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This synthesis report documents the implementation process, results and lessons learned under a three-year Technical Assistance (TA) program undertaken by the Water and Sanitation Program of the World Bank’s Water Global Practice (WSP) in Cambodia between May 2013 and June 2016. It also presents recommendations for the government on key steps to accelerate service delivery at scale for Rural Water Supply, Sanitation and Hygiene (RWSSH) and for the World Bank to strategically engage in the sector. For comprehensiveness, annexes are attached that include key supporting documentation, and resources and deliverables developed under this TA are also provided in the resource pack (the resource pack is linked to Box folder which is available upon request).

This synthesis report details the process, outputs, intermediate outcomes, lessons learned, and recommendations of the World Bank executed technical assistance (TA) on strengthening local providers for improved rural water supply in Pakistan implemented by the water and sanitation program of the global water practice. The development objective of this TA was to support the Government of Punjab (GoPunjab) in strengthening service provision by communities to ensure improved access to rural water supply, particularly for the marginalized and poor. These objectives were targeted through capacity building and introducing systems to better respond to community needs to manage rural water schemes via community based organizations (CBOs). This TA was primarily focused on the province of Punjab having a population of 100 million with of which 60 percent population live in rural areas. From inception, this TA was focused on institutional strengthening and sustainability. The back-up support mechanism for CBOs and information and communication technology (ICT) monitoring of scheme performance are extremely significant initiatives to have been integrated into the government system.

This synthesis report details the process, outputs and intermediate outcomes of the Water and Sanitation Program - World Bank (WSP) Technical Assistance (TA) to Service Level Benchmarking, Citizen Voice and Performance Improvement Strategies in Urban Water Supply and Sanitation (UWSS) in India. This technical assistance (TA) sought to strengthen accountability for service outcomes in urban water and sanitation, by providing support for strengthening (i) supply and demand side monitoring processes under national programs, and (ii) integrating use of performance data into decision making by public providers in select states, with specific focus on services to the poor. This TA was a continuation of WSP’s past technical assistance to the Ministry of Urban Development (MoUD) on adoption of benchmarking and accountability processes for the urban water supply and sanitation sector. During the period 2008-12, WSP had extended support to MoUD for development of the Handbook on Service Level Benchmarks (SLB), implementation of a national pilot followed by its rollout across the country. This TA was designed to provide follow up support for deepening of these performance monitoring and reporting processes, and activate demand side monitoring mechanisms to strengthen accountability. This TA has contributed to the following outcomes: (a) Demonstrated an innovative approach for ICT-based citizen feedback processes (“SLB Connect”) which has been leveraged for conduct of city level ratings under a national urban program, informed preparation of city level service improvement plans, and been integrated in the design of a Bank funded project. (b) Strengthened use of performance data for planning and investment processes in one state including development of a prioritization framework to guide allocations. (c) Supported analytical work and advocacy for strengthening of performance monitoring processes at the national and state levels. Going forward, in the Indian context, it would be important to operationalize the National Performance Monitoring Cell (NPMC) at the earliest, so that it can further strengthen performance monitoring processes in the sector.

This report, developed for policy makers and sector development partners, highlights the manner in which the domestic private sector is successfully participating in the delivery of water and sanitation services in Niger. It outlines the factors for success as well as the challenges that need to be addressed to harness private sector resources and motivation for improved and sustainable services.There is a need to further strengthen the capacities of various rural water supply stakeholders, particularly communes, which contract and supervise the work of the operators. The capacities of operators and users’ associations also need to be developed to pursue ensure the operational sustainability of the systems.The technical assistance (TA) described in this Note has, over the past five years, supported the sector’s stakeholders’ efforts to work in synergy to foster the participation of domestic private entities in the management of rural water supply systems (RWSSs).The purpose of the TA hasbeen to ensure improved operational policy applicationof the PPP frameworks in the context of water supplyand urban sanitation in rural and small towns , which hasnot evolved much over time in relation to urban waterservices. The TA program consisted of training activities,market assessments, and options development studiesto inform decision-making and consensus-building ofdifferent stakeholders on resolving some challenges facingthese subsectors.Opportunities exist for the Government to promote the emerging domestic private operators with a view to raising their level of professionalism for better service delivery.

