capacity for regulation is low.
The best way of ensuring that the poor do not miss out under a PSP is
to monitor in great detail against appropriate indicators the level of
possible private partners

are a limited number of
international companies
with a dominant profit
motive and whose thinking
is geared to the water
supply and sanitation
systems of the western
world.
If these contracts are to
serve the poor they must
be formulated accordingly
and be closely regulated.
Both functions require the
strong institutional
structures that are often
lacking in countries where
the needs of the poor are
greatest.
service provided to the poor communities, before and during a PSP.

Appropriate measures can then be taken to improve their services.
Appropriate clauses will need to be included in the contract. The
problem is that detailed measurement of service levels in poor areas is
rarely undertaken regularly by water utilities and municipalities. This
calls into question the capacity of such authorities to regulate longterm PSP contracts.
Standpost supplies may not be effective under a long-term PSP contract,
because it is notoriously difficult to collect water charges from standpost
users, so the private operator has little incentive to maintain these
supplies. Group connections could be a better alternative option. In
Buenos Aires, which has a Concession contract, means of reducing
connection charges for the poor are being examined. They include
allowing the poor to pay in kind through labour in making pipe
connections to their houses. Alternatively, if water from standposts is
subsidized, the private operator can bill the government for the water
consumed in the same way as other large consumers.
Successful PSP is a balanced partnership between the private sector
and government/client. The regulatory role is crucial; if the
government/utility are not well versed in the practice of the
measurement of financial and technical performance in the sector,
they are not likely to make good clients/regulators without substantial
ID. Well-designed contracts with the right balance of minimum
standards with penalties and success incentives are a key factor.
Where substantial PSP contracts are being considered in LICs, the
regulatory authority will need to focus on services to the low-income
areas, because the operator will be inclined to focus on the richer
areas to maximize income.
DFID could facilitate increased PSP in the sector by a number of
potential interventions, including technical assistance on:
feasibility studies;
risk analysis;
institutional development for generating management information
and regulation, particularly for poorer areas;
contract development;
enterprise support and restructuring;
policy and legislative development;
developing training capacity;
public/private sector consultations; and
support to lending institutions.
Further advice on potential means by which DFID can provide
assistance is included in DFID Technical Note No.11 (1997) on
Private Sector Development.
151
2.6
Further reading
General and policy issues
DFID, (1995) The Management of Risk in DFID Activities,

Technical Note No.12, Department for International Development,
London.
Harrold, P. & Associates (1995) The Broad Sector Approach to
Investment Lending: Sector Investment Programs, World Bank
Discussion Paper No.302, World Bank, Washington DC.
Minnatullah K.M., Hewawasam, T., and Gross, A. (1998) Structured

Learning in Practice: Lessons from Sri Lanka on community water
supply and sanitation, UNDP-World Bank, Washington DC.
Draws out useful lessons for a demand-responsive approach.
ODA (1995d) An Overview of British Aid for Water in Developing
Countries, Overseas Development Administration, London.
WASH (1993) Lessons Learned in Water, Sanitation and Health:
Thirteen years of experience in developing countries, Water and
Sanitation for Health Project, USAID, Washington DC.
White, J. (1997) Evaluation Synthesis of Rural Water and Sanitation
Projects, DFID Evaluation Report, EV 596, Department for
International Development, London.
Wright, A.M. (1997) Towards a Strategic Sanitation Approach:
Improving the sustainability of urban sanitation in developing
countries, UNDP-World Bank, Washington, DC.
2.6
Human resource development
Carefoot, N. and Gibson, H. (1994) Human Resources Development

Handbook Guidelines for ministries and agencies Responsible for
water supply and sanitation, WHO, Geneva.
DFID (1997b) Guide to human resource development and training in
developing countries, Department for International Development,
Engineering Division, London.
Edwards, D.B. and Salt, E. (1989) A Training Guide for Management
Development Programs in Water and Sanitation Institutions, WASH
Technical Report No.59, Water and Sanitation for Health Project,
Washington DC.
Edwards, D.B. and Salt, E. (1990) Strategy for Developing a Training
Capability in a Water and Sanitation Institution: A guideline, WASH
Washington DC.
Institutions
ADB, (1997) Second Water Utilities Data Book: Asia and Pacific
Region, Asian Development Bank, Manila.
Useful comparative information.
152
Cullivan, D.E., Tippett, B., Edwards, D.B., Rosensweig, F., and

McCaffery, J. (1988) Guidelines for Institutional Assessment for
Water and Wastewater Institutions, WASH Technical Report No.37,
Water and Sanitation for Health Project, Washington DC.
Davis, J. and Brikke, F. (1995) Making Your Water Supply Work:
O&M of small water supply systems, IRC Occasional Paper No.29,
IRC International Water and Sanitation Centre, The Hague.
A good general reference for smaller water supply systems.
DFID (1995a) Institutional Development, Technical Note No.14,

Department for International Development, London.
Edwards, D.B. (1988) Managing Institutional Development Projects:
Water and sanitation sector, WASH Technical Report No.49, Water
and Sanitation for Health Project, Washington DC.
A good overview document on ID.
Edwards, D.B. and Salt, E. (1992) Making Choices for Sectoral
Organisations in Water and Sanitation, WASH Technical Report
No.74, Water and Sanitation for Health Project, Washington DC.
Edwards D.B., Rosensweig, F., and Salt, E. (1993) Designing and
Implementing Decentralization Programs in the Water and Sanitation
Sector, WASH Technical Report No.89, Water and Sanitation for
Health Project, Washington DC.
Korten, F.F. and Siy, R.Y. Jnr. (eds.) (1988) Transforming a
Bureaucracy: The experience of the Philippine National Irrigation
Administration, Ateneo de Manila University Press, Philippines.
Useful guidance on developing an organization that supports the
management of communal systems.
Roark, P. et al. (1993) Models of Management Systems for the
Operation and Maintenance of Rural Water Supply and Sanitation
Facilities, WASH Technical Report No.71, Water Sanitation for
Health Project, Washington DC.
Private sector participation
DFID (1997c) Private sector development, Technical Note No.11,

Franceys, R.W.A. (1997) Private Sector Participation in the Water
and Sanitation Sector, DFID Water Resources Occasional Paper
No.3, Engineering Division, Department for International
World Bank (1997) Toolkits for Private Participation in Water and
Sanitation, World Bank, Washington, DC.
Systems development
AWWA (1995) Water Utility Accounting, 3rd Edition, American Water

Works Association, Denver, USA, 1995.
153
2.6
DFID (1997) Major Engineering Systems: Guidance on Issues to be

Considered in Policy, Maintenance, Cost and Training, Engineering
Division, Department for International Development, London.
DFID, (1997) Good Practice in Developing Sustainable Information
Systems, GID, Department for International Development, London.
DFID (1992) Public Enterprise Pricing and Financial Management,
Technical Note No.5, Aid Economics and Small Enterprise Group,
Fry, S., (1993) Helping Communities Manage Their Water Finances: A

manual for extension workers in rural or peri-urban communities,
WASH Technical Report No.93, Water and Sanitation for Health
Project, Washington DC.
Johnson, S.S. (1990) Guidelines for Conducting a Financial
Management Assessment of Water Authorities, WASH Technical Report
No.53, Water and Sanitation for Health Project, Washington DC.
Johnson, R.W. (1992) Guidelines for Cost Management in Water and
Sanitation Institutions, WASH Technical Report No.54, Water and
Sanitation for Health Project, Washington DC.
WHO (1994) Financial Management of Water Supply and Sanitation: A
handbook, WHO, Geneva.
Wyatt, A. (1989) Guidelines for Maintenance Management in Water
and Sanitation Utilities in Developing Countries, WASH Technical
Report No.63,Water and Sanitation for Health Project, Washington DC.
2.6
Key institutional terms

as used by DFID Government and Institutions Department
Institution
There are two basic interpretations of the term institution:

The first is sociological, and refers to a set of constraints and humanly
devized rules which influence and shape the interaction and behaviour
among groups and individuals. Institutions are the arrangements which
exist in society. They are often referred to as the rules of the game.
The second interpretation is a more specific and refers to an individual
organization. An organization is defined as an individual body with an
explicit structure and hierarchy of authority and the formal allocation of
tasks and responsibilities.
The terms Institution and organization are used synonymously
throughout this manual (although a more strict definition of the second
interpretation would require, in addition, the organization to have a
collective set of values and interests which define the way it presents
itself to the world).
154
Institutional structure
The institutional structure is the totality of institutional arrangements

that exist in an economy in order to undertake particular activities. It
encompasses linkages among individual organizations, and the
framework of law, policy, convention, ideology and culture in which
they operate. This is also sometimes referred to as a countrys
institutional endowment.
Institutional arrangement
The institutional arrangement refers to the set of behavioural rules that

govern and influence behaviour and interaction in a specified domain,
such as the legal sector.
(It is worth noting that DFID Technical Note 14 referred to both

institutional structure and institutional arrangement as the external
environment).
Institutional strengthening
Institutional strengthening is designed to improve the capacity of an

organization to deliver its existing remit in a more effective and
efficient manner, the purpose being to improve the effectiveness of the
existing structure, processes, and systems. Institutional strengthening
therefore does not admit organizational innovation.
Following on from the two-fold interpretation of the term institution,

this term can be used to refer to two types of change:
the creation or development of the capacity of an organization both
to reflect upon its role and function in relation to its changing
environment, and to plan, implement, and manage its own change
programme. Institutional development therefore enables an
organization to act reflexively. It encompasses the capacity of an
organization to introduce changes in its internal structure,
processes, and systems, as well as the process by which they are
brought about. It reflects the capacity to introduce change and
development in the way the institution is organized in order better
to meet its mission; and
change in the broad institutional arrangements for a particular
sector or domain.
Institutional change
A generic term referring to either institutional strengthening or

development.
Institutional appraisal
The process of analysing:

a countrys institutional structure;
the institutional arrangements of specific sector (a sector
institutional appraisal); or
the formal and informal functioning of an individual organization.
155
2.6
Capacity building
Often used loosely and interchangeably with institutional

development and institutional strengthening. DFIDs Glossary of Aid
Terms defines it as training, and other actions, that enable personnel
in a recipient organization to develop the necessary skills to carry out
required tasks.
Some writers suggest that this term should only be used with regard to
the construction of new organizations.
Capacity development
Another term used interchangeably with institutional development,

some suggest it should be used to refer only to developing the
capacity of existing organizations.
Organizational structure
The distribution and disposition of functions, activities, processes and

responsibilities within an organization; where
Function refers to the basic role of the unit or department (marketing,
production, financial reporting, policy and planning, etc.);
Activities refer to subsets of functions, i.e. to the individual jobs
performed (selling advertising space, preparing budgets etc.);
Processes refer to the ways in which functions and tasks are strung
together within the organization; and
Responsibilities refer to the authority vested in individuals to manage
and deploy resources, and the lines of accountability that exist in an
organization.
2.6
156
2.7 Technical aspects

This section examines the technical principles and practices involved
in the successful implementation of WS&S projects and programmes.
It accepts from the start that the associated principles covered in
relation to social development (Section 2.2), health and hygiene
promotion (Section 2.8), and institutional development (Section 2.6)
will apply in conjunction with the technical principles outlined here.
In particular, that means assuming that the consideration of
technological options, design features, and operation and maintenance
requirements takes place in a participatory way. Though it may not
say so explicitly every time, the guidance should be read as indicating
approaches and decision-making carried out with the full involvement
of appropriate stakeholders. These issues are developed in Chapter 3,
which also includes a list of indicators in Section 3.6.7.
General principles
Health benefits are
maximized only when
improvements cover the
three inter-related areas of
water supply, sanitation,
and hygiene behaviour.
A major shortcoming of
past interventions has been
a concentration on water
supply alone. User demand
is heavily biased in this
direction, where the needs
are perceived and the
benefits tangible.
This does not apply to
hygiene or sanitation where
the education and
promotion of benefits are
essential components of
support.
Water supply stands apart
in one other important
respect. It has a relatively
high technological content
requiring technical support
that continues from the
design and planning stage
through construction and
into operation and
maintenance.
2.7.1
Water, sanitation, and hygiene promotion
Household water supply, sanitation, and hygiene promotion need to be

planned together, if the desired health and other benefits are to be
achieved. In making the link, it is also necessary to recognize that
there are significant differences in the approaches to the different
elements.
All are essentially local issues, usually with wider connotations in
terms of integrated water resources management and pollution
prevention. At the community level water supply is primarily a
communal service, whereas sanitation and hygiene behaviour are
individual or family affairs (although in urban areas especially,
inadequate sanitation has communal implications and solutions may
well involve shared facilities such as sewer systems).
Water supply improvements are usually implemented by some form
of co-operation between an organization or institution and
representatives of the communities to be served. User involvement in
construction and management is commonly through a community
committee, as are payments for implementation, operation, and
maintenance. The levels of technology involved are often such that
there is a need for technical support at all stages of the process. The
key technical issues are selection of possible solutions, detailed
design, costing, supervision of construction, and management of
operation. It is common for technologists to be the professionals most
involved in implementation. Furthermore improved water supply is a
commonly felt need of communities; hence they are usually happy to
co-operate in its development.
Sanitation for the poor can involve shared facilities, but more often
the appropriate facility is a household latrine for which the family
retains responsibility. Families decide when and what to construct and
are normally responsible for construction, operation, and
maintenance. The role of external organizations is usually limited to
sanitation promotion, aiding the selection of technical options, and
157
2.7
For these reasons support

in water supply
programmes is dominated
by technicians whereas
sanitation and hygiene
interventions mainly need
social and health workers,
with inputs beginning well
before facilities are
installed.
support to implementation. The groups most involved in development

are primarily social and healthworkers. The ability to understand and
relate to ordinary people is more important than technical expertise.
The main technical issues are related to selecting feasible solutions,
preparing detailed designs and material lists, determining unit costs,
and advising on construction or production of prefabricated
components. While these look similar to the issues addressed in water
supply, the level of technical skill required is usually considerably
lower.
Since water supply is so different from sanitation, there is no reason
why they should be implemented by the same organization. This is
particularly true when the implementing agency is connected to
government. All the evidence points to the fact that when a single
organization is charged with implementing both water supply and
sanitation in a region, one of them will receive more attention than the
other and it is usually water supply. Concurrent, co-ordinated
development should be the guiding principle, but the lead partners
may well be different for each component, depending where the
appropriate skills reside.
Hygiene promotion is important because it provides the link between
the technologies and users. It explains why the new systems are so
important and how to obtain the maximum benefits from their use.
Promotion must begin before implementation as it gives users the
knowledge with which to make informed decisions. It helps, too, to
create the demand which is necessary for all community-based
activities. Although hygiene promotion is a necessary component of
both water supply and sanitation interventions, the skills required for
its use are more likely to be found in organizations linked with
sanitation than in those focused on water. Hygiene promotion is
discussed further in Section 2.8 below.
2.7
2.7.2
To be sustainable
technology-based
improvements must be
affordable to the users and
properly operated and
maintained. The supporting
institutions must ensure
adequate training for the
latter functions, and
assured systems for
obtaining spare parts and
technical assistance for
major repairs. In-country
supplies should be aimed
for, the more local the
better.
158
Sustainable technology choices
Water and sanitation facilities are community services, just like

electricity and roads. If they are to be of long-term use to the
community and the country they must operate reliably for a
considerable period. In other words, they must be sustainable. As we
saw in Section 2.1, sustainability is dependent on financial, social,
institutional, and environmental factors, but the choice of technology
is also central to achieving sustainable systems.
The technology must be understandable and physically within the
capability of the people responsible for operation and maintenance.
Spare parts and equipment need to be easily obtainable, preferably
in-country.
The technology must be affordable to operate and maintain for the
people bearing these costs.
The technology or level of service provided must be attractive and
culturally acceptable to the users.
Appropriate technology and levels of service for the

urban poor
A housing estate for council employees was constructed in a town in Uganda
during the 1960s. The houses were all equipped with internal plumbing and
flush toilets with water-borne sewerage. The council undertook to pay all
employees water bills.
Since Idi Amins regime, the council has not been paying these bills; a survey in
1996 found that, as a result, 92 per cent of the inhabitants of this estate had
been disconnected from the water supply system but were still using flush
toilets with water-borne sewerage clearly an unsanitary situation.
The lesson is that people should be provided with facilities and levels of service
which they can fully afford to maintain without relying on external subsidies.
Handpump production and maintenance by women

The Sarvodaya Movement in Sri Lanka trains mostly uneducated women to
produce, install, and maintain a type of handpump. Among the skills the
women learn are metalworking and borehole drilling. Sarvodaya staff work with
the communities, showing the men how to construct the apron slab ready for
installation of the pump. They train the local women in handpump maintenance
and give back-up support when required. They also provide health and hygiene
promotion.
House, Smith, and Smout, 1997
An appropriate technology is, by definition, a sustainable one, but it

does not necessarily have to be low cost. ActionAid has recently
installed windmills in Uganda to drive borehole pumps for rural
communities. This is not a cheap option, but it seems appropriate in
an area that is frequently windy but has poor access and a population
that cannot afford to pay for the fuel to run a motor pump.
Support agencies should
be alert to ongoing training
needs. Skills are valuable.
In many cases those
initially trained in O&M
duties, for example, move
on and have to be
replaced.
Sustainability of technology will depend on the institutional

arrangements that are in place, and on the capacity building that has
been undertaken to make available local spares, materials, and skilled
operators (see also Section 2.6). Staff must be motivated and skilled to
ensure that duties are carried out correctly.
An area of sustainability often overlooked is training. Projects
frequently include training for all cadres, but it is often forgotten that
people do not remain static after the end of the project. Handpump
mechanics move on and engineers become managers. Sustainability
requires that structures are in place to replace skilled workers as they
depart.
2.7.3
Design for operation and maintenance
The ease of operation and maintenance of a facility is central to its

sustainability and must be given careful consideration in design. Some
operation and maintenance issues are location specific, but urban and
rural projects differ fundamentally in the complexity of the
technologies involved.
159
2.7
For rural projects the

principle of designing for
Village Level Operation and
Maintenance (VLOM) has
proved its worth. There is
no reason why the
enshrouded maxims of
simplicity of operation and
ease of maintenance, so
that systems can be
managed by the
community, cannot be
extended into urban
systems. More technically
advanced hardware may
mean that operation and
maintenance is not within
the scope of users but it
should be possible for
suitably trained local
technicians.
For all systems the
objective is minimum need
for external input.
In rural areas the concept of Village Level Operation and Maintenance

Management (VLOM) is a philosophy which has been gaining favour
over the years. The VLOM approach restricts technology choices to
those that can be operated and maintained within the community for
which the intervention is intended. It was coined at the beginning of
the International Drinking Water Supply and Sanitation Decade, as an
approach for achieving reliability, sustainability, and replicability.
VLOM was first proposed as a concept for use in handpump projects.
Twenty years ago the handpumps supplied for most projects in
developing countries were similar in design to those used in Europe in
the last century. They were expensive and could only be maintained
using specialist equipment and skills. The VLOM principle has
revolutionized handpump design and manufacture. Many are now
capable of being maintained by local people using very simple tools.
The concept has been so successful that it has spread to many other
areas of rural development.
It is rare for the VLOM principle to be taken to its ultimate
conclusion. In most situations there will be a time when external
materials or skills are needed. Good planning will ensure that those
occasions are minimized and support is available when required. In
fact, the VLOM concept allows for this. The two Ms (Maintenance
and Management) imply only that the village manages maintenance.
The fact that it may choose to do so by summoning a district
mechanic from the nearest centre does not invalidate the principle,
providing the service is dependable, affordable, and under village
control.
In urban situations, where supply systems will generally be more
complex, the design and technology chosen will shape the long-term
operation and maintenance requirements. The following quote
(Wagner and Lanoix, 1969), although it is thirty years old, illustrates
the responsibility of the engineer in finding and designing appropriate
solutions:
2.7
If by diligent work he can eliminate a pump, an engine,

another piece of equipment or a treatment process, he is
thereby removing a possible obstacle to efficient operation.
(Of course, many water engineers are women nowadays!)
When designing a piped water supply or sewerage system, the
engineer must take into account operation and maintenance factors
such as the availability of chemicals for treatment, spare parts, and
equipment, the reliability of power supplies, and the availability of
local skills and capacity to undertake O&M.
2.7.4
Standardization
At first it may seem that there is an inherent conflict between the

principles of user choice and standardization. In fact, standardization
is a crucial part of any strategy to achieve sustainability and
replicability, and users can appreciate that point just as well as any
160
Standardization of designs,
equipment, parts and
construction methods is a
valuable aid to effective,
sustainable improvements.
When allied to simplicity of
design the benefits are
pervasive. Familiar
techniques lower the skills
levels needed in all
programme phases from
design to maintenance; the
benefits of training
programmes are spread
wider. In plant and
equipment terms more of
the same encourages local
production and
stockholding, thereby
aiding availability.
Some caution is needed
there must be options, for
example in construction
materials or elements, to
ensure affordability for all.
And, at a wider level, donor
agencies and host country
organizations must seek to
address a major continuing
failing of standardization
planning the lack of
linkages between the
practices of donor
agencies that can leave a
country with a host of
localized standard
systems impossible to
sustain.
The Afridev experience: The original VLOM handpump

The Afridev handpump is the result of a design and development process
which started in 1972 and has been evolving ever since. The original pump was
designed to the following criteria. It:
used appropriate technology;

used lightweight, non-corrosive components;
could be maintained by women;
could be manufactured locally to an exact specification;
needed only one or two simple tools for installation and maintenance;
was relatively cheap; and
was designed with preventative maintenance in mind.
Over the years some design features have been modified and improved to aid
VLOM. The Afridev has been specified for standardization in many countries
including Ethiopia, Cambodia, Pakistan, and Ghana.
Wood, 1993; Skinner, 1996
other stakeholders. The point is that standardization applies within a

range of technological options and alternative management
approaches. So users may choose whether they want supplies from a
handpump, standpost, or house connection, accepting that if, for
example, they opt for handpump supplies, the model will be a
standard one for which local spares are available and which local
mechanics can be trained to repair.
The standardization of equipment, parts, designs, construction
methods, etc., has many benefits. Design is simpler. Choices are made
from a limited range of options. In the short term this may marginally
increase construction costs as the standard designs may not be
perfectly suited to the situation. But it requires lower skill levels in the
design process, and repetitive construction of the same item improves
quality.
Operation and maintenance benefits too. Limiting the range of spare
parts increases the quantity of each item that is required (i.e. more of a
few items rather than less of many). This encourages local
manufacture because the limited range reduces start-up costs and the
increased quantity improves profitability. Local tradesmen will also be
more willing to stock the parts because the increased demand for a
more limited range of items will both reduce the investment required
in stock and increase turnover. Standardization also reduces the
number of skills required to install and maintain the piece of
equipment, thus increasing the probability of local craftsmen being
able to carry out the work.
In rural water supply schemes it is common to standardize the design
of storage reservoirs and limit the number of pipe sizes used.
Handpump schemes usually limit the number of types of pump used
to two or three. In sanitation projects it is common to limit the range
of latrine designs offered, and to design them so that many of the
components used in each design are the same (the pit cover slab for
example).
161
2.7
Handpump standardization in Cambodia

The Cambodian government recognized the need for handpump
standardization in order to achieve sustainable VLOM in rural areas. The
following pumps were selected for national standardization:
suction lift No.6 Pump
medium lift TARA Pump
deep lift Afridev

These choices were made through a two-day standardization workshop which
was attended by all the partners involved in public water supply The selected
pumps have all been proved to be reliable and easy to maintain at village level
and can be locally manufactured.
Kjellerup & Ockelford, 1993
Standardization is very common within individual projects,

particularly those related to water supply. It is less common between
projects, especially if they are funded by different donors. The
multiplicity of designs and equipment installed under different donor
projects has left many countries with such a wide variety of facilities
that none are supportable. It is important that governments develop
policies and guidelines to address this problem and that donors
respond with a willingness to support national standardization
strategies.
In some cases, though, standardization can be detrimental, particularly
where it limits user choice. Insisting that all families construct a
simple pit latrine with a concrete floor slab and brick superstructure
may prevent the poor complying because of the high cost, and deter
the wealthy because of the perceived low level of technology being
promoted. Standardization must never be so narrow that it prevents
users choosing from several options to suit their income and
preference.
2.7
Project partners must

confront too the fact that
donor-based projects can
do no more than illustrate
the way ahead, building
operating systems and
supporting institutions that
can be replicated by the
indigenous populations
using their available
material and human
resources. Only in that way
can the growing WS&S
needs of the poor be
satisfied.
162
2.7.5
Replicability
Project-based development, especially when funded by external aid,

will never be able to satisfy fully the demand for water and sanitation
services for the poor. If full coverage is to be achieved, then
populations will have to implement their own services. National and
local governments must draw up policies and strategies for ensuring
that best practice, as developed in individual projects, is expanded to
improve coverage in other areas of the country. If we wish those
facilities to be of good quality then we must set good examples that
others can follow. In other words we should try to develop solutions
that others want, can afford, and are able to copy. This is what is
meant by replicability.
Replicability applies to process as much as to outputs. Wells, piped
supplies, pit latrines, etc., should be constructed using designs,
materials, and techniques that local populations appreciate and are
Condominial sewerage in Brazil: A case for replication

Condominial sewerage is a low-cost system which was developed in Brazil in
the 1980s. Sewers are laid through back yards at shallow depth, rather than
under the street. This approach involves a high level of negotiation between
agency staff and customers, who are offered the choice of three levels of
service. The system has been proven to work well when there is political will
and the pace is driven by customers demands. While there are still problems
with implementation, the condominial approach has been successfully scaled
up and replicated in a number of cities in Brazil, where there are now extensive
condominial networks.
Watson, 1995
Incremental upgrading of pit latrines, Medinipur, India

An incremental improvement approach can be used to upgrade a pit latrine as
the familys income increases. They can start with a simple pit and
superstructure. In time, the latrine can be upgraded to a pour-flush type, a more
permanent structure can be built, and ultimately a twin-pit might be added.
willing and able to copy. In addition, management and operational

structures must be installed that can be understood and copied.
Community motivators, like the teams in the WAMMA project
described in Section 2.2, can be real powerhouses for replication, if
they are empowered and equipped for the task.
2.7.6
An incremental approach
The essence of a WS&S programme is offering people a choice of

improvements over what they already have. All people need water to
live, so there must be some form of water supply already or the people
would not be there. Similarly, everyone needs to excrete and so there
must be some existing sanitation facility or practice.
To design improved facilities, it is first necessary to look in detail at
current practices, views, and the performance of the existing
infrastructure. The problems, constraints, and shortcomings of the
existing water and sanitation infrastructure need to be identified. In
rural areas these issues may include:
unlined pit latrines are collapsing

people have to walk far to water sources
handpumps have failed
traditional sources are contaminated
seasonal droughts affect surface water
In urban areas, with more complex infrastructure, a whole different

set of problems may be encountered, including:
sewers are blocked

water supply is intermittent and unreliable
water pressure is low
illegal connections are common
distribution system is too limited.
163
2.7
2.7
User demand may drive an

improvement programme
or, as frequently happens
with sanitation or hygiene
projects, the driving force
may come from an outside
agency with the expertise to
see that improvements
could bring health benefits.
In either case a step by
step approach is to be
favoured, fashioning
improvements that are
affordable and relevant to
immediate shortcomings
rather than to an ambitious
long-term objective. At the
same time the next step
should be borne in mind,
building in upgradability
where possible.
At the most basic level,
where communities have no
sanitation and no close
water source, new facilities
are the only answer. There
are many other instances
where improvement may be
brought about by repairing
or rehabilitating what exists,
always bearing in mind that
systems do not fall into
disrepair without reason.
Dysfunctional facilities may
have been inappropriate to
need or demand or suffered
from inadequate support.
Corrections in these areas
are an essential preliminary
to technology changes.
Rehabilitation is not always the best option

Mozambiques Limpopo Railway Line, which was constructed by the
Portuguese in the 1950s, originally ran steam trains. In order to meet the high
daily water demand of these trains, elaborate water supply systems were built
to supply the main stations. These systems were sabotaged and ceased to
function during the years of the civil war.
In 1995 a project was initiated to restore water supplies to the townships
around these stations. The client was keen to rehabilitate the existing systems,
some of which comprised up to 35 miles of transmission mains together with
numerous pumping stations. Since the steam trains are no longer running,
however, and the projected demand of the local population was found to be
less than half the existing systems capacity, it was clearly inappropriate to
rehabilitate. It was found to be much cheaper to develop groundwater sources
at most stations.
The state of the existing system or practices will affect the decision of
whether to replace, upgrade, rehabilitate, or leave it as it is. In a
demand-responsive approach, however, the needs and desires of the
primary stakeholders will be central to this decision-making process.
(See Sections 2.1, 2.2, 2.5 for discussion of participatory approaches
and willingness-to-pay surveys.)
If the facility is operating satisfactorily, not producing a significant
health hazard, and all the users are happy with it, then there will
probably be no effective demand for change. There may, however, be
a case for promoting improved hygiene behaviour or improving the
sanitation facilities, building on satisfaction with an existing water
supply system. The main point about the incremental approach is to
seek feasible and affordable improvements to the current situation,
rather than insisting on major change to achieve an ultimate solution.
Small improvements are likely to be more sustainable and replicable.
An emphasis on upgradable technology also provides scope for further
improvement to meet growing demand, as shown in Figure 2.7.1.
If a facility is functioning satisfactorily and is sustainable but does not
meet the demand from the community, then upgrading or extending
what is already there may turn out to be the best option. The old adage
If it aint broke dont fix it! is very appropriate.
If the current facilities are beyond repair or improvement, then the
provision of new infrastructure has to be considered. The main reason
for their failure must be investigated, however, to ensure that the new
facilities do not suffer the same fate.
2.7.7
Cost is a major
consideration. For
affordability, least cost must
be the aim.
164
Least-cost solutions
All WS&S interventions should be designed to provide the best value

for money to all stakeholders. This is particularly important when
targeting the most vulnerable users in both rural and urban areas.
Engineers have a responsibility to find the most appropriate, least-cost
solution to match the needs and desires of a community. Initially this
2.7
Figure 2.7.1. Incremental improvements to sanitation facilities
165
2.7
Technical options must be

assessed on their whole life
costs with main equipment
items and structures given
an annual depreciation
value based on assessed
design life, and all costs
converted to Net Present
Value.
In choosing equipment an
obvious consideration is
the longer design life and
lower maintenance costs
that might be expected
from an item with higher
initial cost. Less obvious,
but equally important, are
the repercussions of
breakdowns on such items
typically a need for more
skilled maintenance labour
and more sophisticated
parts and tools than might
be locally available; long
periods off line are the
usual result.
Cheaper equipment may
fail more often but be easily
and quickly repaired with
local resources. It has one
other distinct but not
immediately obvious
advantage in that the long
design life of an expensive
item may never be fully
used in the volatile
environments of the
poverty-ravaged areas
where WS&S interventions
are made. Situations and
demand on equipment can
change very quickly.
will involve developing a range of options and building up a cost

estimate for each option. This estimate should include all the capital
costs of the infrastructure (e.g. the handpump, pipeline, valves,
standposts, etc.), the construction costs, and the long-term operating
costs (electricity or diesel, replacement of spare parts, maintenance).
The operating costs need to be considered for the entire design life of
the system, so in order to compare different options on an equal basis,
the long-term costs for each option should be discounted to the
present so that all the options are compared by their Net Present Value
(NPV).
The design life is the length of time that a system or piece of
equipment is expected to be in use before it either wears out or can no
longer meet the demand. It can be an important criterion in identifying
the standardized technologies which will be most appropriate for a
country or region. The choice of design life is always a compromise
between cost and durability. Facilities with a long design life will tend
to be more robust and require less major maintenance. On the other
hand, they will tend to be more expensive than equipment designed to
last a shorter period.
It is necessary to consider changes which are expected to occur during
the design life of the facility, for example new demand due to
increases in the population served, or growth in demand due to
increased consumption (e.g. from consumers changing to higher levels
of service). This is particularly important for the water supply
distribution system.
Long design lives assume a stable environment where the future can
be predicted with some certainty. In unstable societies or those
undergoing rapid social or political change, such as urban slums,
designing facilities to last a long time is probably inappropriate, as no
Example of incremental design approach
A simple spring catchment and transmission main for a rural community can be
upgraded. As demand increases a header tank can be added to provide the
storage capacity. The dendritic distribution system can then be upgraded to a
loop main, with additional tapstands or yardtaps, etc.
Convenience of water sources is important

Gravity systems were built in rural areas of Rwanda to provide water of good
microbiological quality. Two years after construction, water fee payment had
dropped from over 90 per cent to under 20 per cent and many people went
back to their traditional sources. On carrying out a participatory analysis with
the community, it was discovered that a major reason for this was that the
waterpoints were often no nearer than the old polluted sources. To the
community, distance was more important than quality. They saw little
improvement in the new system and therefore were unwilling to pay for it.
Bailey, 1996
166
one can predict what is likely to happen even in the short term. There
is also a trade-off between durability and repairability. Heavy pumps
and valves need special equipment for repair and may be out of action
for a long time when they do eventually break down. The origin of the
VLOM concept was the long downtime of old-style handpumps
waiting for trucks and mechanics to make long journeys to repair
them. Lighter pumps, it was argued, may break down more frequently,
but if they could be repaired in a few minutes by a village caretaker,
the reliability was much improved.
There is no need for all parts of the same facility to have the same
design life. The water pumps in a simple water treatment plant will
probably have a shorter design life than the buildings or the pipework
in the distribution system, simply because mechanical equipment
wears out more quickly than buildings and pipes. Similarly the floor
slab of a pit latrine may be designed to last longer than the
superstructure if the slab is to be used on a succession of pits as the
previous ones fill up.
2.7.8
WEDC/Sohrab Baghri
Improvement means more

convenience (in terms of
use) than what was
previously available, but
there is more to
convenience than siting the
water source nearer the
house. In sanitation
matters, for example,
women and children
especially may have good
but less overt reasons for
wishing to take more than
the first step up the
improvement ladder.
Support agencies must be
alive to the underlying
personal and family values
and community social
norms that may influence
demand.
Convenience
As Section 2.3 makes clear, the health focus of government and donor
investments in WS&S improvements is not the benefit most
understood by users. Convenience of both water supply and sanitation
facilities is given a high priority, particularly by women and children.
Facilities need to be easily accessible and easy to use: if they are not,
users will look for alternatives. It is important therefore that new
facilities are at least as convenient to use as existing ones. This
concept is particularly relevant to selection of levels of service for
water supply programmes (see Section 2.7.14). In the case of
sanitation facilities, the level of service considerations are more
subjective. They often relate to feelings of pride, prestige, and local
custom rather than any measurable indicators. A flush latrine with a
soakaway pit will provide the same measurable benefits as a latrine
connected to a sewer, but most families would consider the latter a
higher level of service.
2.7.9
Gender in technology
Sanitation and water supply facilities are used by women and children
more than by men. It is therefore imperative that all sections of the
community are fully consulted at all stages of the project and that the
facilities are designed for all to use. Most water and sanitation
technologies are designed by men and they are frequently unaware of
the impact that the differences between the sexes can make on the
convenience of using a piece of equipment. Simple things such as the
height of taps and handles or the spacing of footrests on a latrine slab
can make all the difference to the ease with which a facility can be
used.
Gender has other impacts on technology besides simple design. The
location and the way the technology interacts with the community are
important and can affect their usage. For example, women may not
167
2.7
use a handpump placed near a mosque. While men see a tapstand

purely as a place for collecting water, women may see it as a place to
meet others and discuss points of common interest. Designing
facilities to promote such interactions may make them far more
desirable to the users. Similarly, designing a latrine superstructure so
that it can be used for bathing or laundry may considerably increase
its value to women but have little impact on men. There are many
other socio-cultural issues involved in the design and use of WS&S
facilities which make it crucial for women to have an influential role
in their selection.
2.7.10 Construction
WEDC/Sohrab Baghri
The quality of construction will impact on the sustainability of the

scheme: for example, a concrete mix made with a low cement content
will be weak and could ultimately result in the failure of pit latrine
slabs. It is therefore important to have an adequate level of skilled
supervision in order to ensure that the desired quality is achieved. If
the work is not properly supervised then incompetence, corruption, or
corner-cutting may affect the end product.
2.7
A key consideration in the

construction of WS&S
improvements is the need
for effective supervision
both to ensure worker safety
and the quality of the end
product. Neither may be of
the standard expected on
UK sites but the same
principles should be
applied, with the desired
standards instilled by
appropriate training and
communication.
Community labour and
supervisory input is
desirable if local conditions,
such as viable moneyearning activities elsewhere,
do not preclude it. Local
input almost always
produces the least-cost
solution.
168
While it is often considered appropriate to involve the community in

construction and supervision, this may not always be possible. In
urban or peri-urban areas many people already earn a living and
would not be prepared to contribute labour to a water supply or
sanitation scheme but would rather contribute cash. This situation
needs to be assessed at the early stages of a project. It is generally
more cost-effective to use labour from within the community as much
as possible. Using community labour does have training implications,
however, since most residents will not be skilled in construction. It
would clearly be inappropriate to use small local contractors and
community supervision for the construction of a large pumping main
or a complex treatment works.
Construction is a notoriously dangerous occupation and it is important
that local safety standards are maintained at all times. These may be
well below the accepted UK standards, but it is not realistic to expect
all labourers to possess hard hats and steel toe-caps! The key to good
safety and also to quality construction is good communication, so
Table 2.7.1
Comparison of construction and supervision costs of

collector sewers in Orangi, Pakistan
Construction and supervision
Length of
sewer (m)
Cost per
metre (Rs)
Built by small contractors, supervised by

community group
89,536
52
Built by small contractors, supervised by

individual user groups
189,926
50
Built by large contractors, supervised by

local government agency
34,267
295
Design for the needs of the users normally women

