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Reliable evidence on the quality of current WSS service conditions is scarce and consumer experience and views and voices are not systematically collected and used for policy development. International experience suggests that poor drinking water and sanitation services can cause households to incur high costs for dealing with this situation. However, in Uzbekistan and other Central Asian countries, there is a lack of data on service quality and on such coping costs. Together with limited feedback from consumers to those that design WSS policies and programs this makes it difficult to design effective reform measures and assess their ex-ante impact on households, in particular for those at the bottom of the income distribution. This study assesses consumer experiences with current WSS services across a range of selected sites in Uzbekistan and determines consumer readiness for reform. First of all, the study analyses how surveyed consumers currently meet their drinking water and sanitation needs and what proportion of their household budget is spent on meeting their WSS needs. Second it assesses the interaction between consumers and service providers. Third it examines stakeholder views and positions on service modernization needs and assesses consumer willingness to pay for quality networked WSS services. Comparisons are made across consumers in a selection of cities, small towns and rural areas, between consumers that are connected to a networked service and those that are not, and between households in the bottom 40 percent and top 60 percent of the income distribution (as estimated through a wealth index).

The purpose of this economic and sector work (ESW) is to support the Republic Forum for potable water and sanitation (FOCARD-APS) member countries in improving the resilience of water supply and sanitation (WSS) services. This report summarizes the findings from seven country-specific assessments carried out in 2013 and 2014 that characterize the national disaster risk management (DRM) and climate change adaptation (CCA) frameworks and efforts designed to reduce the vulnerability of WSS services to disasters and climate change. This activity also supports the World Bank strategy for enhancing DRM in Central America. This analytical effort is the result of a comprehensive participatory process that contributed to building the analytical capacities of the institutions that conform the FOCARD-APS’s regional thematic group (RTG) for DRM. It involved thorough document reviews and two rounds of country visits for data collection, as well as consultation with national and regional experts. The findings of all assessments were validated through national and regional workshops by the RTG-DRM. Regional learning exchanges and study visits were organized as part of this activity to provide policy makers with concrete examples of approaches and potential measures for addressing disaster risk challenges from a WSS service provision perspective and through a broader political and sectoral scope covering policy development, financing, capacity building, and institutional reform.

This report analyzes the progress and challenges of 16 countries in the Danube watershed in delivering sustainable water and wastewater services to all, while meeting the European Union environmental acquis communautaire. After putting the services that are being delivered into context, the report analyzes the organization of services in the region and the level of access to services, that is, how well countries are doing in terms of providing access to water and wastewater services for the entire population. It then looks at the performance of the sector, including the quality of services provided and customer satisfaction with it. It also draws a picture of the efficiency of services, including whether they reflect accepted good practices. Finally, it analyzes the financing of services, looking at whether the financing of operation, maintenance, and investments is secured and affordable. The report draws largely from existing public data sources at the national and regional level, and consolidates them into a coherent, regional narrative, and analysis. The methods of analysis include horizontal comparisons among countries at a given point in time and trends within the countries or the region over a given period of time. Given shortcomings in the availability and comparability of data across 16 countries, the report seeks to encourage and inform a policy dialogue around sector challenges rather than provide a definitive set of policy recommendations.

To evaluate the sustainability of services in the region, an overall sector sustainability assessment was done taking into account four main dimensions: access to services, quality of services, efficiency of services, and financing of services. Each of these dimensions is measured through three simple and objective indicators. For each indicator, best practice values are established by looking at the best performers in the region, and countries closest to those best performers are deemed to have a more mature sector. A more complete description of the methodology to assess sector sustainability is included in the annex of the state of the sector regional report from the Danube Water Program. The outcomes of this assessment for the FYR Macedonia water sector are presented in Figure 9, which also shows average and best practices in the Danube region. The Macedonian sector sustainability score is 61, which is below the Danube average of 64. The assessment shows that, on average, the country performs well in terms of access to piped water and flush toilets, continuity of service, staffing level, and affordability. The main deficiencies of the FYR Macedonia water sector identified through the sector sustainability assessment are investment level, operating cost ratio, wastewater treatment coverage, and the nonrevenue water level. The main sector challenges are: securing a multiyear investment budget; improving the efficiency of service providers; and implementing fully the existing water laws.