With the exception of Myanmar, Cambodia has the lowest access to piped water supply in the South East Asia region, which was estimated to be 21 percent in 2015. Less than one in ten rural households (7 percent) have access to piped water services on their premises, while for urban households, three out of four households enjoy these services (75 percent) (WHO and UNICEF, 2015). Against this backdrop, the Government of Cambodia in its National Strategic Development Plan 2014-2018 (Royal Government of Cambodia, 2013) prioritizes the acceleration of access to piped water services, in partnership with the domestic private sector. Private water operators are licensed and regulated by the Ministry of Industry and Handicraft (MIH). Scarce public domestic financial resources are solely channeled to state-owned utilities and enforcement of regulations is generally weak. With the exception of the French Development Agency (AFD), most development partners focus their grant and lending support on public utility investments. In 2012 the private sector is already estimated to provide 1.4 million Cambodians with piped water services, with the immediate potential for expansion of existing schemes covering another 2 million and further new schemes that could viably be developed for another 3 million Cambodians (Sy, Warner, & Jamieson, 2014) and ( (DFAT, 2014). Around 300 private sector utilities, around half of which are licensed by the Ministry of Industry and Handicraft (MIH), have a market share of almost 50 percent of those with access to piped services, mostly situated in rural towns and agglomerations of settlements, with 750 to over 3000 household connections. Driven by demand for higher services, the private sector in Cambodia will be an important driver for increasing access to piped water supply, especially in the rapidly urbanizing rural growth centers of Cambodia.

Provision of safe drinking water is a basic necessity and has been a major topic for key political discourses in the country over the last decade. The Government of India has been focusing on safe drinking water since 1972-73 when it introduced the Accelerated Rural Water Supply Program (ARWSP) to assist States and Union Territories to accelerate the coverage of drinking water in the country. Despite increased outlays since then, access to safe drinking water in India remains a challenge. Apart from access, water quality and sustainability of resources (water points and infrastructure developed) are issues of major concern. The National Rural Drinking Water Program (NRDWP), which is supplementing the efforts of the State Governments by providing technical and financial assistance, is looking at rural drinking water from a holistic viewpoint. The Ministry has shifted its focus from hand pumps to piped water supply systems with the aim of providing monitored clean water and is focusing on those States which have low levels of piped water supply. The Water and Sanitation Program has compiled an excellent collection of success stories and best practices from the States of Kerala, Karnataka, Maharashtra, Gujarat, Jharkhand, Punjab and Uttarakhand which address these key constraints. Some of these success stories, such as the Asoga village intervention in Karnataka which showcases a unique demand driven approach to facilitate participatory decision making leading to community ownership, the Bidholi piped water supply scheme in Uttarakhand which manages and recovers 100 per cent operation and maintenance costs from the community, the Shikayat Nivaran Kendra experiment in Punjab which uses information technology for online web enabled centralised complaint redressal and the Water and Sanitation Management Organisation experiment in Gujarat where the registered body acts as a facilitator in developing water and sanitation facilities owned and managed by communities, are all outstanding examples of how to address various challenges and shortcomings the program is facing.

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).

Urbanization is occurring rapidly in Melanesia at 3-4 percent per annum. Due to unaffordable land and housing in formal urban areas, new migrants settle on marginal land without formal legal titles (‘informal settlements’). These settlements are growing and new settlements are emerging within and on the outskirts of towns and cities across Melanesia, at a rate that outpaces efforts to serve them. Settlements in the Melanesian capitals of Suva, Port Vila, Honiara, and Port Moresby comprise 20 percent-45 percent of the city population and at current urbanization rates will be between 30 percent and 65 percent by 2023. Information about informal settlements is scarce. This report provides a rapid review of water and sanitation services in the informal settlements in and around the capital cities of Solomon Islands, Fiji, Vanuatu, and Papua New Guinea.