WaterAid/Jim Holmes
In 1992 DFID evaluated the Eastern Region Water Supply Project in Nepal. The
project had been primarily engineering-led, and local and expatriate technical
staff had liaised with communities mainly through the leaders of the Panchayats,
the local political structures. Links with the communities were therefore only
through a small group of local leaders who might not have been broadly
representative of the various interests and views of all sections of the
communities. Where users developed views on scheme design, there were no
channels for these views to be fed back to the engineers. The distribution of
water supplies was generally equitable, but in some cases tapstand locations
were considered to be unduly public, especially for women. Tap stands are used
for bathing purposes, and some tapstands were close to roads, where there
was little or no privacy. The design of the tapstands was also considered
unsatisfactory, as users and especially women wanted larger concrete aprons
around the tapstands for washing clothes and to reduce crowding.
In the town of Letang, some hand-dug wells were in use, and these had head
walls built above ground level. The head-walls were tall and wide, so it was
difficult and exhausting (even for one of the assessors, a tall man), to lift water
from the wells because the headwalls came up almost to his armpits, and he
had to lift the water with his arms straight. The difficulty must have been much
greater for Nepali women, who were significantly shorter.
House, Smith, and Smout, 1997
channels of communications between all parties on site should be

simple and well-defined (Coburn, 1995).
Perceptions of project completion
Construction planning
should take account of and
aim to circumvent the
common tendency for
community commitment to
wane when users believe
their main demand
objective has been
achieved. If less obvious
health benefits are to be
realised, support agency
staff may need to devise
means to maintain user
interest until all the works
are completed as planned.
Sometimes there must be
acceptance that substantial
completion gives most of
the benefits; the users may
raise their sights at a later
date.
The decision on when a project is complete often causes friction

between implementers and the community. Completion for the
implementer is quite straightforward. It is defined by contracts,
drawings, and statutes. Communities have a more practical approach
to completion. Once the project produces the benefits for which they
agreed to undertake it they see no reason to spend further time and
money on it. A common example of this is in shallow well
construction. When communities participate in their construction they
will frequently cease to participate once the hole is dug. The
implementing agency may wish to build some form of structure on top
of the well to improve both durability and the quality of the water
produced. To a community suffering from water shortage this is often
seen as unnecessary. Once the hole is dug and the water reached they
have access to water and the implementers desire to spend additional
time and money on the well-head may not be supported, even though
it is necessary to maximize health benefits.
The answer is to reach some form of compromise. The main reason
for improving WS&S provision is to improve the health and wellbeing of the community. If this has largely been achieved then trying
to force people to do things that they do not want to, especially when
they are paying for it, is counter-productive. If there are any items that
the implementer considers essential but the community does not (e.g.
a building to put a water pump in), then the reasons for it should be
169
2.7
explained to the community to try to persuade them to build it before

the main works reach a point where work is likely to cease, or to build
the project into some form of contract between the implementer and
the community. The principle of incremental improvement is worth
bearing in mind here. The project may not be finished to the
implementers perception of completeness, but it is the users who
count. It is possible that at a later date they will upgrade the facility to
something similar to what was wanted originally.
WaterAid/Jim Holmes
Sanitation principles
In rural areas, the most appropriate and affordable technology for
excreta disposal is generally provided by on-plot pit latrines, such as
simple pits (Figure 2.7.2) with pre-cast slabs which may be reinforced or domed (Figure 2.7.3), ventilated improved pit latrines
(VIPs) (Figure 2.7.4), and pour-flush latrines (Figure 2.7.5). A
particularly low-cost solution is to upgrade an existing pit with a
SanPlat a pre-cast concrete slab placed on top of the existing pit
cover. This is also usually the case for poor people in small towns and
peri-urban areas. In urban slums on-plot sanitation is often the most
cost-effective solution, but it may not be appropriate in some
circumstances, for example:
2.7
In most instances
affordable sanitation for the
poor means on-plot latrines
of varying degrees of
sophistication. Restricted
space or unsuitable ground
conditions may force
people to resort to other
techniques in urban slums;
usually piped sewerage is
the only safe alternative.
This expensive solution
generally brings with it an
obligation of long-term
subsidy as cost recovery
for construction and
probably operation will be
beyond the means of
users.
Adherence to western
design and construction
standards has contributed
to an in-built acceptance of
high costs. More
appropriate standards are
beginning to be used to
170
if there is no room available to construct a latrine with an on-site

disposal system (see Section 2.7.20 for more detail on this);
if ground conditions are unsuitable for on-site disposal systems; or
where water usage is greater than the disposal capacity of the
existing facilities.
There is commonly pressure from urban communities to provide a
higher level of service for waste disposal, in which case pour-flush or
cistern-flush latrines may be used with on-site disposal. These can
also be used on upper floors in multi-occupancy buildings, which pose
problems for other types of on-plot sanitation.
When on-plot sanitation cannot provide a solution, alternative forms
of sanitation must be considered. In nearly every case that will be
sewerage. Unfortunately sewerage is very expensive and usually
unaffordable by the urban poor. It must be accepted that if sewerage is
to be implemented then subsidies will be required during both
construction and operation, and the local government or other body
will need to accept the recurrent subsidy as a justifiable long-term
commitment (see Section 2.5 on subsidies).
2.7.11 Reducing the cost of sewerage
Work carried out in a number of countries has shown that the cost of
sewerage can be considerably reduced. Past design and operation of
sewerage has been based almost entirely on methods developed in
North America and Europe. Many of the standards used are
inappropriate for either developing countries or the needs of their
communities. Costs can be significantly reduced by:
Figure 2.7.2. A simple pit latrine
2.7
Figure 2.7.3. A domed slab
171
Figure 2.7.4. A VIP latrine
2.7
Figure 2.7.5. Pour-flush latrines
172
good effect and costs can

also be reduced by revised
approaches to operation
and maintenance and
charging.
Western thinking is biased
towards off-site disposal of
faecal material with piped
sewers leading to hightech sewage treatment
works where wastes are
processed to separate the
liquid and solid
components, remove
nutrients from the liquid,
and make the solid
residues (sludge) fit for
disposal. Public health
remains a priority objective
but others, ranging from
clean rivers to avoiding
public nuisance, are added
to dictate the need for
these hugely expensive
systems.
Properly maintained on-site
sanitation is equally
effective as a barrier to the
spread of pathogenic
organisms the overriding priority in the
developing world and
has the added advantage
of dispersing rather than
concentrating wastes, an
important consideration if
facilities are not well
maintained. As the
affordable, least-cost
option it should therefore
be the first choice in WS&S
interventions unless user
demand or local physical
conditions force a move to
piped sewerage.
One other serious
disadvantage of piped
reducing construction costs by revising design criteria, and

eliminating redundant features (see Section 2.7.21);
improving the quality and methodology of operation and
maintenance; and
strengthening institutions to improve the efficiency of tariff setting
and collection.
In addition, a marginal costing approach can be used to encourage
families to connect to the sewer network after it has been constructed.
2.7.12 Sewage treatment
On-site sanitation is often (and should be) the first option when
considering a sanitation intervention. Such systems have very distinct
advantages, not least that they are individual systems, which means
that the disposal of faecal material is dispersed over a wide area and
not centralized, as with a conventional sewage treatment works. One
problem with centralized facilities is that when they go wrong, the
resulting problems are much more acute.
It should be remembered that from a health point of view, there is not
much difference between any of the different options for sanitation
(both on- and off-site) as long as they are all functioning properly.
It is largely a question of convenience an off-site system where
wastes are flushed off the owners property is more convenient as it
gets rid of the problem from the owners property. Off-site sanitation
is usually much more expensive than on-site.
There are instances where off-site sanitation is deemed necessary
because of unsuitable ground or housing conditions for on-site
systems, or because of a communitys desire to have a better system.
There is a certain amount of prestige in having an off-site connection
such peer pressure is often a significant motivating force.
Once the decision has been made to implement an off-site system,
then sewers become a necessity. Water has a large dispersion, dilution,
and carriage capacity, and it is therefore used as the carriage medium
in most sewer systems. Usually, potable water is supplied to the house
and used for flushing toilets and as much as 40 per cent of
household water use may be for this purpose. Some countries do use
dual-supply systems where non-potable water (often seawater) is used
for toilet flushing, but such a system requires more infrastructure and
has obvious capital cost implications. Therefore, most sewer systems
are a heavy user of precious potable water supplies, which should be a
factor when considering their implementation, especially in watershort areas.
Sewerage is a mechanical system for removing wastes (sewage) from
the place where it is generated. It does not clean the wastes. At some
point the wastes must leave the network to be either treated or
discharged into the environment. The decision as to whether or not to
treat the wastes is an important one, as installing a sewage treatment
173
2.7
sewerage systems should

be borne in mind they
need a lot of carrier water,
and may require increased
water supply.
2.7
Going a stage further, to

sewage treatment, raises
more questions. It can
double construction costs
without adding any health
benefit to the community it
serves. Unless adverse
impacts on other
communities are clearly
indicated, the money spent
on sewage treatment is
usually better allocated to
extending piped sewerage
or more basic sanitation to
other deprived
communities.
Where treatment facilities
are planned the selection of
appropriate technology is
fundamental, as is a shift
from the design thinking of
the West. Domestic sewage
uncontaminated with
dangerous industrial
constituents need not be
viewed as a problem to be
disposed of after removing
as many undesirables as
possible. It can be a
resource.
plant may almost double the cost of construction. There can be no

doubt that sewage treatment is preferable. It reduces the
environmental damage done by polluted waters and removes a
potential source of disease.
Unfortunately, in a developing country these benefits have to be
weighed against the benefits that could be obtained from using that
money in other ways, such as constructing more sewers. The biggest
benefits of sewerage are gained by the communities using the
system. Sewerage improves the local environment and reduces
exposure to disease. In most societies these benefits will far
outweigh the potential damage being done to the environment
downstream of the outfall by untreated sewage, and the economic
justification for sewage treatment may be weak (see Section 2.5.12).
It should be remembered that in Europe and the USA sewage
treatment only became common practice many decades after the
sewers were constructed.
The discussion in Section 2.4 on water quality objectives for water
courses is highly relevant to decisions on whether or not sewage
treatment should be considered.
Traditionally, sewage has been seen as a problem requiring treatment
and disposal. Most conventional sewage treatment options are based
on protecting the aquatic environment in Northern countries
which has usually meant a reduction in biodegradable organic
material and suspended solids and, perhaps, some nutrients (nitrogen
and phosphorous). Treatment involves removing these pollutants
but removal is usually conversion to another product, usually
sludge. The disposal of sewage sludge is a major consideration in
many locations it is often seen as an offensive product which is
either dumped or burned.
The priorities in developing countries are often different from those
in developed countries. Often the main issue is protecting people by
controlling pathogenic material and any form of sanitation (on- or
off-site) should have this as the main objective. There are treatment
options which can remove pathogenic material notably waste
stabilization ponds (see Section 2.7.20).
Increasingly, sewage is being seen as a resource, and it is often reused legally or clandestinely. The water and nutrient content, in
particular, can be very useful for agricultural purposes for
example, through irrigation particularly in relatively arid
environments. This can involve substantial health risks, for both
those who consume the crops and those who grow them. There are
various ways in which the practice can be made safer, including:
treating the waste;
restricting its use;
using it only on industrial or fodder crops; and
applying the waste in specific ways or only at certain times.
174
Whenever sewage is put to

use in this way the
practices must be
adequately regulated to
prevent health risks.
Experience has shown that regulation of the practice to make it safer

is more effective than attempting to ban it. For further details see
Mara and Cairncross (1991).
There are treatment options which seek to use this resource potential
(see Section 2.7.20). As another example of re-use, traditional sewage
treatment practices in South-East Asia pass wastes through pond
systems which are used to cultivate fish and generate feed for animals.
Some community-based approaches (in Latin America in particular)
separate grey wastewater (non-faecally contaminated wastewater)
from black water (that which is faecally contaminated) so that they
can both be recycled and re-used as appropriate. In principle, the grey
water can be re-used as irrigation water and the black water/waste
treated and re-used as fertilizer.
Traditionally, sewage is treated through large centralized schemes.

Many of these do not work and when they do not work, the
resultant pollution and health problems are often severe. The reason
for failure is frequently that inappropriate, unsustainable, options have
been chosen in the first place. Often, sewage treatment is a low
priority compared to water supply, and municipal councils simply do
not have the resources to keep the facilities operational. In such
circumstances, there is a growing body of opinion that advocates
moves towards decentralized, local systems, which, it is argued, could
be supported by community-based organizations. Such approaches
have been implemented in locations in South America.
Water supply principles
2.7.13 Quantity and quality
SCF/Alan Nicol
As we saw in Section 2.3, research into the relationship between

water quantity and quality and health impact shows that the benefits
of additional water quantity far outweigh those of improved quality.
From a technical standpoint the aim should be to deliver the quantity
and quality of water that the user demands. However these aspects of
demand are not always clear. Users may know how much they use
now, but may be unaware of how a change in supply will affect their
future use. To that extent the professionals must use their knowledge
of similar situations to advise users on what is likely to happen in the
future. This applies particularly to the use of water for productive uses
such as watering livestock and gardens.
For water supply
interventions the starting
point for facilities design is
to establish the quantity
and quality of water
needed. It has already
been said that health
benefits depend more on
quantity than quality of
Water consumption will depend on the convenience of the supply, as

shown in Table 2.7.2, but as a general rule, water supply systems for a
minimum level of service should be designed to deliver at least 20
litres per person per day (plus wastage) without excessive queuing.
For the design of standposts, including flow rates, number of taps,
etc., see IRC Technical Paper No.14 (1979).
Particularly in urban areas, a major component of total supply from
the source may be unaccounted - for water due to leakage, illegal
connections, and deficiencies in metering and billing. It is also
175
2.7
supply, and here two key

points should be borne in
mind; consumption
increases with convenience
of supply (current
consumption is therefore
not a good guide to the
future), and system input
must be greater than supply
at the tap to account for
intermediate losses by, for
example, leakage and
illegal connections.
necessary to consider water consumption by institutions such as

schools, hospitals, markets/shops, and offices.
Water quality demand is even more difficult to quantify. Few users are
aware of all the factors that affect quality. They are more likely to be
interested in aspects such as taste and colour than in bacteriological
quality. Again the professionals must advise the users on what is
feasible and acceptable. The World Health Organizations Guidelines
on Water Quality (1993) permit countries to adapt standards to suit
local circumstances, and are a good source of information on the
parameters to be taken into account. It is recommended that countries
adopt national or regional standards for drinking water quality, and
that sources and treatment options be assessed in accordance with the
agreed standards.
2.7.14 Levels of service
2.7
Convenience of supply, use

of facilities, and affordability
are three of the closely
linked issues that make
decisions on levels of
service a complex matter. A
single level of service may
have to be accepted in
some instances, but is not
usually the best choice or
what users want.
Willingness and ability to
pay vary within
communities; service levels
should be varied
accordingly.
Convenience is accorded a
high priority; tap supplies in
some houses may provide
the impetus for wider
moves from yardtaps and
standpipes at a later date.
Conversely unreliable but
clean standpipe supplies
will do little to advance
community health if dirty but
free pond water is close by.
In general, the more water a community uses, the better the prospects
for health and the higher the communitys status and well-being.
However, the amount of water used is related to the level of service
the convenience of the water-supply facility in terms of distance to
source, time to collect, quality, quantity, and timeliness. Thus, for a
given system, a private house connection provides a higher level of
service than a yardtap outside the house, which in turn gives a higher
level of service than a public standpost at some distance from the
household (see also Section 2.1.4). This convenience factor is a high
priority for users, particularly where a range of sources or supply
options is available. People will choose the level of service which is
perceived to suit their needs best at an affordable price, and may use
different sources of water for different uses.
Therefore it is desirable to design for a mixed level of service within a
community, in order to provide each customer with the service they
are willing to pay for. This is more complex than designing and
implementing a uniform level of service, and in some circumstances
the simpler uniform approach may be preferred as a pragmatic
solution.
A rural example would be the installation of new handpumps in a
village. If the original water source, say a pond, was easier to use and
required less effort, then it is likely that users would continue to use
the pond rather than change to the handpump. This would be
Planning for demand
If the progressive development of service levels is not planned ahead, piped
water supply schemes can quickly meet capacity problems. A public standpost
scheme for 400 villages in Latin America ran into financing problems because
the demand for private taps was higher than anticipated. Conversion to house
connections brought operational problems which resulted in non-payment. The
whole scheme was eventually abandoned.
IRC, 1991
176
Table 2.7.2
Example of average water supply consumption figures
Type of supply
Distance
from home
Communal water-point (well or standpost)
>1000m*
Communal water-point (well or standpost)
250m1000m*
10 - 30
Village well or Communal standpost
<250m
15 - 50
Yardtap
in compound
20 - 80
House connection single tap
in house
30 - 80
House connection multiple taps
in house
70 - 250
Range of
consumption
(litres/capita/
day)
5 - 15
* Note these supply systems are below the minimum level of service standard
(see Section 2.1.4)
Table 2.7.3
Typical
weekly
household
income (US$)
Average
Cost of
water
water per
consumption 20 litres
l/c/d
Weekly
expenditure
on water
supply (US$)
traditional
simple pit
sources,
latrine
springs or
handpumps
<10
15.8
free
standpost
simple/
improved
pit latrine
<30
15.5
USh 36
1.2
yardtap
pit latrine or >30

pour-flush
connected
to septic tank
50
USh 14.4
1.6
house
connection
flush toilet
connected
to septic
tank
>50
155
USh 14.4
4.9
house
connection
flush toilet
connected
to sewer
>50
155
USh 25.4*
8.7*
Level of
service
(water
supply)
The table illustrates the range of
payments that people make for
different levels of service, and
also shows the relationship
between household income and
level of service for water supply
and sanitation. It is interesting to
note that the people using
standpipes are paying 2 times
more per 20 litres than people
with yardtap and house
connections. The actual water
companys tariff for water from
standpipes is only USh9 for 20
litres but the standposts are
mainly operated as private
enterprises and thus water is sold
at a significant profit. Many poor
people could actually receive a
much higher level of service at
the same monthly cost if they
upgraded from a standpost to a
yardtap connection. However
they are normally constrained by
the high initial capital cost of
obtaining a private connection.
Example of levels of service versus household incomes

from Jinja, Uganda
Sanitation
facilities
2.7
*includes charge of 75% of water bill for sewerage

Exchange rate: $1 = USh 1000
particularly true if the users were asked to pay for maintenance of the
handpump. In circumstances with insufficient demand (or tariffs that
are higher than people are willing to pay), it is unrealistic to rely on
hygiene promotion to create demand for improved water supply.
In urban and peri-urban areas, poorer people may be served by public
standposts. The level of service from these standposts may be affected
by low pressure or intermittent supply. Thus a programme could seek
177
to improve levels of service by improving the reliability of supply to

standposts. However, many people would like to improve their level
of service by obtaining their own yardtap to save time on collection
and increase consumption. A demand-responsive approach to
programme development should aim to meet peoples desired levels
of service, and provide flexibility to allow them to upgrade over time.
Generally, the more convenient the facilities are the more people will
be willing to pay for the service.
2.7
Meters are a popular aid to

cost recovery and water
conservation in the West
but there are many valid
reasons for not including
them in WS&S
programmes. In certain
situations some of the
problems may be
overcome by using a prepayment meter, in effect an
in-house control valve that
can be actuated with a
previously purchased token
or card, to pass a known
volume of water. A more
effective route to revenue
collection in low-income
settlements is for the utility
to use a community-based
organization as
intermediary, responsible
for bulk purchase of water
and then for equitable
distribution and cost
recovery from users.
2.7.15 Metering policy
178
Many water utilities are keen to install domestic meters in order to

improve cost recovery and minimize consumer wastage. However,
even if the concept of metering is acceptable to the consumer, there
are still constraints to achieving effective coverage with domestic
meters. The cost of installing a meter is relatively high and the utility
must decide whether to bear this cost or pass it on to the consumer.
This may affect new connection take-up. The utility must then
allocate substantial resources to read the meters on a monthly or
quarterly basis. There is also a risk of sabotage to the meters and
under-reading due to corruption. On the other hand, intermittent
supplies can cause false high readings and damage to meters.
There is also the problem of replacement. Cairncross and Feachem
(1993) refer to a World Bank study in Lahore, Pakistan which found
that the average meter lasted only five years. It concluded that
metering was not an economic proposition unless it reduced
consumption by at least 60 per cent. The situation may have improved
since. Kent Meters (1998) expect a life of at least ten years where the
water is of average cleanliness. Meters are now made in developing
countries, but if they need to be imported the foreign exchange cost
for replacement meters may be substantial.
If a water supply is going to be managed by a community, then there
is a good case for a community-based organization (CBO) bulkbuying water at a metered connection off a transmission main. The
community can then organize itself to take responsibility for
distributing water, maintaining the tertiary pipework, and collecting
revenue to pay the utility. This concept of bulk delivery has another
big benefit in urban fringe areas: it helps to overcome the dilemma
posed by squatter settlements with no land tenure. If a utility delivers
bulk supplies to a legitimate CBO, it avoids the implication of
legitimizing otherwise illegal settlements, while still providing the
means to satisfy basic needs.
Token or card-operated pre-payment water metering has been tried in
some countries, for example South Africa and Uganda. This system
has the advantage of ensuring cost recovery and reducing the
operating costs associated with meter reading, invoicing, and debt
collection. It also enables customers to link consumption directly with
expenditure on a daily basis so that large, unaffordable bills are
avoided. However, prepayment systems require relatively complex
technology, and require a high initial capital investment. In trials in

South Africa, the system has also been faced with political and public
opposition.
2.7.16 Demand management
Demand management has
become the watchword for
water conservation.
Enforced restrictions on
abstractors and end users
can help, but worthwhile
curbs on demand come
only by a composite of
actions on a wide front,
using appropriate tariffs to
discourage waste in
conjunction with a range of
hardware-based
interventions.
Traditionally, engineers and planners have sought to provide for everincreasing demands in water supply. There is now a realization that
there is a limit to water resources, and supplies have to be carefully
managed in all circumstances.
In the face of ever-increasing demands, attention should be shifted
away from trying to manage the supply of water by providing for
these increasing demands. Instead, the management of the demand
should be the priority, i.e. attempts should be made to reduce the need
for increasing the water supplied. Demand management must be a
fundamental aspect of any water supply scheme, including mandatory
practices where appropriate.
Methods of demand management can be grouped into two categories:

financial or physical. Financial control includes the setting of
appropriate water tariffs to penalize waste. Physical methods includes
techniques such as:
control of unaccounted for water and leakage (illegal connections
are a particular problem in many urban areas);
adoption of water-using devices with lower consumptive use (e.g.
low-flush toilets);
use of fittings that give lower flow (e.g. spray or self-closing taps);
use of non-potable water for non-potable uses (e.g. salt water is
supplied in a dual supply systems for use in toilet flushing in Hong
Kong and in several small island states, e.g. Marshall Islands,
Kiribati, and Cayman Islands); and
re-use of suitably treated wastewater for irrigation purposes. This
is quite common practice in many locations worldwide. In extreme
Freshwater resources in short supply
There are many areas of the world where freshwater resources are in short
supply. Many major cities are in severe danger of water becoming so short as
to present a severe constraint on any future development. The location of some
new cities in developing countries has not taken account of available water
resources these are located where they are because of other reasons (e.g.
mining/mineral resources). Cities like Bulawayo in Zimbabwe regularly face
water shortages. In the drought of 1992-3, Bulawayo was days away from
having no water at all. It has been estimated that Beijing will have a daily water
shortfall of 500,000m3 by the year 2000.
Faced with such problems, many city authorities have turned towards grand
water transfer schemes. The Lesotho Highlands Water Project is an example of
this water is transferred from one river basin to a neighboring one to supply
Johannesburg and the cities in the Transvaal area of South Africa. The financial
costs of such schemes are huge, and the environmental implications of such
inter-basin transfers are largely unknown.
179
2.7
cases, treated wastewater can be recycled back into the supply

network (e.g. in Windhoek, Namibia). Bulawayo (Zimbabwe)
uses wastewater for irrigation of park land, after treatment both
by sewage treatment and water treatment processes.
2.7.17 Leakage control
Not all the water that leaves a water treatment works reaches the
consumer. A significant amount as much as 50 per cent, or even
more is lost through leakages. All pipe materials deteriorate with
age, and all connections are potential sources of leaks. A common
feature of water distribution networks in developing countries is the
high number of unauthorized connections to the network. These
cause many problems, including loss of pressure and contamination
of the supply, and contribute significantly to leakage.
For real effectiveness

leakage monitoring and
control must be a regular
activity, and not based on
incident response as is
often the case in
developing countries. Leaks
waste a scarce resource:
the money invested in
treatment and distribution
and the revenues from lost
sales.
There are many electronic methods of leakage control used in

developed countries. Most of these are expensive and inappropriate
for developing countries. A common feature of water supply
networks in low- and middle-income areas is that they do not supply
water 24 hours a day. Sometimes, the rationale is that by limiting the
hours of supply, then the consumption can be limited, but the reverse
if often true. When supply is limited, many people store water as a
safeguard, and when supply is resumed they waste the stored water.
Also, as the supply is limited and there are many illegal connections,
the pressure of the water is often very low. In such circumstances,
people tend to connect their own small booster pump to their
connection to the main, and draw out what water they can. This
reduces the pressure in the main further and sucks out all the
available water and adds to the possibility of further leakage.
It is impossible to get zero leakage from a system. There comes a

point where the cost of leakage detection and control outweighs the
benefits of locating and repairing the leaks. This is sometimes
referred to as the economic level of leakage. Recent experience in
the UK where great efforts have gone into leakage control show that
it is difficult to get under a figure of about 12 per cent of water lost
through leakage. Typical figures for leakage in an average
developing country are around 30 to 40 per cent.
Water in a pipeline is under pressure, so when there is a hole it will

escape. As it does so, there is a noise a hissing sound. Most
leakage detection methods are based on listening for this sound.
There are many types of sophisticated instruments used to listen for
the sound electronically, but the most traditional way is through the
use of a listening stick used by a trained operator. As labour is
usually cheap and listening sticks can be made by local craftsmen,
this is often the most appropriate way of detecting leaks. When there
is an intermittent supply at low pressure, however, leakage detection
is very difficult because if there is no flow in the pipe, there will be
no sound to detect. Under such conditions, leakage detection has to
be carried out by isolating sections of the network and testing under
Mott MacDonald Ltd
2.7
One example, offering

potential for significant
savings, is leakage control.
Leakage losses are typically
40 per cent or more,
aggravated in developing
countries by the high
incidence of leak-forming
illegal connections. Hightech methods of leak
detection are not essential;
effective investigation can
be made by locally trained
operators using simple,
locally manufactured
listening sticks.
180
pressure when it is there (and it will often have to be artificially

induced).
Leakage detection and control in many developing countries is usually
done as a response when a leak is reported it is repaired. However,
leakage detection should be a routine preventative function of a water
utility as the water lost is a waste of a valuable commodity which
is limited in its availability, and of money (in the effort spent in
treating and distributing the water which is wasted, and in the loss of
the potential revenue associated with the lost water).
2.7.18 Source selection and treatment
Source selection
determines treatment needs
and, in turn, construction
costs for abstraction and
treatment and the ongoing
operating and maintenance
costs of the treatment
process. Groundwater is
generally preferred, often
requiring only minimal
treatment, but it can be
difficult to locate and to
assess yield.
In most areas, there will be more than one source to choose from
when developing a new supply system. The different types of source
are detailed in Table 2.7.3 and the range of treatment processes is
shown in Table 2.7.4. Broadly, water sources are classified either as
surface (e.g. rivers, streams, and lakes) or sub-surface groundwater
(which can be deep, shallow, or a spring). The choice of water source
and the level of treatment are interdependent: in general groundwater
is preferred, particularly in rural areas, because the water is relatively
pure and requires minimum treatment. However, groundwater can be
difficult to locate and yields (the amounts of water which can be
abstracted) are often hard to assess.
The choice of source and treatment will affect the design of the
system, the cost of construction, and the long-term operating
requirements. It must therefore be a well-informed decision based on
available data, local knowledge, and field surveys.
2.7.19 Wastewater drainage
At water delivery points,

whether communal or in
households, designers
must make adequate
arrangements for the
collection and safe disposal
of spillages and wastewater.
Standing water breeds
disease.
Programmes should
institute systems for
maintaining sullage drains
from households and from
standpoints where clothes
washing and other activities
occur.
Whenever water is delivered to a community some provision must be

made for its removal after use. In rural areas the problem is most
significant at the supply point. All water points waste water and its
removal is important for health and environmental reasons. Standing
water around a water point promotes mosquito breeding. If animals
are present the ground will become smelly and muddy. All water
points need to have an impervious surface around them with facilities
for collecting and disposing of the spilt water. This usually takes the
form of a concrete apron discharging into a nearby surface-water drain
or soakaway. Sometimes, users will want to have dishwashing or
clothes washing facilities adjacent to the water point, in which case
disposal of the sullage water has to be part of the design too.
In urban areas the problem can be much greater. Not only is there a
larger quantity of water entering an area but there is less space for its
disposal. It is common to provide surface drains along the side of
roads to collect waste from both water points and domestic properties.
Drainage systems need a lot of maintenance to keep them operating
properly. They frequently block up with silt and refuse and can
become a favourite place for defecation. A structured maintenance
programme is therefore required to keep them running.
181
2.7
Technical staff supporting

WS&S programmes have
clearly defined duties that
begin with the selection of
appropriate technical
solutions and go on to
cover all stages of design
and construction. They can,
and should, contribute to
technical training on current
projects and, by using the
experience gained, to the
improvement of future
designs.
Practice
The descriptions of technical principles outlined above generally have
clear implications for the actions to be taken by DFID staff and other
members of the stakeholder team who are designing and implementing a
WS&S project or programme. The main responsibilities of the technical
staff in a water and sanitation project are:
determine which technical solutions would operate successfully in
the particular environment;
prepare outline costings and lists of parameters that would make
each of the options successful and sustainable;
in association with others produce a short list of options acceptable
to all stakeholders;
in association with stakeholders prepare outline designs and both
capital and recurrent costs for each option, followed by detailed
designs, costings, and materials lists for selected options;
provide supervision and advice during the implementation of the
project;
support long-term sustainability and replicability by arranging
training for local technical personnel and organizing the
management of operation and maintenance;
monitor project implementation and evaluate on completion; and
disseminate lessons learned to improve future projects.
See Chapter 3 for further details.
Sanitation practice
2.7.20 On-site sanitation
WaterAid/Jim Holmes
2.7
(Recommended reading for information on the design and construction

of on-site sanitation are Franceys, Pickford and Reed (1992) and
Cotton and Saywell (1998b).)
Plot size and building design for pit latrines
In urban areas, small plot size is frequently given as a reason for

discounting the use of pit latrines. The evidence shows, however, that
Cultural considerations for location of toilets and
design of plots, India
A slum area in Vijayawada, Andhra Pradesh, India, had been upgraded but the
community were not using the new toilets provided on their house plot. This
was not immediately apparent to outsiders, but when a local woman resident
was asked by a speaker of the local language (Telegu) if there were any
problems with the recent developments, she explained that most of the
residents had not been using the toilets provided. The reason she gave was
that the toilets are located on the north-east corner of the house plots, and
according to Hindu astrology this is a bad place to locate the toilet. The northeast corner is preferential for items such as the water source, the prayer
room or the main door. Toilets should be located at the south of the plot. As a
result, many residents do not use the toilets provided, and go to the edge of
the upgraded area to defecate in the open areas.
House, Smith and Smout, 1997
182
Some misconceptions
surround the design and
applicability of pit latrines,
the most common solution
to the sanitation problems
of the poor. Lack of space,
for example, is rarely a
governing factor. If there is
space for a toilet room there
is space for a pit latrine;
pour-flush types are
suitable for use inside
buildings, including multistorey buildings. Nor, with
correct but minimal
horizontal separation, do
they pose threats to
groundwater sources and,
where risk is identified,
another source is generally
a cheaper option than a
piped sewerage system.
in most low-income housing areas this is not a valid reason. A pit

latrine requires little more than one square metre of land and even the
most densely populated areas usually have that much land available
on the plot outside the house. If the property has sufficient land to
construct a toilet room then it has enough room for a pit latrine, as the
pit can be constructed beneath the toilet.
In many parts of Asia, pour-flush latrines are constructed with the pit
immediately outside the property. The toilet building is constructed
adjacent to the boundary wall and connected to a pit or pits built
under the footpath immediately outside. There are very few situations
in urban Africa where housing density is so great that a pit latrine
could not be built. Constructing a pit latrine inside the house is not
always recommended, but there are examples of indoor pit latrines
which work well, and in Lamu (Kenya) they have been used for
hundreds of years. Pour-flush latrines are a particularly suitable way
of meeting demand for low-cost indoor latrines, including in multistorey buildings.
Groundwater pollution
Potential pollution of the groundwater is another common argument

against pit latrines. Again, it can easily be overstated. In general,
provided a pit latrine is located more than ten metres horizontally
from a groundwater source such as a spring or well, there is little
chance of source pollution (Lewis, Foster and Drasar, 1980).
Even if technical advisers identify a possibility of cross pollution, it
will often be more economic to find an alternative water source than
to opt for a more expensive sewered alternative to a pit latrine.
Control of smell and flies
Designs exist too that

overcome the often-quoted
problems of smells and
flies, provided the facilities
are respected and
maintained.
Another common reason given for not promoting pit latrines is that
they smell or are filled with flies. User surveys, however, show that
these do not have a serious effect on satisfaction with improved
latrines such as SanPlats and VIPs (Cotton and Saywell, 1998b), and
the problems are less than in unimproved latrines. Flies are attracted
to pit latrines because of the presence of a food supply and a suitable
breeding site, and flies born in latrines are covered in faecal
organisms.
WEDC/Darren Saywell
All latrines give off some odour. Whether that odour is objectionable
or not depends on the experience and background of the user. If the
contents are more than a metre below the latrine floor, there will
normally be no objectionable smell.
Where flies and odour are a problem they can be controlled relatively
simply; a simple stopper in the latrine hole will often be sufficient. In
more difficult cases the installation of a ventilation pipe will usually
eliminate the problem. Pour-flush latrines should not have fly or
odour problems. It is important to keep all types of latrines clean to
prevent the slab or pan and surrounds becoming the sources of fly and
odour problems.
183
2.7
Emptying latrines
Latrine emptying is a
practice best avoided
unless absolutely enforced
by local conditions, usually
as a result of space
restrictions in urban slums.
Rural areas do not often
suffer in that respect; pits
may then be cheaply
constructed, used once,
and abandoned. A higher
standard of construction is
needed when pits have to
be emptied. There are no
convenient or hygienic
solutions although twin pits
alternately used may slightly
reduce the health risks and
obnoxious nature of the
task. Risks continue at the
disposal stage the safest
option is a sewage
treatment works, otherwise
burial.
2.7
The golden rule when it comes to pit-latrine emptying is: if possible,

dont. Unless properly managed, using the correct equipment, pitlatrine emptying is a highly hazardous procedure. It requires the
handling and movement of fresh excreta, exposing the operators and
general public to unhealthy and unsightly conditions.
In rural areas there should be no need to empty a pit latrine. Sufficient
land is usually available that when a pit is full (the contents are within
half a metre of the surface) a new one can be constructed. It is only in
urban areas where land for new pits is unavailable or specific ground
conditions occur that it is necessary to consider emptying pit latrines.
The need to empty latrines impacts on their design. Pits that are
abandoned when full can be constructed of poorer quality materials
since they will only have to last a limited time. Pits that are to be
emptied must be made of more durable materials and the pit itself
must be fully lined to withstand the suction forces. One approach is to
construct twin-pit latrines. Because there are two pits that are used
alternately, the contents of one pit do not have to be emptied until the
other pit is also full. This allows time for the disease-causing
organisms in the excreta to die off, making it harmless to handle.
However, it is rare to find twin-pit latrines used correctly, and they are
much more expensive than simple pits.
The option of emptying by mechanical means (a slurry tanker) is
favoured by many local authorities because it reduces contact with
excreta and appears quicker than other options, but there are
problems. Tankers are very expensive to purchase and maintain and
they are frequently unable to negotiate the narrow roads and alleys of
urban slums. They also cannot remove large solid objects such as
stones, sticks, tin cans, and plastic bags. If they are to be used then a
strong promotion campaign is required to persuade the community not
to throw such articles into their pits.
Manual emptying is common in many parts of the world, though it has
little to recommend it. Workers, usually unprotected, dig or bucket out
the pit contents into a nearby hole or a small tanker that takes the
sludge away for disposal. Fresh excreta are invariably spilled on the
Latrine emptying technology
The two common techniques for emptying pit latrines are to manually excavate
with a bucket or to use a large vacuum tanker. The former is unhygienic and the
latter is costly and sometimes impractical. Alternative technologies have been
devised; for example the MAPET (Manual Pit Latrine Emptying Technology)
which has been used in Dar es Salaam. This technology builds on the
traditional method of hand emptying, but uses a piston pump with a flywheel
and a 200-litre vacuum tank, both of which are mounted on a handcart. The
equipment provides a low-cost solution in areas where latrines are inaccessible
to latrines.
Muller & Rijnsburger, 1994 and Waterlines Technical Brief No.54, 1997
184
surrounding ground and the workers are exposed to serious health

hazards. While the method cannot be condoned it has to be accepted
that it will continue to be used in some places. Making the practice
illegal is unlikely to work if a demand still exists. It is better to
remove the need for handling fresh excreta by installing twin-pit
latrines or, in the last resort, improve the conditions of the workers
and the tools they use, to minimize health risks.
Ultimate disposal of the sludge must also be considered. In the case of
twin-pit latrines this should not be a problem since the sludge is
harmless if the twin-pits are used as intended, and it can be deposited
anywhere. While not a good fertilizer, it has some beneficial qualities
and can be used as a soil conditioner. Fresh excreta must be disposed
of safely. Options include adding the sludge to the inlet of a local
sewage treatment plant, burying it, or mixing it with domestic garbage
(when this is disposed of hygienically!). Composting sludge with
other organic matter has been tried in a number of countries but is
rarely a success because of the level of management required to
operate the system successfully.
There are a number of designs for recycling human waste at the

household level (Winblad and Kilama, 1985). These have generally
been developed in North America and Europe and are not
recommended for developing countries because of their cost,
difficulties with operation, and maintenance and health hazards.
2.7.21 Sewerage options
If on-site sanitation is not
feasible the alternative of
piped sewerage need not
attract the high costs
inherent in systems
designed to the standards
and specifications of the
developed world.
Professional advice and
some caution should
govern deviations from
standards that are known to
protect infrastructure and
ensure trouble-free
operation but, with that
proviso, several cost-cutting
techniques can be used.
They include increased
spacing of access
structures and system
designs that allow
reductions in pipe sizes and
in the depths at which they
are laid.
(For further information on low-cost sewerage options, recommended

reading includes Reed (1995) and Mara (1996).)
For areas where on-site sanitation is no longer a satisfactory option,
the only realistic alternative is sewerage. While traditional sewerage
schemes have relatively high capital and running costs, lower cost
solutions have been adopted in some communities. The main
sewerage options are:
conventional sewerage;
simplified sewerage;
condominial sewerage; and
an interceptor tank system.
A sewerage system is a series of underground pipes collecting and
transporting excreta and household sullage to a point of discharge (a
septic tank, natural watercourse, or treatment plant). The fixtures and
fittings required include: sewer pipes, household connections, grease
traps, interceptor tanks, and access chambers.
The cost of a system can be significantly reduced by limiting the
number of fittings: for example, access chambers which are rarely
used can account for 25 per cent of the capital cost of a system (Reed,
1995). Simplified sewerage systems are modified versions of
conventional sewerage design and are built to reflect the local
environment and customer affordability. This may involve reducing
185
2.7
Table 2.7.4 Options for excreta disposal

Excreta
system
Water required
for operation
(litres per
person per day)
Technical
skills for
construction
Skills
needed for
O&M
Relative
construction
(cost per
person)
Relative
O&M
(cost per
person)
Institutional
dependency
Simple pit
nil
similar to local
housebuilding
cleaning only
promotion
only
Pour-flush
5-25
ditto
ditto
1.1
1.1
promotion and
minor education,
pit emptying
service
Twin-pit pourflush
20-30
ditto
Changing and
emptying pit
every 2 yrs
1.2
promotion,
education and
minor ongoing
technical
support
VIP pit
nil
some
additional
skills required
cleaning only
promotion,
education, and
technical support,
pit emptying
service
Twin-pit VIP
nil
ditto
Changing and
emptying pit
every two
years
promotion,
education, and
ongoing
technical
support
On-site septic
tank*
5-40
some
additional
skills required
periodic tank
emptying
15-25
2-3
Design,
construction,
emptying
Conventional
sewerage*
>100
considerable
additional
skills required
regular
maintenance of
sewers and
operation of
treatment plant
20-70
10
Very high
Simplified
sewerage*
>100
ditto
ditto
10-60
10
Very high
Sewered
interceptor
tanks*
2-20
ditto
ditto plus
emptying
interceptor
tanks
5-70
depending if
interceptors
already
existing
10
Very high
Condominial
sewerage*
> 75
ditto
regular
maintenance of
sewers and
operation of
treatment plant
10-50
10
Very high
2.7
Note: * These options require a reliable water supply.
186
Costs are indicative and need to be related to local unit costs.
minimum pipe diameter to 100mm and minimum collector gradient to

