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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.

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).

Urban sanitation remains a significant challenge for most low- and middle-income countries. While sanitation coverage has been increasing across both the 48 least developed countries (LDCs) and developing regions as a whole, progress has been relatively slow. In many cities, even where improved on-site facilities are used to contain excreta, the level of quality and access to services for the emptying, conveyance, treatment, and disposal of the resulting fecal sludge is usually limited. These services are collectively called fecal sludge management (FSM) services. FSM services are the focus of this study, within the broader context of urban sanitation and integrated urban water management (IUWM). This document provides a summary of the diagnostic tools developed for assessing FSM services and is based on field work carried out in the five cities of Balikpapan in Indonesia, Dhaka in Bangladesh, Hawassa in Ethiopia, Lima in Peru, and Santa Cruz in Bolivia. It summarizes the tools themselves, lessons learnt about their use, and general policy recommendations.

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 concerns two streams of Technical Assistance provided by the World Bank Water and Sanitation Program (WSP) to the Government of Vietnam. They are: strengthening the enabling environment, capacity building systems and evidence-based learning and lesson sharing. Strengthening demand creation and supply chain development together these TAs make up a support program to assist the Government of Vietnam, particularly the Ministry of Health (MOH) in accelerating progress on sanitation under the third National Target Program on Rural Water Supply and Sanitation (NTP3). WSP has supported the government to improve the enabling environment for sanitation service delivery; strengthen rural sanitation supply chains; generate demand for improved sanitation; and inform service delivery models through knowledge and learning. The TAs began in Dec 2012 and are due to end in Jun 2016. This report documents the results and lessons learned from the TA, and makes recommendations for future activities in support of rural sanitation.

This report concerns two streams of Technical Assistance provided by the World Bank Water and Sanitation Program (WSP) to the Government of Vietnam. They are: strengthening the enabling environment, capacity building systems and evidence-based learning and lesson sharing. Strengthening demand creation and supply chain development together these TAs make up a support program to assist the Government of Vietnam, particularly the Ministry of Health (MOH) in accelerating progress on sanitation under the third National Target Program on Rural Water Supply and Sanitation (NTP3). WSP has supported the government to improve the enabling environment for sanitation service delivery; strengthen rural sanitation supply chains; generate demand for improved sanitation; and inform service delivery models through knowledge and learning. The TAs began in Dec 2012 and are due to end in Jun 2016. This report documents the results and lessons learned from the TA, and makes recommendations for future activities in support of rural sanitation.

This report summarizes the results, lessons and recommendations to the Government of Lao PDR from two Technical Assistance projects (TA) “Supporting Demand Creation for Sanitation through Community Led Total Sanitation” and “Sanitation Marketing in Lao PDR” carried out by the World Bank’s Water and Sanitation Program between October 2012 and December 2015. The development objective of the TAs was to increase improved sanitation and hygiene practices and change community behavior to achieve Open Defecation Free (ODF) status at the village level. This report documents the results and lessons learned from the TA program that includes experiences both from government-led rural sanitation service delivery within two provinces in Southern Lao PDR (Champasak and Sekong) , as well as from national-level engagement to strengthen systems, tools and capacity building approaches for scaling-up rural sanitation service delivery. The report makes recommendations to government on how - with the support of development partners – the effectiveness and scale of rural sanitation services can be increased to achieve sustainable sanitation outcomes for the rural population of Lao PDR. It also proposes recommendations for the engagement of the World Bank Water Practice in the sector in support of rural sanitation service delivery, aligned with lending operations,notably the Poverty Reduction Fund (PRF3) and the Health Governance and Nutrition Development Project (HGNDP). In addition a number of important learnings at implementation level are highlighted, so that operational processes can be improved to make last-mile delivery more effective and efficient.

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.