This note explores the Bangladesh experience in implementing the widespread use of a private operator model for building and operating rural piped water schemes. Since the early 1990s, the World Bank has, through a series of development projects, designed, piloted, and attempted to scale up use of the model as a mechanisms to address the very real issues of arsenic contamination and delivery at scale. The latest of these projects is still in implementation. The experience with these projects to date has been disappointing, and while a limited number of schemes are still in operation, the model has not been replicated in a large number of communities as intended and has not proved to be particularly sustainable. Over this same period, the government and other development partners also have been using alternative methods to deliver the same kinds of services in rural areas. Some of these efforts seem to have been modestly successful. However, much of the evidence about the performance of these other models is anecdotal and there has been little rigorous analysis to compare the performance of these different models with the private sponsor approach. This paper attempts to do this on the basis of a desk review of existing World Bank literature, including project documents and research reports, coupled with interviews with key stakeholders and World Bank staff. The first section of the paper provides an overview of the rationale and key issues associated with efforts to scale up a private operator model in Bangladesh. The second section reviews government efforts and those of its other development partners, to use a more traditional mode of service provision, involving community management. The third, fourth, and fifth sections review efforts by the government and the World Bank to design, test, and scale up a private operator model for service provision. A sixth section reviews some of the international research that provides insights into the use of such models in other countries and sectors. The paper ends with tentative conclusions about the experience in Bangladesh, lessons learned, and several options for further analysis.

Professionalization contracts are a new concept. The aim of these contracts is to enlist the support of specialized private firms in turning public water utilities into competent professional operators. This report looks at how the business model for such contracts may work. This report builds on fieldwork and consultation in India. The model described in this report reflects two weeks of meetings with water sector stakeholder in India, including a workshop held at the World Bank country office in Delhi on 22 March 2011. The report gives introduction in section one. It describes briefly the need for professionalization contracts in India, and the target market section two. It then summarizes what the contractor will do, and how this differs from traditional capacity building, as well as from traditional public private partnership (PPP) concepts such as management contracts section three. The report then describes the complementary policy and institutional reforms that will be needed at the state and local government levels to make professionalization contracts successful section four. Section five looks at the political economy of professionalization contracts, identifying risks, and how these risks can be mitigated through design of the institutional reforms and the business model. Section six then turns to the true business model aspects by describing indicative costs of the professionalization contract and the complementary investments required. Section seven considers what the sources of funding for these costs would be, and section eight goes on to explain how the contractor will be paid, and hence the incentives under which it will operate. Section nine looks at the market of potential contractors, and examines their incentives to participate. Finally, section ten sets out some considerations for developing the concept.

From 2012 to 2014 water and sanitation service delivery assessments (SDA) have been carried out in seven selected countries in the East Asia and Pacific region under the guidance of the World Bank’s water and sanitation program and with valuable contributions of other development partners, such as United Nations Childrens Fund (UNICEF), WaterAid, and Asian Development Bank (ADB). Countries where SDA were carried out are Cambodia, Indonesia, Lao Peoples Democratic Republic (PDR), Papua New Guinea, Philippines, Timor-Leste, and Vietnam, while in Myanmar, a broad joint sector assessment took place by World Bank, UNICEF, ADB, and Japan International Cooperation Agency (JICA). SDA were implemented as a country-owned process led by key government agencies, and drew on the experience and methodology of similar assessments conducted in more than 40 countries (and states) in Africa, Latin America, and South Asia. It has three main components: a review of past water and sanitation access trends, a costing model to assess the adequacy of anticipated future investments, and a scorecard that allows diagnosis of bottlenecks along the service delivery pathways.