1 in 220, increasing spacing between access points, and postponing
construction of treatment works.
Condominial sewerage, which has been used extensively in Brazil,
involves the laying of collector sewers at the rear of properties close to
the point of waste generation. This unconventional layout reduces the
length and depth of house sewers and also minimizes the amount of
pumping required. The maintenance of condominial sewers is the
responsibility of the community, and the housing block will generally be
required to pay all the construction costs. The total cost of condominial
sewerage is about half the cost of a conventional system, and it may be
cheaper than on-site systems at high population densities (Mara, 1996).
An interceptor tank system relies on the settlement of solids near the

point of generation. This allows the sewer network to be designed for
a much reduced peak capacity: the minimum sewer diameter can be as
little as 40mm. This type of system evolved from the need to sewer
communities with individual septic tanks, but some systems have
been specifically designed to function in this way. It is estimated that
costs can be up to 75 per cent cheaper than conventional sewerage
where interceptor tanks already exist.
The choice of sanitation
system should take full
account of its technical
complexity and operation
and maintenance needs in
relation to the available
skills and local institutional
capacity.
Caution in this respect
takes on added
significance if sewage
treatment is contemplated.
There are too many nonfunctioning treatment
plants in the developing
world, memorials to wasted
investment and
inappropriate technology
transfer. The lesson is that
the large-scale, high-tech
facilities of the West are not
sustainable in regions
where human and financial
resources are severely
limited.
Table 2.7.4 summarizes the range of options available for excreta

disposal as discussed above. The column headings attempt to combine
the principles in a way that is easy to use and non-technical.
The columns on capital and operating costs are used to bring in
considerations of affordability, sustainability, and replicability.
Institutional dependency data can be compared with the strength of
local institutions. A technology with a high institutional dependency
in an area with weak institutions is unlikely to be sustainable.
Information on skill levels will help in deciding the level of
community or family involvement in construction and operation.
Technologies with high skill requirements will tend to require external
inputs which will have to be paid for. This too will impact on
sustainability and replicability. Water for operation links excreta
disposal to water supply. Disposal systems that use a lot of water will
require a high level of water supply service. Note too that though
some latrines are described as requiring no water for operation,
hygiene considerations mean that water for cleansing after defecation
should be conveniently available.
2.7.22 Sewage treatment
In Section 2.7.12, the factors to consider when thinking about the

implementation of a sewage treatment scheme were discussed. It is
not a straight-forward decision. Most sewage treatment facilities in
most developing countries do not work. This is often because most
technologies for sewage treatment are big, centralized schemes which
have been developed in Northern temperate climates, where adequate
financial, material, and human resources are available. Transferring
these technologies to tropical low- and middle-income communities is
187
2.7
Figure 2.7.6. A schematic cut-away view of a sewered interceptor system
2.7
Figure 2.7.7. Condominial sewer layout in Petrolina, Brazil
188
fraught with potential difficulties. However, there are some sewage

treatment options which are more appropriate to developing country
scenarios. Such systems should generally be low cost, have low
operation and maintenance requirements, and maximize the use of the
potential resources (principally, irrigation water and nutrients).
Sewage treatment options may be classified into groups of processes
according to the function they perform and their complexity:
Preliminary includes simple processes such as screening (usually by
bar screens) and grit removal (through constant velocity channels)
to remove the gross solid pollution.
Primary is usually plain sedimentation simple settlement of the

solid material in sewage can reduce the polluting load by significant
amounts.
Secondary applies to further treatment and removal of common
pollutants, usually by a biological process.
Tertiary is usually for the removal of specific pollutants, e.g.
nitrogen or phosphorous, or specific industrial pollutants.
Preliminary and primary treatment are common to most sewage
treatment works, and are effective in removing much of the gross
pollution. There are many different types of secondary processes, and
the most common are described in Table 2.7.5, with brief comments on
their suitability for low- and middle-income countries. Tertiary
treatment processes are generally specialized processes which are
beyond the scope of this manual.
For further information on sewage treatment options, the reader is
guided to standard texts such as Metcalf and Eddy (1994) and Mara
(1976).
The majority of secondary treatment processes are biological in their
nature that is, they use the activity of bacteria to break down
polluting material. Much of the polluting material is organic waste
(such as faeces). Biological treatment processes can themselves be
divided into two general sub-divisions aerobic and anaerobic
processes. With aerobic processes, bacteria use oxygen to feed on the
organic material (which is a food source) to produce carbon dioxide
and water, with the production of large quantities of extra bacterial
mass (sludge). Most aerobic processes require the mechanical addition
of oxygen to the process, which is expensive. In addition the sludge
material requires disposal itself, which is often a very significant
problem. Anaerobic processes take place in the absence of oxygen, and
the bacteria break down the organic wastes to produce carbon dioxide
and methane. This mixture of gases is often called biogas and can
potentially be harnessed as an energy source. An additional advantage
of anaerobic processes is that they produce much less excess sludge
than aerobic processes. The major disadvantage is that the treatment
efficiency is not as high as it is for aerobic processes. Some processes
are a mixture of aerobic and anaerobic.
189
2.7
Table 2.7.5
2.7
Options for secondary sewage treatment (*indicates processes more suitable for
developing countries)
Treatment process
Description
Key features
*Land treatment (soil

aquifier treatment
SAT)
Sewage is applied in
controlled conditions to
the soil
Soil matrix has quite a high capacity for treatment of normal domestic
sewage, as long as capacity is not exceeded. Some pollutants, such
as phosphorus, are not very well removed. Can be used as a method
of recharge of aquifers.
*Reed beds (or

constructed
wetlands)
Sewage flows through

an area of reeds
Treatment is by action of soil matrix and particularly the soil/root

interface of the plants. Requires significant land area, but no
oxygenation requirement.
*Waste stabilization
ponds (WSP)
(lagoons or
oxidation ponds)
Large surface area

ponds
Treatment is essentially by action of sunlight, encouraging algal

growth which provides the oxygen requirement for bacteria to oxidize
the organic waste. Requires significant land area, but one of the few
processes which is effective at treating pathogenic material. Natural
process with no power/oxygen requirement. Often used to provide
water of sufficient quality for irrigation, and very suited to hot, sunny
climates.
Aerated lagoons
Like WSPs but with

mechanical aeration
Not very common oxygen requirement mostly from aeration and

hence more complicated and higher O&M cost.
Oxidation ditch
Oval-shaped channel
with aeration provided
Has more power requirement than WSPs, but has much reduced land
requirement, and not as difficult to control as processes such as ASP
(see below)
Rotating biological
contactor (or
biodisk)
Series of thin
vertical plates which
provide surface
area for bacteria to
grow.
Plates are exposed to air and then the sewage by rotating with about
30% immersion in sewage. Treatment is by conventional aerobic
process. Used in small-scale applications in Europe.
Trickling (or
percolating) filters
Sewage passes down

through a loose
aggregate bed
bacteria on aggregate
treat sewage
An aerobic process in which bacteria take oxygen from the

atmosphere (no external mechanical aeration). Has moving parts,
which often break down in developing-country locations.
Activated sludge
process (ASP)
Oxygen is mechanically
supplied to bacteria
which feed on organic
material and provide
treatment
Sophisticated process with many mechanical and electrical parts,

which also needs careful operator control. Produces large quantities
of sludge for disposal, but provides high degree of treatment (when
working well).
*Upflow Anaerobic
Sludge Blanket
(UASB)
Anaerobic process
using blanket of
bacteria to absorb
polluting load
Suited to hot climates. Produces little sludge, and no oxygen

requirement (no power requirement) but does not produce as high
a quality effluent as processes such as ASP.
Note: Other anaerobic processes exist, but UASB is the most common at present.
190
Table 2.7.6
Source selection for water supply
Source
Yield features
Abstraction
requirements
Advantages/
benefits
Risk factors
Likely
treatment
requirements
Rainwater
harvesting
Variable and
unlikely to meet
demand. Useful
as a household
supplement
Catchment structure
(e.g. roof) and
storage facilities
Simple to
implement and
low cost
Seasonal supply
only
Depending on
catchment, may
need
Disinfection,
sedimentation
Lake or pond
Depends on size
yield may
diminish during
dry season
Intake structure and

pumping equipment
Generally easy to
locate and assess
Difficult to protect
source from
contamination by
humans and
livestock, so
bacteriological
quality is poor.
Fluctuations in level
may cause
abstraction problems
Sedimentation,
filtration, and
disinfection
Lowland river or
stream
Large river flows

are normally
stable. Some
rivers dry up in
dry season
Intake structure and

pumping equipment
Generally easy to
locate and assess
Need to protect
upstream
catchment and
ensure adequate
downstream flow.
Fluctuations in level
or changes in
channel profile
may cause
abstraction problems
Sedimentation,
filtration, and
disinfection
Highland river or
stream
May be
seasonal
Gravity flow through

piped supply with
diversion structure
No pumping
costs, good
quality for surface
water
Source may be
inaccessible.
Protection from
moving boulders
required. Upstream
catchment may
also need
protecting
Disinfection.
Higher turbidities
may also need
sedimentation/
filtration
2.7
Spring
May be
seasonal or may
move location
Gravity flow through

piped supply with
spring box or
protected spring
High-quality water,
no pumping
required
Spring may be
inaccessible or
require long
pipeline to point of
delivery
Disinfection only
Shallow well
Depends on
aquifer, depth of
well
Hand-dug well,
caisson well or
drilled/jetted well.
Range of lifting
devices from
windlass and bucket
to handpump to
electric/diesel
pumps
Better quality than

surface water.
Flexibility with
lifting
arrangements
potential for
upgrading
Groundwater may be
difficult to locate or
access
Disinfection.
Higher turbidities
may also need
sedimentation/
filtration
Deep borehole
Can be high
depending on
aquifer. Not
normally
affected by
seasonal
variations
Submersible
pumps, borehole
housing and
transmission system
High quality water,

well-protected
from
contamination,
potentially high
reliable yields
Difficult to locate
water extensive
data or field tests
required. Cost of
drilling high and
requires specialist
equipment. Water
may have high
mineral content/
poor taste
Disinfection and
possibly aeration
and
sedimentation or
filtration
191
Waste stabilization ponds

are the only sewage
treatment process to make
a significant reduction in
transmission of diseasecausing agents at a
reasonable cost.
As stated previously, the requirement in most low-income countries is

for a low-cost, low-maintenance sewage treatment system. Waste
stabilization ponds (WSPs) provide the best option in most cases
good levels of treatment at low capital and particularly low O&M
cost. In addition, it is one of the few processes which provides good
treatment of pathogenic material. This has significant application
potential for the re-use of the treated effluent in irrigation. The major
disadvantage is that significant areas of land are needed for treatment.
WSPs are used in many locations worldwide, including Africa and
Asia.
Anaerobic processes, especially the upflow anaerobic sludge blanket,
are receiving more attention as suitable treatment options for
developing countries. They have the advantage of having no oxygen
input requirement (unlike aerobic processes) and hence low O&M
costs, and they produce low quantities of sludge for disposal which
can be a significant advantage. They are suited to hotter climates as
the anaerobic bacteria like warm temperatures. The major
disadvantage is that the treatment capacity is limited and their role is
often as a roughing treatment to be followed by a polishing stage to
remove pathogens.
However, any sewage treatment plant needs significant investment
and O&M and control, and therefore any decision to implement such
a facility should be carefully considered.
Water supply practice
2.7.23 Source selection
The Table 2.7.6 provides guidance on source selection for rural and
urban water supply systems. It can serve as an initial checklist, but for
detailed information the relevant texts listed at the end of this section
should be referred to. Source assessment should be carried out by an
experienced hydrologist or hydrogeologist.
2.7
For further guidance on source selection, see Emergency Water

Sources, House & Reed, 1997 and Small Community Water Supplies,
IRC Technical Paper No.18, 1983.
Using groundwater has many advantages - it is pathogen free, non
turbid and drought resistant. However, there are disadvantages
including non uniform distribution, extraction costs and remediation
difficulties if problems occur.
There are risks associated with groundwater usage and understanding
and data are required to reduce those risks. In any groundwater
development project it must be accepted that some boreholes or wells
will not find water.
Not all rocks contain water in useable quantities and those that do
hold it in different ways. In sands, gravels and sandstones the water
lies in the intergranular pore spaces throughout the rock which may be
192
sub-divided into near horizontal layers or aquifers. Harder, crystalline

rocks such as limestones, granites and gneisses are generally not
porous but are often fractured and these can contain water.
Unfortunately fractures can be of variable spacing and aperture so
prediction of storage capacity can be problematic.
To overcome and minimise the associated risks a hydrogeologist
would map and characterise all potential aquifers in a project area.
This is done by adopting a structured and logical investigation which
could involve the analysis of satellite images or aerial photographs,
and by carrying out geophysical surveys to record the electromagnetic,
resistivity or seismic properties of the area. Interpretation of these
data should help to lower the risk when physical groundwater proving
is done by drilling or well digging.
For all projects but especially low budget ones a vital source of data is
local knowledge of groundwater occurrences together with a
vegetation survey. Because of the potential complexities groundwater
development is often remote from community development but such
surveys can involve recipients as would the use of Low Technology
Drilling Methods which can also increase the skills base.
Low-technology drilling methods
Low-technology drilling methods (LTDM) are simple drilling methods that can
make boreholes suitable for handpumps in unconsolidated and weak rocks.
A variety of drilling techniques fall into this category including:
percussion;
augering;
jetting; and
2.7
rotary.
The key aspects of all these methods, however are as follows:
They are simple and easy to use by local artisans after limited training.
They are lightweight and able to be carried by hand or small vehicles to
remote locations.
They are robust and easy to maintain.
The purchase and operating costs are low.
They involve community members in the drilling process.
A long-term aim is that the equipment should be able to be manufactured and
maintained in-country. The designs should not prevent anyone from being
involved and they should be a means of skill transference.
Examples are the Vonder Rig (auger) made in Zimbabwe and the Eureka porta-rig (mud rotary) made in th UK, but there are many others.
Elson and Shaw, 1995
193
2.7
Figure 2.7.8. Hand-auger drilling
2.7.24 Choice of treatment

Commonly used treatments
The water treatment process that is eventually selected will clearly
need relatively high skill
levels for operation and there depend on the quality of the water source to be used. There may be
limitations due to the availability of chemicals, lack of skills or
may be recurring costs for
supervisory staff, cost, and so on. The desired end quality of the water
chemicals such as chlorine
should be appropriate to the situation, thus WHO or EC drinking
(hypochlorite) for
water standards may be too arduous to attain in certain situations. The
disinfection. Professional
range of water treatment processes available to an engineer is
advice is essential to
determine quality objectives, summarized in Table 2.7.7, together with an indication of the O&M
treatment options, and plant skills and costs associated with each process. The design of an
appropriate treatment process should be done by an experienced
design, and in the selection
engineer. Further information on treatment processes is available in
and assessment of the raw
the references at the end of this section.
source.
194
Table 2.7.7
Water treatment processes for potable water
Treatment process
Description
Action on water
Screening
Physical filtering using a metal screen
Removes large floating particles
Infiltration
Filtering water through natural material e.g. river bank Removes some turbidity and has screening and antibacteriological effect
minimal
Roughing filtration
Horizontal or upflow through designed filtration bed
Reduces turbidity and removes some bacteria and

pathogens
low
Sedimentation
Separation of smaller particles by settlement in a

tank
Removes suspended particles and some bacteria

and pathogens
low
Sunlight
Exposure to sunlight radiation
Kills most bacteria in uncovered tanks
none
Assisted
sedimentation
Separation of smaller particles by adding chemical

coagulant to form flocs
Removes turbidity, some bacteria and pathogens,

and can remove some chemical contaminants
high
pH adjustment
Chemical adjustment of acidity/alkalinity
Modifies pH to required level
high
Pre-chlorination
Initial chlorine dose to assist sedimentation/rapid

filtration
Kills bacteria and algae to improve sedimentation or

filtration
medium
Aeration
Introduction of oxygen into water
Removes iron and manganese to reduce taste or

colour problems
medium
Slow sand
filtration
Water is passed down through a designed sand-bed Removes 99% of bacteriological contaminants and
turbidity
under gravity
Rapid sand
filtration
Water is pushed down through designed sand-bed

under pressure to speed up process
Removes some bacteriological contaminants and 5090% of turbidity
high
Disinfection
Chlorine is added to water in regulated dosage
Appropriate dose of 2mg/l after 30 minutes contact

time will kill bacteria and most viruses but not cysts
medium
Significant technical input is

also needed in designing
and costing supply
infrastructure. Careful
comparison of options on
pipe/pump characteristics
is particularly important
where high pumping heads
are involved.
As always designs and
costs must aim to meet the
various levels of service
demanded by users.
O&M skills
minimal
medium
Detailed information on treatment processes can be found in Water

Supply by Twort et al., 1994 or Water and Wastewater Technology,
Hammer and Hammer, 1996.
2.7
2.7.25 Water transmission and distribution systems
The complexity of the water supply transmission and distribution

systems provided will depend on a range of factors, including the
location and quality of the source, the levels of service demanded by
the community, available capital expenditure, predicted future
demand, availability of equipment, local capacity for construction,
operation and maintenance, and so on. The broad range of supply
options is shown in Table 2.7.8. Detailed design of water supply
systems is well covered in Twort et al. (1994), IRC Technical Papers
14 and 18 (1979, 1983), and Jordan (1984).
Table 2.7.9 outlines the wastewater drainage requirements. The
drainage requirements are directly related to the water supply level of
service, as outlined in Table 2.1.1.
When designing a new water supply or sanitation system and its
component parts, the preferred choice is usually the least-cost option
for delivering the required level of service. In order to design the
optimum least-cost system it is important that both the capital and
recurrent costs are taken into account for each option. In terms of a
rural water supply scheme this may mean weighing up the benefit of
195
Table 2.7.8
Options for rural water supply
Supply system
Skills required
for
construction
Skills
needed for
O&M
Relative per
capita
capital cost
Relative per
capita
O&M cost
Institutional
dependency
Hand-dug wells
Usually locally
available
minimal
1-2
1-2
promotion and
construction
Borehole with handpump
medium
medium
5-10
2-3
high
Protected spring
low
low
low
Rainwater catchment
(including surface)
medium
low
5-15
low
Pipe network to communal

standposts
high
high
10-15
20-25
high
Pipe network with yardtaps
high
high
30-50
40-60
very high
Notes:
1. Costs are indicative and need to be related to local unit costs

2. Comparisons for urban supplies are more difficult because a number of source types and distribution systems may be combined
3. Surface water sources are excluded because of the range of technologies and costs possible, depending on the source.
Table 2.7.9
Options for wastewater drainage from waterpoints and domestic premises
Disposal system
Technical skills
for construction
Skills required
for O&M
Relative
construction
cost per
person
O&M cost
per person
Water
disposal
capacity
Surface infiltration
nil
nil
nil
nil
low depends nil

on land area
and soild
impermeability
Sub-surface
infiltration
similar to local
house building
cleaning
grease trap
low depends nil

on land area
and soild
impermeability
Surface water
drains
some
additional skill
required
routine
maintenance
10-100
10-50
depends on
drain size
construction
and O&M
Sullage drains
some
additional skill
required
routine
maintenance
10-20
10-20
depends on
drain size
construction
and O&M
Sewers
See sewerage
in Table 2.7.5
2.7
Notes:
196
Costs are indicative and need to be related to local unit costs

Surface infiltration is not usually recommended because of the environmental and health risk of ponding
Institutional
dependency
Table 2.7.10
Selection of pipe material
Pipe material
Typical range of
diameters
Cast iron
150-600mm
Typical
maximum
working
pressure
(bar)
25
Typical usage
Disadvantages/Constraints
Old transmission mains. Still

used for fittings for asbestos
cement pipes
Very brittle. No longer widely

available or popular
Ductile iron
150-1600mm
25
Transmission and distribution

pressure pipelines.
Expensive for diameters
>1000mm
Corrosion protection required:

plastic sleeve externally and
bitumen or cement-mortar lining
Galvanized mild
steel
15-150mm
10
Small diameter service

connections
Not suitable for high pressure/

large diameter pipes. Needs
corrosion protection if used
underground
Steel
400-2130mm
40
Cost effective for larger

diameter pressure mains
Very susceptible to corrosion if

not adequately protected. High
degree of skill needed for joint
welds. Bedding design also
important
Asbestos cement
150-900mm
12.5
Widely manufactured and

used in developing
countries. Used for
underground transmission
mains and sewers
Good bedding design required,

pipes are brittle. Health hazard
from dust when cutting pipes
Pre-stressed
concrete
400-1500mm
12
Pumping trunk mains and

sewers
Pipes are heavy. Susceptible to

chloride/sulphide attack
Specially manufactured joints are
required
GRP
400-1800mm
16
Good in corrosive
environment used for
trunk mains and sewers. Very
light for handling
Manufacture is difficult and

limited experience makes
construction difficult
uPVC
80-600mm
15
Service connections and

distribution mains (low
pressure)
Susceptible to fracture problems

and degrades in sunlight
MDPE
20-600mm
12
Service connections and

distribution mains (low
pressure). Light and easy to
transport in coils (small
diameters only)
Only suitable for lower pressures

Strength of pipe decreases with
time and with low temperatures.
HDPE
20-600mm
25
Pumping mains and sewers,

transmission and distribution
Higher cost than MDPE but

stronger and more durable.
Larger diameters have lower
pressure rating
Note: Other materials such as copper, lead, bamboo, vitreous clay, and wood are also sometimes used for distribution pipes.
197
2.7
purchasing a more expensive handpump initially, which will have

lower maintenance costs than a cheaper one. Note however that this
choice must be made not just on cost grounds, but also considering
ease of maintenance at village level.
This issue becomes much more complex for urban piped supplies and
needs a rigorous approach. If a system involves a significant amount
of pumping, the capital cost of the pipe needs to be optimized against
the long-term cost of pumping: that is to say, smaller diameter pipes
are cheaper, but have higher associated pumping costs due to high
friction losses. If the system has significant lengths of pipeline, this
may be the single highest cost component and it is therefore important
that the most appropriate pipe material and diameter are carefully
selected. Table 2.7.10 gives an overview of the range of pipe materials
available and their different properties. The actual choice of pipe
material will depend largely on local conditions and preferences,
availability, relative costs, etc. The information in this table has been
gathered from a range of sources. Detailed information on particular
materials should be obtained from manufacturers.
2.7.26 Defining and costing different levels of service
The demand for different levels of service has been discussed a

number of times in this manual, but it is important to be clear about
the definition of each level of service and to understand the cost
implications. There is often confusion over the difference between
standposts (used by many households) and yardtaps (used by one
household and possibly their neighbours). Detailed cost estimates
should be prepared by engineers, based on local data and comparable
schemes wherever possible. A useful design guide is Public Standpost
Water Supplies: A design manual (IRC, 1979).
2.7
Table 2.7.11 Cost data from the Policies and Guidelines of Ugandas Water Development
Department for Rural Towns and Sanitation Program (1992)
System
Construction Cost
(USH 000 per capita)
O&M Cost
(USH 000 per capita per year)
Spring catchment
2-6
0.1-0.2
Hand-dug well and handpump
8-12
0.3-0.5
Drilled borehole and handpump
20-30
0.3-0.5
3-6
2-5
100-200
5-10
Piped supply to standpost

Piped supply to yardtap
SanPlat latrine
4-8
2.1
1-2
12-40
1-2
Septic tanks
100-150
3-5
Sewers
100-200
10-20
VIP or pour-flush latrines
198
Further reading
General technical

This book provides an interesting overview on policies and philosophy. Also
has useful chapters on practical procedures for environmental management,
water supply and sanitation, and people and institutions. Unfortunately it is
currently out of print.
Cairncross, S., Carruthers, I., Curtis, D., Feachem, R., Bradley, D. and
Baldwin, G. (1980) Evaluation for Village Water Supply Planning, Wiley,
Chichester.
Cairncross, S. and Feachem, R. (1993) Environmental Health Engineering in

the Tropics, 2nd edition, Wiley, Chichester.
Excellent text providing linkages between disease and engineering. Detailed
chapters on water quality, water treatment, excreta disposal, and wastewater
treatment.
Davis, J. and Lambert, R. (1995) Engineering in Emergencies: A practical
guide for relief workers, IT Publications, London.
Although intended for use in emergencies, this book has a lot of practical
information for engineers in the field. Particularly good on water source
development, drilling techniques, water storage, and pump selection.
Grover, B. (1983) Water Supply and Sanitation Project Preparation
Handbook, Volume 1: Guidelines, World Bank Technical Paper No.12.
Hammer, M.J. and Hammer, M.J. Jnr (1996) Water and Wastewater
Technology, 3rd edition, Prentice Hall, New Jersey.
2.7
WASH (1993) Lessons Learned in Water, Sanitation and Health: Thirteen

years of experience in developing countries, Water and Sanitation for Health
Interesting read for all water and sanitation engineers who want to do things
better it summarizes twenty lessons learned from the field which cover all
project phases from programme development to operation and maintenance.
Sanitation
Cotton, A. and Saywell, D. (1998b) On-plot Sanitation for Low-income Urban

Communities: Guidelines for selection, WEDC, Loughborough University.
Franceys, R., Pickford, J.A. and Reed, R.A. (1992) A Guide to the
Development of On-Site Sanitation, WHO, Geneva.
Mara, D.D. (ed.) (1996) Low-Cost Sewerage, Wiley, Chichester.
Pickford, J. (1995) Low-Cost Sanitation: A survey of practical experience,
IT Publications, London.
Reed, R.A. (1995) Sustainable Sewerage: Guidelines for community schemes,
199
Water supply
Cairncross, S. and Feachem, R. (1986) Small Water Supplies, Ross Bulletin 10, London
School of Hygiene and Tropical Medicine, London.
House, S. and Reed, R. (1997) Emergency Water Sources: Guidelines for selection and
treatment, WEDC, Loughborough University.
This publication has a great amount of detail on source assessment and water treatment
which would be equally applicable to non-emergency projects.
IRC (1979) Public Standpost Water Supplies: A design manual, IRC Technical Paper
No.14, IRC International Water and Sanitation Centre, The Hague.
IRC (1983) Small Community Water Supplies, 2nd edition, IRC Technical Paper No.18,
IRC International Water and Sanitation Centre, The Hague.
Excellent handbook for engineers planning and designing relatively small-scale water
supplies. Covers all aspects of water sources, treatment, transmission, and distribution.
IRC (1991) Partners for Progress: An approach to sustainable piped water supplies,
IRC Technical Paper No.28, IRC International Water and Sanitation Centre, The
Hague.
Jordan, T.D. Jnr. (1984) A Handbook of Gravity-Flow Water Systems,
Twort, A.C. et al, (1994) Water Supply, 4th edition, Arnold, London.
Classic text for water supply engineers covering the procurement, treatment, and
distribution aspects of public water supply systems. Not specifically written for
application in developing countries, but design data are applicable to urban or periurban projects.
Wagner, E. and Lanoix, J. (1969) Water Supply for Rural Areas and Small
Communities, WHO, Geneva.
2.7
WHO (1993) Guidelines for Drinking-Water Quality. Volume 1: Recommendations,

2nd edition, WHO, Geneva.
Other
Coburn, A., Hughes, R., Spence, R. and Pomonis, A. (1995) Technical Principles of
Building for Safety, IT Publications, London.
Dudley, E. and Haaland, A. (1993) Communicating Building for Safety, IT Publications,
London.
Snell, M. (1997) Cost-Benefit Analysis for Engineers, Planners and Decision-makers,
Thomas Telford, London.
Trew, J.E., Tarbet, N.K., DeRosa, P.J., Morris, J.D., Cant, J. and Oliff, J.L. (1995) Pipe
Materials Selection Manual, 2nd edition, WRc, Medmentham, Bucks, UK.
200
2.8
The provision of safe

sanitation facilities will only
improve peoples health if
the sanitation facilities are
well maintained and people
have good personal
hygiene.
A latrine provides the
primary barrier against the
spread of faecal matter.
This barrier is easily
breached by a dirty latrine
or if hand washing after use
does not become normal
practice.
A social marketing approach to hygiene

promotion and sanitation promotion
As we saw in Section 2.3, sanitation, along with good hygiene, acts as a

fundamental primary barrier to prevent faecal matter, the source of most
diarrhoeal pathogens, from spreading in the environment.
It is as important to enable people to change their hygiene behaviour
as it is to provide improved facilities. Practices which stop faecal
material contaminating the domestic environment are vital, especially
for children. The priorities in behaviour-change programmes are thus
likely to include hand-washing with soap after stool contact and the
safe disposal of stools (see Section 2.3.3).
According to Almedom et al. (1997),

Hand-washing with soap and water after contact with faecal
material can reduce diarrhoeal diseases by 35 per cent or more.
Using a clean pit latrine and disposing of childrens faeces in a pit
latrine can reduce diarrhoea incidence by 36 per cent or more.
This section looks at ways of encouraging safer hygiene-related
practices. It is based on a new promotional approach that draws on
social marketing, health communications, anthropology, and health
promotion. It emphasizes inclusion and builds partnership at all
levels.
Promotion of safer
practices will best be
achieved by new,
promotional communitybased, social marketing
approaches that seek out
and use the messages that
will motivate change. These
must be established and
used as the starting point to
inspire behavioural change.
Principles
The recommended approach differs from classic hygiene and
sanitation programmes because it places the consumer at the heart of
the programme. Instead of beginning in an office, programme design
begins in the community. Consultation actively involves the many
different groups in society and develops a shared agenda for action.
The process starts with data collection, to find out what target
communities need, want, and do. Appropriate interventions are then
negotiated with the health or engineering specialists and developed
into a strategic programme.
The approach works well in a participatory, village-by-village manner.
It is, however, most useful and cost-effective on a large scale, where
the intervention is first developed in a small-scale, participatory
manner, and then applied across regions or urban centres.
The promotional approach is not without contradictions. It is centred
on the users perspective, but it has a firm agenda. It uses
participatory methods but it is not wholly participatory. And there are
other contradictions to be addressed:
Faecal contamination of the environment may be the main cause of
preventable disease. This does not mean it will be the communitys
highest priority for change.
201
2.8
Though improved health is the programmes main objective, the

target communities are more likely to be interested in latrines and
hygiene for reasons of dignity and aesthetics.
Messages about potential health benefits are not effective at
motivating people to change their behaviour. Attractive, positive,
messages which appeal to peoples sense of dignity are often more
effective.
It is important to consider the implications of these and other
contradictions. The agendas and priorities of development workers
often differ from those of the communities with whom they work.
This problem is not specific to the promotional approach but is
inherent in much development work.
The promotional approach aims to make scant public health resources

work effectively and sustainably over large areas, and for large
numbers of people.
We will look at the principles of social marketing and hygiene and
sanitation promotion and then turn to the nuts and bolts of
implementation.
2.8.1
Getting the right messages
depends on first obtaining
detailed information of what
consumers know, do, and
want. Successful promotion
is then centred on two key
processes:
developing messages or
products that suit target
audiences; and
2.8
communicating the
messages in ways that
are appropriate,
attractive, and motivating.
Definitions
The following terms are used in this section:

Promotion seeks better health through encouraging behavioural
change. It puts consumers at the heart of programmes, ensuring
participation and partnership in programme development. The
focus of this section is on hygiene and sanitation promotion.
Social marketing uses marketing approaches to match available
resources with social needs. Social marketing may be applied to
service provision and use, the development and acceptance of
products, or the adoption of new behaviour. It can be product- or
behaviour-focused.
Consumer-orientation is fundamental to social marketing and
demands that social programmes respond to peoples perceptions
and aspirations.
Data collection is a systematic process of investigation and
collaboration with target communities to find out what they need,
do, and want, that provides information that is essential to
programme design.
Hygiene promotion encourages people to adopt safer practices in
the household to prevent sanitation-related disease.
Sanitation promotion is the marketing and promotion of
sanitation products and services.
The two key processes in hygiene and sanitation promotion relate to
the consumer. They are:
the development of messages or products that suit target audiences;
and
communicating these messages in ways that are appropriate,
attractive, and motivating.
202
What can social marketing achieve?

In Honduras, deaths due to diarrhoea decreased almost 50% following a
programme to educate mothers about the use of ORS.
Over six months of hygiene promotion with a pilot group in Lucknow, India, the
proportion of mothers washing their hands with soap after defecation went from
under a quarter to over a half.
It is used in industrialized countries in programmes to prevent heart diseases,
smoking, and AIDS, and to encourage the use of seat-belts.
In Indonesia, 85% of women now feed their child a mixed food with green
leaves, which has lead to a 40% improvement in the nutritional status of
children under two years of age.
A 30% decline in infant mortality was achieved through the promotion and
marketing of ORS in Egypt.
44% of men in Bangladesh discussed family planning with their wives
within 12 months of campaign launch. Contraceptive prevalence increased by
10%.
adapted from Mehra, 1997
Social marketing offers a

staged, customer-focused
approach, converting
assessed user needs into
demand and then providing
the means of satisfying the
demand.
Hygiene promotion and sanitation promotion are both concerned with

facilitating behaviour change. Health education, social mobilization,
community participation, and central planning models have failed
more than they have succeeded. Marketing models provide an
alternative approach to behaviour change.
The promotional approach starts with the systematic use of data
collection to find out what consumers know, do, and want. The results
are used to develop concise, positive messages that address specific
health problems and to develop behaviour-change objectives that can
be monitored and measured by the project team.
2.8.2
Why hygiene and sanitation promotion programmes

need a social marketing approach
Lessons from hygiene education and sanitation programmes have

shown that:
When water and sanitation projects do not take adequate account
of individual and community behaviour the expected health
benefits are not fully realized.
In sanitation projects, goals have tended to focus on the number of
latrines constructed or the number of people given access to them.
The behaviours that determine whether new facilities bring health
benefits are rarely considered. These behaviours include handwashing, safe disposal of childrens excreta, personal and
household hygiene, food handling, and so on.
Hygiene and sanitation programmes have commonly been concerned
with the supply of education, and materials, rather than with
satisfying a demand from intended beneficiaries. Demand creation is
the main aim of commercial marketing. The social marketing
203
2.8
approach is demand led in that it uses a strategic, managed process of

assessing and responding to felt needs, creating demand and then
setting achievable and measurable goals.
Social marketing is a systematic approach to public health problems.
It goes beyond marketing. It is not motivated by profit alone but is
concerned with achieving a social objective. Social marketing is
therefore concerned with how the product is used after the sale has
been made. The aim is not simply to sell latrines, for example, but to
encourage their correct use and maintenance. The key components of
social marketing are:
systematic data collection and analysis to develop appropriate

strategies;
making products, services, or behaviours fit the felt needs of the
consumers/users;
strategic approach to promoting the products, services, or
behaviours;
methods for effective distribution so that when demand is created,
consumers know where and how to get the products, services, or
behaviours;
improving the adoption of products, services, or behaviours and
increasing the willingness of consumers/users to contribute
something in exchange; and
pricing so that the product or service is affordable.
2.8.3
2.8
Social marketing
programmes use data
provided by the target
audience to set promotional
objectives that satisfy the
particular demands of likeminded groups in the
audience. These objectives
may be the use of
sanitation products, or the
awareness of sanitation
services.
What happens in social marketing?
1. A sample of the intended audience, or consumers, are consulted and

questioned about their needs, wants, and aspirations. They collaborate
in the development of feasible, attractive solutions. This is Data
collection and is crucial to orienting the promotional activities (see
box below).
2. Achievable overall marketing (or promotion) objectives are
developed.
3. These data are analysed and used to develop an overall marketing
plan in collaboration with key stakeholders.
Data to collect for a latrine programme
How many households/neighbourhoods have inadequate sanitation facilities
or systems?
What do people perceive as good and bad sanitation?
What do people see as the advantages of latrines?
What type of system do women prefer?
What type of system do men prefer?
What are the characteristics they prefer?
How much do people pay and how much are they willing to pay?
204
4. The audience is segmented into discrete units with common

characteristics. This is based on an analysis of the initial data.
5. Products and messages are developed based on consumer
preferences and characteristics for the relevant segments. These are
tested among representative samples of target populations. How much
are people willing to pay for this product? How far are people willing
to travel for this service? How feasible is the new behaviour?
Products, messages, and price are modified, refined, and re-tested
until they are acceptable. Key stakeholders are consulted throughout
this process.
6. The product is launched or service introduced.
7. The performance of the product or service is monitored and

evaluated in the market and the strategy revised accordingly. This may
involve revising the marketing plan or improving the product or
service.
The four Ps of social marketing
The basic characteristics of

the social marketing
approach are the four Ps:
Product, Price, Place and
Promotion.
As in commercial marketing, the four Ps are the basic characteristics

of the social-marketing approach (see box below). A clear and wellresearched background to define each of these characteristics is
essential for the success of social marketing.
The four Ps of social marketing
Product
Decide on what is the product, its
form, format, and presentation in
terms of packaging and
characteristics
Examples
Price
Decide on what the consumer would
be willing to pay, both in terms of
direct and indirect costs and
perceptions of benefits: make the
product worth getting
Monetary or direct: Cost of products

(with or without subsidies), social cost
Opportunity/indirect: Time lost from
other activities, missed opportunities,
transport, loss in production or income
Psychological or physical: Stress in
changing behaviour, effort involved in
maintaining latrine or obtaining
additional water required
Place
Where will the product be available
to consumers, including where it is
displayed or demonstrated
Delivery of product: Tea shops,

builders yards and suppliers, clinics,
pharmacies, clubs, local businesses
Promotion
How the consumers will know the
product exists, its benefits, costs,
and where and how to get it.
Delivery of message: Television, radio,

newspapers, posters, billboards,
banners, folk singers or dramatists,
public rallies, interpersonal/counselling
Products: VIP latrines, SanPlats

Practice or behaviour: Wash hands
after using the latrine
Idea: Clean environment, good
sanitation for health
205
2.8
Target audiences or who the project needs to contact

Primary target audiences are those people who are carrying out the risk
practices, e.g. mothers and/or schoolchildren or, for a product-based
programme, those who take the decision to purchase particular goods.
Secondary target audiences are those who influence the primary audience
and who are in their immediate society, e.g. fathers, mothers-in-law.
There is a third target audience which is very important: people who lead and
shape opinion, e.g. schoolteachers, religious leaders, political leaders,
traditional leaders, and elders. These people have a major influence on the
credibility and hence on the success or failure of the programme.
2.8.4
Targeting
Targeting the audiences
For maximum efficiency of

resource use and impact in
the community, audiences
and unsafe practices must
be carefully targeted.
Promotion must
concentrate on the primary
users and on those who
influence them in the family
circle or the wider
community social
structures.
2.8
The targets for messages

on unsafe practices must
be those assessed as
having the greatest adverse
health effects.
Programmes are more effective if a small number of key messages are

focused to specific target audiences (see box above). This
concentrates resources and increases the chances that behaviour
change will result.
The community is made up of many different groups, or segments.
Each segment of the audience may need to be addressed separately,
e.g. house-to-house visits to reach mothers, street theatre to reach
fathers, and public meetings with a video show for opinion leaders. It
is also important to ensure support for the programme from partner
and collaborating agencies; they may also be an audience to target.
Data collection is important as it provides conditions for a shared
agenda. Through the process of consultation, the best communications
strategy for each segment can be developed.
Targeting the practices
Stools are the main source of diarrhoeal pathogens. Practices which

stop faecal material contaminating the domestic environment are vital,
especially for children. The priorities for public health in behaviourchange programmes are therefore likely to include hand-washing with
soap after stool contact and the safe disposal of stools, especially
childrens stools, preferably in latrines.
Potential risk practices need to be documented and their frequencies
assessed. Practices which occur often and which allow faecal material
into the domestic environment are likely to be candidates for
behaviour change. The final target practices, to replace the risk
practices, are developed in collaboration with target audiences.
Communicating messages
Messages should bolster

those aspects of the
desired practice that users
see as advantageous. The
messages must not dwell
on negative aspects of
current practices.
206
Messages about child diarrhoea, doctors, and death are more likely to
repel target audiences than to encourage behaviour change.
Message positioning involves the selection of positive values that the
primary target audience associates with the target practices. For
example, if the data collection shows that using a latrine for stool
disposal is valued for self-respect and dignity, then the messages
should reinforce this existing positive value of hygiene.
The data to inform the message-positioning decision can be collected

in three ways:
1. Interview people who already use the safe practices.
2. Carry out focus group discussions.
3. Interview people after they have tried the safe practices for a few
weeks.
Communications strategies are then built around these positive values,
e.g. hand-washing with soap makes your hands smell good.
With a simple questionnaire it is possible to find out what social
groupings exist and what access people have to information, e.g.
whether people listen to the radio and when, whether people read
papers, which papers they read, who goes to the weekly market, etc.
In focus groups it is possible to identify which channels are seen as

most suitable and attractive for hygiene messages.
2.8.5
Seek and take
opportunities to enlist
leaders from all sectors and
at all levels of society to
play an active part in
promotional activity.
Broadening the active
stakeholder base increases
the sense of consumer and
community involvement
and helps to spread the
message more widely.
Political will
Sanitation and hygiene improvements require political will and

support. Programmes will benefit if social, cultural, and political
leaders are motivated and given an active role (mobilized) such as:
religious leaders actively supporting the campaign for sanitation; or
schoolchildren and teachers playing a leading role.
A partnership approach to promotion does not assume ignorance on
the part of the people. It is less top-down and develops, and works
from, a shared agenda. It widens ownership of the programme by
increasing the number of stakeholders who are actively involved from
the start. These additional stakeholders not only provide their
endorsement (thus widening the appeal of the initiative) but also
accept increased responsibility for implementation.
Advocacy creates partnerships with government and NGOs. It
operates on many levels: everyone from the head of state to local
government leaders should become aware of the importance of the
programme (see box on following page).
2.8.6
Good communication
stems from accurate
identification of the routes
best suited to reach
individual target groups.
Integrate a mix of routes
into a promotional strategy.
Use as wide a range of
communication routes as
possible and use training to
improve all aspects of
promotional output.
Programme communication
Programme communication covers identification, segmentation, and

channelling. First of all, the communication channels used by target
groups are identified. Then a mix of channels of communication is
devised to combine reach and cost-effectiveness. Specific groups/
consumers are reached through:
strategies and messages for safe sanitary and hygienic practices;
various mass media and interpersonal channels; and
improved fieldworker and supervisor training methods.
This process binds advocacy and programme communication together.
It makes the programme a priority for the society as a whole and not
just the concern of a government department, a programme manager,
or a donor.
207
2.8
Strategies and agents for advocacy

Main strategies
National conferences, speeches, special events, seminars, field visits, letters,
directives, news coverage, articles, TV and radio general programming, and
special publications
Main targets-cum-agents
Media:
press institutes, journalists forums, TV and radio
Political:
president, prime minister, ministers, parliamentarians, political
parties
Administrative: cabinet secretary, secretaries, commissioners, project
directors
Donors:
UNICEF, USAID, JICA, WHO, and others
NGOs:
NGO umbrella groups and major NGOs, service clubs, and
voluntary societies
Political leaders, opinion leaders, social groups, the media, celebrities, and
donors should be the focus of advocacy. The aim is to turn these people into
advocates themselves voices who will take the opportunity to speak through
their own channels of influence in their own words. Advocacy must change
according to progress in the programme.
Programme communication strategies include:

Interpersonal communication training: Strengthen the ability of
government and NGO fieldworkers to reach potential latrine
adopters and to promote sanitation and hygiene. Address
interpersonal communication skills and the quality of available
support materials.
Mass media: Build on existing policies and strengthen government
and private-sector capacity for creative presentation of
standardized messages.
2.8
Print media: Promote the development and dissemination of a

clearly defined programme logo to build awareness and aid
identification. Develop strategies using print media, e.g. billboards,
posters, site-signs, interpersonal support, and other learning
materials, manuals and programme guidelines.
WEDC/Ian Smout
Community-based media: Use local-level media, e.g. public

address systems, and employ traditional, community-based
entertainment artists, e.g. popular folk singers, dramatists, and
poets, and use their talents through the mass media.
Ring-fencing the promotional activities
Do not let promotional

activity become a
subsidiary to the flagship
phases of a project.
208
Too often the promotional effort is an add-on to a project whose

budget and timetable is largely committed to hardware (water
supplies, sewage, etc.) and the promotional activities (e.g. the
software) are swamped, rushed, or curtailed. The separate projects
need to be ring-fenced but must be carefully co-ordinated to maintain
an integrated approach. (See the box on page 210.)
Table 2.8.1
Examples of mobilization
Elements
Political
mobilization
Examples
Aims
Involves
Communication methods
Gaining political and

policy commitment
National policy-makers
and decision-makers
Advocacy
Resource allocation
Lobbying
Goodwill ambassadors
Mass media
Government
mobilization
Community
mobilization
Informing and enlisting

co-operation
Informing and gaining

commitment
Service providers
Training programmes
Other government
organizations who can
provide direct or indirect
support
Study tours
Local political, religious,

social, and traditional
leaders
Training
Local government agencies

Non-governmental
organizations
Mass media
Participation in planning
Coverage of activities by
mass media
Womens groups
Co-operatives
Corporate
mobilization
National and international

companies
Securing support
Endorsement and space in:

Product advertising
Product labelling
Popular
mobilization
Informing and motivating

the target groups
Community groups,
households, families, men,
women, children
Training programmes
Establishment of
community groups
Traditional (dramas, songs);
mass media
2.8.7
The teacher and pupil
approach is very labourintensive and not always
effective. Hygiene promotion
accentuates positive aspects
of clean behaviour that
consumers can relate to dayto-day practices.
2.8
Hygiene promotion
Health education programmes, traditionally included as the software

part of a hardware intervention, have consistently failed to realize their
full potential to effect an improved health status. Why is this? Why do
health education programmes fail to hold any relevance to their target
audience? If the risky practices which health education identifies are
socially undesirable, why do they persist?
Hygiene promotion addresses these and other questions. Hygiene
promotion does not educate people about their risky practices but
looks at what motivates people to act, and at how hygiene behaviours are
articulated within everyday life. It builds on positive values, such as those
attributed to cleanliness, and draws on lessons from the social sciences,
e.g. anthropology, psychology, adult education, and marketing.
From health education to hygiene promotion
Four principles guided the development from a narrow educationfocused approach to a broader promotion outlook:
209
The evolution from hygiene

education to hygiene
promotion has
acknowledged four key
principles:
Adults are not clean slates on which to write new ideas.