The objective of this World Bank technical assistance has been to support the Government of Bangladesh’s (GoB) national capacity development framework for improving water and sanitation services (WSS) in Bangladesh, focusing on demand-responsive peer-to-peer or horizontal learning processes and improve horizontal accountability communication and monitoring systems to track progress in the sector. This technical assistance is in line with the World Bank country assistance strategy (CAS) which seeks to support the GoB target of ensuring safe drinking water and sanitation for all. It has contributed to strengthening the long-term capacity of the government, in particular the union Parishad (UP) which is responsible for ensuring water and sanitation services for all in Bangladesh.

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 authors have assembled 1960–2012 infrastructure stock data from 145 countries to estimate the demand for infrastructure services in emerging markets and developing economies. This paper identifies that the required resource flows to satisfy new demand while maintaining service for existing infrastructure amounts to $836 billion or 6.1 percent of current gross domestic product per year over the period 2014–20. The annual infrastructure investment gap for emerging markets and developing economies is $452 billion per year, which implies that emerging markets and developing economies should almost double their current spending. The paper also estimates that half of the spending should be allocated to maintenance of existing assets. Acknowledging the challenges to compare infrastructure investment estimates across different methodologies, the authors recognize this result as a lower bound estimate and compare the results with others available in the literature.

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.

This paper is organized into three main sections. Section one presents the background, objectives, scope, and limitations of the study. It also provides a general definition of OM and presents prototypical OM arrangements for rural CDD and community-based subprojects. Section two presents the detailed case studies for the seven selected projects. Section three summarizes the conclusions from the review and recommends steps for moving ahead. Five annexes provide extra background information, including the complete list of projects from which the seven main case studies were selected, as well as: examples of maintenance requirements for rural infrastructure; considerations for task teams planning for OM design and implementation; sample OM measures and timelines; and links to OM materials.

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.

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.

This paper presents the design a set of three simple and replicable behavioral interventions, which use stickers that can be added to water bills at low cost, and test their impact on water consumption in Belen, Costa Rica, using a randomized control trial. Two of the three interventions were found to decrease water consumption significantly in the months following the intervention. A descriptive social norm intervention using neighborhood comparisons reduces consumption by between 3.7 and 5.6 percent relative to a control group, while a plan-making intervention reduces consumption by between 3.4 and 5.5 percent. While the two interventions have similar results, they are effective on different subpopulations, with the plan-making intervention being most effective for low-consumption households, while the neighborhood comparison intervention is most effective for high-consumption households. The results demonstrate that behavioral interventions, which have hitherto utilized sophisticated software to deliver customized messages, can be effectively implemented by local governments in developing countries, where technology and resource constraints render the sorts of customized messaging that has typically been used to deliver them in developed countries unfeasible. The results further confirm that raising awareness about how much water an individual consumes, and comparing this consumption level with peers, can go a long way in helping change individuals’ behavior regarding the use of a finite resource such as water.

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 Hungary’s water sector are displayed, which also shows average and best practices in the Danube region. The Hungarian sector sustainability score is 74, which is far above the Danube average sustainability of 64, and is among the best practices in the region. The assessment shows that, on average, the country performs well in terms of continuity of access to piped water and flush toilet, collection ratio, nonrevenue water and staffing level. The main deficiencies of Hungary’s water sector identified through the sector sustainability assessment are the operating cost ratio, affordability, and investments. The main sector challenges are: achieving full cost recovery; preventing the degradation of assets in the long term; and preparing for the risks caused by climate change.

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 the 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 Moldova water sector are presented, which also shows average and best practices in the Danube region. The Moldova sector sustainability score is 50, which is below the Danube average of 64, and is among the lowest scores in the region. The assessment shows that, on average, the country performs well in terms of collection ratio, nonrevenue water, and continuity of service. The main deficiencies of the Moldova water sector identified through the sector sustainability assessment are access to piped water and flush toilets, affordability, and investment level.