Better access to improved infrastructure services is an important engine for economic growth. The poor state of infrastructure is a key bottleneck to growth in African countries, and Cameroon is no exception. Between 2000 and 2005, improvements in information and communication technologies boosted Cameroon's growth performance by 1.26 percentage points per capita, while deficient power infrastructure held growth back by 0.28 percentage points. If Cameroon could improve its infrastructure to the level of the middle-income countries of Africa, the growth effect could be on the order of 3.3 percentage points. Cameroon has made significant progress in many aspects of infrastructure. Across a broad range of sectors, the country has made serious efforts to implement institutional reforms with a view to attracting private sector investment. Private sector concessions have been awarded for the Port of Douala, the CAMRAIL railway, the national power utility, and the national water utility (CDE). These arrangements have generally led to performance improvements and attracted significant volumes of finance. Power supply remains expensive and unreliable. Cameroon needs to accelerate the development of some of its prime hydropower sites, which would greatly improve the domestic power situation and potentially allow Cameroon to play its natural role as hydropower exporter to the Central African Power Pool. Cameroon's information and communication technology (ICT) reform remains frozen at an early stage. The telecom incumbent, CAMTEL, remains state-owned and receives substantial public subsidy. The mobile sector is relatively uncompetitive, operating as a duopoly. Moreover, while Cameroon enjoys access to a submarine cable, CAMTEL's monopoly control over the international gateway has prevented consumers from benefiting.

This study is a product of the Africa Infrastructure Country Diagnostic (AICD), a project designed to expand the world's knowledge of physical infrastructure in Africa. The AICD provides a baseline against which future improvements in infrastructure services can be measured, making it possible to monitor the results achieved from donor support. It also offers a solid empirical foundation for prioritizing investments and designing policy reforms in Africa's infrastructure sectors. The AICD is based on an unprecedented effort to collect detailed economic and technical data on African infrastructure. The project has produced a series of original reports on public expenditure, spending needs, and sector performance in each of the main infrastructure sectors, including energy, information and communication technologies, irrigation, transport, and water and sanitation. This report presents the key AICD findings for Mozambique, allowing the country's infrastructure situation to be benchmarked against that of its African peers. Given that Mozambique is poor but stable country, two sets of African benchmarks will be used to evaluate its situation: those for non fragile Low Income Countries (LICs) and those for Middle-Income Countries (MICs). Detailed comparisons will also be made with immediate regional neighbors in the Economic Community of West African States (ECOWAS).

Between 2000 and 2005 infrastructure made a modest net contribution of less than one percentage point to the improved per capita growth performance of the Central African Republic (CAR), despite high expenses in the road sector. Raising the country's infrastructure endowment to that of the region's middle-income countries could boost annual growth by about 3.5 percentage points. Assuming that the inefficiencies are fully captured, comparing spending needs against existing spending and potential efficiency gains leaves an annual funding gap of $183 million per year. By far the largest gap exists in transport. The CAR has the potential to close this gap by raising additional public funding for infrastructure from increased fiscal receipts of various kinds. Furthermore, the CAR has not captured as much private finance for infrastructure (measured as a percentage of Gross Domestic Product, or GDP) as many of its neighbors. This scope for improvement, coupled with the prospect of an economic rebound and prudent policies, could lift the country from it fragile state back to and beyond the prosperity standards it once enjoyed.

Between 2000 and 2005 infrastructure made a net contribution of only 0.3 percentage points to the improved per capita growth performance of Niger, one of the lowest in Sub-Saharan Africa. Raising the country's infrastructure endowment to that of the region's middle-income countries (MICs) could boost annual growth by about 4.5 percentage points, mainly by improving the condition of the road network. Niger has made significant progress in some areas of its infrastructure. Important reforms liberalizing the water supply and information and communication technology (ICT) sectors have boosted performance. In particular, reforms in urban water are among the most promising on the continent. Increased competition in the ICT market has contributed to the rapid expansion of mobile services. NIGELEC, the national power utility, has enhanced its performance. The Nigerien portions of regional corridors are in relatively good or fair condition. Air transport connectivity has improved. Niger has the potential to close this funding gap by tapping alternate sources of financing or adopting lower-cost technologies. There is plenty of room for private sector participation in Niger's infrastructure sectors, in particular ICT. Meanwhile, the adoption of alternate lower-cost technologies in the water supply, power, and road sectors would reduce the financing gap by almost a half ($219 million).