Adults may have neither the time nor the motivation to learn new
ideas.
New knowledge does not equal new practice.
It is not feasible to expect people to change a whole variety of
hygiene practices.
These are discussed in turn.
Adults are not clean

slates on which to write
new ideas
All adult societies have
their own ideas of what is
clean and of what
causes disease. Those
practices and beliefs
must be used as the
starting point for change,
not ignored in the
mistaken belief that
consumers will instantly
reject generations of
tradition and rush to
embrace the truth as
pronounced by hygiene
educators.
Adults are not clean slates on which to write new ideas
Classical hygiene education is based on the premise that people

persist in unhygienic practices because they do not know about the
germ theory of disease transmission that microbes cause disease
and so on. Hygiene educators, and others, sometimes equate this with
ignorance and clash with indigenous systems of knowledge.
All societies have concepts of cleanliness which are central to notions
of individual, and group, identity. Throughout the world there are
many explanations for the appearance of diarrhoeal diseases in
children, all of which are internally consistent. In regions as distant
from each other as India, Africa, and Europe diarrhoeal episodes are
attributed to a variety of social, climatic, and environmental factors.
These include the transgression of particular social rules, the
consumption of unsuitable foods, the presence of concurrent illnesses,
teething, and straightforward bad luck (see box opposite).
If we take no account of what adults in the target population know and
we treat them as clean slates on which new (and Western) ideas can
simply be inscribed, then, at best, we create confusion and
incomprehension. At worst the teaching is entirely rejected: these
outsiders have no real idea what is making my child sick.
Solution: Hygiene promotion is founded on knowledge of key aspects
of what people know, do, and want.
2.8
Adults may have neither

the time nor the motivation
to learn new ideas
The women of poor
communities have little
time to sit in on formal
education sessions but
they are the ones most
likely to see the benefits
of change and to strive to
bring it about. Clear
messages must be
disseminated along
effective communication
routes.
210
Adults may have neither the time nor the motivation to learn new
ideas
Traditional school-type teaching is common in hygiene education

programmes. This may be appropriate for children, but is unlikely to
appeal to adults, especially hard-pressed mothers who have other
higher priorities for their time and energy.
How to drive a SanPlat
The promotion of sanitation and the production of sanitary wares require totally
different skills. This is recognized in other markets and should be accepted in
hygiene and sanitation promotion.
The person who builds a car is different from the person who sells that car, who
is in turn, different from the driving instructor.
SanPlat manufacturers make SanPlats (page 170). They are not necessarily the
best people to sell them, to advise customers how to use them, or to suggest
to their customers ways of dealing with childrens stools.
Folk taxonomies of diarrhoeal diseases in Burkina Faso

Folk taxonomy of diarrhoeal diseases in Burkina Faso the least important of
which is that described by health educators, diarrhe des blancs or white
peoples diarrhoea
New knowledge does not

equal new practice
Promotion must be to
practical effect,
encouraging changes
that are possible and are
wanted, not merely
relating lists of good
hygiene practices that,
for the time being at
least, have little chance
of being implemented.
It is not feasible to expect
people to change a
whole variety of hygiene
practices
Long wish lists confuse
consumers and dilute the
promotional effort.
Attention must be
focused on a few
practices that present the
greatest risk in the target
community.
Causes
Name
Symptoms
KOLOBO
Green, frothy, frequent stools Teething

Vomiting, Weight loss
KOTIGUE
Small, mucoid stools,

Irritated anus
Fever
WOLINA
Whitish, liquid stools smelling Breast-feeding mother steps

on an egg
of rotten eggs
Infection
Sunken fontanelle
SERE
Thick, whitish, bad-smelling

stools
Child thin
Breast feeding after having

sexual relations or while
pregnant
DIARRHEE DES
BLANCS
Liquid stools
Ballooned stomach
Parasites/worms
Dirt
Carrying the child on the back

Contact with damp ground
Solution: Hygiene promotion uses repeated, coherent, and simple

messages. These are disseminated through a mix of communication
channels designed to reach target audiences for the greatest effect and
the least cost.
New knowledge does not equal new practice
Even if the target audience of the hygiene education programme accepts

the germ theory of disease, this does not guarantee they will change their
hygiene behaviour. Fear is not a good motivation for change. A fear that
germs may make a child ill is unlikely, by itself, to prompt people to
adopt new domestic practices (see first box on page 212).
There are other reasons why new behaviours are not adopted as a
direct result of new learning: the suggested safe practices may be too
expensive or time consuming, appropriate facilities may not be
available, and there may be no support, or even discouragement, from
other members of society. In other words change may be too difficult.
Solution: Hygiene promotion is based on what people can do and
what people want to do. It works to find solutions and not problems.
It is not feasible to expect people to change a whole variety of
hygiene practices
It is likely that only a small number of practices are responsible for

the majority of diarrhoeal episodes (WHO, 1993b). However, hygiene
education programmes rarely identify and target particular risk
practices (see second box on page 212). Getting people to change the
habits of a lifetime is extremely difficult. The more practices that are
targeted the more efforts are diluted.
211
2.8
Cries of resistance from a cholera programme

Government efforts to control a cholera epidemic in north-eastern Brazil caused
indignation. Favela residents were highly resistant towards the mass media
campaigns and official cholera control interventions. They were reacting against
the accusatory attitudes and actions of the social lite.
Cholera is popularly called The Dogs Disease. It carries many connotations
and must be understood as part of a history of domination and social and
economic inequity in north-eastern Brazil. The official campaign, which used
two stereotypes, pessoa imunda (filthy, dirty person) and vira lata (stray mutt
dog), suffered a backlash as these seemed to equate the poor with cholera
and poverty with dirt. Using this disgracing and disempowering imagery
blamed, punished, and stigmatized the poor
Nations and Monte, 1996
Solution: Hygiene promotion is built by providing simple, attractive

alternatives to a few common risk practices. The process is
systematically planned and monitored and the impact on the targeted
behaviour is measured.
2.8.8
A three month period of
data gathering within the
community provides a
sound base for programme
planning and will bring its
own rewards. A short period
discussing the collated
results with the community
will allow the formulation of
a promotion programme
founded on what
consumers know, do, and
want. Messages,
communication channels,
target audiences, and
target practices should be
accurately defined to
achieve optimum results.
WaterAid/Jim Holmes
2.8
212
Hygiene promotion in practice
Consumer-oriented, demand-led promotion is an iterative process

with the following stages:
Stage 1
Stage 2
Stage 3
Stage 4
Collaborative data collection

Feedback and discussion with all key stakeholders
Formulation of the hygiene promotion plan
Implementation, monitoring, revision, etc.
If resources and key personnel are available, data collection can be

completed within three months and the feedback and project design
can be completed in a further month. This investment of time and
resources in finding out what people know, do, and want will be
repaid many times over in enhanced programme effectiveness.
Message overloading in hygiene education
wash vegetables
filter drinking water with sand
place basins of water in the sun
keep finger-nails cut short
wash hands with soap
do not wash hands with mud
spray insecticides
wash hands before eating
wash hands before feeding a child
wash hands after defecation
wash dirty dishes after meals
clean surrounds
burn rubbish
do not bottle feed
wash latrine slabs
wash well
use fly-screens for food

boil drinking water
do not spit in public
add disinfectants to drinking water
chlorinate well water
bury faeces
construct water containers with taps
wash hands before preparing food
wash childrens hands
wash hands after contact with child faeces
sprinkle lime
bury rubbish
do not store food
comb hair
disinfect latrine slabs
construct latrines
Table 2.8.2
Key steps in a hygiene promotion programme
Objective
Questions to answer
Methods
Identify risk practices
Which specific practices allow

diarrhoeal microbes to be
transmitted?
Epidemiological commonsense
Environmental walk
Checklist observation
Select practices for intervention
Define target audiences
Determine message positioning
Which risk practices are most

widespread?
Structured observation
Which risk practices are

alterable?
Focus group discussions
Who employs these practices?
Structured observations
Who influences the people that

employ these practices?
What motivates those who

currently use safe practices?
What are the advantages of the

safe practices?
Select communication channels
What channels are currently used

for communication?
What channels are trusted for
such messages?
Behaviour trials
Interviews with safe

practisers
Behaviour trials
Interview representative
sample of target
audiences
The table outlines the key questions and some of the quantitative and
qualitative data-gathering techniques that can be used (Curtis et al.,
1997).
During implementation the
key requirements are to
start on a small scale and to
be prepared to modify
programme details as the
effects are continuously
evaluated. The effects are
measured in terms of
behavioural change rather
than health benefits.
The mix of techniques develops an understanding of the needs, desires,

and perceptions of the target audience, and helps to create likemindedness among the project team members and between the project
team and the community.
Different methods will be suitable for answering different questions. For
example, questionnaires are of little use in finding out about peoples
behaviour (Curtis et al., 1993), but may be useful in identifying existing
channels of communication. Setting clear objectives for the data
collection and a commitment to find out what people really know, do, and
think is more important than the choice of methods.
Consultation with key stakeholders is a crucial component of hygiene
promotion. A brief, attractive report presenting the recommendations for
hygiene promotion is widely disseminated. It is translated into local
languages, and made accessible to key stakeholders. A communication
plan listing the key objectives of the programme is then drawn up on the
basis of the findings (see Table 2.8.3).
Implementation of a hygiene promotion programme
The hygiene promotion programme should begin on a small scale.

Time must be allowed for testing and revising strategies in the light of
continued monitoring. Use structured observations to conduct an
initial survey of target behaviour and establish a baseline. Follow this
up at intervals to gauge the extent of behaviour change towards the
213
2.8
Table 2.8.3
Components of a communication plan
Components
Examples
Behaviour change objectives
Hand-washing with soap after cleaning a childs

bottom will go from 5% of occasions to 35% in
two years
Key messages
The targeted hygiene practices
Target audiences
Age, sex, number in each group
Motivation for behaviour change
Why do the target audiences want the new

practices?
Channels of communication
Street theatre, house visits, radio, schools
Communications materials
LSHTM/Sandy Cairncross
Methods of monitoring progress
In programme activities
In programme outputs
In behaviour change
Budget
Project management
2.8
Figure 2.8.1. The process of promotion
projects objectives. Monitoring behaviour change is difficult, but

more practical and useful than conducting a health impact study. It is
difficult, and expensive, to separate the signal of the public health
intervention from the noise of parallel events such as epidemics,
economic, climatic, or social change.
2.8.9
Sanitation programmes and the social marketing

approach
Social marketing can be a bridge between technology (hardware) and

behaviour change (software) for effective sanitation programmes. The
following tables take you through the process.
214
Table 2.8.4
A social marketing plan for sanitation

Examples
Steps
1A Identify data collection needs
What are the causes?
What beliefs, attitudes, and current

practices contribute to the problem
or possible solution?
Determine and define the

evaluation indicators (to include for
baseline data)
1B Define the intended audience

Who will be most responsive to the
intervention (primary audience)?
Who can support the primary
audience in its new practices?
1C Define feasible behaviour(s)

or appropriate products for
each audience
What is the desired ideal
behaviour? Or ideal product?
What is the current behaviour? Or
products used?
What are the feasible behaviours to
be promoted? Or appropriate
products?
Low level of latrine coverage in two rural

provinces,
Children at high risk of diarrhoeal disease
Latrines are expensive
Materials are hard to find
Latrines are seen as urban structures
Latrines are too dangerous for children to
use
Pregnant women must not use latrines
People dislike using the bush at night
Flies and bad smells are seen as a
nuisance
Number of latrines
These could be based on overall
programme/project objectives
Number of latrines in regular use
Including evaluation indicators with data
Proportion of childrens stools thrown in
collection helps measure impact at the
latrines
end of the programme/project inputs
It also means that information need not
be gathered separately and it thus saves
time and resources
Identify consumers and their traits
Fathers take the decision to buy a latrine
Mothers encourage
Landlords are constrained by law to
provide latrines (not enforced)
Allies such as
healthworkers
grandmothers
community leaders
Who will do it?
What type of research/timing?
A fly- and smell-free, cheap latrine which can

be used safely by all family members
Adults go to the bush

Children defecate in the yard
Paying a mason to construct a latrine
Buying and using a potty for small
children under three
Why do heads of family not buy latrines now? Use research or consumer-based data to:
What would motivate them to do so?
Identify Price and Place
Why do mothers not buy potties now?
What would motivate them to do so?
Project field team
Research specialist and students
Experienced extension workers
Sociologist
Quantitative latrine coverage survey 400
households
Focus group discussions with mothers,
fathers, landlords
Construction of six model demonstration
latrines
Observations in 200 households of child
defecation
Trial marketing of potties in two provinces
1D Develop the research plan

What do you need to know?
Notes
Define the Product or behaviour
2.8
215
Steps
Examples
2. Establish programme goals and objectives

Use results of Step 1.
Research finding
Possible programme goal or objective
60% of respondents are aware of

proposed sanitation method
15 percentage point increase in the level of awareness of modern method of sanitation

from 60 to 75% among respondents by two years
Only 10% of respondents are

aware of distribution outlet for
sanitation product
A 30 percentage point increase in awareness of distribution outlet from 10 to 40%

among respondents by two years
30% of respondents rate the

sanitation product as effective
10 percentage point increase in effectiveness rating from 30 to 40% (or modification of

the product to achieve 40% rating) among respondents by three years
15% of respondents currently use

sanitation product
A 5 percentage point increase in use of sanitation product from 15 to 20% among

respondents by three years
Steps
Examples
Notes
3. Estimate the potential market for a given brand or product

Research results are very useful if
the sample is representative of the
total population to be served
5% of households have a latrine

Overall potential market is 200,000
households
25% would build a latrine if it cost less
than 50,000F
15% intend to build a latrine this year
Conservative estimate of potential market
is 20,000 latrines in two years
The data can be projected for the whole

population and the size of the market (and
potential demand) can be calculated
Usage data will provide estimates of
the overall size of the current market
Intention to use can predict the
potential market
4. Develop a marketing mix strategy

Use the information from Step 1 for developing marketing mix
Product Strategy:
A choice of models at different prices
What product(s) will best fulfil the

needs of the intended audience/
consumer groups
2.8
Price Strategy:
What does intended audience
currently spend in this area?
What can they afford?
Distribution Strategy:
What are the distribution
channels which are most readily
accessible to the intended
groups?
What outlets do they use?
Where are they most likely to
look for the sanitation product?
Current models are VIPs constructed by a Cost calculations should include both
previous project. They were provided free. direct expenditures of money and
resources and
VIPs are too expensive for most
indirect costs e.g.
households.
time
energy
Masons shops in local market towns
embarrassment (difficult to quantify)
Village mason
Advertising and Promotional

Strategy
Research findings can be used for
Setting the communication
Masons promote latrines on market days
objectives for the programme for Extension worker makes house-to-house
each intended group
visits with brochures/invitations to visit
The media strategy to reach each
demonstration latrines
intended group
216
Steps
Examples
Notes
When developing the marketing strategy you need to know ...

Current usage
What methods and products are
consumers using, if any?
What is the competition?
Some VIPs
Landlords have provided simple latrines in
some compounds
Attitudes/perceptions
What benefits are relevant,
meaningful, and persuasive?
Advantages include
privacy, dignity, and convenience
What barriers will need to be

overcome?
Product image
What is the image of either the
method or product or brand
among the intended audience?
How can this be improved?
Main barriers
Cost
Previous latrines were subsidized
VIPs seen as very grand, only for the
wealthy
VIPs seen as to be kept for adults and
visitors only
Emphasize low-cost models
Stress child use
Consumer communication
What information does the
intended audience want and
need to use?
Misperceptions about cost and danger

to children need correcting
What sources does the intended

audience currently use for
information?
Which one(s) do they believe?
What other potential media are
available?
61% of male heads of household listen to

local radio regularly
72% of women attend weekly market
Baptisms and weddings
Consider sources of information for

product effectiveness
product availability
correcting any misperceptions
2.8
217
Further reading
Almedom, A., Blumenthal, U., and Manderson, L. (1997) Hygiene
Evaluation Procedures: Approaches and methods for assessing waterand sanitation-related hygiene practices, International Nutrition
Foundation for Developing Countries.
This book provides the non-expert with guidelines for evaluating
water- and sanitation-related hygiene practices. It focuses on the
practical concerns of field personnel and enables existing field staff to
carry out hygiene behaviour diagnoses. The book looks at how to
gather, review, and interpret qualitative information. It weighs the
pros and cons of a wide range of techniques and assumes no prior
knowledge of social sciences.
Ankur Yuva Chetna Shivir (1996) Diarrhoea and hygiene in Lucknow

slums. A document produced for the Gomti River Pollution Control
Project, Lucknow, London School of Hygiene and Tropical Medicine,
June.
An account of a hygiene promotion project in Lucknow which was
written for, and disseminated to, project stakeholders. Producing an
accessible report is integral to the process of increasing the
ownership of the project. This is attractive and easy to read and
shows how the project was designed and what lessons were learned.
Boot, M.T. (1991) Just Stir Gently: The way to mix hygiene education
with water and sanitation, IRC Technical Paper No.29, IRC
International Water and Sanitation Centre, The Hague.
As the title suggests the main concern of this book is hygiene
education, and it is based on the paradigm most prevalent in the USA.
The book considers issues in project design: for example, negotiations
with project stakeholders needed to introduce behavioural
components, and the timing of articulating behavioural components
with other project components. This is still a good source of
techniques for data collection and it stresses the importance of both
finding out, and working with, what people know.
2.8
Boot, M.T. and Cairncross, S. (1993) Actions Speak: The study of

hygiene behaviour in water and sanitation projects, IRC International
Water and Sanitation Centre, The Hague and London School of
Hygiene and Tropical Medicine, University of London.
A comprehensive analysis of ways of studying hygiene behaviour and
interpreting the results. The recommended approaches are
demonstrated with lots of practical examples and anecdotes. Planning
and pre-testing hygiene behaviour studies, involving community
members in study design and information gathering methods, the
types of behaviours most relevant to achieving health improvements,
and different interviewing techniques are all considered.
218
Cairncross, S. (1992) Sanitation and Water Supply: Practical lessons

from the Decade, UNDP-World Bank Water and Sanitation Discussion
Paper No.9, UNDP-World Bank, Washington DC.
A personal perspective on the ten-year effort to provide low-cost
waste facilities. This is a concise explanation of how water-supply and
sanitation programmes are part of a wider picture which includes land
tenure, housing, drainage, and solid-waste disposal, etc. The main
lesson is that sustainable success depends on consumer demand and
that programmes should be designed and managed to sell a product,
e.g. water supply and sanitation, and not to provide a service.
Curtis, V. (1997) Hygienic, happy and healthy. A series of practical

manuals designed to help you set up a hygiene promotion programme.
Part 1. Planning a hygiene promotion programme. Draft manual
prepared for UNICEF.
This series of manuals describes how to carry out the data collection
vital for the design of an intervention. They are very readable and
have lots of graphics.
Curtis, V., Sinha, P. and Singh, S. (1997) Accentuate the positive:
Promoting behaviour change in Lucknows slums Waterlines, Vol.16
No.2. pp.5-7.
A brief article by the project team in Lucknow. It covers the
techniques used when planning a hygiene promotion intervention and
reminds readers of the need for good news, not doom and gloom.
WASH (1993) Lessons Learned in Water, Sanitation and Health:
Thirteen years of experience in developing countries, Water and
Sanitation for Health Project, USAID, Washington DC.
A review of the lessons WASH took from the Water Decade. The
book looks at technical assistance, at shared responsibility and
different stakeholders in partnerships, at all levels of programme
strategies, and at long-term sustainability and the importance of
enabling behaviour change through a range of initiatives.
2.8
219
While WS&S interventions

bring benefits in their own
right, the wider objective is
to exploit these gains as a
catalyst for general
improvement to the
services and living
environment of the poor.
Success in this area has
been limited. It can be
increased and make a more
positive contribution to
DFIDs prime aim, poverty
elimination, by encouraging
a move away from isolated
WS&S projects in favour of
the development of regional
and national sector policies
in the host countries.
Success will be enhanced if
these policies can be
integrated into pro-poor
sector programmes.
2.9 Maximizing benefits of interventions

Chapter 2 highlighted the principles and practice of successful WS&S,
seen as both a social and an economic good. Safe water and sanitation
can not only lead to better health opportunities, but can also promote
sustainable livelihoods and improve living and working environments.
Moreover, participatory approaches within the context of process
projects and partnerships can promote improved civic engagement
and demand responsiveness, along with meeting the needs of the poor
for these services. Effective support to WS&S provision can also
make a substantial contribution to DFIDs principal aim, the
elimination of poverty.
However, it has to be said that globally, the contribution of WS&S to
poverty reduction has not been well documented. It has also been
constrained by project design. This concluding section summarizes
the principles and practice of WS&S which is concerned as much with
equity as with efficiency and effectiveness, and it provides a link into
the challenge of taking these goals forward into DFID programmes
and partnerships. An important starting point for successful
interventions is a pro-poor sector policy. In many cases, however,
projects are begun without established water and sanitation policies
and many successful WS&S projects are confined to the local level. A
key challenge, therefore, is to link positive processes and quality
services at the micro-level to policy dialogues and sector
programming.
2.9.1
Meeting needs and responding to demand
Two key issues which have emerged from the review of principles and
practice in WS&S are:
the benefits of WS&S are not evenly distributed and often fail to
reach the poor; and
WS&S programmes invariably face problems when they are not
based on genuine demand.
2.9
Superficial assessments of
demand can lead to
misdirected programmes
that meet none of the real
needs of the poor. Shared
agendas, that unearth the
true needs and demands of
individuals and
communities, are the
essential framework on
which to build sustainable
interventions capable of
meeting the combined
objectives of equity, poverty
reduction, efficiency and
cost-effectiveness.
220
The challenge facing DFID and its partners is to combine the poverty
reduction and equity goals of meeting the objective needs of poorer
households and communities, with the efficiency and effectiveness
goals of demand responsiveness. The most vivid example illustrating
this is the now widespread acknowledgement that women benefit in
terms of time, health, and well-being from improved water supply and
sanitation. This is frequently cited as a justification for intervention in
the sector and yet in many communities throughout the world, in the
face of competing priorities, poor women find it difficult to make
their demands heard. Thus, matching needs and demand implies going
beyond posing dichotomies between supply driven and demand
driven approaches and identifying means by which shared agendas
can be negotiated. Demand can be latent or uninformed, while
meeting needs does not have to be a top-down or non-consultative
process. Hence the use of the term Demand-responsive approach
see the box opposite for an example of this in practice.
Case study: Demand-responsive approach

The Mvula Trust in South Africa has been implementing a rural WS&S
programme using a demand-driven approach since 1994. The process starts
by a Mvula Trust representative visiting the community to explain the approach.
The community is then responsible for contracting a consulting engineer to
assist them in carrying out a feasibility study prior to funding application. The
project is allocated a fixed amount of money by the Mvula Trust, and so the
community water committee, with the assistance and advice of the engineer,
must make informed decisions on the type and level of service they require. For
example, in Morapalala, the original design provided 20 public standposts. The
community felt this was inadequate coverage and so the committee decided to
review the design to save money in other areas and provide 30 standposts. The
community also played a central role in identifying potential spring sources and
deciding on the location of the reservoir and standposts. This is a good
example of interactive planning.
Lessons learned from Mvulas demand-driven approach

Public standposts are proving unpopular as a level of service. There is a high
demand for yardtaps, which cannot be financed under the limited Mvula grants.
New mechanisms for funding (e.g. loans) need to be developed so that higher
levels of service can be achieved.
Delegating management responsibility to community-based organizations is
risky and there have been some failures. In two or three projects, money has
been stolen from the project bank account. However, the majority of projects
(360) have been successful and free of corruption.
The private sector has played an important role in providing training to
community-based organizations; for example pipe suppliers, which are
contracted by the water committees, offer training in pipe laying in addition to
supplying and delivering the pipes.
The fixed ceiling on capital grants has ensured equity between projects and
also encourages cost efficiency: the engineer and the community have to work
together to design solutions which achieve the highest affordable level of
service.
Palmer, 1998
In the past, a communitys willingness to make contributions to the

capital cost of new facilities has often been seen as evidence of
demand. External support agencies have often provided funding to
community groups if they accept the project proposals or rules and
agree to pay the specified capital cost contributions. The danger is that
the full costs and implications of operation and maintenance are not
dealt with at this stage, and that other feasible technical options are
not considered, for example because of the limited capacity of a local
NGO. While such a process may reveal that the community has a
clear demand for improved services, it does not mean that the best or
preferred technical option has been selected, nor does it mean that the
community is willing and able to fund and manage the operation and
maintenance of the facilities in the long term. A demand-responsive
approach should therefore also include a full consideration of viable
options and a participatory assessment of the management and finance
of O&M of viable options, if sustainability is to be achieved.
221
2.9
2.9.2
Crucial to meeting the challenges posed in water supply and sanitation

is recognizing that successes and failures hinge as much on people as
on pipes. Stakeholder analysis and participation (see Section 3.2.2) go
a long way towards identifying the different actors involved and their
interests and capabilities in the sector. The rationale for primary
stakeholder participation is summarized as follows:
DFID/Dilshad Sheikh
Participation of primary
stakeholders has proved its
worth at project level but
the principles are only
beginning to be applied to
sectoral policy and
programme development.
It is an evolutionary
process which, in these
early stages, can benefit by
absorbing the best
experiences of project
partnerships.
Overlapping capabilities
and responsibilities in the
several agencies typically
involved in WS&S
programmes make for
management inefficiencies
and inter-agency tensions
and disputes, and have
frequently caused projects
to fail.
2.9
People, participation, and process
Responsibility for specific

aspects of the programme
must be clearly defined at
the project formulation
stage, seeking to make
best use of the strengths of
the individual organizations
involved, and to effect
good lines of
communication between
them.
Particular attention must be
given to the difficult
problem of forging reliable
links between internal and
external services.
222
services and service providers are more responsive to and

accountable to users;
sustainability of services improves when technology choices, cost
recovery, operation and maintenance, and management of services
correspond to what users are able and willing to contribute; and
conflict over water resource allocation and other competing
sectoral uses will more likely be resolved by participatory and
processual approaches.
While stakeholder participation is well accepted in DFIDs project
work and is seen as vital in extending services to the poorest
communities, partnership approaches in water and sanitation
programmes are comparatively new. Much is yet to be learned about
ways to optimize stakeholder participation in sector programming and
policy dialogue in the sector. There is no blueprint method but the
development of best practice in process projects constitutes an
important starting point.
2.9.3
Institutional linkages and partnership
Policy, planning, implementation, and management responsibilities in

WS&S, span several agencies and levels of government without welldefined jurisdictions. This causes confusion and is often a reason for
project failure. Communities are often then included, in order to
rescue or redeem projects, without their participation being rooted in
demand and a clear understanding of what community members are
willing and able to do. The solution lies not in simply adding more
actors to the institutional mix, but rather in looking at the links
between those who are involved in or affected by interventions.
If the two main emerging themes of WS&S are integration and
partnership, then the challenge is to plan initiatives that ensure
effective co-operation across organizational and institutional
boundaries, whether formally or informally. This involves negotiating
a division of responsibilities based on a thorough understanding of the
comparative advantage, capabilities, and priorities of the different
groups involved, be they agencies, different levels of government, or
relationships between the community, private, and public sectors.
With community-based initiatives and demand-led approaches, a
critical issue is the problem of establishing linkages between internal
and external services. One approach is the intervention of
intermediary NGOs. Another is the promotion of processes aimed at
institutionalizing links between community efforts and government
and agency provision of primary infrastructure and services, processes
which need to be built into project design and management.
Benefits of WS&S
interventions are maximized
by integrating the inputs of
the community and public
and private sector
organizations in an ordered
framework with strong
institutional links.
In order to develop institutional linkages and maximize benefits in

WS&S, the key questions that should be asked at the time of project
formulation and implementation are as follows:
Who should be responsible for which aspects of design, delivery,
and management?
How can individuals or organizations be strengthened in order to
undertake these responsibilities effectively?
When are partnerships between communities and public and
private sector actors possible, and under what conditions?
What changes are necessary in attitudes, expertise, and procedures,

and what action is necessary to reorientate officials and professions
to adopt more participatory approaches?
2.9
223
Chapter 3
WEDC/John Pickford
Water supply and sanitation

in the DFID programme and
project cycle
The principles and practices described in Chapter 2 are relevant
throughout the programme and project cycle. In this Chapter, the aim
is to demonstrate how the interdisciplinary nature of the WS&S sector
can be taken into account in each stage of the cycle. First, a reminder
of the eight stages of a Project Cycle used in this document, based on
DFID practice.
8
EVAL
1
POL
7
NEXT
6
OP
1.
2.
3.
4.
5.
6.
7.
8.
2
ID
3
PREP
5
IMP
4
APP
Policy development, sector planning, and programme formulation

Preparation
Appraisal and approval
Extensions or next-phase project identification
Evaluation
The dotted arrow linking Stages 7 and 3 represents a cycle within a

cycle. Stages 1 and 2 are conducted at national level at the start of
DFIDs co-operation in the sector. They are major exercises
establishing partnership arrangements involving all stakeholders.
Their outcomes then set the criteria for what may be a series of
projects within the country. Those criteria may change as the overall
programme or project is evaluated (Stage 8). Within the criteria, new
projects may be identified (Stage 7) and prepared (Stage 3) without
necessarily repeating Stages 1 and 2.
225
Demand assessment needs to be a central part of a

process for project development which:
is multidisciplinary, holistic, and involves key stakeholder groups, including
users, from the outset;
does not close off technical options too early;
systematically consults all users about feasible technical and institutional
options for improved services and about the prices that might be charged for
them;
is multi-stage, allowing for iteration towards a solution acceptable to all
stakeholders. Each stage is likely to involve;
- a degree of technical design, costing, financial projection, and tariff design;
- demand assessment, participation, and consultation on feasible options;
- an analysis of findings; and
- a political review and decision; and
allows some flexibility for different users to opt for different levels of service,
including the possibility of upgrading over time.
DFID, January 1998
The guidance in this chapter includes frequent cross-referencing to

Chapter 2. DFID staff are also referred to the DFID Office
Instructions, which include fuller descriptions of the purpose,
structure, and reporting requirements of the eight stages than it is
possible to include in this manual. Brief summaries of the process are
included here stage-by-stage, to set the context of the guidelines
which follow.
A number of basic principles are common to all stages. They are
described in Chapter 1 (Section 1.4) and Chapter 2 (Section 2.1) and
include:
Dialogue and joint activities with partners and other stakeholders,
including continuously matching project objectives and
achievements with the agreed goal of improving services for the
poor.
Promotion of partnership, local ownership, and the empowerment
of communities.
Adoption of the process approach in which projects evolve through
a continuous learning process and regular review.
Interlinkages with the broader issues of water resources

management, sustainable development, and environmental
protection.
Matching the recognized need to treat water as a scarce and
valuable resource which must be paid for, with the priority of the
poor for affordable services which meet their basic needs.
Considering a wide enough range of technical, institutional, and
financial options to ensure that stakeholders are not unreasonably
226
constrained in their choice of service level, management structure,

or financing methods.
Capacity building which enables stakeholders to participate as
equal partners in decision-making and to fulfil their subsequent
roles effectively.
At the heart of the whole process is the requirement to be responsive
to demand. DFID has developed guidance (summarized in the box
opposite) on how best to incorporate demand management into the
process of project formulation and design. It has implications
throughout the project cycle in that care must be taken in planning
consultancies and technical assistance to create flexibility in both
timing and project options. This argues for a series of consultancies,
with each Terms of Reference (ToR) reflecting the emerging picture,
rather than one major study. As it may take several years to reach
large-scale activity and expenditure, interim measures such as pilot
projects may be needed to maintain momentum and strengthen
stakeholder partnerships. This increases programme managers
responsibility for maintaining continuity, and detailed attention must
be paid to drawing up ToR and briefing information, monitoring
consultants performance, and reviewing their work. The logical
framework is a key tool for integrating the different professional
perspectives within a single programme or project, and at each stage
of the cycle.
Moves towards user-oriented partnerships take time. Institutions and
organizations may require training and professionals may feel that
they are compromising what they are used to doing. The time and
resources needed to bring the whole team with you are worthwhile
investments that will reap benefits in programme effectiveness,
appropriateness, and sustainability.
Social marketing to promote improved hygiene behaviour is an
iterative process, which does not fit easily into the stages of the
Project Cycle, the demands of which will vary from project to project.
In these guidelines it is assumed that the programme and project
preparation will include data collection and planning with
stakeholders. The implementation stage will include the training of
health promoters and the development of promotional materials; it
also covers piloting and scaling up. Revision and refining through
consultation run throughout the programme.
3.1 Stage 1: Policy development, sector planning,
This first step in the development of a WS&S programme is where the
partnerships are established and the criteria for collaboration agreed
with the partner government and other stakeholders. In some cases
WS&S may be only part of a package of proposals that are being
negotiated. At other times, a WS&S component may be being
proposed as an addition to an ongoing programme, or the WS&S
intervention may be DFIDs first involvement in a particular country.
227
The different types of negotiations may involve different DFID

professional staff, but the WS&S sector principles remain valid for
each type.
The ultimate decision at this stage is whether or not the programme
goes ahead. That will depend on DFID, possibly other donors, and the
partner government committing themselves to a series of common
objectives and specific inputs to be made during the following stages.
This is the time therefore when it is vital to ensure that the partners
policies are compatible and that all agree on the need to maintain a
multidisciplinary approach from the start. Often in the past, hygiene
promotion, for example, has been seen as an element to be added in
later (if at all). As we saw in Chapter 2 (Section 2.2.8), the long lead
time needed for successful hygiene interventions makes it crucial that
inputs are made from the start.
Important outputs of Stage 1 will be a comprehensive review of the
WS&S sector in the partner country, and a strategy for achieving the
agreed objectives. In some countries, this may be a matter of
reviewing a national strategy that has already been formulated, and
relating it to a range of activities which DFID is interested in cooperating. In others, there may be a need to commission a
participatory study to develop a strategy and establish baseline data.
Key issues which will need to be addressed relate to the management
of the WS&S sector in the country, and the governments declared
policies on sector approaches. The attention will focus on:
the relevant WS&S institutions;
how decisions are made and responsibilities shared between
governments and communities in a particular country or context;
NGO and private sector participation, and the regulatory
framework;
policy towards sustainable WS&S for poor people (particularly
institutions, finance, the scale and uses of public subsidy, and
hygiene promotion issues);
interaction between WS&S and related sectors or sub-sectors such
as health (particularly on hygiene promotion) and irrigation
(including integrated water resources management);
national indicators of need (WS&S coverage and other available

indicators); and
key external support agencies and their programmes.
The discussions are likely to be held at senior levels of government
and with high-level representation of all partners. Briefing documents
need to make clear the non-negotiable elements of sustainable
WS&S programmes.
Figure 3.1 shows the type of steps which may be involved in reaching
a satisfactory outcome from the strategy development process.
228
Participatory processes take time and there may be pressures from

various sources to take shortcuts. In particular, some stakeholders may
wish to identify and design projects quickly to meet specific demands
or electoral promises. In some situations, it is possible that partners
may agree to undertake some activities while the sector review is in
progress.
The types of questions which need to be addressed during the review
are grouped by discipline, matching the headings in Chapter 2.
Figure 3.1.1. Sector strategy development an iterative approach
229
3.1.1
General considerations
Are existing national/state policies compatible with DFID aims

and objectives?
Compatibility of policies makes collaboration in programme

development easier. However, a willingness to reform and introduce
changes can be a good basis for providing support in policy and
programme development. Consider where is the sector now? and
look at opportunities for making improvements. This implies a
thorough understanding of the existing institutional and socioeconomic environment. If a proposed project or programme is
dependent on policy or institutional changes for its sustainability,
there are risks that the policy changes may take a considerable time to
agree and operationalize (see Section 2.6 for advice on institutional
issues).
Is the environment appropriate for using a Broad Sector
Approach in order to develop a Sector Improvement Programme
(SIP)?
DFID Institutional and Economic Advisers should be consulted as to

whether it is advisable to consider a SIP. Even if it is not appropriate,
it may be worthwhile to seek donor and host government
collaboration in sector-wide work, including institutional aspects,
focusing on DFIDs priorities (see Sections 1.6.3 and 2.6.6).
With whom should DFID collaborate in the development of a
water sector strategy?
The first contact point is invariably the appropriate national

ministries. The collaboration of other key stakeholder institutions who
have a primary role in the sector should be sought at an early stage.
DFIDs Guidance Note on Stakeholder analysis of aid projects and
programmes (ODA, 1995b) has a comprehensive checklist for
identifying stakeholders.
Should field data collection be conducted as part of a Sector
Strategy Review?
Existing data on water supply and sanitation service levels is prone to

inaccuracies because of reasons such as poor maintenance and rapidly
increasing demand. A judgement needs to be made as to whether further
field data should be collected either at the sector strategy stage or the
project identification stage when a particular area has been identified.
3.1.2
Social development perspectives
The questions here relate to entry points for advancing a social

development perspective in policy dialogue, sector planning, and
programme formulation. They focus on:
maximizing the use of existing commitments on social
development issues by partner governments and donors;
evaluating and building on past experience in the sector; and
identifying secondary stakeholders and their involvement in the sector.
230
Beijing Platform for Action Paragraph 252

In addressing the lack of adequate recognition and support for womens
contribution to conservation and management of natural resources and
safeguarding the environment, governments and other actors should promote
an active and visible policy of mainstreaming a gender perspective in all
policies and programmes, including, as appropriate, an analysis of the effects
on women and men, respectively, before decisions are taken.
Do existing national policies on water resource management and

sanitation services have a focus on issues of poverty, inequality,
and gender?
The task of integrating a poverty or equity focus into policy dialogue

and sector planning will be much easier if existing policies on water
and sanitation are already concerned with these issues. Some national
programmes and investments in water supply and sanitation also take
into account gender differences in needs, priorities, and access to and
control over resources. This makes it easier, although not automatic,
to ensure that benefits and opportunities are extended equitably to
both women and men.
What national commitments have been made to poverty
reduction, equality, human rights, and gender equality?
In many of DFIDs partner countries, even if policies on water supply

and sanitation do not have an explicit pro-poor focus, other national
policies or the adoption of international conventions may provide a
basis and a justification for pursuing social development agendas. For
example there may be constitutional guarantees relating to equality
and human rights, while partner countries may be signatories to
international conventions such as the UN Committee on the
Elimination of Discrimination Against Women (CEDAW) and the
Beijing Platform for Action which pursue womens rights and gender
equality.
What are the policy approaches of other donors involved in the
water supply and sanitation sectors to poverty reduction, equity
issues, gender equality, and participatory approaches?
A key challenge for DFID is to promote pro-poor, gender-aware, and

participatory approaches to water supply and sanitation within the
context of co-ordinated support to sector planning. In order to engage
in effective brokering and to identify entry points, it is important to
understand the concern and capacity of partner agencies in relation to
social development in water supply and sanitation. It is important at
this stage too, to draw upon the DAC Guidelines (DAC 1997a and b).
Are there lessons from previous water supply and sanitation
programmes or other parallel sectors regarding participatory
approaches and partnership?
Participatory approaches are not usually enshrined in constitutions or

guidelines, but rather gain acceptance through evidence of good
practice. It is useful, therefore, to draw on examples of successful
231
participatory projects, ideally from the country or region concerned.

