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Convenient access to safe water is central to human health and development. Water-borne disease remains a major cause of mortality and morbidity in the world, much of which could be eliminated by a combination of better water, sanitation and hygiene (WaSH). The WHO estimates that around 502 000 deaths a year in low and middle income countries from diarrheal disease are attributable to unsafe water, and that over 1 000 children under 5 die each day from diarrheal disease caused by inadequate WASH. UNWomen estimates that in Sub-Saharan Africa alone, women and girls spend 40 billion hours a year collecting water, the time valued at around $20 billion a year. Sustainable development goal no. 6 ‘ensure availability and sustainable management of water and sanitation for all’ creates a framework for tackling the challenge of mobilizing the large investments required and making WaSH available at affordable prices. The purpose of the study on which this report is based is to analyze, capture and synthesize lessons learned from closed GPOBA water projects in order to evaluate the impact of the subsidy schemes and inform the scale-up and replication of OBA approaches. These lessons offer insight to successes and failures of project design and implementation as well as solutions to more complex projects and/or less tested environments.

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.

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.

Since the introduction of the Water Law in 2004, national river basin management in Indonesia has been carried out by 30 public river basin management organizations (RBOs), called either Balai Besar Wilayah Sungai(s) (BBWSs) or Balai Wilayah Sungai(s) (BWSs); the two are referenced together here as B(B)WSs. These national government agencies fill both regulatory and management functions, as well as undertaking construction, operation, and maintenance of river infrastructure and irrigation systems larger than 3,000 hectares. Provincial water agencies also provide water resource and river basin management in provincial basins and basins of national river territories, in coordination with the national river basin agencies.

This synthesis report details the process, outputs and intermediate outcomes of the above technical assistance (TA) which was aimed at service delivery improvement in urban water and sanitation, especially to the urban poor, by: (i) supporting the government in establishing efficient, autonomous and responsive utility in Peshawar; (ii) facilitating the provincial/regional governments in formulation of water sector policies; (iii) designing demand based ‘Pakistan water sector technical advisory program’ for clients; and (iv) strengthening and aligning the urban (water) reform agenda in three provincial urban units through national urban forum.

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 assessment has been 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 the 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 Serbian water sector are presented, which also shows average and best practices in the Danube region. The Serbian sector sustainability score is 61, which is below the Danube average sustainability of 64. The assessment shows that, on average, the country performs well in terms of access to piped water and flush toilets, nonrevenue water, and affordability. The main deficiencies of the Serbian water sector identified through the sector sustainability assessment are the level of investment, wastewater treatment coverage, and the operating cost ratio. The main sector challenges are: strengthening and clarifying sector governance; ensuring tariff setting according to the cost recovery principle to improve overall performance in preparation for EU accession; and enhancing water utility staff capacity and training.

In order 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 Slovak Republic water sector are displayed, which also shows average and best practices in the Danube region. The country sector sustainability score is 82, which is far above the Danube average sustainability score of 64, and among the best practices in the region. The assessment shows that, on average, the country performs well in terms of continuity of service, access to piped water and flush toilets, wastewater compliance, staffing level, nonrevenue water, and collection ratio. The main deficiencies of the Slovak water sector identified through the sector sustainability assessment are the level of investment, the operating cost ratio and the wastewater treatment coverage.

To evaluate and reflect the sustainability of services in the region, an overall sector maturity 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 the sector maturity 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 Austrian water sector are presented, which also shows average and best practices in the Danube region. The Austrian sector maturity score is 96, which is significantly higher than the Danube average maturity of 64, and the highest score in the region. The assessment shows that, on average, the country performs very well in terms of access to piped water and flushes toilet, wastewater treatment coverage, customer satisfaction, continuity of service, wastewater compliance, collection ratio, and nonrevenue water.

The overview over the next pages summarizes key themes and findings from on-going technical assistance provided to the Kenyan water sector by the Water and Sanitation Program (WSP) of the World Bank’s Water Global Practice. Kenya’s new Constitution (Constitution of Kenya 2010) came into effect in 2013, declaring water supply and sanitation services a basic right and devolving key water and sanitation functions to the county level. Key legislation, including the County Government Act of 2012 and the Urban Areas and Cities Act of 2011, have provided the framework for far reaching changes. As these changes took shape before and after the new constitution came into effect, WSP’s TA programs have been providing specific advice at the national level1 to align the sector’s legal and institutional frameworks to the new decentralized constitution. The engagement and support to counties to adopt the new frameworks has been stepped up substantially since mid-2013. This is evidenced by the progress of the transition process under the Transition Authority and Commission for the Implementation of the Constitution. This note seeks to briefly highlight priorities and practical suggestions to pursue those priorities in order to support counties as they navigate the process of devolution.

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.

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.