Despite general economic decline and power supply deficiencies, infrastructure made a modest net contribution of less than half a percentage point to Zimbabwe's improved per capita growth performance in recent years. Raising the country's infrastructure endowment to that of the region's middle-income countries could boost annual growth by about 2.4 percentage points. Zimbabwe made significant progress in infrastructure in its early period as an independent state. The country managed to put in place a national electricity network and establish regional interconnection in the power sector; to build an extensive network of roads for countrywide accessibility and integration into the regional transport corridors; to lay the water and sewerage system; and to make progress on building dams and tapping the significant irrigation potential. Unfortunately, at present the cross-cutting issue across all these sectors is Zimbabwe's inability to maintain and rehabilitate the existing infrastructure since the country became immersed in economic and political turmoil in the late 1990s. Neglect of all sectors due to the crisis has resulted in a generalized lack of new investment (in the power and water sectors in particular), and the accumulation of a huge rehabilitation agenda. Quality of service has declined across the board. The power system has become unjustifiably costly, inefficient, and unreliable. The condition of roads has deteriorated to the point that Zimbabwe became a bottleneck on the North-South transport corridor. Rural connectivity hardly exists. Failure to treat potable water, along with the deterioration of the water, sanitation, and garbage disposal systems, was responsible for the spread of cholera in 2008. By 2010 cholera affected most areas of the country and posed a health threat to neighboring countries. Looking ahead, Zimbabwe faces a number of important infrastructure challenges. Zimbabwe's most pressing challenges lie in the power and water sectors. Inefficient and unreliable power supply poses major risks to the economy, while the maintenance and upgrading of existing power infrastructure no longer looks to be affordable. At the same time, overhauling the water and sewerage system is imperative for curbing the public health crisis.

Infrastructure has contributed significantly to the growth of West African economies during the past decade. In Sierra Leone, infrastructure added only around 0.51 percentage points to the per capita growth rate over 2003-07. Similarly to other countries in the region and the rest of the continent, the boost to historic growth came predominately from the ICT (Information and Telecommunications Technology) revolution while power-sector deficiencies and poor roads held back growth. After nine years of peace, economic activity is flourishing at every level in Sierra Leone. Political stability, high government accountability, good governance standards, and streamlined tax reform helped Sierra Leone to become a bright success story, turning the country into the easiest and quickest place to start business in West Africa. Sierra Leone's image in the eyes of investors is strengthened as the country ranked as one of the top five countries in Africa for investor protection. Looking ahead, the country faces a number of critical infrastructure challenges. Perhaps the most daunting of these challenges lies in the power sector, the poor state of which retards development of other sectors. Access to power is very low, at around 1 to 5 percent in urban areas, and is nonexistent in the countryside. The country's installed power-generation capacity is around 13 megawatts per million people, which is lower than what other low-income and fragile states have installed. The entire existing power infrastructure is concentrated in the western part of the country, and even with the functioning of the Bumbuna power plant, only half the suppressed demand for Freetown, let alone that for the rest of the country, is being met. Regardless of recent reduction in tariffs, Sierra Leoneans still pay some of the highest tariffs in Africa. In 2010, Sierra Leoneans paid three times as much for power as did residents of African countries that relied on hydropower. Making investments in more cost-effective power generation options is therefore an important strategic objective for Sierra Leone, without which further electrification will simply be unaffordable for the wider population.

Infrastructure contributed just over one percentage point to Ghana's improved per capita growth performance during the 2000s, though unreliable power supplies held growth back by 0.5 percentage points. Raising the country's infrastructure endowment to that of the region's middle-income countries could boost annual growth by more than 2.7 percentage points. Today, Ghana has a very advanced infrastructure platform when compared with other low-income countries in Africa. But as the country approaches the middle-income threshold, it will need to focus on upgrading its infrastructure indicators in line with this benchmark. The Africa Infrastructure Country Diagnostic (AICD) has gathered and analyzed extensive data on infrastructure in more than 40 Sub-Saharan countries, including Ghana. The results have been presented in reports covering different areas of infrastructure, including ICT, irrigation, power, transport, water, and sanitation, and different policy areas, including investment needs, fiscal costs, and sector performance. This report presents the key AICD findings for Ghana and allows the country's infrastructure situation to be benchmarked against its African peers. Given that Ghana is a relatively well-off low-income country well on its way to reaching middle-income status, two sets of African benchmarks will be used to evaluate Ghana's situation. Detailed comparisons will also be made with immediate regional neighbors in the Economic Community of West African States (ECOWAS). As on the rest of the continent, West Africa's growth performance improved markedly in the 2000s. The overall improvement in per capita growth rates has been estimated at around 2 percent, of which 1.1 percent is attributable to better structural policies and 0.9 percent to improved infrastructure. During the five years from 2003 to 2007, Ghana's economy grew at an average annual rate of 5.6 percent, which accelerated to 7.3 percent in 2009. Ghana's infrastructure improvements added just over one percentage point to the per capita growth rate for the period 2003 to 2007.