This will require exploring the activities of NGOs and local initiatives
as well as other donors.
Are there international, national, regional, or local-level
organizations that could support the development of povertyfocused, participatory, and gender-aware interventions in WS&S?
Even when they are willing, governments are not always able to engage
in participatory processes. It is useful, therefore, to identify and involve
intermediary NGOs working in water supply and sanitation or in the
target areas which can provide links to community-level organizations.
3.1.3
Water, sanitation, and health
The objective here is to ensure that the national government and all
local and national stakeholders understand the issues and the
relatively small incremental costs involved in achieving optimum
health benefits. Answers to the questions raised here should form the
basis of a health improvement component as an integral part of the
project formulation.
What are the current national objectives for WS&S-related health
improvements?
How significant are water supply and sanitation-related health

problems to public health in the country? How large do they figure in
the health and/or social welfare policy? Official statistics are probably
not reliable for ranking health problems as so many cases and deaths
go unrecorded; conversations with those working on health among the
poor will often indicate a higher priority for water, sanitation, and
hygiene than may be evident from reported statistics. Improved
health should not be the only objective for WS&S interventions, but it
is an important and well-established one.
How is progress towards the health objective measured within
the sector?
It is not realistic to expect routine health statistics to reflect the health

benefits achieved by water, sanitation, and hygiene interventions, nor
is it worth counting on epidemiological studies in the country to
establish the benefits; done rigorously, measurement of environmental
health will divert a substantial amount of relevant human and
financial resources away from the work of actually improving health
(see Section 2.3). Instead, it makes sense to focus on proxy indicators,
such as sales of childrens potties and soap, use of latrines, etc.
Experience elsewhere has already established the significance of these
variables in contributing to health. Not only are they easier to
measure; the results have greater diagnostic power as they will
suggest concrete steps to improve the project and its prospects of
attaining health improvements (see Section 2.3.9).
What, if any, scope is there for linkage between hardware and

software in the sector?
What is the current attitude and policy towards the linkage of

hardware (water supply investment, latrine construction, etc., with
232
software (promotion of demand, hygiene promotion, community

organization)? To what extent are approaches culturally aware,
recognizing local systems of belief and understanding? Are current
approaches didactic or based on dialogue? Sector objectives can be
expressed in different ways, for example, The supply of water to the city
through the construction and maintenance of plant and pipe, funded by
the sale of water, or Creating conditions for the satisfaction of demands
for the sustainable provision of clean and palatable water. Sanitation can
be viewed as Protection of the environment through the construction and
maintenance of sewerage, funded by public taxation, or The
improvement of environmental health and well-being, especially among
the poor, through the promotion of hygienic excreta management. These
differing definitions have different software implications, particularly if
health is a major objective, which require development or support of
hygiene promotion.
How effective is current interdepartmental collaboration?
To what extent, and at what levels, do relevant government agencies

collaborate on environmental health? This collaboration often varies
across levels; in some cases stronger at the top than at the bottom, and
in others stronger at the bottom than at the top. What works to
promote this collaboration, and what are the obstacles?
3.1.4
Under this heading, DFID and partners are seeking to ensure that any
WS&S programme which emerges is effectively integrated into a
national water resources management strategy and that projects will
be designed to contribute to water quality protection and
environmental improvement objectives. The Commission for
Sustainable Development (CSD) recommends that national water
policy should include, among other things:
an understanding of the quantity and quality of the freshwater
resource base;
principles for allocation of the resource;
the incorporation of health concerns into freshwater management;
the protection of the aquatic environment;
management of demand; and
the development of appropriate institutions.
The policy also needs to be supported by an appropriate regulatory
and legislative framework.
What is national policy towards the environment and
environmental assessment?
Most countries have a high-level political commitment to Agenda 21,

the action programme of the Rio Earth Summit, and to environmental
resolutions at other international meetings following on from Rio.
Existing national conservation strategies and environmental action
plans are a helpful starting point for determining programme
objectives and procedures.
233
Water Resource Control and Review Council (WRCRC)

Tamil Nadu
In 1993, in recognition of the fact that water resource developments were
taking place across the state in a piecemeal manner on a scheme-byscheme basis, the government of Tamil Nadu established a high-level coordinating body called the Water Resources Control and Review Council
(WRCRC). This council is chaired by the Chief Minister and includes
ministers representing all government departments concerned with the
development and use of water resources.
The WRCRC was created to handle multi-sectoral water planning and
allocation, and acts as the states principle water policy implementation body.
The Council receives support and advice from a technical secretariat on
issues such as water policy, strategy, legislation, regulation, and allocation
within the state.
Recent institutional reforms in Tamil Nadu
There have been a number of key institutional reforms in Tamil Nadu, many
under the auspices of the World Bank-funded Water Resources Consolidation
Project (WRCP). The principal changes where the:
issuing of the Tamil Nadu State Water Policy;
creation of the specialist Water Resources Organization (WRO);
creation of a Water Resources Control and Review Council (WRCRC) to
oversee multi-sectoral water planning and allocation;
reorganization of the Chief Engineers of the WRO on a river-basin basis;
institution of river-basin allocation and planning committees headed by
basin Chief Engineers; and
strengthening of WROs environmental management capabilities.
In addition, a major component of the WRCP has been directed at planning
and institutional strengthening in the water sector. The changes and
rationalization of the water sector in Tamil Nadu are consistent with the new
international agenda and its focus on integrated water resource
management. In particular, the water sector has been given a higher profile
via this disaggregation of water sector functions under the newly formed
WRO.
Changing roles and responsibilities in Tamil Nadu
One of the changes introduced by the TN-WRCP has been the reorganization
of operation decisions on a basin, rather than district basis. Tamil Nadu
therefore finds itself with at least three families of institutional structures.
District collectors from the colonial period, sectoral departments of the
1960s, and the new river basin institutions headed by basin managers.
Committees comprising the basin managers, local representatives of other

sectors such as agriculture, industry, and domestic water supply, and the
collectors of the relevant districts will make water allocation decisions at a
basin level. Basin managers head these committees, but the changing roles
and responsibilities may lead to conflict or resistance from the district
collectors. Despite the potential for conflict, the reorganization has generally
met with wide approval.
DFID, 1998b
234
Is there a national procedure for environmental impact

assessment which includes public participation?
DFIDs own Manual of Environmental Appraisal (ODA, 1996b) has details

of favoured approaches. There may be a national procedure, or some
countries may follow the World Banks OD 4:01 (World Bank, 1991).
What is the current national environmental picture and how
dependable are the data?
Reports and secondary data can be used to obtain an environmental

profile. They may also provide a good indication of how serious the
issue of environmental sustainability is in the country and how
complete the data are. In addition to statistics on historic WS&S
coverage and future targets, data on river water and groundwater
quality trends will be important. Policies and plans related to
wastewater treatment, re-use, and disposal should be assessed in
relation to pollution trends.
Is any form of integrated river basin management in operation?
Though this is an institutional issue, it relates also to considerations of

environmental sustainability and integrated water resources
management (IWRM) as a whole. (See Sections 2.4.1 and 2.4.3.) A
river basin or sub-basin base is a very practical unit for IWRM. In
relation to WS&S programmes, the basin may also be a useful
confining unit when identifying stakeholders.
Is there a mechanism for resolving conflicts over water demands
and usage?
Conflict resolution is becoming a bigger and bigger issue as scarcity

increases. WS&S is generally specified as a priority use, but that does
not help many communities who suffer regular cut-offs and service
interruptions, despite the small amount of water that is used for
domestic purposes. A logical output of the development of agreed
priorities and allocations for water demands is a system of abstraction
licences which can include conditions specifying rates of abstraction
and constraints related to season and/or river flows or groundwater
levels. It is important that such systems be properly funded, to ensure
enforcement.
3.1.5
Economic perspectives
The general questions are How appropriate is the enabling

framework of policies? and What changes are needed? More
specific questions under various policy headings are given below.
Integrated water resource management
National water sector policies should be cohesive and consistent with

efficient and equitable water use for agricultural, industrial, and
domestic purposes. Pricing policy should reflect the opportunity cost
of water. Although water is an increasingly scarce resource, irrigation
water is heavily subsidized in some countries, often to the detriment
of the affordability and sustainability of domestic water supply
schemes. There should be a framework of incentives for the use of
water, based on demand management (using pricing and non-pricing
235
measures), and reinforced by a public expenditure programme in the

water sector in support of these principles. Such a framework is
spelled out in the Draft DAC Guidance on the treatment of aidfinanced projects in the water sector (Winpenny, 1997b).
Key questions are:
Are policies (e.g. on water pricing) giving the right incentives to
water users to reduce integrated water resources management
problems?
If there is intersectoral competition for water, do prices for
irrigation water need to be raised to release water for urban use?
Is sufficient use made of water demand management approaches?
Policy towards the poor
Ensuring the sustainable provision of basic water and sanitation

services to those who lack them should be a governments first
priority in the water sector. Policy on the use of subsidies, or on
reforming utilities or sector institutions, or on increasing the role of
the private sector, should be built around this priority. The proportion
of the population with access to functioning safe water and sanitation
services is important. So are trends showing how this proportion has
been changing. Coupled with subsidy analysis, they can help to focus
attention on alternative uses for available public subsidy and the
trade-offs between extending service coverage on the one hand and
recovering a higher percentage of costs from those served on the
other.
Policies with the best prospects for reducing poverty are likely to be
built on principles of:
recovering overall a high proportion of costs from users;
ensuring basic services to poor people are available at affordable
prices;
targeting available subsidies on poverty-focused services; and
adopting a demand-responsive approach which allows consumers a
choice between the level of service options.
Key questions include:
What proportion of poor people currently have reasonable access
to safe water and sanitation? (If using official statistics, check what
proportion of water systems are actually working.)
What is the policy on charging poor people for water and sanitation
services?
What do poor people actually pay?
What are governments plans to extend coverage of services to
more poor people?
Policy on cost recovery and financial sustainability of sector

institutions
A sustainable extension in the coverage of safe water and sanitation

systems among large numbers of poor people, especially in urban
areas, is heavily dependent on much stronger cost recovery than has
been the norm. It will be difficult for individual projects to attain
financial sustainability where tariff setting is politically controlled and
236
tariff levels are kept very low. Agreement is needed at the political
and policy level before progress can be made in improving the
financial sustainability of sector institutions.
Key questions are:
What is the financial status of key sector institutions?
Are they able to cover O&M costs fully?
How far is failure to recover capital costs limiting the scope for
improving the coverage or quality of service?
What is policy on recovering (a) capital and (b) recurrent costs
from:
- users in small rural schemes;
- users in urban schemes;
- commercial and industrial users; and
- government establishments.
Are proposals for tariff reform appropriate?
Policy on subsidies
Subsidies are legitimate on income distribution grounds and where

significant external benefits are expected, but they should be
transparent, equitable, and sustainable. Subsidy analysis (see Section
2.5.10) can reveal who benefits from current subsidies. If cost
recovery is low, a reform of utilities will need to form part of any
proposed package of DFID assistance to extend the coverage of safe
water and sanitation to poor people on a sustainable basis.
Key questions are:
Are subsidies transparent?
What is the objective of subsidy?
Should subsidy policy be more clearly targeted (e.g. on services for
poor people)?
What is the realistic forecast of the future availability of the
subsidies, from domestic and foreign sources?
How could these be used more effectively (e.g. to extend coverage
to more people)?
Policy on attracting private investment
Private investment in water and sanitation is needed because the scale

of funds required to meet demand is well beyond public sector and
donor financial capacity. The private sector has better prospects than
the public sector for improving operational and financial efficiency of
sector institutions. A range of private sector participation (PSP)
options is available.
Key questions are:
What are the main options for attracting more private investment
(private sector participation) into the sector?
How can more private investment be promoted?
Policy on demand responsiveness
WS&S service providers have rarely been responsive to demand.

Consumers vary greatly in what services they want, however, and
what they are willing to pay for. There is scope for both increasing
aggregate well-being and enhancing the impact on poverty reduction
237
by responding to peoples willingness-to-pay for improved services

and recovering a higher proportion of costs from users. Demandassessment surveys can help identify willingness-to-pay for a wider
range of levels of service than has been traditionally planned, and can
inform policy dialogue about sector reform.
Key questions are:
What evidence is there of unmet demand?
How can policy encourage more demand-responsive water and
sanitation services, such as by making a range of level of service
options available, or showing flexibility on standards of service?
3.1.6
A broad institutional appraisal should be one of the first activities

undertaken in a sector strategy review. The aim should be to ensure
that the institutional structure is adequate to plan, manage, and sustain
a WS&S programme with a fully participatory approach. In most
cases, the appraisal is likely to identify a need for capacity building
and possible institutional reform, depending on the scale of the
planned DFID co-operation in the sector. The focus areas and tools to
be used in institutional appraisal are described in Section 2.6.
Is the institutional framework (with any planned changes) able to
operate sustainable services for the urban and rural poor?
As we have seen in Chapter 2 (Sections 2.6.2 and 2.6.3), the

institutional needs vary enormously both between rural and urban
communities and within urban areas, depending on whether existing
urban utilities are able to offer services to squatter settlements.
Deficiencies need to be identified at this stage, so that capacitybuilding initiatives can be included if necessary.
What is the history of NGO and private-sector involvement in
WS&S?
The right model for any particular country may well involve an
enhanced role for NGOs or private entrepreneurs in all aspects of
WS&S service delivery. The scope for their involvement should
emerge from the participatory appraisal of any proposed programme.
Is there any commitment to decentralization and management at
the lowest appropriate level?
Most countries have decentralized in recent years, but in some

instances it may be more a matter of passing the buck than equipping
and empowering local agencies to manage services autonomously. It
is important therefore to assess progress on decentralization both in
terms of determining the long term sustainability of any proposed
project, and in agreeing the scope of any institutional support.
3.1.7
Technical aspects
Though detailed technical considerations apply later in the project

cycle, this initial stage is an important one. It is the time when
partners need to agree on both the principles of consumer-led choices
of technology and service levels. These principles will have
238
implications for government norms and standards and donor

conditionality.
Is there a national or local policy of standardization of
engineering practices?
Standardization of equipment, design, and construction methods may

be desirable at a country level (see Section 2.7.4). If the government
has made any attempts to standardize practices then this should be
discussed and built upon at the earliest stage. It may be appropriate to
encourage the development of policies and guidelines for the
standardization of future projects or programmes in the sector. This
will ultimately aid sustainability and replicability. The purpose of
standardization needs to be clarified, however, so that it does not
constrain innovative approaches.
Are there any policy constraints or preferences which preclude or
favour certain technology choices?
There may be political reasons why certain technologies are favoured

by donors or governments. These preferences (or constraints) need to
be identified at the start of the project cycle and, if appropriate,
incorporated into project or programme planning. The Benin and
Belize governments specify the use of India Mark II handpumps for
example. If it is unacceptable to work within these constraints,
alternative technologies must be negotiated with the project partners.
Do all the project partners accept that the choice of engineering
hardware must be demand responsive?
The importance of a demand-responsive approach to design must be

understood and adopted at the highest level. While technology may be
able to address most water and sanitation situations in developing
countries, policymakers and engineers must appreciate that the
hardware has to match peoples desired level of service. If these are
mis-matched, the project will not be successful or sustainable. (See
Sections 2.7.8 and 2.7.14.)
Are government-specified levels of service too specific?
Some country governments specify precise service levels or norms, for

example a minimum supply of 55 litres/capita/day. This can be counterproductive to a demand-responsive process that is based on willingnessto-pay, and may lead to some appropriate technical options being
rejected. Partners should be encouraged to take a more flexible view.
3.1.8
How should a consumer-oriented approach to hygiene promotion

and sanitation promotion be presented to DFIDs partner
governments?
The sector is undergoing a major paradigm shift towards consumer

orientation. Some new approaches have yet to be accepted; for social
marketing, for example, may be a suspect phrase in some circles. The
approach described here to hygiene and sanitation promotion draws
on social marketing but is less top-down (see Section 2.8). Insisting
on a user-oriented approach to hygiene and sanitation promotion may
239
be too radical a move for programme partners. There is the wider

problem that partners may become weary and sceptical of the
continual introduction of a succession of supposedly new approaches.
It is a mistake to rely on external consultants; rather, DFID needs to
offer human resource development to local partners so that they can
lead such initiatives from the start. An external consultant might
provide guidance and on-the-job training at the formal research stage.
If a local group carries out the formal data collection, capacity is
created for subsequent projects. Instead of insisting on the new
promotional approach DFID should offer it as an option and ensure
that there is the capacity for it to be a viable alternative.
What are the attitudes and policies (formal and informal) towards
health and hygiene promotion?
What is the attitude of the government and other potential project

partners to a demand-responsive approach? (See Section 2.8.2.) What
are the stumbling blocks? How can these be overcome? If the partner
government has no experience, then DFID can help reduce the risks of
the approach. If they have had a bad experience, the focus needs to be
on what made it fail the first time. Are there key individuals within
the Ministry of Health, or other responsible agency, who are open to
the marketing approach to hygiene promotion, rather than the simple
didactic approach based solely on information transfer? Is there
experience in the country which can be shown to officials to convince
them? (See Section 2.8.5.) Does the capacity exist, possibly among
local consultants or NGOs, to implement the approach? Is there room
for some experimentation, and is there the possibility that
experimentation and piloting may influence policy?
3.2 Stage 2: Programme and project identification
The agreements reached in Stage 1 with project partners on policy and
strategic background and on the roles of different stakeholders form
the basis for this stage. With most negotiations still conducted at the
national level, Stage 2 extends the discussion process to include local
stakeholders involved in specific project proposals. Usually, the
government partner will have a pipeline of possible projects and a set
of criteria for prioritizing them. During Stage 1, these will have been
reviewed in general terms, and the criteria may well have been revised
to accommodate the principles and approaches agreed by the
programme partners.
WaterAid/Jim Holmes
In Stage 2, the criteria need to be developed in detail and then applied

to the preparation of an agreed programme of WS&S projects with
defined roles for all partners. This stage includes environmental
appraisal and its outputs for DFID, including an Environmental
Screening Summary as described in the Manual of Environmental
Appraisal (ODA, 1996b) and a Project Concept Note, Volume II: D4
(ODA, 1996c). The Concept Note will include an outline of the key
features of each selected project in the form of a narrative summary
(not the complete log frame). It will also have notes on the
Stakeholder Analysis which is the key activity in this stage. It is
240
important that the identified projects are defined in sufficient detail to

confirm the multidisciplinary approaches which will be followed and
the roles of different partners in the design and implementation stages
to come. The definition should not be so precise as to inhibit
flexibility of choice in subsequent stages, when the process approach
to project development will require discussion of a wide range of
options.
Figure 3.2.1 illustrates the process of project identification. In addition to
the overall agreements reached in Stage 1 with all partners, DFID may
have its own specific criteria, reflecting the UK Governments priority
focus on the poor, the involvement of other donors, and DFID
comparative advantage. The selection will be influenced too by the
dialogue with potential project partners and the climate for innovation
and change communicated by the project champions.
Suggested key questions to be addressed in Stage 2 follow.
3.2.1
General
Are the rules for selecting and defining projects clear to all
stakeholders?
Selection criteria for inclusion of village/areas should be transparent

and based on need and demand. Project Rules such as the capital cost
contribution, disbursements of funds, and management arrangements
need to be agreed and understood by all stakeholders.
Do all partners agree on the approaches to be followed in
defining the projects?
A participative process approach is needed, encouraging local

institutions and community organizations to take a proactive and
leading role in the project. Demand assessment is required to confirm
a communitys commitment to a project and may include willingnessto-pay surveys and beneficiary assessments.
Is there agreement on the institutional and financial implications
of project selection?
The right institutional framework is crucial in terms of providing

adequate support to community management and stakeholder
institutions. Funds and financial flows are a key feature in project
progress and sustainability. Fund allocations and disbursements
should be adequate, flexible, timely, and involve simple procedures.
Will there be a flexible approach to enable communities to make
real choices in the design stage?
Technology and choice of service level involves spending time with

interested communities, working out and explaining to the
communities the implications of each viable technical option, thus
enabling them to choose the technology and service level.
Are the identified projects clearly linked to an IWRM strategy?
The means of achieving full integration of projects into national sector
strategies should have been agreed in Stage 1. It may involve a master
plan approach or a learning process or a combination of the two,
241
Figure 3.2.1. The project identification process
242
particularly where there are area-wide problems such as water

resources management or contamination problems.
Will there be adequate provision for monitoring progress and
assessing the sustainability of selected projects?
Monitoring and evaluation processes need to be spelled out at this

point. They should support community management and encourage
community self-assessment activities. Participatory evaluations with
project partners should focus on progress in achieving the project
purpose.
Each of these questions is addressed in more detail in the disciplinespecific questions which follow.
3.2.2
Social perspectives
Good programme and project identification depends crucially on

social analysis and the two critical tools used are social impact
analysis (SIA) and stakeholder analysis. The key questions informing
social impact analysis and stakeholder analysis in water supply and
sanitation schemes are:
Is the programme or project responsive to the needs of the
people affected?
Is the project culturally appropriate in terms of technology and

planning approaches?
Is behaviour change necessary for the project to have an impact
and do primary stakeholders see a need for changes to the practices
associated with the new technology?
Will some groups be excluded from or negatively affected by the
project, for example water vendors or owners of land where current
water resources are located?
Have user preferences about feasible technical options, the siting
of installations, and the institutional arrangements for operation
and maintenance been elicited?
Does the programme or project reach poor and disadvantaged
people?
Are the areas where poorer people live and work included in or
targeted by the project?
Does the project include all members of the target communities,
particularly those who may be disadvantaged by poverty or their
status in society?
Does the project take account of the different needs of women and
men, of older and younger people, and of people with different
abilities?
What are the financial costs of current water supply and sanitation
provision and will they be affordable, for example connection fees
and maintenance charges?
If user charges pose a problem for poorer households what
arrangements can be made to facilitate take-up such as credit
funds, public standposts, or cross-subsidization?
Where necessary, what inputs are needed to reform the policy and
243
institutional frameworks in which water supply and sanitation are

delivered, so that they take account of poverty?
Does the programme or project recognize the different roles,
needs, and contributions of women and men?
DFID/R Lokanadham
Will women benefit as well as men?

Have women and men been consulted about the issues raised, such
as the sitings of installations, technological choices, and
institutional arrangements, and have their responses informed
project design?
Is hygiene promotion directed towards those most often
responsible for it, that is adult women, and are the informal
communication networks of women and men used to develop
health education messages?
Are the multiple demands on womens time and the opportunity
costs they face recognized when planning to include women in
consultation and participation?
Have womens and mens different responsibilities for household
budgeting been taken into account for assessing willingness and
ability to pay?
What is the level of demand for water supply and sanitation and
where will it be necessary to develop a shared agenda?
What problems are identified in relation to water supply and

sanitation? What causes are discussed? Who sees them as
important?
Are there competing requirements for water use, for example
between domestic use and productive activities such as livestock
raising?
Do priorities differ between primary and secondary stakeholders?
Do priorities differ among different members of a community or
among different communities/villages/neighbourhoods?
What are the existing land and property ownership arrangements
and will these be affected by the project?
What institutional relationships exist at the local level and how
will they relate to the project?
Is there a tradition of setting up or maintaining water supplies,

waste management systems, or public facilities?
What institutional structures have been involved and could they be
used again? Will women be represented?
Could existing local institutions or a modification of them be used
as channels for dialogue with potential users in the design,
implementation, and monitoring of the project?
Who in the community will make decisions and how will local
power structures be affected by the project?
What level of participation and partnership is possible and

appropriate among stakeholders?
Are the professionals and officials involved in the project

experienced in taking a participatory approach to water supply and
sanitation provision? If not, what capacity-building components
244
could help facilitate this approach?

Do community members have the confidence and skills to engage
effectively in participatory processes and partnerships? Which
groups need support and of what kind?
Is provision being made for community maintenance and how will
the project deal with abuse of the system, for example through (a)
mobilizing community pressure through existing organizational
structures; (b) additional work incentives; (c) public awareness
campaigns; (d) disincentives for abuse such as all residents sharing
the cost of repairs; and (e) maintenance skills training?
Who from the community will contribute labour and engage in
operation and maintenance? Will this affect their status? Will it
contribute to their income?
Will the project increase the responsibilities and workload of
certain groups?
In order to assess the participation of different stakeholders it is
important to identify them in the first place. As well as identifying
appropriate types of participation by different stakeholders at different
stages of a project, stakeholder analysis can help assess different
interests in a project, conflict of interest, and the potential for cooperation and coalitions. Examples of what a stakeholder analysis and
a summary participation matrix for water supply and sanitation might
look like are included for illustration (see Tables 3.1 and 3.2).
A stakeholder analysis helps assess which stakeholders are important
for project success. In Figure 3.1, for example, although politicians
are not directly involved they are ranked relatively high because they
could sabotage the project. Stakeholder analysis also helps assess
appropriate and feasible roles for different stakeholders. For example,
when is it appropriate to expect primary stakeholders to participate
and in what capacity? While DFID has the right to make a judgement
on the extent of participation it wishes to see from different
stakeholders in a project, other stakeholders may reach different
conclusions. This will require discussion and the development of
mutual understanding.
3.2.3
Because improved health is a key objective of WS&S programmes,

comparison of project options has to include an assessment of realistic
health benefits which might arise from an intervention. Even where
the total numbers are uncertain, the differences in health impacts
between various options can often be clearly identified.
What is the existing environmental health situation?
To understand the links between water, sanitation, and hygiene, and

the possible effects of any proposed intervention, you need to
understand the existing environmental health conditions. Ideally, it
would be valuable to know something about beliefs and practices
concerning hygiene behaviour as well; if this is not possible,
formative studies should be included as part of the project preparation
245
Table 3.2.1
Stakeholders in a water supply project with a participatory approach and cost

recovery dimension
Stakeholders
Interests
Potential
project
impact
Relative
priorities
of interest
Secondary stakeholders
Ministry of Water Affairs
Achievement of targets
(+)
Co-ordination of activities
(+)
Liability for failures and

resource misuse
(-)
Politicians
Timely delivery of visible services
Formal suppliers
DFID
=2
(+)/(-)
=3
Sales and profits
(-)
=6
Short-term disbursement of funds
(-)
Effective delivery
(+)
Evidence of poverty impact
(+)/(-)
=2
Improved access to water
(+)
Better health and opportunities
(+)
More time and energy
(+)
Better health and education
(+)
Access to water for livestock

and crops
(+)
Better health
(+)
=1
Private water vendors
Loss of income from water sales
(-)
=4
Nearby middle-income
users with connections
Increased costs on ability to pay

principle
(-)
Loss of status and income

from water sales
(-)
Primary stakeholders
Low-income communities
Women and children

in those communities
Men in those communities
=1
= 1+
External stakeholders
246
=5
Table 3.2.2
Type of
participation
A summary participation matrix for a water supply project with participatory

approach and cost recovery dimensions
Inform
Consult
Partnership
CBOs
Womens groups
DFID
Control
Stage in
Project Cycle
Identification
Ministry
NGOs
Other donors
Planning
External
consultants
DFID
Ministry
Ministry
NGOs
CBOs
Womens groups
Implementation
DFID
External
consultants
Ministry
Implementing
agency/ PMU
NGOs
CBOs
Womens groups
Monitoring and
evaluation
DFID
Ministry
Ministry
External
consultants
NGOs
CBOs
Womens groups
PMU
247
(Stage 3). To begin with, however, what are the levels of service available
for water and sanitation; which fractions of the population receive what
levels? The water and sewerage utilities are aware of the number of
formal connections, but this is often only a small part of the story; in
many cities the turnover of the informal water sector (i.e. vending) is
greater than the revenue of the water authority. It is especially important
to focus on the existing situation for the poor and marginal groups, as
they are usually at greatest risk and are the target groups for DFID cooperation. To determine their access to water and sanitation services
you need to visit poor communities and look closely at how people get
their water and dispose of their wastes. Existing health statistics and
studies can sometimes highlight dramatic outbreaks attributable to water
and sanitation, but often understate the daily toll of endemic disease.
Consultation with healthworkers regularly working with the poor may
give a better idea of the relative significance of sanitation-related diseases
than official statistics.
How plausible are the health benefits of the project?
It is critical to understand how many people will be affected, and in

precisely what ways. Health benefits accrue when (a) people use
more water; (b) more people (especially children) use sanitation; and
(c) hygiene is effectively promoted (see Sections 2.3.1 to 2.3.3). The
main health benefits of increased water consumption are likely to be
in reduced faecal-oral diseases, especially diarrhoea, and reduced skin
and eye infections. The main health benefits of sanitation are likely to
be reduced faecal-oral disease, especially diarrhoea, and reduced
intestinal worm burdens. Health benefits rarely accrue from sewage
treatment, with the possible exception of waste stabilization ponds
(see Section 2.7.22), in which case downstream beneficiaries using
the receiving water should be explicitly identified.
Who will really be affected, in health terms?
WaterAid/Jim Holmes
Health benefits tend to be focused on changes in the household

environment (see Section 2.3.8). Will more water reach more people
at the household level? (Note Figure 2.3 showing water consumption
as a function of travel time.) Will more households have sanitation
coverage? How is the issue of childrens health and hygiene
promotion likely to be addressed? While centralized investment is
also necessary, it is critical to find out what the effects of such
investments will be at the household level.
Who can be project partners in health?
Who are the partners responsible for maximizing health benefits from
the project, and what are their understandings of the role of health in
the project? Do they have resources and an interest in adopting the
hygiene promotion approach outlined in Section 2.8? What has been
the past experience in health education and hygiene promotion in the
project area? Partners with a willingness to try new approaches, and
with local credibility with the community, are far more valuable than
formally qualified professionals who see no alternative to the
traditional educational approach.
248
3.2.4
Environmental perspectives
Stage 1 will have established the national environmental goals and

policies and the institutional, legislative, and regulatory framework
under which projects will operate. In Stage 2, the aim is to assess the
likely environmental impacts (positive and negative) of proposed
projects. An Environmental Screening Summary is a DFID
requirement for all projects. It will also be necessary to judge the
sustainability of the project itself and its possible impact on the
sustainability of the local environment and/or future downstream
projects.
Does the scheme have any significant environmental
consequences?
River abstraction schemes may involve the construction of weirs or

barrages which can prevent the passage of fish and inhibit water
transport. Impounded waters may encourage algal growths which can
alter the ecology of the water. Wastewater discharges to a watercourse
or lake can affect the fish population and may encourage algal
growths and eutrophication. On the positive side, improved urban
sanitation can significantly reduce the polluting load on rivers. One
cautionary note here: sewerage without treatment simply converts
scattered pollution into point-source pollution where the sewers
discharge. It can actually have a negative environmental impact, by
short-circuiting the natural biodegradation of human wastes and so
increasing the pollution load.
Is there a guaranteed and sustainable allocation of water for the
WaterAid/Jim Holmes
project?
In some cases, such as where a community is drawing small quantities

of drinking water from a well-replenished aquifer, there may be no
doubts about the long-term sustainability of good quality water. More
frequently, there will be competing uses for the resource, and the
modest WS&S needs may be threatened by larger demands from
agriculture and/or industry. (See Section 2.4.1.) In such cases, all
significant existing and potential uses of water within the area need to
be identified and quantified as accurately as possible. Realistic
forecasts of future needs for the various uses must also be made in
order to assess the longer term sustainability of a scheme. There needs
to be an agreed mechanism for allocating water, and an agreed priority
of maintaining potable supplies in times of scarcity or drought.
Surface water developments
Is the source perennial?
If the source is perennial it may be able to supply the demand

throughout the year, whereas an intermittently flowing river will need
an impounding reservoir to maintain supply during periods of no flow.
In the absence of a reservoir alternative sources of water must be
available if supply is to be maintained.
Are validated flow records available?
In the absence of reliable flow records at the abstraction point it will

be difficult in later stages to estimate the likely surface water
249
availability or the yield of a river basin. Precipitation records can be

used in conjunction with estimates of direct runoff and evaporation to
estimate yield in the absence of flow records. It may be possible to
estimate the yield in an ungauged basin by comparison with a similar
gauged basin if one exists.
What existing abstractions occur upstream and downstream of
the proposed development?
Even though the government or basin agency should have guaranteed

the allocation of water for the proposed scheme, its effective
sustainability will be governed by the balance between yield and total
abstractions. It is therefore important that, as part of a resource
management exercise, all significant abstractions are identified and
investigated (possibly including gauging), and that estimates are made
of likely changes in these abstractions. Upstream uses, if consumptive,
will reduce flows at the abstraction point. Downstream uses may not
be able to continue if the abstraction means that the river is unable to
support the required flow. Diversionary uses which return water to the
river system may return most of the abstracted water (cooling water)
or relatively little (irrigation). Returned waters do sustain low flows
but are likely to have some degree of quality deterioration, and quality
also needs to be investigated.
What regulatory or legal mechanisms control abstractions and
polluting discharges?
Although collaboration and co-operation between water users should be a

target, feelings can run high about water and its availability. The
existence of a legal or legislative framework to control abstractions in
times of stress is essential. Such administrative frameworks are, however,
of little value if the regulatory authority lacks the resources to undertake
its duties. They are also ineffective if they ignore or counter informal
community-level rules and institutions governing common property.
Unless both some form of appropriate pollution prevention and control
measures are available it will be difficult to maintain good quality water
at an abstraction point. (See Section 2.4.5.) All major effluent discharges
should be subject to discharge consents which place limits on the content
and volume of the discharge. Where potential pollution risks are present
measures should be available to institute remedial or preventative steps.
Human and financial resources must be available to implement pollution
control measures and ensure compliance without being subverted by
corrupt malpractice.
Are other abstractions and/or developments under consideration

for the same river basin?
Liaison with other administrative, planning, and commercial

organizations within a river basin must be undertaken to ensure, as far
as possible, that the project will not be negated by new demands in
other parts of the basin.
Groundwater developments
Are validated records of groundwater levels available?
If abstractions from aquifers exceed the recharge, groundwater levels

will fall. There are many instances where increasing the number of
250
boreholes to provide a greater yield from an aquifer has resulted in

eventual failure of the source. Over-abstraction can cause the ingress
of seawater if near the coast, or of poorer quality groundwaters from
contaminated sites (see Section 2.4.1). Reliable records of
groundwater levels supplemented by pumping tests will give some
indication of the potential yield, although the yield of groundwater
sources is more difficult to predict than that of surface water sources.
What regulatory or legal mechanisms control potentially polluting
discharges to the aquifer?
Groundwater protection policies should prevent the establishment

and/or operation of potentially polluting activities in the vicinity of a
groundwater abstraction, and should closely regulate such activities
over the area of the groundwater catchment. (See Section 2.4.5.)
Are the environmental quality objectives for the scheme derived
from appropriate local criteria?
The use of environmental quality objectives from developed countries

can sometimes be quite inappropriate for developing countries with
very different conditions. For example, a water quality objective
approach for environmental management of a receiving water is quite
unrealistic for a watercourse which is not perennial. In the absence of
natural flow, water quality downstream of a discharge cannot be better
than that of the discharge. (See Section 2.4.2.)
3.2.5
Questions arise under various policy headings.

Project Purpose
Is the Purpose appropriately specified?
Key questions are:

Does the Project Purpose, and the approach to project development:
allow consideration of a wide range of technical, policy, and
institutional approaches (e.g. demand management) to solving the
project problem?
recognize that provision of the same level of services to some
people will be more costly than to others, for technical reasons,
because of population density, etc.?
recognize that some people may be willing to pay the full costs of a
higher level of service, so the cheapest project design or level of
service option is not necessarily the most desirable economically?
Demand assessment
Demand assessment is central to designing a demand-responsive

project. A variety of demand assessment techniques are available (see
Table 2.1.2, Section 2.5) and the most appropriate approach will
depend on project circumstances. Contingent valuation method
(CVM) studies are the best way to assess demand for improved levels
of service, especially where users will be required to pay much more
than they do at present, but CVM studies are expensive. Revealed
Preference surveys are cheaper but only show what people are
251
currently doing, and are a less reliable guide to how they might
respond to new options made available in the future.
Often a multi-stage process using a mix of informal and formal
approaches will be appropriate. Demand assessment needs to be coordinated with participatory processes undertaken as part of the social
analysis.
Key questions are:
How important will demand assessment be to project design
decisions? What will be the most appropriate methods to assess
demand?
How will reliability of demand assessment be assured (e.g. using
randomly selected survey sample, using specialist expertise for
quality control of contingent valuation studies)?
What are the present use and consumption patterns: for different
groups, from different sources, and for different purposes?
What signs of unsatisfied demand are there?
What are projections of demand, and sensitivity to price?
Equity issues
It is inequitable to require poor people to pay more per litre for water
than richer people. The main ways to make services more affordable
for poor people are through tariff structures (e.g. lifeline tariffs),
cross-subsidy, and targeted subsidy (see Section 2.5.11). Given the
scarcity of public funds, however, a higher level of subsidy per litre
will usually translate into fewer poor people benefiting from it.
Key questions are:
Who will benefit, and by how much, under each project design
alternative or level of service option?
Which poor people are expected to benefit?
How much might they be expected to pay for improved services?
How might this compare with what they currently pay, and with
what other consumers currently pay or might pay in the future?
Could more poor people have access to affordable services if
subsidies were restructured?
Prospects for economic justification
The economic justification for alternative approaches to addressing

the Project Purpose should be compared. Other things being equal, the
approach with the strongest economic case should be adopted. Where
possible, projects should be subjected to cost-benefit analysis, using
standard economic techniques. Benefit estimates can be derived from
demand assessment studies.
Where it is not possible to value demand, cost effectiveness analysis

should be used. Comparison of unit costs (capital and O&M) with
those from similar projects elsewhere in the same country can help
cross-check cost-effectiveness, (although on occasions meeting
relatively high unit costs may be justified if there are strong reasons
for expecting a similarly high level of benefits).
252
Benefits, which often vary seasonally, can include financial savings,

time savings, convenience benefits, health benefits, and sometimes
production benefits. Focus group meetings and field observations can
help gain a first impression of possible benefits. The scale of water
vending and the prices charged, and/or the round-trip time fetching
water, can be useful proxies of demand for improved water supplies.
However, these rough indications of the current situation will not be
sufficient if the options presented by the project will require users to
pay much more money than they do currently. In such cases the
numbers of people choosing to use the new option and how much
water they use will have a big impact on the scale of project benefits.
Without using the contingent valuation method it is difficult to predict
benefits accurately. Revealed Preference studies may underestimate
demand. Both Revealed Preference and CVM will tend to
underestimate the health benefits (both private benefits and
externalities) which are likely to be particularly important in
sanitation projects, but health benefits are in any case hard to forecast
or measure directly. Distance to water and the nature of the disease
burden can help identify whether they are likely to be significant.
Key questions are:
Is a suitably wide range of options being considered?
Has there been an investigation of the scope for phasing investment
more slowly, to match growing demand incrementally?
What costs capital and recurrent are associated with each
option?
From projections of demand, what are the projected benefits?
What steps will be taken to ensure investment funds are used
where economic returns will be high (that is to consider the costs
as well as benefits, for instance, in deciding which villages should
benefit from public investment in supply systems?)
What is the economic case for wastewater treatment, versus
wastewater collection, treated separately?
What would the costs and benefits be without the project?
Are the incremental net benefit flows (i.e. benefits minus costs,
relative to the without-project situation) likely to justify investment?
Demand management
Key question:
Have demand-management options (e.g. tariff reform; pricing for nonessential uses; reducing unaccounted for water; leak reduction; use of
low-volume flush toilets; tighter billing, enforcement, and collection)
been systematically considered?
Prospects for financial sustainability
Key questions are:

What are the broad financial targets for key institutions?
What is likely to be the impact of the project on their finances?
Will they be able to cover at least O&M costs?
What is the process for reform of cost recovery, tariff structure,
tariff levels, etc.?
253
What prospects are there for

- stronger billing, collection, and enforcement (specially
important when large increase in revenues are forecast);
- metering (where this is economic);
- improving the operational efficiency and lowering the costs of
utilities; and
- recovering installation and connection costs?
Prospects for use of subsidy
Key questions are:

What will be the projects impact on the public budget?
What limits will be there on use of subsidy?
What are the alternative ways in which subsidy could be used?
Options for Private Sector Participation (PSP)
Is a sufficiently wide range of options for PSP being examined?