This report discusses the key findings and recommendations emerging from a pilot Citizen Report Card (CRC) on water, sanitation, and sewerage services in Karachi. This initiative comes, on one hand, in the wake of deteriorating services, weakened community interfaces and accountability structures, poor revenue generation and dysfunctional governance structures and, on the other, an emergent consensus to bring in far-reaching institutional reforms that should move beyond financial and technical imperatives. The CRC, pioneered by the Public Affairs Center (PAC), Bengaluru, is a simple but powerful tool to provide public agencies with systematic feedback from users of public services. CRC gains such feedback through sample surveys on aspects of service quality that users know best, and enable public agencies to identify strengths and weaknesses in their work. A CRC on public services is not just one more opinion poll; it reflects the actual experiences of people with a wide range of public services. The survey on which a report card is based covers only those individuals who have had experiences in the use of specific services, and interactions with the relevant public agencies.

Infrastructure plays a key role in promoting economic growth and opportunities.In particular, the efficient provision of basic infrastructure services, like water and sanitation, is a key ingredient in fostering a country's social and economic development. Previous studies have found that infrastructure has a positive impact on output, and can improve economic opportunity, including health and education for the poor, particularly in developing countries. In Argentina, a 2005 study, found that child mortality fell by 8 percent in areas that had experienced improved coverage and quality of basic water and sanitation through utility reform, with most of the reduction occurring in low-income areas where the water network expanded the most. More generally, Fay and Morrison found that allowing the poorest quintile in developing countries the same access to basic services as the richest quintile would reduce child mortality by 8 percent and child under development by 14 percent. Calderon and Serven also found a significant positive impact of infrastructure access and quality on overall inequality. Furthermore, the book sheds some light on how to address the main challenge for the future which may be to attract specialized operators to the smaller municipalities which do not currently have them. For that purpose in Colombia, for example, over the last two years, the policy framework has been focused on promoting the sector's development, by using the departments as the intermediate institutional level between the National Government and the municipalities, to formulate programs with regional impact and promote comprehensive investment plans.

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 improvements contributed 0.6 percentage points to the annual per capita growth of Zambia's gross domestic product (GDP) over the past decade, mostly because of the exponential growth of information and communication technology (ICT) services. Poor performance of the power sector reduced the per capita growth rate by 0.1 percentage point. Simulations suggest that if Zambia's infrastructure platform could be improved to the level of the African leader, Mauritius, per capita growth rates could increase by two percentage points per year. Zambia's high generation capacity and relatively high power consumption are accompanied by fewer power outages than its neighbors. But Zambia's power sector is primarily oriented toward the mining industry, while household electrification, at 20 percent, is about half that in other resource-rich countries. Zambia's power tariffs are among the lowest in Africa and are less than half the level needed to accelerate electrification and keep pace with mining sector demands. Meeting future power demands and raising electrification rates will be difficult without increasing power tariffs. Zambia's infrastructure situation is more hopeful than that of many other African countries. Infrastructure spending needs, though large, are not beyond the realm of possibility, and Zambia's resource wealth and relatively well-off population provide a more solid financing basis than is available to many other countries. Zambia's infrastructure funding gap, though substantial, can be dramatically reduced through measures to stem inefficiencies and lower costs.

Infrastructure contributed 1.2 percentage points to the annual per capita growth of Malawi's gross domestic product (GDP) over the past decade, thanks mainly to the revolution in information and communication technology (ICT). Raising the country's infrastructure endowment to that of the region's middle-income countries could further boost annual growth by 3.5 percentage points per capita. Today, Malawi's basic infrastructure indicators look relatively good when compared with other low-income countries in Africa, although the performance of that infrastructure could be significantly improved. Malawi is one of the few African countries to have already reached the Millennium Development Goals (MDGs) for water, almost a decade ahead of the target. The private sector has made Global Management System (GSM) telephone signals widely available without public subsidy. A substantial road investment program has raised the average condition of the country's road network, and a foundation for institutional reform has been laid in the ICT, power, and road transport sectors. Even if those inefficiencies could be eliminated, Malawi will still face an infrastructure funding gap of almost $300 million a year. This could be lessened to $100 million by engaging in regional trade of electricity, using lower-cost supply modalities in water supply and sanitation, and adopting appropriate technologies for road sector development. As long as efficiency gains are captured and spending sustained at the levels of the recent past, the country's infrastructure targets could be reached within 16 years.

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.

Uganda has placed the fight against corruption high on the development agenda by establishing a range of anti-corruption institutions and strategies. The Uganda third National Integrity Survey, released in 2008 by the Inspectorate of Government, recommended that if Uganda was to make real progress in tackling corruption nationwide, individual sectors would need to undertake sector-specific studies to identify best practice and facilitate scaling-up of anti-corruption efforts. In that year, the good governance sub-sector working group, chaired by the Ministry of Water and Environment, commissioned a water integrity study to establish how citizens in both rural and urban areas contractors, private operators, local government officials and staff from the main water utility experience integrity in the provision of water services. The study would also facilitate development of an updated action plan to address integrity risks. This note describes the key ingredients to putting in place a nationwide good governance action plan in Uganda's water sector, the challenges to be overcome and lessons learned to date. The implications for practice are discussed from the perspectives of policy makers, regulators and ombudsmen, development partners, water service providers and civil society actors. This provides guidance for the replication of best practice by stakeholders in other countries and sectors.

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.