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 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 Croatia water sector are displayed in Figure 9, which also shows average and best practices in the Danube region. The Croatian sector sustainability score is 72, which is above 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, continuity of service, nonrevenue water and customer satisfaction. The main deficiencies of the Croatia water sector identified through the sector sustainability assessment are the wastewater treatment coverage and the operating cost ratio. The main challenges are: financing compliance with the European environmental acquis; ensuring affordability of future tariffs; implementing successfully the aggregation reform; and strengthening regulation in the water sector.

This report summarizes the results and lessons learned from the Technical Assistance (TA) Support to Rural Sanitation Scale Up under the Philippine National Sustainable Sanitation Plan. The TA was carried out by the World Bank’s Water and Sanitation Program from July 2012 to March 2016, and is part of a larger programmatic assistance by the Bank to the Government of the Philippines in framing relevant institutional and financial reforms by key sector agencies and in strengthening the government’s capacity to accelerate delivery of basic water and sanitation services particularly to the poor. This synthesis report provides recommendations to consolidate and accelerate the scaling up rural sanitation initiative focusing on priorities for World Bank engagement and alignment with the incoming government’s overall strategic direction.

In order to evaluate 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 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 Bosnia and Herzegovina water sector are displayed in Figure 10, which also shows average and best practices in the Danube region. The BiH sector maturity score is 57, which is close to the Danube average maturity of 64. The assessment shows that, on average, the country performs well in terms of access to piped water and flush toilets, and customer satisfaction. With regard to the BiH water sector, the main deficiencies identified through the sector maturity assessment are level of investment, staffing level, and wastewater treatment coverage.

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 the 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 Bulgaria’s water sector are presented, which also shows average and best practices in the Danube region. The Bulgarian sector sustainability score is 66, which is just above Danube average sustainability of 64. The assessment shows that, on average, the country performs well in terms of access to piped water, staffing level, and nonrevenue water. The main deficiencies of Bulgaria’s water sector identified through the sector sustainability assessment are operating cost coverage, investment level, and customer satisfaction level.

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 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 the 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 Czech Republic water sector are displayed in Figure 9, which also shows average and best practices in the Danube region. The Czech sector sustainability score is 88, which is much higher than the Danube average sector sustainability of 64, and is among the best practices in the region. The assessment shows that, on average, the country performs very well in terms of access to piped water and flush toilets, continuity of service, wastewater compliance, staffing level, collection ratio, and nonrevenue water. The main deficiencies of the Czech water sector identified through the sector sustainability assessment are operating cost ratio and affordability. The main sector challenges are: implementing reform regarding the regulatory framework of the sector. Within the framework of the 2014-2020 operational program for environment, the European Commission stipulated ex-ante conditions, requiring the Czech Republic to establish a regulatory office for the sector. Different alternatives are discussed at the governmental level, and regulatory impact assessment papers are being prepared; and facilitating sector strategic planning despite the heterogeneity of the utility ownership structure. Around 6,000 entities (owners, public services providers) operate in the water sector (Expert estimate). To some extent, the heterogeneity of those entities in terms of size, legal status, scope of competencies and interests prevent effective strategic planning, resource balancing, and efficient asset management of regional systems, including drought and water scarcity issues management. Addressing this situation could help implement more efficient sector planning.

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.

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 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 synthesis report details the process, outputs and intermediate outcomes of the World Bank’s Water and Sanitation Program (WSP) Technical Assistance (TA) to Support Government of India for implementation of the National Urban Sanitation Policy (P131963). The objective of this TA was to (i) strengthen urban sanitation services and target the urban poor by development of strategies for regulation, funds allocation, improved accountability mechanisms and implementation of inclusive sanitation policies at national level and in at least five states, with two of these low-income states (LIS). This was to be supplemented with (ii) enabling design and use of improved performance monitoring systems by Government of India, 3 states and 300 urban local bodies by 2015, and (iii) strengthen capacity of local urban government institutions to provide improved – inclusive and sustainable – sanitation services for all. This TA provides the building blocks for sustainable sanitation improvements which are being adopted and implemented as part of another TA (P131967) in Madhya Pradesh and Tripura to pilot and operationalize City Sanitation Plans (CSPs) towards outcome oriented sector improvements. The areas addressed in this TA include the following specific goals of the NUSP: open defecation free cities, and integrated city-wide sanitation. The TA provided assistance to central government and the states in putting in place various elements identified as necessary for sector improvement, including planning, provisioning and monitoring processes. The TA also identified the need for the cities to see opportunities for financial recovery of investments through reuse and recycle strategies, to strengthen the incentive for investment in sanitation improvements.