Risks and sensitivity
How sensitive to key assumptions are costs, benefits, poverty

impact, financial sustainability, and budgetary impact?
What measures can be taken to reduce these risks (e.g. building
more flexibility into project design)?
3.2.6
The national institutional appraisal undertaken in Stage 1 will provide

a basis for comparing project proposals and identifying any
institutional strengthening needs. It needs to be supplemented in this
Stage with appraisal of local institutional frameworks related to
individual project localities (see Section 2.6.8). It is worth noting here
that some past DFID WS&S projects have experienced difficulties
because institutional and financial appraisals were not undertaken at
an early enough stage.
Discussions with stakeholders should include critical assessments of
the existing institutional set-ups as they relate to each stakeholders
anticipated role. Almost invariably there will be suggestions for
strengthening the capacity of partner institutions to respond to user
needs and maintain the participatory approach. The need for
strengthening should not in itself invalidate a project proposal.
Capacity building is an important part of DFIDs co-operation with
partner countries and can have knock-on effects in terms of improved
sustainability and replicability.
As in Stage 1 (Section 3.1.6) two questions need to be addressed first:

Is the institutional framework (with any planned changes) able to
operate sustainable services for the urban and rural poor? And
what is the history of NGO and private sector involvement in
WS&S?
This time, the assessments are more localized, relating to particular

local and regional institutions and their capacity to manage specific
proposed projects.
254
The third question extends the appraisal undertaken in Stage 1 related

to decentralization and management at the lowest appropriate level.
Do local agencies have the skilled human resources needed to
implement and manage participatory WS&S projects?
Stakeholder participation, gender sensitivity, responsiveness to user

demands, and the participatory management of services all demand
specialized skills (section 2.6.15). These are not the kind of skills
commonly taught in engineering courses, where many sector agency
staff received their training. Human resources development (HRD)
components are frequently a key part of institutional strengthening.
They require careful consideration in the Preparatory Stage (Stage 3).
Now the aim should be to ensure that there is scope for HRD to be
effective. That means a minimum core staff committed to the WS&S
sector principles, working in a utility or agency with autonomy (or a
government commitment to achieve autonomy), and incentive
structures capable of retaining trained staff.
3.2.7
Technical aspects
At this stage, the engineer should provide a supportive and enabling

role for the project partners by assessing the technical viability of
outline project options.
WaterAid/Jim Holmes
What baseline information is available?
Baseline studies should be carried out in the proposed project area(s)

alongside the development of project concepts by the stakeholders.
The type of baseline information required includes data on existing
infrastructure/levels of service, local skills and resources, potential
water sources, and other technical or physical constraints. The
exercise will probably be a desk study, making use of available
secondary data through information sharing and discussions with
partners. Some supporting fieldwork or observations may be required.
The potential for rehabilitating or upgrading existing infrastructure
should be considered at this stage but is not always the most
appropriate solution. Before rehabilitation is adopted, the cause of
past failure has to be clearly identified and the means of remedying it
judged feasible (see Section 2.7.6).
Are there lessons to be learned from past programmes/projects?
An important part of the desk study will be to establish which

technological solutions have been most successful in the past. There
will be many lessons to be learned from the successes and failures of
previous projects in the region and these must be taken on board and
also fed back to sector or programme level.
How is a viable outline project arrived at?
This will be an iterative process with engineers assisting the partners

to develop a broad range of options and outline costs. The options
proposed initially may be reviewed and refined a number of times
with the partners until an acceptable and viable project is arrived at
for submission in the Project Concept Note. At this stage, no final
decisions should have been made on the choice of technical hardware.
255
Issues such as replication, incremental improvement, and operation

and maintenance are crucial to project sustainability (see Sections
2.7.5 and 2.7.6) and should have been addressed. These issues may
already have limited the choice of appropriate technologies.
3.2.8
Is there a need for better excreta disposal and hygiene?
Local data on diarrhoeal disease incidence from routine data sources

is unlikely to be of much use. Clinic reports, for example, can be
underestimates and give biased views which reflect only those cases
reported at health facilities, and not those actually occurring in the
community (see Section 3.2.3). Extrapolation from studies in similar
environments is more useful. It is more important to find out if there
are problems of poor hygiene and faecal contamination. If so there is
likely to be a diarrhoeal problem.
What is the time scale for these interventions?
While improving sanitation infrastructure house-by-house is a longterm project which can take many years, hygiene promotion can do
something about risk behaviour in the short term, and it can create
demand for sanitation. Nevertheless, any attempt to by-pass the
essential period of formative research and programme design
(typically three to six months, if local capacity exists already) will
lead to failure of the intervention.
Who are the partner organizations in government for hygiene
promotion and sanitation promotion?
Water and sanitation are generally the responsibility of different

agencies from those which deal with hygiene. While some degree of
co-ordination between them is necessary, this separation may not be a
bad thing. Agencies which implement engineering works are likely to
be ill-suited to offer the flexible response required by promotion and
the resources for promotion need to be ring-fenced to protect them
from the vagaries of the (much more expensive) infrastructure
construction programmes. Different solutions will fit different
countries.
There is little point in going with a project if there is no real
government commitment to it, if the relevant ministry is unconvinced
or does not have the capacity to take on more projects. Is there
potential for other partnerships with NGOs, CBOs, etc., who may
have the flexibility to grow, learn, and be motivated? Investing in
NGOs has short-term benefits in getting the work done. This,
however, will be both a short- and a long-term drain on government
capacity. Hygiene promotion is not sustainable if it depends on an
externally funded NGO.
Who will do hygiene promotion and sanitation promotion?
Which organizations will partner the programme team and be

responsible for hygiene promotion and sanitation promotion? Are
there likely NGOs, CBOs, or social research organizations? Do they
have resources and an interest in adopting the hygiene promotion
256
approach outlined in Section 2.8? What has been the past experience
in health education and hygiene promotion in the project area? Are
there partners who are willing to try new approaches, and who have
local credibility with the community? These will be far more valuable
than formally qualified professionals who see no alternative to the
traditional educational approach.
What other organizations will be affected by the programme?
What does a stakeholder analysis suggest? What role will the water
and sanitation utilities play? This may be important if they are not
keen on low-cost sanitation, are not familiar with it, and feel it is not
their job.
Who pays for hygiene promotion and sanitation promotion?
If there is a choice between funding hardware or software, funds

should be allocated to promotion. It makes more sense to create
demand than to create supply. In the same way subsidies for hardware
should be to manufacturers or workshops as start-up funds to enable
the businesses to succeed. If the construction of household sanitation
facilities themselves are subsidized then the market is effectively
constrained by the programme funds available. If any subsidy is
devoted to the promotional activities then the funds required are not
linked to the number built and the potential for growth is enormous.
3.3 Stage 3: Programme and project preparation
Stages 1 and 2 relate primarily to discussions about national and
regional priorities. We are now entering the project cycle proper and
focusing on the detailed requirements for designing the identified
projects and the supporting software components. Its outcome will be
a clear statement of the goal and purpose of each project with
measurable indicators of performance. Except for very small projects,
executed for example by NGOs, a full project logframe will be
prepared and agreed by all partners.
DFID has its own guidelines for the format and content of a Project
Submission (Volume II: D6 Annex 2, ODA 1996c). It includes
summaries of the evaluations and agreements from the first two stages
documenting the stakeholder consultations. There are separate
sections dealing with technical, environmental, economic and
financial, institutional, and social issues. Staff also need to identify the
management arrangements for implementing the project (Stage 5), the
contracting and procurement requirements, and the timing and
accounting procedures for DFID inputs.
In the past this stage has often meant a feasibility study of the
identified project by a consultant. This may be less appropriate in the
favoured process approach, in which the project develops over a
period of time in dialogue with stakeholders. This is a more iterative
process, which may involve DFID staff and consultants working with
partners in several separate studies, to consider different options and
to develop from these the most acceptable solution. The project
components will consist of both software and hardware.
257
Typical software components would be: hygiene promotion and

sanitation promotion work, including training workers and
preparation of materials; training community management teams;
institutional strengthening activities, etc.
Hardware components could include: building of workshops to
manufacture sanitation equipment; procurement of equipment (for
example handpumps); and construction of water systems and
latrines.
Project preparation will include quantification of the outputs and
inputs for each component, and time scheduling to ensure that they
occur at the right times to maximize the impact on the project
Purpose. Note that software components will often need to precede
the hardware. This stage also involves agreement with partners on
appropriate management arrangements for the project, to meet the
time-bound, quantified Output targets.
In addition, the logical framework design requires the selection of
indicators at each level and a decision about how these indicators will
be measured using a suitable baseline and monitoring framework.
It is during the project preparation stage that technical options are
selected, and Figure 3.3.1 illustrates an outline process for water
supply and sanitation technical-option selection with the participation
of community and support institutions. Many of the activities
indicated are likely to be done in the project implementation stage,
but project partners need to understand the likely process at the
preparation stage. If an agreed process is not developed, there is a risk
that the whole process can become too drawn out and stakeholders
will lose interest in participation. Processes/action plans also need to
be agreed for other project components.
3.3.1
General
Which stakeholders will be appropriate project partners?

DFIDs Guidance Note on Stakeholder Analysis (ODA 1995b) has
checklists to help identify appropriate stakeholders in different project
environments. The analyses and institutional appraisals already
undertaken in the earlier stages should have revealed the main
institutional stakeholders. This is particularly important where there is
fragmentation of responsibilities, which is common in WS&S
programmes. The choice of partners could include: government water
boards, national, state, or local government departments (for water,
sanitation, and health), private firms, NGOs, academic institutions,
consultants, or a combination of these partners. Discussions in the
target community may identify which are likely to have a potentially
influential role on project preparation. Aspects such as
implementation capacities and willingness to adopt a participative
approach will be among the criteria.
3.3.2
It is during this stage that fundamental decisions are made on the

design of the programme and the project process. It is therefore
258
Figure 3.3.1. Project preparation outline process for WS&S technical option selection
259
essential for the social development specialists to discuss the potential

impact on the poor and other vulnerable groups, the gender
approaches to be used, and the need for contingent valuation or rapid
appraisal methods for assessing the communitys needs and
aspirations.
Key questions to be addressed are:
Do secondary stakeholders understand the implications of
process projects?
If projects are demand responsive, include cost-recovery measures,

and adopt participatory approaches, they will foster more assertive
users. They will also require more professional and project time. It is
important that secondary stakeholders recognize that this may involve
a less familiar approach involving the development of shared agendas
and two-way lines of accountability. Partnership may also involve a
re-negotiation of roles and responsibilities at different stages of the
process.
Are primary and secondary stakeholders familiar with
consultative and participatory practices and methods?
Process approaches involve on-going consultation, going beyond

assessment exercises to include participatory planning and
management. Half-hearted commitment or poorly understood
application of participatory approaches on the part of secondary
stakeholders or confusion over objectives and goals on the part of
primary stakeholders can do a great deal of harm. It can raise
unrealistic expectations or lead to suspicion and mistrust. There are
capacity-building implications here.
Can primary stakeholders develop and agree objectives and
weigh up risks for themselves?
It is important that the people involved in or affected by a project fully

understand the implications of any decisions they make. For example,
they need to understand in cost-recovery projects that agreement to
pay for water supply or sanitation provision may go beyond
contributions to capital and construction costs and extend into
payment for operation and maintenance.
Have local institutional arrangements and management regimes
been identified?
Externally imposed institutional arrangements for water and sanitation

projects can interfere with the customary management of common
pool resources. It is possible to work with existing informal
institutions and it is necessary to identify whether local management
regimes can be incorporated into project management. It is also
important to identify how they will need to be supported or developed.
Have all primary stakeholders been involved in selecting

appropriate objectives, outputs, and indicators?
Monitoring is discussed in more detail in Section 3.5 but it needs to be

noted here that the involvement of primary stakeholders in monitoring
is often facilitated after the initial project framework has been drawn
260
up, rather than during preparation. However, stakeholders

involvement at the early stage is crucial, particularly in relation to
monitoring outputs and process, and should not be delayed.
For example, if communal latrines are opted for by community
leaders on the basis of cost and convenience in an informal urban
settlement, the implications of collective management have to be
understood by all those involved. While leaders might agree to a
roster for the cleaning and maintenance of the latrines, the overburdened women who are expected to perform this task are rarely
consulted and may be unable to deliver.
3.3.3
As with the social development considerations, this is the stage in

which the principal health-related inputs and anticipated outcomes
need to be defined. The questions aim to ensure that DFID staff and
partners identify the interventions needed to maximize health impact.
Do you know enough about how many people get sick and how?
Even for a single disease, there may be low-risk and high-risk routes
of transmission. Before claiming health benefits for a project,
someone must study how people become sick. The first stage of
formative research for hygiene promotion (Section 2.8) is critical for
identifying major faecal-oral disease transmission routes. A critical
review of outbreak reports may also be helpful. Ways in which people
currently handle water, their excreta disposal, and hygiene practices
are important to understand in order to recognize which issues need to
be addressed.
DFID/Eric Don Arthur
What changes are most important to reducing illness?
Is part or all of the project or programme aimed at these changes? If not,

can activities aimed at these changes fit within the scope of the project or
programme? Is this seen the same way by both DFID and partners, or are
there different perceptions about the importance of health and the effect
of the proposed interventions upon it? To gather support both within
DFID and among partners, a consensus should be reached early in the
project design on the importance of health benefits and the ways in which
the project will achieve them. Disagreement about this undermines
confidence in the project and its credibility.
What means are most suitable for effecting these changes?
If hygiene promotion is needed, which groups are most likely to be

involved? If they are unable to be involved now, why? Is it simply an
issue of training, or are there issues of policy, power, and political will
involved? Can these be overcome? If so, how? What are the best
routes to overcome these difficulties? If technical measures are
required to improve health (e.g. house or yardtap connections), are
these on the agenda of the local water supplier?
How can collaboration with project partners in health be
strengthened?
The earlier identification stage focused upon identifying potential

partners and allies in achieving health objectives, from government at
261
all levels in the education and health sectors, and from NGOs and
CBOs concerned with health. Now the focus must be on developing
strong partnerships in project and programme design, so that sound
activities for health are developed and integrated into the project, and
the health partners are effectively integrated into the project team.
Without such team integration, health can become an ineffective final
stage bolt-on to the project, which will not withstand serious
appraisal.
What is the existing level of service? How will it change?
For water supply, health is most improved when water is delivered at

the household or courtyard level, provided adequate drainage is part
of the package. Some improvement in health can also be expected
from increased water consumption when return travel time is reduced
to below 30 minutes, or when particularly heavily contaminated
sources are replaced. For sanitation, service at the household level is
by far the best arrangement. Where this is not possible, sharing
facilities among a small number of households may be viable for
maintenance; in such arrangements, childrens access to sanitation
remains critical. Public latrines are usually unhealthy because of poor
maintenance, and they never fully meet peoples needs. They are
therefore not recommended as an intervention.
Where wastewater treatment is part of the project, how effective
is the technology in removing disease-causing organisms?
WEDC/Michael Smith
Most conventional sewage treatment is good at removing organic

matter, solids, and nutrients, but almost completely ineffective at
removing bacteria, viruses, and parasites. 90 per cent bacterial
removal by conventional treatment as reported in many textbooks has
little value for public health where wastewater contains between 106
and 108 E. coli/100 ml. Waste stabilization ponds (Mara,1992 and
1997) are a low-capital, low-maintenance alternative that are very
effective in removing disease-causing organisms; where adequate land
for the site is available, they are by far the most effective treatment
technology from a public health perspective.
Who is at risk from untreated wastewater? In what ways?
Wastewater, combined with freshwater, is often re-used for crop

irrigation. The risks of such practice depend very much both on which
crops are irrigated, and on how the wastewater is applied.
Investigation of the practice of wastewater re-use, as described in the
WHO Guidelines for Wastewater Re-use (Mara and Cairncross, 1991),
may identify opportunities to reduce health risks.
3.3.4
The Project Submission document needs to identify all the potential

adverse and beneficial environmental impacts of the proposed project.
Precautionary and mitigation measures must also be described. A useful
way of presenting the required information is to compare a series of
design alternatives with each other and with the do nothing situation.
262
Depending on the outcome of the earlier environmental screening and

on the agreements reached with partners, this stage may require any of
three progressively more detailed approaches: Environmental
Analysis; Environmental Audit; or Environmental Impact Analysis.
These three options involve significantly different levels of data
collection and analysis. They are each described in the DFID Manual
of Environmental Appraisal (ODA 1996b).
If a full Environmental Impact Analysis is needed, there are
comprehensive checklists and standard procedures for impact
identification, quantification, and valuation including provision for
public participation.
Some of the main environmental impacts of WS&S interventions
were described in Section 3.2.4. In this stage, they need to be
addressed in a project-specific context and comparisons drawn with
development alternatives. The end product of this stage is an
Environmental Management Plan which describes how positive
impacts can best be achieved and negative ones mitigated. It is also
necessary to:
draw up environmental criteria for engineering design and
environmental management clauses for construction contracts;
carry out pre-construction baseline surveys for monitoring and
evaluation;
check national environmental acts and design appropriate
monitoring protocols; and
establish or reinforce an interdisciplinary institutional structure for
environmental issues.
Key questions to be addressed are:
Surface water
Will the proposed abstraction together with any existing
abstractions be less than the reliable yield of the river basin?
If this is the case the management of the river basin should be

sustainable but the yield and demands must be assessed on a
probability basis to determine the likely return period of failure to
satisfy all demands. Prioritization of demands is essential in times of
limited resources to avoid collapse of the system.
Is the river basin vulnerable to pollution from existing or future
planned activities within the catchment area?
River basins which have within them industrial activities likely to

give rise to polluting discharges or accidental releases of pollutants
will require additional water quality monitoring provisions and
possibly the provision of bank-side storage and/or additional
treatment processes. Communities without effective sanitation can
pose major threats to water quality in a river basin as can grazing
cattle and intensive agricultural activities. Solid-waste disposal
practices can sometimes generate serious water pollution problems.
A land-use study of the basin above the abstraction point is therefore
recommended.
263
Groundwater
Has an assessment been made of the potential yield of the
aquifer?
Evidence should be sought as to whether the yield of the aquifer has

been determined by pumping tests and/or groundwater modelling
procedures. Estimates of recharge can assist in this assessment.
Will the proposed abstraction together with any existing
abstractions from the same aquifer be less than the long-term
recharge?
It is normally considered that, over a period of say three years, total

abstractions should not exceed 95 per cent of the recharge of an
aquifer for sustainability. For short periods it is permissible to abstract
at a rate in excess of the long-term recharge, but abstractions must be
reduced at other times to maintain the permitted average abstraction
rate.
Is the aquifer vulnerable to pollution from existing or future
planned activities in the source catchment?
The catchment of the aquifer needs to be defined and land uses within
the area determined. Particular attention needs to be given to solidwaste disposal sites and to industrial or agricultural activities which
may give rise to soluble pollutants.
Processes
Are water treatment project proposals based on reliable
information about raw water quality?
In the absence of water quality data covering at least 12 months, and

preferably longer, any decision as to the location of intakes and type
of treatment required can only be tentative, although it may be
possible to draw on information from similar basins.
Will potentially hazardous chemicals be used in the treatment
process?
Disinfection using gaseous chlorine or liquid chlorine requires the

provision of safe transport and handling arrangements to reduce the
risks of a release of chlorine caused by leaks, breakages, or faulty
handling. Since chlorine gas is heavier than air it can escape from a
leak and reach areas beyond the treatment plant site. Chemical
coagulation often needs acid or caustic reagents to control pH and
here again care is necessary to ensure that leaks and spillages do not
contaminate the treatment plant or the surrounding locality.
Coagulants are normally added as strong solutions which can be
corrosive and potentially harmful if misused. Potential hazards should
be subjected to risk analysis to avoid the situation where the perceived
existence of a hazard results in the abandonment of a process which
brings with it clear benefits. Reducing chlorine usage because of the
formation of disinfection by-products or possible accidents in
handling the gaseous form cannot be seen as a fair exchange for
increasing the risk of supplying water containing cholera or typhoid
bacteria.
264
Have provisions been made for the satisfactory treatment and

disposal of residues from the treatment process?
Sludges and residues are produced by the clarification and filtration

stages in the treatment of surface waters. Much of the material used is
inorganic silt from the water to which chemical coagulation adds
metallic hydroxides. If the bacteriological quality of the raw water is
poor the residues may contain large concentrations of microorganisms. It is not good practice to return these residues to the source
of raw water since they cause problems for downstream users. A
treatment plant which will produce significant quantities of residues
must make provision for their dewatering and ultimate disposal.
Sanitation
Does the sanitation component pose any significant threat to
water quality in local watercourses?
Surface soakaways and sewerage schemes, even with some form of

treatment, are capable of significantly contaminating nearby waters
with bacteria. (See Section 2.4.2.) Such discharges must not be made
to watercourses upstream of nearby abstraction points and ideally not
to sources used for water supply. The effects on water quality required
by other uses of the receiving water should also be assessed since
water supply considerations may not always be the most demanding.
Could the scheme cause significant pollution of local
groundwater sources?
Wet latrine systems, septic tanks with soakaways, land treatment, and
lagoons are all potentially capable of contaminating groundwaters
depending upon the local soil and geology (but see Section 2.7.20
these risks may be exaggerated). Groundwater protection policies
should be implemented to monitor and reduce these risks.
If soakaways have been proposed for the disposal of
wastewaters is there evidence that the percolation capacity of
the soil is sufficient to absorb the volumes expected?
With low percolation rates wastewaters will accumulate in the soil

and may waterlog the surrounding area, creating unhealthy conditions
and encouraging insects. High percolation rates will ensure that
wastewaters are rapidly dispersed but may result in dangers to local
groundwater quality.
If wastewater is to be discharged to a watercourse is there

evidence that possible effects on the watercourse have been
assessed in a rational way?
The effects of conservative pollutants like salts and non-conservative

pollutants such as organic matter and micro-organisms can be estimated
by simple mass balance and decay calculations to predict the downstream
effects of wastewater discharges. The consequences of the wastewater
discharge on water quality objectives for the receiving water can then be
determined and the quality of the discharge regulated accordingly. The
possible beneficial effects of treated wastewaters in supplementing
natural flows in dry weather should be assessed.
265
Have provisions been made for the safe treatment and disposal
of sludges from any treatment process?
The sludges from wet latrines, septic tanks, and conventional

wastewater treatment processes are potentially very polluting because
they contain organic matter and large populations of faecal microorganisms. The nutrient content of wastewater solids is of
considerable value in developing countries, but its use in agriculture
must be carefully regulated to prevent contamination of the food
chain. Has consideration been given to the possible beneficial uses of
the sludges? (See Section 2.7.12.)
3.3.5
Questions arise under policy headings as follows:

Demand responsiveness
What is the mechanism for allowing users to choose between

levels of service?
What is the estimated demand for different levels of service at the
anticipated tariffs?
How is this demand expected to change over the project time
frame or life of the facilities (say 20 years), taking account of
increases in coverage, shifts to improved service levels, and
population growth?
Equity issues
What is the predicted impact on the poor of the chosen project

option?
What specific measures are to be used to meet the basic needs of
poor people at affordable prices?
How are cross-subsidies to work?
Project economic justification
Relative to the without-project situation, what is the economic

justification (using cost-benefit analysis if possible, otherwise costeffectiveness analysis)?
Demand management
How are opportunities for demand management to be realized?

Financial sustainability of key institutions
What are the financial targets for key institutions?

How will the financial sustainability of these institutions be
assured? (What are the financial projections?)
What are the specific targets and mechanisms for reform of costrecovery levels and processes?
What are targets and mechanisms for improving utility operational
performance and efficiency improvements?
Subsidy
How will subsidy be kept transparent, targeted, and limited in

scale?
266
What are the specific measures for promoting PSP?

What regulatory provisions will maintain quality and protect users?
Risks
What mechanisms for flexibility have been built into the design?
For example, is there scope for the system to be incrementally
upgraded over time, depending on demand, and for individual
households to upgrade the level of service they access over time?
3.3.6
In this stage, the institutional appraisal is more detailed and relates

especially to the institutions which will be charged with the long-term
management of the facilities installed through the selected project
(Section 2.6.8). The appraisal results will also need to be placed in the
context of the overall sector and the external environment. A priority
is likely to be the collection of essential institutional performance
data. That may take time to obtain. Decisions will need to be made
concerning how much of the appraisal work and institutional
development (ID) design can be left to the implementation stage,
bearing in mind that ID work is best done as part of a process
approach. On the other hand, an early activity may be longer term
training to develop the necessary capacity to undertake the project.
In developing any institutional strengthening/development proposals,
aspects to be considered include:
Project support to local training institutions as HRD is likely to be
a key component.
Working with project champions in host government organizations,
to identify who owns the project at the various stages and to
provide appropriate encouragement and support.
Ensuring that where new institutions are created as part of the
project or where there are significant changes proposed, legitimacy
and legal aspects are dealt with. Changes to legislation or
regulations can be time consuming and delay the project. In general
terms new institutions such as Village Water Committees (VWCs)
require a lot of support if they are to be sustainable. The alternative
of working through existing institutions should also be assessed.
Encouraging options for piloting institutional strengthening, with a
view to replication elsewhere, so maximizing potential benefits.
How can commitment to the ID project design and process best
be promoted among project partners?
Project partner participation should be encouraged in the process of

institutional analysis, in promoting ID ideas, and in the development
of institutional strengthening options, with the use of workshops,
consultants, and core groups (Section 2.6.7). The level of commitment
will need to be continually assessed in order to assess the planned
pace of change or to consider whether change is achievable. The
prospect of significant capital funds may lead to conditions being
agreed without real commitment. Look for progress indicators on
267
things that the organization could do from its own resources (DFID,
1995).
What are the potential benefits of including project conditions?
Conditions included in the Project Agreement can be used to establish

the minimum institutional/financial arrangements for project
implementation and operation. Further dialogue can then proceed with
project partners on the adequacy of arrangements for sustainability.
Conditionality should support commitment rather than be a substitute
for it and hence back those promoting change (DFID, 1995).
Conditions can also be included as minimum benchmarks for
community participation and management. For example on the DFID
Maharashtra Rural Water Supply Project, a condition stipulated that
VWCs shall be formed, trained, and established before the village
pipe distribution network was agreed. That ensured that construction
organized by the State Water Board did not take place until the
condition was met and community participation took place. Project
partners may also find project conditions useful in terms of providing
a lever in obtaining support for government approvals or changes in
policy.
What are the key considerations in agreeing project management
and support arrangements?
It is important to establish effective arrangements for delivering all of

the project software and hardware components with co-ordinated
timing. This may be through local government structures or a
dedicated Project Management Unit (PMU). For reasons of
sustainability after the donor has withdrawn, it is preferable not to
establish PMUs as part of a new project. PMUs often are established
in water and sanitation sector projects, however, for a number of
reasons:
Water, sanitation, and health projects normally involve a number of
government departments, parastatals, etc., so a PMU provides an
opportunity to co-opt people from the various departments into the
PMU and thus enable more project integration.
Larger projects, particularly those involving participatory
approaches, are usually time consuming and involve substantial
co-ordination. Capable staff within existing institutions are
invariably busy with a multitude of duties and are not able to
devote sufficient time to the co-ordination of such participatory
projects.
A wide variety of skills are invariably required on projects in the
sector, including: HRD/communications, womens development,
social development, technical, finance and administration, health
promotion, sanitation, etc. The PMU provides the opportunity to
assemble experts in these fields, in order to ensure that adequate
attention is given to each of these important disciplines.
A key issue is the level of autonomy a PMU should have from

government. It is generally preferable for the PMU to be within
government, although this depends on how restrictive bureaucratic
268
procedures are on project implementation. Obtaining agreement/

commitment to placement/replacement of key project staff is
particularly important where there are skill shortages.
What technical support can DFID offer to help the PMU develop
the skills to do its job?
Appropriate inputs need to be quantified, scheduled, and costed.

These may include technical assistance and/or external training.
What arrangements should be considered for phasing,
sequencing, monitoring, and evaluating project components?
The introduction of a pilot phase to a project can be beneficial where

there are doubts about institutional arrangements. It provides an
opportunity to test and agree processes, as well as time for further
appraisal and dialogue. Activities such as hygiene promotion, HRD
for project preparation and implementation, and institutional data
collection should commence as early as possible in the project to
enable other activities to proceed satisfactorily. It is preferable to
agree arrangements for: piloting/phasing, stakeholder participation,
reviewing, and incorporating lessons learned into the project. A
process approach entails focusing on key project milestones rather
than construction completion dates.
Project proposals should include arrangements for participative
monitoring, evaluation, and impact assessment, including baseline
surveys where appropriate.
3.3.7
Technical aspects
The flowchart in Figure 3.3.1 (page 259) illustrates technical option

selection at the project preparation stage for a typical water supply
project.
Many of the important principles which need to be considered are
detailed in Section 2.7. These include: linkages between technology
and hygiene promotion, standardization of technology and
management, sustainability, operation and maintenance, convenience,
incremental improvement, design life, gender in technology, and
choice of water supply and sanitation technologies. Some additional
issues to bear in mind at this stage are discussed briefly below:
Confidence on water source selection will aid the consultation
process. The choice of source will affect the range of technical options
available. It is therefore important to try and obtain reliable
hydrological/hydrogeological information as early as possible. This
will ensure that the stakeholders only have to consider viable options,
For example, there is no point in going through a lengthy consultation
process for a new deep borehole scheme, only to find at a later date
that the water is too saline. Sections 3.2.4 and 3.3.4 describe the main
criteria for water source selection.
Speed is not of the essence in a participatory approach
The participatory approach means that options or outline designs may

have to be revisited a number of times until all the stakeholders are
269
happy with the final design package. This will clearly take time, and
the engineering team must be prepared to match its pace with the
consultation process.
Choices of levels of service must be clearly explained
The different levels of service on offer to the community need to be

well understood so that they can make informed choices. The example
in Figure 3.3.2 proposes three alternative design packages. Each
package will offer water at a different cost for its particular level of
service. The three levels of service offered to individuals are private
house connections, private (or shared) yardtaps, and communal
standposts.
Photographs, diagrams, or pictures are useful to communicate, in
simple terms, the levels of service potentially on offer to communities.
Project cost estimates need to be as accurate as possible
At this stage of the cycle preliminary cost estimates need to be made

for the proposed design packages (see Section 2.7.7). Although these
packages will change and evolve throughout the consultation process,
it is important that early cost estimates are reliable. They will be used
as the basis for discussions with stakeholders on potential capital
charges and tariffs, and it would be inadvisable to base these
discussions on tenuous estimates. Also, willingness-to-pay surveys
need to be based on accurate estimates of the likely range of costs for
different services. Cost data should be obtained from similar,
completed projects in the same area if possible.
How can arrangements be made for spare parts to be available
during the operation stage of the project?
This may require provision of spare parts during the implementation

stage or working with private-sector suppliers to set up supply
channels.
Case study to illustrate technical aspects in the project
cycle
Figure 3.3.2 represents the decision-making process at project preparation
phase for a typical water supply project. The scenario is as follows:
Community X is a peri-urban community situated some five miles from a
significant urban centre which has a centralized water supply system,
Community X currently has no access to a piped supply and relies on
traditional sources such as protected springs or shallow wells. There is
perceived, by the local government, to be a strong need and desire for a more
convenient and safer water supply. The average consumption is 15 l/c/d and
some women take up to three hours a day to collect water. The wealthier
people pay vendors to transport water from the distant sources. Although most
households rely on subsistence farming, there is a certain amount of
expendable income available in families where the males work in the informal
sector in the town.
270
Figure 3.3.2. Case study to illustrate technical aspects in the project cycle
271
3.3.8 Hygiene promotion and sanitation promotion
By the end of this stage the Ministry of Health, or its local equivalent,
should have agreed if they will contribute and, if so, in what capacity.
The roles of the different institutions will be laid out, defined, and
harmonized.
Data collection for hygiene promotion and sanitation promotion
This stage is analogous to the Feasibility Study of a major engineering

programme. In the same way that baseline data are collected before
the rehabilitation of a sewer system, or before a borehole programme
proceeds, so must baseline data be collected on the population (see
Section 2.8.9).
If water agencies do not have enough engineers to conduct a Feasibility
Study, they hire in expertise by contracting out to consultants. If there is
not a government department with capacity for collecting data pertinent
to promotion, it is advisable to use NGOs or local consultants.
When the data have been collected the programme must not be rushed
sustainable demand takes time to create and even longer to
translate into sales (see box opposite). This is a common problem
between hardware and software projects. Avoid short cuts. Hardware
and software projects have different rhythms and it is disastrous to
allow the promotional activities to be rushed by the impetus to pour
concrete (see Section 2.8.6).
How should terms of reference for good data collection for
hygiene promotion and sanitation promotion be drawn up?
The ToR for data collection should ask questions on the specific
behaviours which allow diarrhoeal microbes to be transmitted, which
of these behaviours are most widespread, and which are most
amenable to change. It is vital to ask how existing hygiene and
sanitation practices differ according to gender. Who socializes
children about hygiene-related practices?
There are a number of questions as to who should form the cadre of
marketers/trainers/mobilizers. What is their social status in the
community? Some people might not accept a message from women or
from young women, for example. Would they be accepted and at what
opportunity cost (e.g. time) and with what benefits (e.g. improved
status)? Are there existing roles or positions in society which could be
used e.g. traditional story tellers? Is there a role for those already
involved in selling and installing sanitation equipment?
If there is no existing market for latrines, this must be investigated and

the reasons why not determined.
How will the data be collected for hygiene promotion and
sanitation promotion?
What local partners have the necessary capacity and experience?

What experience do they possess? Do they have experience of the
promotional approach or are they wedded to the didactic educational
approach? Is there a need for training and if so, how much? Is this
feasible within the time-frame of the project? How far afield should
272
WEDC/Darren Saywell
WEDC/Darren Saywell
Urban sanitation in Maputo, Mozambique

A pilot sanitation programme in Maputo set up a workshop to sell prefabricated
concrete slabs to place over existing pits. Care was taken to put no more effort
into the marketing than could be replicated on a city-wide basis.
Sales built slowly. Neighbourhood surveys found that many people were waiting
for their old latrine pit to fill before purchasing a slab for the new one. Some
people did not know the purpose of the slab while others had difficulty in
transporting them. However, everyone who was interviewed was interested in
buying a slab. An information campaign was organized to explain the use of the
slabs. Handcarts were acquired to help with transport.
The pilot was replicated. Slab
production co-operatives were
formed in each of the peri-urban
neighbourhoods. The members,
who were predominantly women,
were also trained in accounting and
advertising techniques, such as
puppet shows.
Monthly sales of latrine slabs

in Maputo, Mozambique
The project has now been

replicated in other towns in
Mozambique and there is a total
annual production of over 10,000
latrines a year.
Cairncross, 1992
the project look if there appears to be no capable research

organization locally?
How much demand needs to be created for hygiene promotion
and sanitation promotion?
What facilities for sanitation promotion exist? What kind of market

exists already? Are there competent contractors who can cope with an
increased demand and carry out the work satisfactorily? Is the project
unrealistic in assessing the logistical necessities? Is there a
distribution system and are there points of sale for the materials, e.g.
builders yards or sanitary marts?
How are hygiene and sanitation promotion linked?
Funds are often committed with undertakings to co-ordinate the

hygiene and sanitation promotion closely to ensure complete demand
creation, cost recovery, and sustainability. The problem, in reality, is
that if the hardware is brought in before the software the demand for
the products will be small. If the software is introduced too early, or
by itself, then the health promoters may be encouraging people to
change their behaviour but not offering the means. The effectiveness
of the programme is reduced if there is no possibility of
recommending hardware. Health promoters should be able to refer
people in the project area to somebody who can answer their
questions, and supply the technologies. Is there a realistic low-cost
sanitation option to which the health promoters can turn?
273
What are the key steps in a hygiene promotion plan?
The box in Section 2.8 has examples of how to formulate objectives,

to pick out key questions, and to develop an appropriate mix of
methods for developing answers. Remember that the focus is on only
a few key issues and that results are returned to stakeholders for
discussion and collaborative programme design. The key questions for
both hygiene promotion and sanitation promotion are: what are the
target practices (or product)? Who and where are the target audience?
How do the beliefs and practices differ across groups within the target
audience? What attention has been paid to message positioning and,
through which communication channels will the message, or
messages, pass?
These results are used, collaboratively, to develop an intervention
which is imparted along appropriate channels. The chief
characteristics of the message are that it is positive, simple,
repeatable, feasible, affordable, attractive, and memorable.
3.4 Stage 4: Project appraisal and approval
In this stage, the Project Submission Document is reviewed by highlevel DFID staff to make the final decision as to which projects DFID
will seek to participate in.
Clearly, the issues elaborated in Section 3.3 related to project
preparation remain valid for the Appraisal stage. They are not
therefore repeated here. In this stage, the decision-makers will wish to
check particularly:
Possible alternatives: Is this the best way (effective, equitable,
sustainable, efficient, replicable) to achieve the project Purpose?
Impact: Is the project well targeted? Are water supply, sanitation, and
hygiene promotion components appropriately designed to maximize
health and other benefits? What will be the impact on the poor? On
women? Have these been realistically assessed in project
preparation?
Risks: Have the risks and assumptions been correctly identified and
recorded in the logframe? Can any of the risks be reduced through
additional project activities?
Sustainability: Is government policy supportive and will the projects
institutional, financial, and technical provisions ensure sustainability?
Has the project been developed in consultation with key stakeholders,
including users, with a realistic package of technical options and
charges tailored to demand?
Project programme and milestones: Are these agreed with partners,

realistic, and providing a reasonable combination of targets, review,
and flexibility?
DFID/C.J.Oxlee
Focusing of programme investments: Software needs as much

investment, if not more, in a promotion programme, and judgments
may be needed on the likely ratio of inputs to impact.
274
Long-term commitments: Are partners likely to continue activities

after cessation of external funding?
Social development v. social marketing: The proposals for hygiene
promotion and sanitation promotion may need to come under special
scrutiny, as this is an area where there could be a danger of DFID
seeming to exercise undue influence on community development. The
compatibility between social development and social marketing aims
should have been made clear in the Project Submission Document and
verified by the logframe, but a few extra checks are merited (see box
below).
Once approval is given, the logframe becomes the key tool for
assessing progress on the project.
Appraisal of social marketing component:
Some key questions
What steps were taken in the preparation of the hygiene promotion and
sanitation promotion components to ensure that the partnerships will be fruitful?
Will the projections from the preparation stage hold good when the project is
scaled up? Have the projections been based on a short visit to the area of
interest or has a pilot project already been run? How was the pilot project
assessed? By whom, and on what basis? Did the success of the pilot project
rely on a high degree of intensive one-to-one work or is it replicable? Was the
positioning of the message such that demand was created?
What did DFIDs partners make of the promotional approach?
Is the scheduling of the programme for hygiene promotion and sanitation
promotion realistic and flexible?
It can take a long time for demand to translate into sales. While people may well
be interested in, and tempted by, the advertized latrines, they may also want to
wait for their old pit to fill before changing to a new slab or a new design. They may
also want to see the performance of similar latrines installed by their neighbours
before investing in their own. Can the programme cope with this time span and
with the need to continually refine and check the way the promotional efforts are
being received? How will the promotional activities be reviewed?
At an institutional level what partnerships were built and what interest was
shown in the promotional approach?
Urban sanitation programmes often face the seemingly intractable problems of
land tenure and drainage. Have the programmes been considered in the wider
context of sanitary infrastructure and urban planning? Did the demand-led and
consumer-oriented focus minimize these, and other, difficulties? Did it spread
beyond the boundaries of the project? What role did partner organizations play?
Was there any interest in the promotional approach at a ministerial level or were
the relevant ministries involved more as passive observers? Which other
organizations helped?
What assumptions are being made about the target population? Did the project
have any adverse effects? What are the costs, be they social, psychological, or
financial, of the proposed behaviour change? Do the changes affect different
groups disproportionately? How was the message received by the target
audience? Is the message perceived as being relevant to all people and not
morally stigmatizing?
275
3.5 Stage 5: Programme and project

implementation and monitoring
3.5.1
General
The implementation stage extends to the end of DFID-funded

involvement in project activities, and will include operation of
facilities and institutional development, where this is part of the DFID
support.
Implementation focuses on the Activities and Outputs levels in the
logical framework. It includes:
assembling packages of interventions based on the implementation
philosophy;
detailed design of components;
procurement;
preparation and delivery of community development, hygiene
promotion, and institutional strengthening activities;
construction of facilities; and
preparation for transition to the operating stage of the cycle
(operation and maintenance procedures, training of staff, etc.).
Table 3.1 summarizes DFID management and monitoring activities at
the implementation stage. With the general use of the process
approach to projects, the setting of annual workplans and the review/
revision of logframes will be particularly important. Section 3.3 gives
guidance on planning Outputs to achieve the project Purpose. It is
important not just to monitor that Ouputs are achieved as planned, but
also to review their contribution to the project Purpose.
3.5.2
The implementation of process projects in WS&S is complex. It

requires the co-ordination of a wide range of activities, diverse
institutional arrangements, and different time frames. It is important
that social development perspectives do not get lost in this
complexity.
Are the engineering and the social development components of
the project well co-ordinated and synchronized?
Implementation is often driven by the engineering components of a

project; the social development dimensions, such as developing local
ownership or capacity to manage water supply and sanitation
facilities, can get left behind. This can happen either because social
development takes longer and is seen to hold the process up, or
because new actors who are unfamiliar with the process approach and
social development issues become involved at the implementation
stage.
WaterAid/Jim Holmes
There are differences between water supply projects and sanitation

projects in terms of how engineering and social development
perspectives impact on each other. For example, water supply tends to
be technically complex from an engineering point of view, while
sanitation projects are often viewed as community self-help activities
276
Table 3.5.1
DFID management and monitoring activities at the

implementation stage
Outputs
Key issues/Activities
Annual workplans
co-ordination of inputs
planning for future years
Revisions to the logframe
review of the logframe
Baseline surveys
Project reports (progress on
planned Activities and Outputs)
Monitoring reports (progress to
achieving Outputs and Purpose)
monitoring techniques
(including participatory process monitoring)
Reviews (Mid-Term and Output to