Successful mid-sized cities will be vital to India’s growth and prosperity in the coming decades. Indian cities are home to over 375 million people now, and their population is likely to double by 2035. Yet water supply in most mid-sized cities falls short of Government of India benchmarks for service, efficiency and cost recovery. In many of them water flows in the pipes for 2 hours a day or less, its quality is poor, and it is provided by utilities that cannot even cover their operating costs. Following a brief introduction to the three city case studies (section two), the report lays out the Indian water sector’s unique challenges, and using case examples to substantiate findings (section three). The challenges include day-to-day operational issues associated with running a utility, as well as policy and planning issues that affect the utility’s governance and investment planning to meet current and future demand. The results of a financial viability gap analysis, applied to Bhubaneswar and Coimbatore reveal the magnitude of improvements required, and the key drivers that affect the utilities’ financial performance (section four). These complex challenges make traditional PPP models, Management Contracts, Concessions and Leases, less amenable for use in mid-size Indian cities. As section five describes, this is because the traditional models are too risky for the operator or government or too limited in scope to create lasting improvements. The remaining sections focus on explaining the design and procurement strategy for the two innovative PPP models, the phased performance based contract and the Joint Venture (JV) Partnership (section six and seven). These models have the potential to deliver better results than the traditional PPPs and business as usual scenarios. This is because in addition to reforming dysfunctional utilities into focused and accountable organizations, they are able to respond to information uncertainty, include strong incentives, have clear sources of funding, and promote capital efficiency.

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.

To evaluate and reflect 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 Ukraine water sector are shown in Figure 10, which also shows average and best practices in the Danube region. The Ukrainian sector sustainability score is 54, which is below the Danube average sustainability of 64. The assessment shows that, on average, the country performs well in terms of collection ratio and affordability. The main deficiencies of the Ukraine water sector identified through the sector sustainability assessment are investment level, wastewater treatment coverage, and nonrevenue water. The main sector challenges are: improving and clarifying the legal regulatory framework of the water sector; ensuring tariff setting according to the cost recovery principle to improve overall efficiency; and improving staff capacities and expertise.

This note has been prepared as part of the work program on multi-dimensional poverty in the Kyrgyz Republic to raise awareness of poverty dimensions, which in turn should help accelerate the development of water supply and sanitation services, and necessary reforms in the Kyrgyz Republic. The note analyzes the quality and reliability of the Integrated Households Survey (KIHS) data to measure access to water supply and sanitation services. The household survey was conducted by the National Statistics Committee (NSC) of the Kyrgyz Republic. It is representative at the national, rural/urban, and oblast levels. Using survey data we analyze the consumption of water supply and sanitation services at the household level with a focus on access, quality, and expenditures.

This toolkit for the preparation of a drinking water security plan provides a model for taking a Gram Panchayat and Support Organization through an action planning process. The toolkit includes a basic action planning format. It is a step-by-step process, covering practical guidelines and a water security plan template. The practical guidelines are designed to standardize and streamline water security planning for all the pilot blocks. The toolkit focusses on the planning and community mobilization as well as the institutional and financial aspects of implementing a drinking water security program in pilot blocks.

The severe conditions in Zimbabwe, which reached a nadir in 2008 and 2009, led to a collapse of basic systems including the reliability and safety of water supply and sanitation services, leading to an outbreak of cholera with more than 4,000 deaths and over 90,000 people infected. The World Bank provided Technical Assistance (TA) to the City of Harare to improve water and sanitation services in the period October 2012 to June 2014 to the value of approximately 600,000 US dollars. This Summary Note summarizes the key elements of the work undertaken and makes a set of recommendations to the City of Harare, the adjacent local authorities of Chitungwiza, Epworth, Norton and Ruwa, and Government of Zimbabwe to inform a strategic plan to improve water and Sanitation services in the greater Harare area. This Summary Note also sets out the context at the commencement of the TA, summarizes the work undertaken in the TA and the outcomes from this work, and makes recommendations for the way forward.

Water supply and sewage (WSS) operations in Ludhiana resemble that of many Indian cities; service levels are poor when compared to benchmarks; cost recovery is low; the municipal corporation subsidises operating deficits; the Government finances capital expenditure; assets are created through a State owned entity; internal capacity, systems and procedures are weak. The State Government has taken a decision to make key municipal corporations (including Ludhiana) responsible for future asset creation and also expects them to share capital expenditure. To improve the quality of service, the city needs immediate capital investments and change in management practices. Key institutional actions to achieve this are a) WSS operations focusing on higher cost recovery, b) increased contribution from the municipal corporation to WSS capital expenditure financing as opposed to O & M financing and c) modern governance structure for WSS operations.