Infrastructure contributed 0.6 percentage points to Ethiopia's annual per capita gross domestic product (GDP) growth over the last decade. Raising the country's infrastructure endowment level to that of the region's middle-income countries could lift annual growth by an additional 3 percentage points. This will represent a significant boost over the growth performance of the mid-2000s, which averaged around 5 percent. The Africa Infrastructure Country Diagnostic (AICD) has collected and analyzed extensive infrastructure data for more than 40 Sub-Saharan countries, including Ethiopia. The results are presented in reports on various infrastructure sectors Information and Communication Technologies (ICT), irrigation, power, transport, water and sanitation and policy areas, including investment needs, fiscal costs, and sector performance. This country report presents the key AICD findings for Ethiopia. This will allow its infrastructure situation to be benchmarked against that of other African nations that, like Ethiopia, are low-income countries, with particular emphasis on immediate regional neighbors in East Africa. Several methodological issues should be borne in mind. First, the cross country nature of the data collection creates an inevitable time lag. The period covered by the AICD runs from 2001 to 2006. Most technical data are presented for 2006 (or the most recent year available), while financial data typically are averaged over the available period to smooth out the effect of short term fluctuations. Second, cross country comparisons require standardization of the indicators and the analysis to ensure consistency. Therefore, some of the indicators may be slightly different from those that are routinely reported and discussed at the country level. During the 2000s, Ethiopia's annual economic growth has averaged 4.8 percent, compared with only 0.5 percent in the previous decade. Notwithstanding this improvement, current annual growth levels still fall short of the sustained 7 percent needed to meet the Millennium Development Goals. Improved structural and stabilization policies generated an estimated 4.2 percent of Ethiopia's improved per capita growth performance during the 2000s, and improvements in the country's infrastructure platform over that period contributed up to 0.6 percentage points to growth. This was due almost entirely to the introduction of mobile telephony in Ethiopia. Simulations suggest that if Ethiopia's infrastructure platform could be improved to the level of the African leader, Mauritius, annual per capita growth rates could increase by 3.8 percent. This potential impact would come equally from improvements to transport, power, and ICT infrastructure.

This study is a product of the Africa Infrastructure Country Diagnostic (AICD), a project designed to expand the world's knowledge of physical infrastructure in Africa. The AICD provides a baseline against which future improvements in infrastructure services can be measured, making it possible to monitor the results achieved from donor support. It also offers a solid empirical foundation for prioritizing investments and designing policy reforms in Africa's infrastructure sectors. The AICD is based on an unprecedented effort to collect detailed economic and technical data on African infrastructure. The project has produced a series of original reports on public expenditure, spending needs, and sector performance in each of the main infrastructure sectors, including energy, information and communication technologies, irrigation, transport, and water and sanitation. The focus of the AICD country reports is on benchmarking sector performance and quantifying the main financing and efficiency gaps at the country level. These reports are particularly relevant to national policy makers and development partners working on specific countries. This report presents the key AICD findings for Kenya, allowing the country's infrastructure situation to be benchmarked against that of its African peers. Given that Kenya is a relatively well-off low-income country that aspires to become a middle-income country, two sets of African benchmarks will be used to evaluate Kenya's situation. Detailed comparisons will also be made with immediate regional neighbors in the East African community.

Under pressure from donor agencies and international financial institutions such as the World Bank, some developing countries have experimented with the privatization of water services. This article reviews the econometric evidence on the effects of water privatization in developing economies and presents new results using statistical data envelopment analysis and stochastic cost frontier techniques and data from Africa. The analysis fails to show evidence of better performance by private utilities than by state owned utilities. Among the reasons why water privatization could prove problematic in lower-income economies are the technology of water provision and the nature of the product, transaction costs, and regulatory weaknesses.