Purpose reviews) or informal
snapshots
achievement ratings
progress ratings against Purpose
issues which may influence progress
remedial action to be considered
Completion report
(at end of implementation)
lessons learned
ODA, 1996c Vol II, GI
(White, 1997). From a social development perspective, however,

water projects can achieve social acceptance more easily than
sanitation projects, where changing peoples attitudes and behaviour,
or generating demand for improved sanitation facilities, is a slow
process.
Are there mechanisms in place to share information collected
within monitoring systems with all project partners?
Within process projects monitoring systems are set up to provide

systematic and continuous assessment of progress for all project
partners, not only donors and governments. It is important to identify
who should be involved in monitoring, including data collection,
maintaining the system, and analysing the data. If joint responsibility
for achieving programme or project objectives is to be established,
information needs to be shared. A key factor during the
implementation and operation stages is feedback. It is important to
provide the opportunities to discuss findings with all people who are
interested in or affected by a project and for the results to be
incorporated into the analysis of the monitoring data.
Are social development perspectives evident in both impact and
process indicators?
Impact monitoring provides information on progress towards

achieving social objectives, such as sustained improvements in water
277
supply. Process monitoring helps track the use of resources, the

progress of activities, and the way these are carried out. In other
words, the information collected should provide an ongoing picture of
progress towards meeting objectives, as well as a picture of the
process of development, analysing, for example, whether it is
developing local capacity or increasing gender awareness among
project staff or partners.
Are both women and men involved in identifying indicators, in
monitoring change and impact, and in feedback processes?
Participatory methods can be used to find out how different groups,

including groups of women and men, are involved in or affected by a
programme, and how they view its progress. To ensure that all are
able to participate in feedback processes, it is necessary to be aware of
the timing and location of meetings so that they do not interfere with
key income-earning activities, domestic tasks, and childcare
responsibilities. The methodology used and the way meetings are run
should reflect the different ways in which women and men participate
in these processes.
Is qualitative information necessary to monitor progress?
On-going monitoring is usually undertaken through filing checklists

and reports. When it includes qualitative information it is useful to use
other methods. For example, diaries or reports written up after
attendance at meetings and based on observation can be used to assess
levels of participation. In order to measure behaviour change as a
result of hygiene promotion, case-studies of particular households or
lanes can be undertaken to assess changes over the longer term.
Indicators of social development in a community-based
rural water supply and sanitation project
Impact indicators:
new sources or improved quality, quantity, and reliability of water
new installations in working order and being used appropriately by all groups
improvements in living environment
reduced workload and time spent collecting water by women and children
reduced reliance on local lites such as landowners controlling access to
water sources
Process indicators:
higher level of participation of primary stakeholders
increased involvement of women in decision-making
better understanding of technical constraints and costs
improved ability to cope with conflict over water sources
greater willingness to approach officials
continued inclusive organization after project completion
278
Environmental units Tamil Nadu, India

An environmental action plan (EAP) has been drawn up with the aim of fully
integrating environmental management in planning, investment, and
management of the states water resources. A key element of the EAP was to
strengthen WROs environmental monitoring and analysis capabilities via the
creation of specialist Environmental Units/Cells. Two such units have been
established in the main planning departments basin- and project-level
with responsibility to:
prepare environmental plans for all river basins in Tamil Nadu;
provide policy advice to WRO on environmental matters and establish statewide planning standards;
perform environmental reviews of projects to comply with Environmental
Protection Acts and Regulations;
provide expert advice on environmental matters to WRO management units;
plan for environmental mitigation and enhancement;
provide environmental clearance from Government of Tamil Nadu; and
undertake periodic (environmental) reviews during operation and
maintenance.
DFID, 1998b
3.5.3
Are the timing and co-ordination of health-related components on

track?
Scheduling and co-ordination issues are critical for all project and
programme implementation. They may be more complex on the health
side, however, because of the need to work across multiple sectors (e.g.
public works, social welfare, health, and education sectors in
government; assorted NGOs and CBOs). One problem could arise if
hygiene promotion creates demand for sanitation or improved water
supply that cannot be met in a reasonable time; alternatively, if major
infrastructure works proceed quickly, but sanitation promotion drags
behind, critical public demand may be lost.
How are working relations between sectors and partners?
Much of the monitoring of collaboration and co-operation must be

informal. Field management staff must make time to establish an
atmosphere of candour and trust with partners during implementation
so that concerns may be raised (and often resolved) informally.
Examples of suitable indicators are included in the sample logframe 3
in the Appendices.
3.5.4
Environmental monitoring
It is important to continue environmental monitoring during the

implementation period to determine whether initial assumptions,
which are almost always necessary, have been confirmed. Such
monitoring can provide valuable information and assistance for use in
later projects in similar situations. (See Section 2.4.3.)
279
3.5.5
The key issue at the implementation stage is to ensure co-ordination

of project components, and ways to do this are considered in the
section below. Implementation in the past has been largely driven by
the engineering components of projects, which dictated the speed and
direction of events, and prevented health, hygiene, and sanitation
components from being fully integrated into the whole (see para 4.14
of DFIDs Rural water and sanitation evaluation synthesis study,
White 1997). Points to monitor are noted below:
Revealed demand
Are communities responding as expected in contributing to the

investment phase and in preparing (e.g. making cash collections)
for O&M?
What is the evidence of demand for improved levels of service
(e.g. new connections)?
Equity
What progress is being made in improving access by the poor to

basic services at affordable prices (coverage, use made of new
facilities, prices paid, etc.)?
Economic justification
How are costs and benefits (demand) diverging from design

projections?
Why? How can economic performance be improved? How can
programme be modified to match demand?
Demand management
How well are demand management targets being met?

Financial viability
What is progress in reform of cost recovery and financial reform?

Subsidy
How well are arrangements for transparency, targeting, and

limiting of subsidies working?
What progress has been made in increasing PSP?

How far has the private sector complied with contractual
requirements?
How well are regulatory arrangements working?

3.5.6
This is the time to encourage the final formulation and

operationalizing of ID plans within the organizations eventually
responsible for providing support to or managing the facilities. This is
best done with inputs from competent consultants/NGOs including
facilitators to guide the process. This should be discussed briefly,
taking note of the importance of co-ordination of components; Section
2.6.8 identifies the likely focus areas. Activities which need to be coordinated in a comprehensive ID programme may include:
280
assembling inter-disciplinary project teams/committees at the various

levels, and selling and reviewing the project concepts and plans;
encouraging good stakeholder participation from the outset;
reviewing key indicators for monitoring and developing a
monitoring/evaluation system for the project process, activities,
and outputs;
encouraging the development and operationalizing of ID plans
within the organizations eventually responsible for providing
support to or managing the facilities. This is best done with inputs
from competent consultants/NGOs including facilitator(s) to guide
the process (see the guidelines on institutional development in
Section 2.6.11);
encouraging interlinkages with other concerned organizations;
ensuring that key posts are filled early in the process;
promoting policy dialogue and further institutional appraisal to
take into account the changing institutional environment, being
opportunistic as new staff or information becomes available;
exploring options for collaboration with other able local
consultants and institutions; and
promoting learning by doing and reviewing the project design
and project management arrangements in the light of experience,
and adapting the project plans and logframe as appropriate.
The focus should be on critical path activities such as HRD,
institutional changes, community mobilization, and planning
activities. Institutional change takes time and may experience
setbacks before substantial progress is achieved. If necessary, consider
reviewing construction targets, in order to allow adequate institutional
and community development to be completed.
Generally water and sanitation projects experience their most serious
problems with operation and maintenance and with cost recovery aspects.
The proposed arrangements for these need particular attention. If they are
not likely to be sustainable, how can they be amended? Consideration
should be given to providing project support during these stages, with a
planned withdrawal of support as local ownership builds.
Plan well in advance for project evaluation and impact assessment.
Participatory evaluations with project partners should be encouraged,
with agreement on key indicators, particularly at the Project Purpose
level.
Seek to develop good project documentation and disseminate lessons
learned to a wider audience.
3.5.7
Technical aspects
The detailed design, tendering, and construction of the project will

take place during this part of the cycle. There are therefore many
281
engineering aspects to be considered. Most of the issues are covered

in Section 2.7 and the previous sections of Chapter 3. Some further
issues are specific to the implementation stage as discussed below:
What choices of technology and level of service can be offered to
each household?
Work at previous stages (Section 3.3.7) will have closed down some
options and settled on a limited range of technologies and levels of
service (with corresponding tariffs) which could be offered. It will be
necessary to decide whether each household can make an individual
choice from the available options (as should be possible for latrines),
or whether small groups of households need to make a common
choice (as is probably necessary for handpumps). (See Sections
2.7.20, 2.7.21, and 2.7.26)
What is an appropriate process for choice of technology?
In the past, choices have often been made by engineers exercising

technical judgement, but ignoring the need to secure the necessary
recurrent funding, which usually has to come from user tariffs. Following
a demand-responsive approach, a simple form of agreement could be
prepared, setting out the choices (technologies and tariffs). The issue of
future changes to the tariffs needs to be considered, as does the question
of who in the household decides (or is approached) and how the
agreement is signed? Clearly this will require liaison with other
specialists (social development, economics, or institutions). The timing of
householders choice should preferably be after they have been exposed
to hygiene and sanitation promotion activities.
How can the system design provide for future growth in
population and per capita demand for water?
Although the system design needs to be based on supplying water to

meet individual households current choices, it should have the
flexibility to meet future demand, especially to facilitate the increased
use of water, which brings important health benefits and increases in
the number of private connections (see Section 2.7.16).
What is the estimated demand for different levels of service at the
anticipated tariffs?
How is this demand anticipated to change over the project timeframe
or life of the facilities (say 20 years), taking account of increases in
coverage, shifts to improved levels of service, and population growth?
Does the detailed design incorporate local practices and

standards?
WaterAid/Jim Holmes
It is not appropriate to design works to a British Standard if these are

not used in the project country. In some countries the quality of
concrete work is very poor, while masonry skills are excellent. These
local practices and skills should be exploited in the design and
construction of the infrastructure. Similarly, local standards for water
treatment and effluent disposal should be specified wherever possible.
282
Is there potential for introducing new skills to the community?
It may be appropriate to use the project to improve the local skill

base, for example by involving the local labour force in construction,
which develops skills which may be useful for O&M (see Section
2.7.10). Another example is by specifying the use of simple pre-cast
concrete units. The local labour force can then be trained to use this
technique, which may prove useful in future projects.
Has the use of local materials and plant been specified
wherever possible?
Local materials and construction methods should be employed

wherever possible. This may not always be possible, for example if
rotary drilling in rock is required, but the community should be
consulted because they may have their own ideas. In some cases the
use of local materials is unacceptable to the partners if it is of a very
low quality; it would probably not be cost-effective to purchase local
asbestos cement pipes with a design life of five years, if imported
ones have a design life of 30 years.
Have the end-users been consulted on the detailed design of
DFID/R Lokanadham
services?
Consultation is particularly important for the location of facilities.

The end-users of water supply projects are often women and children.
The height and strength of these users also needs to be taken into
account when specifying the height of well headwalls, washing
stands, and borehole plinths for example (Section 2.7.9). It is not
uncommon to see handpump outlets which are too low to fit a 20-litre
jerrycan underneath consultation with the end-users would have
avoided this sort of mistake.
Have standard designs been used wherever possible?
Sections 1.5 and 2.7.4 discuss the merits and pitfalls of

standardization. Standard designs for project components have
important implications for sustainability.
What written agreements or contracts are needed to implement
the project?
In many cases it may not be appropriate to have a formal engineering

contract between parties, particularly if the construction work is to be
undertaken by the community (see Section 2.7.10). However, there has to
be some guarantee of quality and an understanding of the scope of the
work. It is useful to have a written agreement between the primary and
secondary stakeholders (community and government, say) defining roles
and responsibilities and also agreeing the scope of the works. This will
avoid confusion or disagreement later on in the project.
Formal written contracts are required where specialist construction or
installation work is being undertaken by external contractors. This
work should be awarded through a competitive tender process to
ensure value for money.
283
How much supervision of construction work will be required?
The level of supervision required will naturally depend on the

complexity of the construction work. However, if the design includes
any engineering specification, then qualified staff should be available
on a full-time basis to oversee construction of the works. The quality
of work will suffer if supervision is inadequate because corners may
be cut, inferior materials used, and safety compromised.
3.5.8
Hygiene and sanitation promotion
How are hygiene promotion and sanitation promotion monitored?
Monitoring a hardware intervention involves checking that it stays on

time and on budget. The procedure for installing a water supply or
sewer system is well established, and it is unlikely that the design will
alter at this stage. On the other hand, the messages which promote
changes in behaviour cannot be standardized. The methods of
promotion are drawn from a wide range. While these methods
themselves are standardized, both the implementation of the
intervention, and the intervention itself, are likely to change as a result
of monitoring. Promotion marketing demands a continual rechecking
of the design and should include qualitative data collection, for
instance from focus groups, to ensure that the messages, their
positioning, and the communication channels continue to be the most
suitable. Allowance should be made for more re-design of the
programme than would be acceptable in an engineering intervention
simply concerned with hardware.
Field managers need to ask questions of partners to ensure good
practice. For example if government co-operation is deemed essential,
is the NGO or project team receiving support?
How is the scheduling of the hygiene promotion and sanitation
promotion proceeding in practice?
If sanitation provision lags too far behind, should resources be

diverted to hygiene promotion or should sanitation promotion be
delayed? This can be monitored by checking project sales, or by
unscheduled visits to find out if people are behaving in a way that is
compatible with the original design. It is important that monitoring
should be done by someone who has no axe to grind with either the
project or the implementing body.
What should be monitored in hygiene promotion and sanitation

promotion?
It is a reality of project management that it is always difficult to get

totally objective data about who has done what. There are many
conflicting interests to negotiate. It is important to answer questions
such as: Did everybody do what they were supposed to do? How
many home visits were conducted? How many questionnaires were
completed? What level of programme coverage has been achieved?
Have the targets for the numbers of people having had one, two, or
three exposures to the programme messages been met? What other
targets for the programme outputs have been achieved? These might
284
include behaviour changes, sale of potties, sale of soap, latrine

construction, and so on. (See Section 2.8.8 for a more detailed list in
Implementation of a hygiene promotion programme and A productbased social marketing plan for sanitation.)
What useful distinctions can be made while monitoring?
Those engaged in social marketing and hygiene and sanitation

promotion should be distinguished from those in the target groups
e.g. number of people trained, or staying on as trainers, is a different
type of indicator to the number of people attending street theatre/
puppet shows, etc. (see Section 2.8.6).
It is also useful to distinguish between those directly affected (target
audience) and those indirectly affected (neighbours who might adopt
practices through observation/demonstration effect) (see Section 2.8.4).
Finally achievement indicators, such as changed behaviour or the
number of applications received, and process indicators, e.g. readiness
of people to participate, degree of user participation in design of
message, communications, etc.
What should not be monitored in hygiene promotion and
Health change (see Section 2.3.9). There are too many variables and
confounding factors which intervene in the relationship between water
and sanitation and health. It is better to concentrate on behavioural
and environmental factors which are measurable and achievable.
3.6 Stage 6: Programme and project operation
and monitoring
3.6.1
General
This stage of the cycle follows the end of DFID support, and
continues for the life of the services or facilities put in place by the
programme, until they need replacement. This stage covers the
delivery of the benefits of the intervention. Both the level of benefits
and also the period for which they are enjoyed are crucial for
assessing the success of the project. Sustainability issues come into
prominence at this stage, particularly any related deficiencies which
have not been overcome in the earlier stages.
3.6.2
Continuous training, support, and supervision are all essential to

ensure successful monitoring of social impact and participatory
processes. This is best achieved when close contact is maintained at
the local level and when primary stakeholders are consulted and
informed on a regular basis.
WEDC/Sarah House
Do those involved in operation and monitoring understand why

they are undertaking their assigned tasks?
For example, people collecting monitoring data on the use of newly

installed tubewells or latrines need to understand why they are doing
it and how the information will be used, otherwise they might see
285
themselves or be seen as policing the community on behalf of

government agencies or donors.
What is the impact of involvement in operation and maintenance
on social relations?
In the post-construction stage careful attention needs to be paid to

those responsible for operating and maintaining water supply and
sanitation systems. It is just as important to identify how involvement
in operation and maintenance activities affects social relations as it is
to provide the right sort of training. The impact on social relations
might only be possible to observe during the operation stage itself. For
example, the following sub-set of questions might present themselves:
If women are involved in pump maintenance, does this challenge
the existing gender division of labour?
In the case of on-going hygiene promotion, does this compete with
or complement the work of community healthworkers?
Are those who are delegated to clean around latrines or public
standposts willing to do it and what effect does it have on their
status in the community?
Do those who collect user fees have sanctions they can use in the
exercise of this task? Do they face resistance or conflict?
Does the management of operation and maintenance activities fit
in with the overall system of governance at the village or
settlement level?
3.6.3
How sustainable are any long-term health interventions in

practice?
The main health-related monitoring issues will be the growth or

decline of activity in hygiene promotion. Is this activity increasing or
decreasing during project operation? Why? Are there unanticipated
stumbling-blocks to growth in this activity? What can be done to
overcome them? At what level do difficulties arise, and what can be
done about them? Do these suggest another project, or a revision of
the current project/programme?
How effective are long-term health interventions in practice?
Part of the sustainability issue is the quality of the work being done,
and the quality of its monitoring by local institutions. Is there regular
local monitoring? How is it done? To what extent does such
monitoring reflect changed behaviour as opposed to repetition of
learned knowledge? Does this monitoring focus on the issues of the
most vulnerable groups (children and adolescents) and the most
influential groups (women, especially mothers)? Effective monitoring
of behaviour change can lead to truly sustainable improvements in the
hygiene promotion programme; without effective local monitoring,
there is a danger that the work will become overly formal and
ritualized.
286
3.6.4
Performance monitoring
This should be aimed at monitoring the performance of the project

against quantifiable environmental objectives such as the:
provision of the design yield without undesirable environmental
consequences like lowered groundwater levels, or reductions in
flora and fauna; and
achievement of the intended water quality in receiving waters
below effluent discharges.
In addition, the performance of the project with regard to its
environmental impact should also be assessed. In particular, whether
there have been impacts as anticipated in the Environmental Analysis,
and whether these have been controlled as indicated in the
Environmental Analysis.
If any of the targets are not being met, this is a serious issue and the
question has to be asked, why not? Is it a short-term deficiency, which
can be rectified later (e.g. construction of an earth dam may be
causing temporary water quality problems which should cease once
construction is complete)? It may be a more serious problem, with
longer term implications. In such circumstances, the environmental
objectives and practices need to be reviewed. Aspects to consider
include:
Are the objectives as set realistic and attainable, in the light of the
project experience?
If not, do they need to be reviewed (for example, effluent discharge
standards may have been set which are too strict and unattainable)?
Were the assumptions made at the beginning of the project valid?
If not, do they need to be reviewed?
If the objectives and assumptions are still valid and monitoring
reveals a serious problem, action needs to be taken. How can the
effects be minimized? What is the effect of any minimization
proposal itself? Is the problem so big that the initial project as
undertaken should be stopped either temporarily or
permanently? Is there a need for another project to mitigate the
negative impacts that have become apparent?
It is important to state that Environmental Analysis and monitoring
programmes are there to serve a purpose. If measurement of
performance against them reveals that the objectives are not being
met, and after review it is recognized that the objectives are still valid,
then this is a very serious issue and action must to be taken. It is for
these reasons that environmental issues and the tools for monitoring
need to be rigorously considered at the very early stages of project
planning and preparation. Also, it is crucial to recognize when
mistakes are being made, and to take action.
287
3.6.5
Questions at this stage are essentially the same as at the previous

stage. Key issues are (a) the extent of and (b) the reasons for
divergences between appraisal projections and observed performance
in relation to:
the impact on poor people;
demand;
supply;
level and use of subsidy;
O&M expenditure; and
adequacy of cost recovery.
Adoption rates of new facilities
It is important at this stage to monitor who actually uses the new

facilities and to what extent, that is the number of connections to a
new system or users of new facilities and, for water, their
consumption levels. The adoption rates determine the financial
sustainability and economic justification for the project. The
sustainability of benefits is in turn crucially dependent on the
operational performance of the utility, or the robustness of the O&M
arrangements put in place for community-managed schemes. It is also
dependent on the project having met peoples needs.
Are funding arrangements for the O&M of projects working
satisfactorily?
A major weakness in past projects has been the lack of funding for
O&M. Actual O&M expenditure should be monitored closely against
that forecast, and compared with what is required. For community- or
village-level managed projects there may be issues of lack of trust in
the accountability and transparency of user committees, which should
be investigated in tandem with social monitoring.
Has the utility achieved its cost-recovery targets?
Financial and operational weaknesses are the main cause of low

standards of service of water and sanitation utilities, and so progress
made by the utility in reforming its financial and operational
performance provides a key indicator of project sustainability. Points
to establish are: is the utility meeting all capital and operating costs,
except those met by transparent public subsidy? Has the tariff
structure been reformed in line with revenue objectives? Are
collection rates improved sufficiently? Is subsidy policy clear in its
objectives and strategy? Are households receiving regular and reliable
water supplies?
Are the new facilities in working order and being used?
It is important to check the number of new water points that are in

operation and in use. Where water-points are functioning, not all
people will use them for all of their needs, all of the time. Conversely
they may be forced to use malfunctioning water-points in the absence
288
of alternative sources. A possible classification of functioning and use

is shown in the box below. For details of approach and indicators of
use see White, 1997. Where water points are not in use it is important
to distinguish between those where people chose to return to their
traditional water sources and those which are broken down.
Improved water supplies functioning and in use:
Borehole rehabilitation programme in Uganda
Boreholes
No. rehabilitated
In heavy use
In moderate use
In light use
Not in use
Total
Percentage
215
100
75
53
26
61*
Functioning satisfactorily
Functioning satisfactorily and
in moderate or heavy use
132
118
35
25
12
28
61
55
* of which 48 (22 per cent) were abandoned, not broken down
SCF/Alan Nicol
Have the poor benefited from the project?
Are poor households receiving a minimum level of water to meet their

basic needs at an affordable price? What measures have been put in
place (possibly within the context of reform of a utilitys costrecovery programme) to protect the poor, e.g. lifeline or block-level
tariffs, and have they had the intended effect? Have the poor benefited
in other ways, e.g. in the form of cost savings? Have some opted for
private connections or individual latrines?
3.6.6
How can institutional support be encouraged to ensure

sustainability after DFID has withdrawn from the project?
All institutional project initiatives should be working towards this

phase when DFID withdraws its support. This implies that those
initiatives should be realistic and not over-ambitious, to avoid donor
dependence. There are means of developing longer term on-going
institutional support, particularly for new or weak institutions, and
these include:
encouraging the use of local consultants, NGOs, and the private
sector by the concerned organizations on an ongoing basis,
providing guidance as appropriate;
promoting better linkages between key institutions by such
measures as joint reviews of the allocation of responsibilities,
management agreements, and the use of benchmarking;
support to nearby training institutions during the project who can
continue to provide appropriate support during the operation
phase; and
289
promoting the development of an appropriate monitoring system

that will produce information for and maintain the interest of other
key institutions. Good institutional monitoring information will
also be invaluable for the Evaluation phase.
Sections 3.6.5 and 3.6.7 on the economic and technical perspectives of
the Operation & Monitoring Phase also address institutional-related issues.
3.6.7
Technical aspects
Monitoring of appropriate indicators must continue throughout the

operational period. Narayan (1993) provides a comprehensive list
(Table 3.6.1) which includes many technical indicators. In addition,
specific indicators may be developed for the particular circumstances,
as described in the following paragraphs.
Are the facilities being operated in the way they were designed to
function?
It is important to monitor the mode of operation that is being

employed for the new facilities, because this may affect the quality of
the service being provided and the long-term sustainability of the
infrastructure. For example, if a new borehole pump was designed to
run for twelve hours continuously each day, this regime should be
adhered to. If the pump is run more erratically then increased
mechanical wear and tear will reduce the design life of the pump, and
storage reservoirs will not be fully used. The root cause of this
problem needs to be investigated: it may be that the original regime
was not designed in agreement with the future operators. The situation
should be reviewed so that an acceptable and sustainable mode of
operation can be achieved.
Is the design level of service being achieved in practice?
The facilities should be monitored to ensure that they are being used
and are providing the design levels of service to all users. Depending
on the complexity of the scheme, this may involve checking operating
pressure and discharge at standposts, checking water quality, or
ensuring that communal water points are draining properly.
Monitoring of on-site sanitation facilities could include smell, flies,
and stability of construction.
Are technological constraints preventing people from using the
facilities?
There may be simple design reasons why users, especially women and
children, are not using the facilities: headwalls may be too high,
handpumps hard to operate, latrines considered unsafe, etc. These
constraints must be identified and rectified if possible.
Is routine preventative maintenance being carried out?
Routine preventative maintenance will include changing washers in

handpumps and taps, greasing bearings, and other straightforward
tasks that would probably be the responsibility of the community. If
these jobs are not being done regularly, then the life of the
installations will be reduced and the system will eventually fail.
290
Table 3.6.1
Indicators of progress in water and sanitation

programmes
Sustainability
S.1
Reliability of Systems
S.1.a
Quality of water at source
S.1.b
Number of facilities in working order
S.1.c
Maintenance
S.2
Human capacity development

S.2.a
Management abilities
S.2.b
Knowledge and skills
S.2.c
Confidence/self-concept
S.3
Local institutional capacity

S.3.a
Autonomy
S.3.b
Supportive leadership
S.3.c
Systems for learning and problem-solving
S.4
Cost-sharing and unit costs

S.4.a
Community contribution
S.4.b
Agency contribution
S.4.c
Unit costs
S.5
Collaboration among organizations

S.5.a
Planning
S.5.b
Activities
Effective Use
E.1
Optimal use
E.1.a
Number and characteristics of users
E.1.b
Quantity of water used (all purposes)
E.1.c
Time taken to use facilities
E.1.d
Management of water resources
E.2
Hygienic use
E.2.a
Water quality at home
E.2.b
Water transport and storage practices
E.2.c
Home practices to improve water quality
E.2.d
Site and home cleanliness
E.2.e
Personal hygienic practices
E.3
Consistent use
E.3.a
Pattern of daily use
E.3.b
Pattern of seasonal use
Replicability
R.1
Community ability to expand services

R.1.a
Additional water/latrine facilities built
R.1.b
Upgraded facilities
R.1.c
New development activities initiated
R.2
Transferability of agency strategies

R.2.a
Proportion and role of specialized personnel
R.2.b
Established institutional framework
R.2.c
Budget size and sheltering
R.2.d
Documented administrative/implementation procedures
R.2.e
Other special/unique conditions
Narayan, 1993
291
The reason for failure to maintain the system must be identified. It

may be due to a lack of spare parts or tools, or because the people
originally trained under the project have moved on without passing on
their knowledge and expertise.
Have any external changes taken place which are affecting
operation?
Physical conditions may have changed during the life of the project to
make the system less efficient (for example: change in groundwater
level or flow of river, new developments or settlements, political
problems, change in water quality). These changes should be
monitored and the need for modification or upgrading may need to be
considered.
3.6.8
Operation, for a software intervention, does not have the same

meaning as ensuring that the hardware is working and is being
maintained. But this is the stage at which the impact of social
marketing should be evident in behavioural change, as people become
accustomed to having the improved WS&S services available. We can
look too at the longer term on a more institutional level: have hygiene
promotion and sanitation promotion and other consumer-oriented
methods been adopted by the Ministry of Health and other
departments?
Has the Ministry of Health, or other partner responsible for hygiene
promotion and sanitation promotion, developed standard operating
procedures for promotional projects and for checking the reliability of
such approaches? Are these procedures used?
3.7 Stage 7: Programme and project extensions or
next phase programme and project
identification
3.7.1
General
This stage in the cycle does not strictly follow Operation, but rather
occurs at about the time of the Implementation/Operation transition,
when possibilities for replication of the project are considered, taking
account of lessons learned in the previous work. If the project has
been successful, there are likely to be opportunities for building on the
partnerships which have been established and expanding the
successful approaches to wider areas as part of a continuing
programme. With the partnership approach, this process may become
expected as a normal part of the cycle and the long-term programme.
3.7.2
It is often at the review stage of the programme cycle that a social

development perspective, gender issues, or participatory approaches
can be revisited. Renewed efforts can be made to introduce or extend
these approaches in the process of reviewing the first phase of a
programme or project and of identifying extensions or subsequent
292
phases. It may be that while DFID is wedded to gender awareness and

participatory approaches, other stakeholders in water supply and
sanitation may be less familiar with these agendas or hostile to them.
In this case discussion is needed to build consensus and decide a
mutually satisfactory approach.
Have all stakeholders been identified and involved?
At this stage it is valuable to do a further stakeholder analysis. On the

one hand this can identify whether additional affected populations
have emerged as a result of the project, and on the other, whether
some stakeholders have changed their level of involvement in
participatory processes. Even if the project was initially identified by
donors or government institutions without any commitment to
participation, it is possible at this point to rectify this by detailed
consultations with users or affected groups.
Is the project being informed by the priorities and views of user
groups?
The views of poor and marginalized people are important in ensuring that
the visions and priorities of the public sector and of donors supporting the
water supply and sanitation sector match those of user groups. At the
level of policy, experience from first phases can be used to illustrate the
benefits of participation or to show what can go wrong if user groups are
not involved in decision-making from the outset.
Have there been any changes in institutional roles and
relationships affecting the project?
Changes in institutional roles and relationships can be identified at this

stage. For example, local organizations might be more robust and
engaged, or those working in ministries or parastatals may have learned
the value of wider consultation and participation by the end of the first
phase of the project. There may be extraneous influences as well, such as
the formation of a new womens organization or the impact on a project
area of other development projects and their structures.
What changes affecting the policy framework have taken place?
At this stage it is also useful to identify important changes relevant to

social development issues since project inception or the last review.
For example, have there been changes in government policy relevant
to water supply and sanitation? This could include new legislation
regarding land tenure which might improve access or rights to water
sources, or community-based finance initiatives which could be used
towards funding water supply or sanitation facilities.
Has capacity building at the local level influenced sector policy?
Where the capacity of primary stakeholders has been strengthened

through participation in the design, implementation, and management
of projects, this may be built on to strengthen their capacity in
contributing to policy debate. It is at this stage in the programme cycle
that the involvement of local representatives beyond the project and at
policy and programme level can be considered.
293
3.7.3
What has been learned during the project or programme about

how to increase health benefits?
Do these lessons suggest further projects or programmes? If work to

date has been successful, the task of identifying new projects is
simplified, as effective project partners will be quick to point out
bottlenecks that may be amenable to change. If work to date has been
unsuccessful, this begs the question of why has the work failed?
which may (or may not) identify further work to be done.
3.7.4
Environmental issues
The process of setting up environmental monitoring practice will have

raised capacities and expertise in the planning and implementing
team. As environmental impact assessment and monitoring is a
specialist process, it makes great sense to seek to take advantage of
this raised level of capacity on other projects.
Environmental monitoring is not an exact science, as the
environment is a complex and diverse entity. Procedures and
practices should be continually under review, and the implementers
should not be afraid to act on the results even if they are not as
expected and even not popular. Environmental degradation may take
a long time to reverse, and may be irreversible in some circumstances.
Replication of lessons learned may naturally lead to development of a
integrated national or regional policy on some aspects of the
environment, such as the development of Integrated Water Resource
Management policies as discussed in Section 2.4.4 if they are not
already in place.
3.7.5
The same steps will need to be gone through as at the preparation and
appraisal stage, but informed by the monitoring and evaluation stage.
3.7.6
Is there willingness and capacity for replicating or scaling-up

institutional arrangements for the next phase?
While institutional arrangements may not be totally established for the

long-term management of the facilities on the current phase, a
decision needs to be made concerning if and how it is advisable to
move to the next phase. Factors to be considered include:
The progress on the design and implementation of institutional and
financial arrangements, assessing reasons for any delays;
Are there sufficient key project stakeholders participating in the

development of institutional arrangements on the current phase and
advocating their use elsewhere?
What are the lessons on the current phase for replication
elsewhere, and are the lessons generally agreed? What changes are
required for a more effective next phase?
294
Are there signs of a willingness to replicate elsewhere regardless of

whether the next phase will be supported by DFID?
Are there viable plans for replication/scaling-up institutional
arrangements for the next phase?
Should project rules or conditions be amended for the next phase?
Institutional aspects are also discussed in Section 3.7.2.
3.7.7
Technical aspects
Is it appropriate to promote replication or expansion of the

chosen technology to other project areas?
Even if the technology choice has proven to be popular and

sustainable in a given project area, it may not be suitable for
replication and standardization in other areas. This will depend on
the physical characteristics of the new project area (topography,
hydrology, distance from existing infrastructure, etc). However, as
already discussed in Section 2.7.4 and 2.7.5, replication and
standardization are desirable. If the technology is to be replicated it is
essential to examine lessons learned and carry these forward.
Particular lessons will be identified through monitoring (Section
3.6.7) and evaluation (Section 3.8.7).
3.7.8
One of the aims of social marketing is to develop an inbuilt impetus

for communicating key messages within the target communities. In
some cases, this may be transferred to neighbouring communities and
contribute to the demand for further improvements. We must, though,
be aware that the effects of social marketing may be transitory.
What are the main limitations of social marketing in hygiene
promotion and sanitation promotion?
The main limitation to the success of consumer-oriented projects is

the persistence of habit. There is some evidence that, with the right
message positioning, new behaviours such as hand-washing with soap
may be sustained for six months or more. Continuous reinforcement
depends on how well established hygiene education becomes within
the community concerned.
How long does it take to create demand?
It is a long process to transform a behaviour or establish a household

good, which may at first be alien, into an integral part of everyday
life. Even when this status has been achieved, it must be maintained
by promotion and marketing. The curve representing the adoption of
innovations has a long slow start (see Rogers, 1983 and the
introduction to Section 2.8). If the message is appropriate and the
intervention attractive it will rise steeply. Coca-Cola is an oft-quoted
example of the continual need for reinforcement by promotion. After
nearly a hundred years of promotion, the manufacturer continues to
check message positioning and invest heavily in selling the brand.
295
What is the geographical scope of hygiene promotion and

As the project or programme increases in size there will be some

trade-off in direct relevance to particular groups and communities.
This can be compensated for by the degree of endorsement and
support the messages received from other areas of society.
3.8 Stage 8: Evaluation

3.8.1
General
Evaluation is undertaken after several years of operation, and should

make use of material in the previous sections to analyse project
performance at the earlier stages. Additional issues arising at this
stage concern the assessment of impact, the drawing of appropriate
lessons, and feedback of these lessons into both DFIDs programme
and project cycle management, and the countrys own sector planning
processes. Evaluation focuses on the Outputs, Purpose, and Goal
levels of the logical framework. Table 3.6.1 can be used as a guide to
suitable indicators, and both Narayan (1993) and WHO (1983) are
valuable references for the evaluation stage.
3.8.2
Evaluation is important for process projects and for a learning

approach to water supply and sanitation provision. A key question for
DFID staff looking to integrate social dimensions into water supply
and sanitation provision, is whether the terms of reference for the
evaluation clearly specify the social development issues and questions
to be addressed in the evaluation, and whether they clearly identify
what DFID and its partners want to know about the social impact of
the project. As with other stages of the project cycle, clear and
acceptable terms of reference can be formulated once there is
agreement on what should be learned.
Evaluations provide the opportunity to assess whether the aims and
objectives of DFIDs White Paper have been followed and the extent
to which a project has contributed to the achievement of poverty
reduction, gender equality, and partnership. However, evaluations
frequently limit themselves to assessing the objectives stated in the
project logframe, rather than broader issues of DFID policy. Thus it is
important to specify that an evaluation should also review project
design and implementation in terms of how it has contributed to the
achievement of DFIDs broad development objectives.
WaterAid/Jim Holmes
Particular methodologies best provide information on social issues. It

is important, therefore, to specify that the evaluation team includes a
member with the requisite skills to undertake social analysis. Support
should be provided to the people with responsibility for social
development issues, who in turn should have clearly defined roles so
that they can effectively carry out their responsibilities. This task
cannot be relegated to a junior team member.
296
Finally, the terms of reference for the evaluation should include a

section on lessons learned and this should include lessons learned
with respect to poverty reduction, equality issues including gender
equity, participation, and partnership. This will avoid losing the
opportunity to learn social development lessons from experience.
There may also be scope for communicating and discussing the
lessons learned through feedback seminars and other forms of
meetings. To be consistent with information-sharing approaches in
monitoring and review, the evaluation should be shared with primary
stakeholders who may also be involved in the evaluation process.
What follows are some questions deriving from a social development
perspective that might inform evaluation of water supply and
sanitation projects. The list is indicative rather than exhaustive.
Questions on project design and implementation:
Was the project concerned with poverty reduction through water
supply and sanitation?
Did the project consider issues of equity in design, including
technological choices and cost-recovery mechanisms?
Was the project based on an understanding of gender issues,
particularly how women and men use water for productive and
domestic uses?
Was the data collected adequate and sufficiently disaggregated to
allow an assessment of change or improvement as it affected
different groups in the community?
Was the project planned specifically to include community-level
participation and to involve women and men equally?
Did primary stakeholders participate in project design and
planning, including siting of installations, technological choice,
and decision-making regarding cost sharing? Did women
participate to the same extent as men?
Were project implementers able to respond to social issues that
arose during implementation?
Questions on resources and activities:
Were sufficient resources allocated to social impact and

stakeholder analysis during the project cycle?
Were resources allocated to local capacity building used

appropriately?
Were both women and men involved in community-based
organization and structures and were their respective priorities
included in final decision-making?
Was the technical assistance provided supportive or undermining
of a participatory approach?
Were activities included to enhance the understanding of social
development perspectives among secondary stakeholders?
297
Do new technologies introduced by the project reflect the priorities

of different groups at community level, associated with domestic
and productive water use?
Have the specific needs and priorities of women and men been
taken into account in the design of water supply and sanitation
facilities?
Questions on socio-economic impact:
Has the intervention met the immediate needs of poor groups and
has it recognized the different needs of women and men?
WaterAid/Jim Holmes
Has the intervention affected patterns of land use, access to, and
control over water resources and other productive assets?
Are the benefits of the project reaching all the people targeted?
Has the project provided income-generating opportunities for
micro-entrepreneurs or local employment opportunities?
Has the project improved the status of poor and marginal groups
and of women?
Has the project affected the ability of people at the local level to
participate in the management of water resources and sanitation
facilities?
Are governments responding more effectively to the immediate
needs and expressed priorities of communities?
3.8.3
How have hygiene behaviour, water consumption, and use of

sanitation changed over the course of the project/programme?
These three indicator groups are critical to establishing health

benefits. The most appropriate indicators will vary from project to
project, and, in the case of hygiene, will themselves be a product of
project preparation. These three areas, however, will be the key to
health improvement in water and sanitation projects.
How have conditions changed at the household level?
This question is implicit in the above, but is restated to make clear

that, for most projects, health benefit evaluation must focus on
changes at the household level. Some project components may
address system-wide problems (e.g. water treatment for urban water
supply) but even these must be translated into changes at the
household level. If, for example, drinking water leaving the
waterworks is free of contamination, but most household samples
remain significantly contaminated because of contamination due to
the intermittent water supply, then few if any health benefits can be
claimed.
3.8.4
The environmental consequences of any action in a project may not

become apparent until several years after the project is completed
298
many environmental aspects are very long term in their nature.