Many empirical studies have demonstrated the close relationship between a country’s economic development and its stock of infrastructure. Decades of deferred maintenance and lack of long-term financing have taken a heavy toll on Zimbabwe’s infrastructure that at one time was ranked at the top in Africa. Only the information and communications technologies (ICT) sector has been performing relatively well but its high tariffs add to the cost of doing business in Zimbabwe. The strategy in the infrastructure sectors is to encourage public private partnerships (PPPs) for the financing and execution of the different sub-projects. This strategy has been emerging in the electric power, road transport, and ICT sectors and is now being extended to water supply and sanitation. This review builds on the findings from an October-November 2013 mission that, upon the request of the Ministry of Finance, assessed the ministerial submissions for the 2014 public sector investment program (PSIP). The review concludes that the perception of the predictable policies is key for attracting responsible private partners for sustainable PPPs. The review recommends less risky options such as: (i) outsourcing operations of existing plants; (ii) lease contracts of existing plants; and (iii) sales of existing thermal plants. The review notes that the analytical multi donor trust fund (AMDTF) is programmed to close on June 30, 2014. It is of the essence to explore the possibilities to locate concessionary funding for a successor to the AMDTF given the high priority of additional studies in the power, water, and ICT sectors to prepare for the reforms suggested.

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.

The study is conducted in two states with different geographic, public health, and socioeconomic characteristics, together spanning a range of conditions in rural India: Maharashtra and Orissa. The secondary objectives of the study were to develop proxy indicators for routine monitoring of the health impact of water and sanitation projects. A proxy is an easy-to-measure indicator for a hard to- measure impact. Here the goal is to identify the intermediate outcomes (for example coverage of toilets and taps) that are causally linked to the policy or intervention and to the outcome. The success of the analysis in establishing such links will determine the salience of the proxy indicators. Finally, World Bank also evaluate the broader impacts of water, sanitation, and hygiene interventions on rural livelihoods, such as savings in time, materials, and money invested in coping activities; improvements in convenience and privacy; and indirect benefits to caregivers (for example gains in work efficiency, and time and work reallocation within the household).

The involvement of the rural private sector in water supply in Cambodia is unique to the country. The presence of this private sector allows other entities to respond to new demands from people living in the larger villages for household water supply, which the State is not yet able to address. These entrepreneurs operate on a merchant basis, lacking an institutional structure which is still being created. Their business is most often based on pushcart delivering water barrels at the house of villagers or more recently on small piped networks usually distributing raw surface water. Service is rough; the water quality is uncertain, but the users are satisfied with this service, because for them, it constitutes another alternative to the already considerable choice of water supplies available-ponds, wells, boreholes, and rivers. Their demands focus more on a practical objective (a supply in the household) than on a sanitary one, even if surveys show that villagers have a good understanding of health risks associated with water. Through the implementation of 14 small scale water supply systems, the goal was to enhance a qualitative improvement of the water service in some Cambodian small towns through the transformation of rough and informal merchant services to a basic water service supplying drinking water to an extended population under a formal institutional arrangement. The MIREP (Mini Reseaux d'Eau Potable - Small Scale Piped Water Supply System) program, launched in 2001 to transform these very basic initiatives into basic services, began as a pilot project supporting one entrepreneur in the implementation of a small piped water system. In order to move forward, the MIREP program made a choice, in particular linked to its proximity to the Ministry of rural development, to assist the nascent involvement of communes in decentralization, to strengthen provincial power through the process of decentralization, and to respect the cultural heritage of those who devised and financed the project.

This briefing note provides a rapid scan of partnership initiatives by the World Bank, the African Development Bank (AfDB) and the Water and Sanitation Program (WSP) to improve the state of water and sanitation services in Africa. The note aims to highlight the gains and challenges of the major collaborative initiatives, focusing on where progress has been made or activities are ongoing at a strategic, thematic, and regional or country level. The collaboration is now focusing on: a) intensifying operational cooperation and joint work in additional African countries, including fragile and post-conflict countries; b) continuing to share information and to participate in capacity-building activities, with an emphasis on training in operational contexts; c) intensifying joint work in water supply, and particularly sanitation and hygiene; and, d) developing a monitoring system focused on results rather than inputs.