Therefore it is important that a long-term review is undertaken to
gauge the lessons that can be learned. This is important for
replication of projects, as discussed in Section 3.7.4.
At this stage, environmental monitoring at every stage of the project
cycle should have revealed:
how the project has performed against the environmental
objectives;
whether the objectives as set were realistic;
what unexpected environmental implications have arisen, and how
these have been dealt with; and
what positive as well as negative environmental impacts have
occurred as a result of the project implementation.
Long-term evaluation should consider such aspects as:
Were all the environmental factors correctly identified and
considered in the execution of the project?
Have the environmental effects of the project been essentially as
predicted?
Have there been unexpected environmental consequences of the
project which, with hindsight should have been foreseen?
The responses to these questions should be fed back, so that the

experience can be used for future projects. At this stage,
implementation of the project will have developed environmental
capabilities of project staff. All lessons can be used to feed directly
into wider environmental policy making which is an integral part of
any developmental strategy.
3.8.5
Did benefits exceed costs?
This requires quantification of benefits, as identified at project

appraisal, or modified during subsequent stages of the project cycle,
plus unforeseen benefits. Were benefits of the right magnitude forecast
at appraisal, and if not, was this because demand was not adequately
met? This will require fieldwork. Costs are relatively easy to obtain
from engineering figures.
Is the project financially sustainable?
Was the project cost-effective?
This is best done by comparison with costs of similar projects incountry.

Is the project financially sustainable?
This requires a repeat of the approach adopted at the preparation and

design stage, informed as necessary by work done at subsequent
stages.
299
3.8.6
How to evaluate institutional project components?
Participatory evaluations with project partners should be encouraged,

with prior agreement on key indicators, particularly at the Project
Purpose level. This requires early agreement on the scope of the
evaluation at the project operation and monitoring stages.
Institutional indicators can cover areas such as the reliability,
adequacy, operation and use of the facilities, cost recovery, HRD,
staffing, and management systems.
Much of the institutional evaluation information should hopefully
come from on-going monitoring data gathered by the institutions
concerned with O&M, cost recovery, regulation, and facilitation.
When assessing project management systems, it matters less whether
the systems differ from those originally conceived, but more emphasis
should be placed on the extent to which the stakeholder institutions
are using systems that address the objectives relating to sustainability.
A key indicator of the effectiveness of institutional initiatives during a
project is the extent of replication of those initiatives. This is
particularly true with government implemented projects. This may
entail moving outside the logical framework, exploring how project
initiatives have been used elsewhere.
The social development, economic, and technical sections dealing
with the Evaluation phase also address institutional issues.
3.8.7
Technical aspects
Are the design assumptions used to develop the project valid?
The technical data and design assumptions used to develop the project
need to be assessed. Any impacts resulting from poor quality data or
inaccurate assumptions should be identified to benefit future project
development. The importance of baseline data may be crucial to the
sustainability of a chosen technology.
Has coverage of water supply and sanitation increased?
If the purpose of the project as defined in the logframe is to increase

coverage of water supply and sanitation, then the physical hardware
element of this needs to be measured during evaluation. A number of
indicators on outputs can be used, including: number of water points
in use, per capita consumption of water, number of latrines in use,
number of leaks reported, etc. (See also Table 3.6.1).
Was the choice of technology driven by the community?
The reactions and attitudes of all the end-users need to be assessed in

order to evaluate the effectiveness of the demand approach. If a
community is unhappy with an installed technology they will tend to
customize or modify the facilities to suit their needs. Such changes
should be noted and any feedback loops should be evaluated to ensure
that stakeholders views are known.
300
Is there an adequate training programme for ongoing O&M?
The training of operators must continue throughout the life of a

project in order to ensure sustainability. The systems in place to
provide the appropriate level of training to the relevant stakeholders
should be assessed.
Did changes to project budgets unduly constrain technology
choices?
3.8.8
Was the output achieved?
The project must be evaluated by somebody who was involved in

neither the preparation nor the implementation of the project.
What impact can be identified from hygiene promotion and
behaviour change?
It takes skill and sensitivity, but these behaviours can be evaluated. A

number of tools are available for evaluating hygiene behaviour, see
Almedom et al. (1997).
301
302
A
304
1. Urban water, sanitation, and hygiene promotion project

Narrative summary
Objectively verifiable indicators
Means of verification
GOAL
Sustainable improvement in
health and well-being for
N,000 poor people in City X
Risks/Assumptions
(GOAL to SUPERGOAL)
Water consumption at household (HH)

level increased to 40 lpcd in 2,000 low-income HHs
converted from public taps to yard connections by
year Z
Use of building water meters plus

interviews with consumers (meters
unreliable in intermittent supplies)
Average price of water sold by vendors reduced by

X% (1998 prices) by year Z
Market survey
In peri-urban fringe areas supplied by distant taps,

water consumption at HH level increased from <10
lpcd to 15 lpcd among 8,000 HHs by year Z. Among
the population with travel times now >30 minutes,
average travel time reduced to 20 minutes by year Z
Interviews, observation at HH level
Socio-economic and political

conditions provide supportive
environment for expansion of
community-based demand-led
approach to WS&S in other cities
Safe hand-washing practice, as identified in project

outputs, increased x% among adults, and increased
y% among school-age children in service population
by year Z*
Observation by local social scientists, for

comparison with baseline survey
Sufficient effort is made to document

and disseminate results in City X so
that they can be applied elsewhere
Hygienic use and maintenance of sanitation facilities

by S% of the households involved by year Z*
Spot checks during household visits by

local healthworkers, checking for
cleanliness of slab, access to soap and
water, evidence of use
Infrastructure improvement does

not lead to further displacement of
poor from where they live to sites with
worse environmental health
conditions
Safe management of childrens stools practised in

q% of households with children within service
population by year Z*

comparison with baseline survey;
Coverage: HH survey
* Values for these indicators, and details of target behaviours, to be determined as part of Hygiene Strategy output. Alternatively, if Hygiene Strategy output is performed as part of
sound project preparation, these values may be included here.
Narrative summary
Risks/Assumptions
85% coverage of target population by competent

hygiene promoters by year Y
Competence of promoters: interviews and

field observation by external consultant
Experience from pilot studies ensures

correct positioning and appropriate
messages to change behaviour to
improve health
PURPOSE
Establishment of sound,
sustainable environmental
services for N,000 poor
people in
Review of behaviour in communities

already served, for comparison with
baseline
water supply,
sanitation, and
hygiene promotion
in City X by year Y
Necessary WS&S interventions keep

pace
Field inspection of sample
Water utility is in financial position, with

management commitment, to continue
maintenance to low-income areas
80% of population are within two kilometres of a

commercial sanitary mart by year Y
Mapping, demographic data, surveys
Population growth is mostly within

service area, not outside it
Services for N,000 people require <10% subsidy of

recurrent cost by year Y
Accounts from public utilities, service

providers
Government policy and economic

conditions permit sustainable growth
Utility investments for extended coverage for the

poor increased by 20% by year Y
Accounts from public utilities, service

providers
As above
Demand for services from sanitary marts increases

by at least 5% p.a. by year Y
Accounts from sanitary marts
As above
80% of installed public water points, and

80% of installed latrines
are in good working order (Y - X) years after
completion
305
A
306
Risks/Assumptions
Build 2,000 yardtaps in lowincome households on a

sustainable basis by year X
No. of yardtaps built by End of Project

No. of taps in good working order two years after
installation
Receipts from billings for these taps
End of Project survey

Inspection
Financial records
Water utility is in good financial position,

with management commitment, to
continue services for low-income areas
Establish effective low-income

HH task force in water utility
by year X
Establish N* competent and
sustainable hygiene
promotion (HP) teams by year
X
Targets and investment budgets established by year

X for extending yard connections to the poor,
consistent with financial status of utility
Interviews with water utility, task force

members, meeting minutes
As above
Establish N viable and

sustainable sanitation
promotion (hardware) teams
by year X
Promotion strategy and tools are sound

Pre- and post-hygiene behaviour in target areas
meets strategy targets by year X
Future funding assured by mix of Ministry of Health
(MoH) budget and sanitary mart profit by year X
Staff levels meet strategy targets by year X
Programme review by external consultant

with HP team members, community
leaders, residents
Budgets of state government
Review of past, current, and future
programme of work, management, and
financing arrangements
Experience from these teams provides

sound basis for HP expansion
pace
Sanitary marts successful enough to
defray some HP costs
Sanitation promotion teams require only 10%

financial subsidy by year X and three out of five are
entirely self-sufficient
Sales figures and costs, management

practices, materials and approaches
used, sources of funding
Government policy is consistent with

demand-led approach, and allows
teams and marts to make a profit
Establish N viable and

sustainable sanitary marts to
produce latrine slabs, sell
sanitary goods, and assist in
latrine installation by year X
No. of latrine slabs sold per month

No. of latrines installed per annum
No. of sanitary goods sold
Revenues
Field surveys
Review of records, tests
Review of accounts
As above
Construction of N viable, fully

functioning and adequate
community-managed water
supplies, serving Z,000 poor
people by year X
No. of enquiries about franchise

No. of hours/day of water in poor HH areas
Water quality meets criteria 85% of time
Supplies meet operating costs
X% of water points achieve design discharges
Community based O&M and

cost recovery system
established and functioning
Routine and preventative maintenance undertaken

satisfactorily on X% of water systems
X% of adequate water charges collected each year
Narrative summary
OUTPUTS TO INCLUDE:
Government policy encourages

expansion of community-managed
approach
Evaluation reports
CBO accounts
Adequate supple of spare parts by

private sector
Back up support provided by
government
Risks/Assumptions
Develop area-wide Hygiene

Promotion Strategy, materials,
and programmes
Draft and final versions of material by year X-2
Quarterly progress reports, interim

reports, review meetings
Agencies and partners in health, water,

and hygiene sectors are supportive of
approach
Hygiene Promotion workers

trained and functioning
m* complete training courses by year X

Hygiene promotion completed in Y h/hrs

Incentives are sufficient to keep hygiene

workers in sector; stability of
employment
Pilot hygiene promotion

among population of X,000
Videos and reports of activities up to year X

(for effectiveness of promotion, see Purpose
indicators for year Y)

Pilot areas, as selected during project

design, are representative of overall
target communities
Water utility HRD in

Distribution & HH connection
revenue collection
p finish Distribution training courses by year X

q finish accounting courses by year X

Utility permits expansion of HH

connections among low-income groups
Sanitation promotion NGOs

n* complete training courses by year X

Sanitation promotion completed for Y households

Incentives and policies (e.g. subsidies)

of other donors, government agencies
do not conflict
Build five sanitary workshops
five workshops built by year X
Project Completion Survey
Continuity and stability of funding base

and consumer demand permit
sustainability of workshop
Build latrines
1,000 built by year X
Hygiene promotion is effective in

encouraging appropriate use
Public water point and

yardtap sites agreed to serve
population of X*,000
Community representatives sign water system

construction and management agreements for
population of X000
Economic and political conditions,

including demand, permit community
management of WS
Train Community
Management Teams
10 trained by year X

management of WS
Participative demand
assessment studies
completed
X no. of households agree to project rules including

community contributions
Develop and agree long term

management arrangements
with local government
Agreements documented
Narrative summary
ACTIVITIES TO INCLUDE:
307
* Values for these indicators to be determined as part of the Hygiene Promotion Strategy developed in this projects preparation.
A
308
Risks/Assumptions
Data collection and pilot

strategy development for
hygiene promotion
Study Report on Hygiene Strategy re: water use,

sanitation, and hand-washing

Project is approved by both DFID and

host country government
Review of existing health and

hygiene promotion and water
sectors
Study Report on existing players in the sectors,

examining MoH, educational, and other government
players as well as NGOs and CBOs

No sudden shifts in sector policy or

priority re: hygiene promotion
Hygiene promotion training

workshops
Participant involvement and learning in workshops
Participant evaluation forms, participant

products, outputs
Sufficient financial incentive and stability

to make continued participation viable
Technical Assistance (TA) to

NGOs/CBOs in planning
hygiene promotion pilot
programme
NGO/CBO willingness to participate in pilot

programme
NGO/CBO plans and proposals for further

involvement
Funding for hygiene pilot programme is

assured, and disbursed rapidly enough
Review of existing channels

for sanitation promotion
Study report on sanitation promotion, describing

who does what and how for how much in sector

Sector is open to poverty focus and

demand-led approach
Review of high priority areas

for improved water supply
services
Well-argued case for areas of highest priority for

water supply improvements, including quantitative
estimate of no. of people benefiting and in what
ways

Sector is free to investigate needs of

informal, illegal residents
TA, materials for pilot water

supply extension
Construction progress reports compared with plans,

specifications and schedules (contracts)

Water agency willing to give project

work priority for completion
TA, materials for NGOs/CBOs

on pilot sanitation promotion

programme
NGO/CBO progress reports, and plans

and proposals for further involvement
Sewerage agency/city government

support poverty focus and demand-led
approach
Narrative summary
PROJECT PREPARATION
TO INCLUDE:
Sites chosen for formative research are

suitably representative
NGO/CBO understanding of requirements for pilot

work

work
2. Rural water, sanitation, and hygiene promotion project

Narrative summary
(GOAL TO SUPERGOAL)
GOAL
Sustainable improvement in
health and well-being for
N,000 villagers in Region R
Risks/Assumptions
Public works department continues

commitment to maintenance support
for larger systems in disadvantaged
areas
309
Water consumption at household (HH) level

increased from <10 lpcd to 15 lpcd among 8,000
HH by year Z
Interviews, observation at HH level
80% of installed water supplies are in good working

order and use 10 years after installation
Inspection of random sample of x systems
80% of latrines constructed are in use (or upgraded)

five years after project completion
Spot checks during HH visits by local

healthworkers, checking for cleanliness of
slab, access to soap and water, evidence
of use
Regular maintenance and emergency repairs as

necessary are achieved on 80% of the handpumps
and spring systems five years after project
completion
Inspection of a random sample of systems

Maintenance records, interviews with
villagers
MoH continues support for extension

work on hygiene promotion
Safe management of childrens stools practised in

q% of HHs with children in target population by
year Z

Economic conditions and demand

foster viability and growth of sanitary
workshops
Safe hand-washing practice, as identified in Hygiene

Strategy, increased x% among adults, and increased
y% among school-age children in target population
by year Z

Ministry of Education can and does

maintain support for, and expansion
of, hygiene education and
demonstration in schools
80% of water and sanitation facilities at schools in

the project area are in satisfactory condition five
years after project completion
Inspection
Political conditions remain favourable

for governmental support to these
and other target communities
Economic conditions remain
favourable for continuation and
expansion of community-based
demand-led approach to WS&S
A
310
Narrative summary
Risks/Assumptions
85% coverage of target population with water

supplies requiring <30 mins round trip travel time by
year Y. Capacity of system from source to public
waterpoints adequate water to ensure 20 lpcd for
year 2010 population
Field survey
Increase in irrigation demand is met

without prejudice to safe yield for village
water supply
80% of installed public waterpoints, and 80% of

installed latrines are in good working order (Y-X)
years after project completion
Field surveys
Department of Public Works maintains

political commitment to continue repair
services for low-income areas
85% coverage of target population by competent

hygiene promoters
Coverage: HH survey
PURPOSE
Establishment of sound,
sustainable environmental
services for N,000 poor by
year Y in:
water supply,
sanitation, and
hygiene promotion
Evaluation reports
Competence of promoters: interviews and

field observation by external adviser
Review of behaviour in communities
already served, for comparison with
baseline
Services for N,000 people require <10% subsidy of

recurrent cost by year Y
Demand for services from sanitary marts increase by
at least 5% a year by year Y
Accounts, records of local committees
Experience from pilot studies ensures

correct positioning and appropriate
messages to change behaviour to
improve health
pace
Government policy maintains ringfence of funds for WS&S, and suitable

cross-subsidy within sector
Government policy and economic
conditions permit sustainable growth
and expansion of marts
Narrative summary
Risks/Assumptions
Promotion strategy and tools are sound
Review of past, current, and future

programme of work by consultant with HP
team members, community leaders, and
residents
Relevant authorities continue to support

hygiene promotion approach
OUTPUTS TO INCLUDE:
Establishment of N viable and
sustainable hygiene
promotion teams within the
MoH to cover target
population of Y,000, by year X
Pre- and post-hygiene in target areas meets strategy

targets by year X
Future funding assured by mix of MoH budget and
sanitary mart profit by year X
Staff levels meet strategy targets by year X
Establishment of five viable

and sustainable sanitation
promotion (hardware) teams
which sell no less than x
Sanitation promotion teams require only 10%

financial subsidy by year X
Construction of N viable,fully
functioning and adequate
community-managed water
supplies in low-income
villages by year X
Sufficient revenue is generated from the community

to cover running costs, with 10% margin set aside for
repairs
Three out of five are entirely self-sufficient
X% of water points achieve design discharges
Hygiene evaluation procedures

Budget, staffing, and financial plans
Experience from these teams provides

sound basis for HP expansion
WS&S interventions keep pace
Sanitary marts successful enough to
defray some HP costs

Government and other External Support

Agency (ESA) policy re: subsidy of
promotion, not the product, supports
viability of demand-led approach
Field surveys
Socio-economic conditions permit wider

use of community management
approach
Review of records, tests

Review of accounts
Beneficiaries within 1000m of water point

No of days without supply <X days in first year
Establishment of N viable and
sustainable sanitary
workshops for sale of latrine
materials, sanitary goods,
and assistance with latrine
construction, by year X
No. of latrine slabs sold per month

No. of latrines installed per annum

Government and other ESA policy re:

subsidies supports viability of demandled approach
Village accounts
Adequate supply of spare parts by

private sector
No. of sanitary goods sold

Revenues
No. of enquiries about franchise
Community based O&M and

cost recovery systems
established and functioning
Routine and preventative maintenance undertaken

satisfactorily on X% of water systems
O&M budgets produced in X% of villages
311
X% of adeuate water charges collected each year
Independent evaluation reports
Back up support provided by local

government
A
312
Risks/Assumptions
Strategy, materials, and

programmes for hygiene
promotion developed
Draft and final versions of material by year X-2
Quarterly progress and interim reports,

review meetings
Health, water, and hygiene sectors are

supportive of approach
Hygiene promotion workers

No. completing training courses

Hygiene promotion completed in X villages

review meetings
Adequate incentives to keep workers in

sector; stability of employment
Piloting of hygiene promotion

among population of X,000
Videos and reports of activities (for effectiveness of

promotion, see Purpose indicators)

review meetings
Pilot areas are representative of overall

target communities
Sanitation promotion NGOs

No. completing training courses

Sanitation promotion completed in Y villages

review meetings, training evaluation forms
Incentives and policies (e.g. subsidies)

of other donors, government agencies
do not conflict
Sanitary workshops built
Five built by year X
Continuity, stability of funding base,

permits use as intended
Latrines constructed
N built by year X
Hygiene promotion is effective in

encouraging appropriate use
Public waterpoint sites agreed

within 1000m / construction
commenced in villages
Community representatives sign water system

constructional management agreements in X
villages

management of WS
Community management
teams trained
p finish technical training course by year X

review meetings, training evaluation
forms.

management of WS
Participative demand
assessment studies
completed
X no. of communities agree to project rules including

community contributions
Institutional Dev. assistance to

government departments in
support of their new roles in
Hygiene Promotion and
Community Management
Government departments agree to establish new

teams
Narrative summary
q finish accounting course by year X
Risks/Assumptions
Data collection on hygiene

behaviour
Study report on hygiene practices re: water use,

sanitation, and hand-washing

review meetings
Sites chosen for formative research are

suitably representative
Review of existing health and

hygiene promotion Sector
Study report on sector, examining MoH, educational,

and other government agencies and NGOs, CBOs
involved in HP

review meetings
No sudden shifts in sector policy or

priority re: hygiene promotion
Hygiene promotion training

workshops
Participant involvement and learning on workshops
Participant evaluation forms, products,

outputs
Sufficient financial incentive and stability

to make long-term participation viable
TA to NGOs/CBOs in
planning hygiene promotion
pilot programme

programme
NGO/CBO plans and proposals for further

involvement
Funding for hygiene pilot programme is

assured, and disbursed rapidly enough
Review of existing channels

for rural sanitation promotion
Study report on sanitation promotion, describing

who does what and how for how much in sector

review meetings
Sector is open to poverty focus and

demand-led approach
Review of high priority areas

for improved water supply
services
Well-argued case for which areas are highest priority

for water supply improvements, including
quantitative estimate of no. of people benefiting and
in what ways

review meetings
Sector is free to investigate needs of

informal, illegal residents
TA, for rural water supply

planning
Definition of suitable technical options for water

supply in selected communities

review meetings
Water agency willing to give project

work priority for completion
TA, materials for NGOs/CBOs

on sanitation promotion

programme
NGO/CBO progress reports, and plans

and proposals for further involvement
Sewerage agency/city government

support poverty focus and demand-led
approach
Narrative summary
PROJECT PREPARATION
TO INCLUDE:

work
313

work
A
314
3. Institutional capacity building for developing participatory approaches in the water and sanitation sector
Narrative summary
GOAL
Sustained improvements in
community managed water
supply and sanitation services
Risks/Assumptions
(GOAL TO SUPERGOAL):
X% of total population with access to reliable water

supply and sanitation facilities at end of project
X% of those with access regularly using facilities at
end of project
Number of new installations still in working order by
end of project
Project records;
no. of connections per head of population
Participatory monitoring and observation
Participatory monitoring and observation
Socio-economic and political conditions

provide supportive environment for
participatory approach to WS&S
Narrative summary
PURPOSE
Increased involvement of
primary stakeholders,
(including marginalized
groups) in decision-making
and management of water
supply and sanitation and
other services, supported by
WS&S staff and other
secondary stakeholders
Risks/Assumptions
(PURPOSE TO GOAL):
X% and spread of primary stakeholders reporting

satisfaction with water supply and sanitation
Project records
End of project participatory evaluation
report
X% and spread of primary stakeholders who decide

upon or manage (a) siting of installations (b) design
and technology choice (c) decisions on cost sharing
(d) operation and maintenance (e) cost recovery and
(f) monitoring and evaluation
Project records
report
X% and spread of primary stakeholders reporting

having influenced project and having an improved
understanding of official and professional constraints
Project records
report
X% and spread of primary stakeholders involved in

provision of or demand for other services
Ex-post evaluation survey
X% and spread of secondary stakeholders reporting

satisfaction with project effectiveness
Project records
report
X% and spread of secondary stakeholders reporting

learning from primary stakeholders and having an
improved understanding of community perspectives
Project records
report
Officials and professionals adopting participatory

approaches in further programmes and projects
Ex-post evaluation survey
Primary stakeholders have sufficient

confidence in government officials to
work with them on water supply and
sanitation project
Government statutory and professional

bodies adequately resourced to
develop and take up participatory
approaches
315
A
316
Narrative summary
OUTPUTS TO INCLUDE:
Leadership training
programmes completed for all
community members to be
represented in decisionmaking
Risks/Assumptions
(OUTPUT TO PURPOSE):
X% and spread of community members and leaders

taking up training
X% and spread of trainees taking part in decisionmaking fora
Project documents
Participatory monitoring through semistructured interviews, focus group
discussions, feedback sessions with
facilitators
Primary stakeholders want to be

involved and represented

report
Project documents
Suitable NGOs exist with the facilitation

skills to enable community members to
participate
Skills training completed for

community members to
engage in maintenance and
management of installations
and hygiene promotion
activities
X% and spread of community members taking up

training
Government implements
policy of adopting a
facilitatory/regulatory role for
community based watsan
services
New policy document distributed and agreed
Capacity building completed

for professionals and officials
to engage in gender-aware,
culturally sensitive, and
participatory water and
sanitation projects
X% and spread of professionals and officials

receiving training
Project documents
X% and spread of trainees participating in joint

decision-making fora with communities and
including representatives of all user groups

report
Suitable institutions available and

willing to take up capacity-building role
in participatory approaches for official
and professional training
Development of participatory
structures and processes for
sustained management of
Frequency of meetings between primary and

secondary stakeholders
Project documents
Monitoring of different groups and individuals

attending meetings

report
User groups and members have time

and resources to engage in capacity
building and participatory processes
X% and spread of trainees taking up positions and

staying in positions
Participatory monitoring
report
Relevant legislation amended

X% of government staff in project area adopt new
roles
Monitoring of different groups and individuals

speaking and being silenced at meetings
Monitoring of issues discussed and ignored at
meetings
Participant observation by facilitators
Secondary stakeholders committed to

adopting participatory approaches
Time and resources are made available

for officials and professionals to engage
in capacity building and participatory
approaches
Narrative summary
Identify and consult primary
stakeholders
Conduct participatory needs
assessment
Provide information sharing,
confidence building, and
communication skills for all
interested groups
Provide training in
communication, organization,
and management for selected
representatives
Conduct information-sharing
exercises with primary
stakeholders on operation
and maintenance and
hygiene promotion
Invite people to participate in
training for operation and
maintenance and hygiene
promotion
Provide training and invite
trainees to apply for positions
Risks/Assumptions
317
A
318
Support development of
training in participatory
approaches in water supply
and sanitation
Provide a programme of
learning-by-doing training for
officials and professionals
Support workshops for follow
up and feedback, including
sessions with primary
stakeholders
Feedback sessions between
trained officials and
professionals and other
secondary stakeholders in
Implement representative
structure for local-level
management of water supply
and sanitation
Assist Government
departments in developing
and implementing their
facilitatory/regulation roles
Implement regular project
meetings with all stakeholders
Develop participatory
monitoring and evaluation
methods
Set up processes for ex-post
evaluation
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329
List of acronyms
BGS
BOD
BOOT
BOT
British Geological Survey

Biochemical oxygen demand
Build, own, operate and transfer contract
Build, operate and transfer contract
CBO
CEDAW
CEMIS
CO
COD
CSD6
CVM
CV
Community-Based Organization
Committee on the Elimination of Discrimination Against Women
Community-based Environmental Management Information System project
Community organization
Chemical oxygen demand
Commission on Sustainable Development Session 6 after the 1992 UN
Conference on Environment and Development held in Rio (The Earth Summit)
Contingent Valuation Method
Contingent Valuation
DAC
DESA
DFID
DO
DRA
DWAF
Development Assistance Committee

Department of Economic and Social Affairs (United Nations)
Department for International Development
Dissolved oxygen
Demand-Responsive Approach
Department of Water Affairs and Forestry (South Africa)
EAP
EC
ECA
ECLAC
EIA
EOP
ESA
ESCAP
ESCWA
EU
Environmental Action Plan

European Commission
Economic Commission for Africa (United Nations)
Economic Commission for Latin America and the Caribbean (United Nations)
Environmental Impact Assessment
End of Project
External Support Agency
Economic and Social Commission for Asia and the Pacific (United Nations)
Economic and Social Commission for Western Asia (United Nations)
European Union
FAO
Food and Agriculture Organization
GRP
GWP
Glass-fibre reinforced plastic

Global Water Partnership
HDPE
HH
HP
HPD
HRD
High density polyethylene

Household
Hygiene promotion
Health and Population Division
Human resource development
IAEA
ID
IDWSSD
International Atomic Energy Agency

International Drinking Water Supply and Sanitation Decade
330
INSTRAW
IWRM
International Research and Training Institute for the Advancement of Women

(United Nations)
Integrated Water Resource Management
JMP
Joint Monitoring Programme
lcpd
LIC
litres per capita per day

Low income country
MAPET
MDPE
mg/l
MoEd
MoH
Manual pit latrine emptying technique

Medium density polyethylene
milligrammes per litre
Ministry of Education
Ministry of Health
NGO
NPV
Non-governmental organization
Net present value
O&M
ODA
OPP
ORS
Operation and maintenance

Overseas Development Administration (now DFID)
Orangi Pilot Project (Karachi, Pakistan)
Oral rehydration salts
PAM
PIMS
PLC
PMU
PRA
PSP
PV
Poverty Aim Marker

Policy Information Marker System
Public Limited Company
Project Management Unit
Participatory rapid appraisal
Permanganate value
RPS
RP
Revealed preference survey

Revealed preference
SIA
SIP
SSA
STEP
SWAp
SWOT
Social Impact Analysis

Sector Investment Programme
Strategic Sanitation Approach
Social, Technical, Economic and Political analysis
Sector-Wide Approach
Strengths, Weaknesses, Opportunities and Threats analysis
TA
TOR
Technical assistance
Terms of Reference
UN
UNCDF
UNDP
UNEP
UNESCO
UNHCR
United Nations
United Nations Capital Development Fund
United Nations Development Program
United Nations Environment Program
United Nations Educational, Scientific and Cultural Organization
United Nations High Commissioner for Refugees
A
331
UNICEF
UNIDO
UNU
uPVC
United Nations Childrens Fund

United Nations Industrial Development Organization
United Nations University
unplasticized poly vinyl chloride
VIP
VLOM
VWC
Ventilated improved pit latrine

Village-level operation and maintenance management
Village water committee
WASH
WC
WELL
WHO
WMO
WRM
WS
WS&S
WSSCC
WTP
WWC
Water and Sanitation for Health programme

Water closet (i.e. flush toilet)
Water and Environmental Health at London and Loughborough
World Health Organization
World Meteorological Organization
Water Resource Management
Water Supply
Water Supply and Sanitation
Water Supply and Sanitation Collaborative Council
Willingness-to-pay
World Water Council
A
332
Index
A
ability to pay 48, 104, 176, 244
activity & responsibility matrix 121
advocacy 12, 50, 207-209
affordability 9, 36, 48, 109, 166
Afridev 131
Agenda 21 10, 78, 233
Andhra Pradesh, activity & responsibility matrix 121
appraisal, institutional 131-135, 155, 238, 254, 267
appropriate technology 36, 51, 159-161, 174, 187
aquifer, vulnerability 89
sustainability 264
Arid and Semi-arid Lands (ASAL) 97-98
B
behavioural change 135, 201-202, 213, 295
Beijing Platform for Action 231
benchmarking 268, 289
borehole rehabilitation, Uganda 289
C
Cairo Wastewater Project 126
capacity building 40, 57, 58, 61, 127, 128, 132, 141, 142, 155-156, 227, 238, 254, 293, 297, 314-319
CBOs 50-52, 59, 121, 127,133, 247, 256, 262, 279, 308, 313
CEMIS 56
change champions 133, 147-148
change management 137, 147-148
Hyderabad Metro Water Board 139
children, health aspects 63, 70, 75, 201, 203, 211, 248, 262
deaths from diarrhoea 2
China, roles and responsibilities 91
industrial pollution control 95
cholera 9, 16, 63, 66-69, 70, 212
Collaborative Council 12
Community-based Environmental Management Information System see CEMIS
Community Based Organizations see CBOs
community management 18, 37, 119, 124, 132, 142, 243, 307, 311-312
community participation 36-37, 58, 119, 268
community WS&S 3, 32, 80, 142
Contingent Valuation Method see CVM
contracts ( BOT, concession, lease, management, service) 148-151
corruption 93, 138, 147, 168, 178, 221
cost, of water 177
cost estimates 39, 198, 270
cost recovery 14, 22, 36, 47-50, 104-105, 108-110, 112-115, 236-237, 253, 273, 280-281, 288, 300
cost-benefit analysis 101, 106-107, 252, 266
cultural aspects 42, 53, 70, 96, 168, 182
Cuttack, O & M 14
CVM 37-39, 55-56, 106-112, 251-253, 260
A
333
D
data collection 73, 201-206, 212, 215, 227, 230, 240, 263, 269, 272, 277
decentralization 17, 18, 125, 130, 143, 175, 238, 255
demand, definition 58
demand assessment 37-39, 55-56, 104-107, 109-110, 133, 226
demand management 80, 83, 179, 227
demand-responsive approach 15, 34, 37, 40, 104, 128, 164, 178, 220-221, 236, 239-240, 282
design life 166-167, 283, 290
DFID assistance 22-23, 237
diarrhoea 5, 7, 9, 63-69, 71, 201, 206, 210, 215, 248, 256, 272
folk taxonomies 211
disease, transmission from faeces 64
diseases, sanitation-related 69
diseases, water-related 66-67
drainage 71-73, 111, 181, 262, 275
options 196
drilling methods 193-194
Dublin Principles 10-11
E
Environmental Action Plan (EAP), Tamil Nadu 279
Earth Summit 10, 30-31, 233
effluent discharge standards 89, 287
empowerment 37, 39, 40, 41, 58-61, 226
environmental health 2, 232-233, 245
environmental impact 78, 90-91, 235, 249, 262-263, 287, 294, 299
environmental protection 85
environmental sanitation 71-73
environmental sanitation, definition 4
excreta disposal 170-175, 186-187, 25
eye infections 7, 65
F
faecal-oral diseases 29-30, 63-70, 248
filariasis 65-69
gender issues 7, 33, 45-46, 51, 57, 62, 110, 167-168, 231, 244, 278, 293, 297
Global Environmental Sanitation Initiative 12
Global Water Partnership 12
Gomti River Pollution Control Project 21
groundwater abstraction 81, 250-251
groundwater levels 81, 250-251, 287
groundwater pollution 82, 88-89, 183, 265
groundwater protection 96-97, 251, 265
guinea-worm 65-69, 71, 87, 106
334
H
handpumps 92, 130, 131, 159-162, 167, 239
handwashing 70
health benefits 63, 67, 74-75, 103, 105-106, 115, 164, 175, 201-203, 232, 245, 248, 261, 298
health impact 5-6, 70, 72, 76, 214, 261
human resources development 125, 138, 144-145, 255
hygiene education 210, 212,
hygiene promotion, key steps 213
I
IDWSSD 7-9, 18, 160
impact indicators 278
incremental approach 163-164, 166
institutional appraisal 131, 132-134, 155, 238, 254, 267
institutional development 37, 40, 118, 125, 127, 139-151, 155-156, 267, 280-281
institutional reform 129, 234
institutional strengthening 127, 146, 155, 254-255, 267
integrated water resource management 30, 83, 93-94, 126, 235, 294
International Drinking Water Supply and Sanitation Deacade see IDWSSD
irrigation 80, 92, 174, 179, 262
J
JAKPAS 50
Joint Monitoring Programme (JMP) 9
L
latrine emptying 184-186
leakage control 180-181
lessons learned 104, 221, 294, 297
logical frameworks 24, 77, 303-319
M
malaria 63, 65-67, 69, 72
Malawi Self-help Rural water Supply Programme 51-52
MAPET 184
metering 178
mobilization 209
Mozambique 164. 273
Mvula Trust 44, 221
N
non-governmental organizations (NGO) 44-45, 50-53, 59, 120-121, 128-129, 130, 207-209, 221-222, 232, 238,
240. 247, 256-258
NGOs see JAKPAS, Mvula Trust, Orangi Pilot Project, WAMMA
335
O
on-site sanitation 83, 86, 88, 170, 173, 182-185
operation and maintenance 14-15, 18, 37 see also VLOM
community-based 132
cost recovery 112-113
models & tiers of responsibility 119
Orangi Pilot Project 44, 50,168
organizational autonomy 137
organizational culture 138
P
PAM 21, 49
Participatory Rapid Appraisal see PRA
partnerships 19-21, 25, 34, 44, 49-53, 59-61, 129-131, 144, 148-151, 207, 222-223, 244-245
performance indicators 134, 136
pesticides 67, 86, 97
PIMS 21
pipe materials, selection 197
Policy Information Marker System see PIMS
polluter pays principle 95
pollution 78, 84-90, 183, 265
types 85
pollution control 21, 95, 250
Poverty Aim Marker see PAM
poverty alleviation 114 127-128
poverty reduction 7, 20-22, 104, 220, 231, 236
PRA 38-39, 56-57
privacy 6, 45, 115, 169, 217
private sector participation 14, 122, 148-151, 237, 254, 267, 280
process indicators 277-278, 285
progress indicators 291
project champions 24, 241, 267
project cycle 5, 225
technical aspects 270-271
project framework 26, 260
project identification process 242
Project Management Unit 21, 268
project preparation, outline process 259
proxy indicators 77, 106, 232
rehabilitation 10, 164, 255, 289

replicability 33-34,162-163, 239, 254, 291, 295
responsibility matrix 120-121
revealed preference 55, 106, 109-112, 251-253
river basin management 91-92, 235, 263
river blindness 65-66
rural water supply, options 196
336
S
saline intrusion 82
sanitary mart 273, 305-306, 310-311
sanitation, definition 4
sanitation-related diseases 69
SanPlat 170-171, 183, 198, 210
schistosomiasis 63-71
Sector Investment Programme see SIP
sector policy, South Africa 142,
sector strategy 23, 130, 229, 230
service levels 34-36, 110-111, 118, 122-123, 151, 176-178, 230, 239, 266
sewage re-use 174-175
sewage treatment, options 190
sewerage, v. on-site sanitation 83
SIP 22-23, 130, 230
skin infections 65, 67
small towns 123, 128
social development 52, 61, 277, 297-298
social impact analysis 47, 53-55, 78
social marketing 29, 59, 120, 201-205, 214, 215-217, 227, 275, 285, 292, 295
solid waste management 72
sorai, water container 70
stakeholder, definition 4
stakeholder analysis 57, 222, 230, 243-245, 258, 293
stakeholder participation 36-37, 59-60, 222, 246-247, 255,
standardization 15, 34, 160-162, 239
STEP 134-135
Strategic Sanitation Approach 17, 122, 123, 128
subsidies 49, 101, 108-109, 114
subsidy analysis 112, 134, 236-237
sullage disposal 35
sustainability 31-32, 158
SWAp 22-23, 130
SWOT 134
T
Tamil Nadu 234, 279
Tanzania, cultural aspects 43
tariffs 33, 34, 35, 36, 112-14, 146, 149-150, 252, 289
transactional analysis 141
transformational factors 141
travel time 45, 74, 166, 262
U
unbundling 17, 123, 128-129
UNICEF, partnerships 20
urban slum communities 49, 127, 182
urban sanitation, Maputo 273
programmes 128
urban water supply institutions, management models 122
performance indicators 136
A
337
V
vector control 72
village water committees 51, 144, 267
VLOM 125, 130-131, 160-162, 167
W
WAMMA, community empowerment 58-59, 163
waste stabilization ponds 175
water collection 45, 74
water consumption 74, 80-81, 136, 176, 177, 304, 309
water policy, national 233
water pollution 3, 82, 86, 87, 88, 91, 95, 100, 183
water pricing 107-108
water quality standards, pollution 90
water quantity, v. quality 65-66, 71, 175-176
water resource development, Tamil Nadu 234
water resources, global 80-81
lack of available 179
water shortage 7, 80, 83, 123, 146, 169
water supply, definition 4
construction and O & M costs Uganda 198
water supply improvements 71, 157, 308, 313
water treatment, processes 195
water uses, classification 79
water vending 6, 105, 110
WELL guiding principles 2
White Paper 6, 19, 41, 296, 323, 328
willingness-to-pay 15, 30, 35, 36, 39, 41, 47-49, 98, 102-103, 111, 118, 176, 238, 239, 241
women 7,11, 36, 42-43, 45-46, 110-111, 159, 167-169, 203, 244, 247, 283
World Water Council 12
A
338

DFID 1998 Guidance Manual On Water Supply and Sanitation Programmes

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DFID 1998 Guidance Manual On Water Supply and Sanitation Programmes

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guidance manual on

water supply and

Published by WEDC for DFID

Designed and produced at WEDC by

About this manual

The themes chosen reflect the multidisciplinary nature of WS&S

Social development and poverty

are evolving continuously. The participatory approach that is at the

promotion with technology at the project identification stage, the

Introduction to water supply and sanitation projects

Definitions and scope of the Guidance Manual ..................................................................3

Why WS&S matters ............................................................................................................. 5

Historical development of the WS&S sector ..................................................................... 8

Evolution of Guiding Principles........................................................................................ 10

Organization of the WS&S sector .................................................................................... 13

The programme and project process ................................................................................ 19

Principles and practices ..........................................................

Key issues and interlinkages ............................................................................................. 29

Water supply, sanitation, and hygiene promotion as a coherent sector ................. 29

Social development perspectives ....................................................................................... 41

Health aspects ..................................................................................................................... 63

Environmental sustainability ............................................................................................ 78

Economic and financial perspectives .............................................................................. 101

Institutional perspectives ................................................................................................. 118

Practices ............................................................................................................................. 131

Technical aspects .............................................................................................................. 157

Sanitation practice.............................................................................................................. 182

Maximizing benefits of interventions ............................................................................. 220

Meeting needs and responding to demand .......................................................... 220

Water supply and sanitation in the DFID programme

General considerations ....................................................................................... 230

Stage 2: Programme and project identification ............................................................. 240

Economic perspectives ........................................................................................ 235

General ................................................................................................................ 241

Stage 3: Programme and project preparation ............................................................... 257

General ................................................................................................................ 258

Stage 4: Project appraisal and approval ........................................................................ 274

Stage 5: Programme and project implementation and monitoring ............................. 276

Stage 6: Programme and project operation and monitoring........................................ 285

General ................................................................................................................ 276

General ................................................................................................................ 285

Stage 7: Programme and project extensions or next phase programme

General ................................................................................................................ 292

Stage 8: Evaluation .......................................................................................................... 296

General ................................................................................................................ 296

Urban water, sanitation, and hygiene promotion project .................................... 304

References ................................................................................................................................... 319

Typical levels of service providing access to safe water supply and

Sample Logical Frameworks

Urban water, sanitation, and hygiene promotion project

The project framework in the project cycle

DFID Guidance Manual on

he White Paper on International Development sets out

Annual deaths per 1,000 people due to diarrhoea

The Manual comprises three chapters and appendices.

Asia and the Pacific

Bern et al, 1992

Child deaths due to

The first chapter sets the scene. It describes the WS&S