This synthesis report details the process, outputs and intermediate outcomes Technical Assistance (TA) ‘supporting impact evaluation studies in water supply and sanitation in India (P144956)’ implemented by the World Bank’s Water and Sanitation Program (WSP). The TA supported the design and implementation of impact evaluations in water and sanitation projects in India and also facilitated data driven analytical work and capacity building. Specific contributions of the TA are the following: enabling monitoring and evaluation, enabling policy, and enabling institutions. In the context of the significant challenges India is facing in water and sanitation access and the extreme complexity of the institutional systems for the provision of water supply and sanitation, the access to flexible yet practical analytical assistance at the point of need is highly valued by government counterparts. This TA on supporting water supply and sanitation has identified the need for a larger regional or global activity that can carry forward impact evaluations in the sector and produce global knowledge that will serve as a public good for the client countries. The TA also underscored the importance of upstream analytical work and replication of results in different contexts as well as the need to develop customizable tools and instruments for faster implementation of data collection efforts. Above all, the TA emphasized the need to invest in expanding local capacity in designing and implementing rigorous impact evaluations so that more evidence could emerge in the coming years for better policy formulation in the water and sanitation sector.

This synthesis report details the process, outputs and intermediate outcomes of the World Bank’s Water and Sanitation Program (WSP) Technical Assistance (TA) to pilot and operationalize city sanitation plans (CSPs) towards outcome oriented sector investments (P131967). This TA addresses issues of ad hoc planning though CSPs that are holistic, intended for city-wide implementation and address the full cycle of sanitation. However, prior to preparation and operationalization of CSPs, it was recognized that this needed to be anchored in a statewide sanitation program. The statewide sanitation program needed to: estimate and provide for the capital requirements to address the gaps in sanitation infrastructure across the sanitation service delivery chain (collection, treatment and disposal), estimate the operation and maintenance (OM) requirements, and set out the framework for prioritization of cities, and attendant institutional frameworks. This TA aimed at piloting and operationalization of CSPs towards outcome oriented sector investments, by supporting (i) select state and local governments with technical assistance to operationalize city sanitation plans by targeting outcome oriented investments, and (ii) improving the institutional and regulatory framework and strengthening state and local government capacity for efficient and sustainable delivery of Government of India or World Bank or other development partner funded programs.

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.

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.

This document aims to share lessons learned from the implementation of the World Bank financed component of the rural water supply and sanitation project (EPAR) in the Sud region after its final evaluation. Leading the reform of the drinking water and sanitation sector in Haiti, the EPAR of the National Directorate of Drinking Water and Sanitation (DINEPA) involved the construction or rehabilitation of drinking water schemes in small towns with fewer than 10,000 inhabitants in the Sud region. As a result of the project, there will be a real and sustainable increase in the water supply to Haiti’s populations of benefitting communities of the Sud region, thus providing improved access for most households. A long-term solution must be implemented in order to make the meters more affordable to the operators and thus enable them to continue expanding their customer base.

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.

Total Sanitation Campaign (TSC) launched by Government of India has been the cornerstone of a decentralized, incentive based approach to achieve rural sanitation objectives. The scheme has developed strategic components to ensure coverage of sanitation facilities through financial and programmatic support for households, and for institutional and community sanitation. Construction of toilets needs to be complemented with mechanisms of waste handling to ensure a safe and hygienic environment in the rural areas. Safe disposal of solid and liquid waste is a major step on the sanitation ladder where communities have begun to successfully tackle. Government at present has specific provision for solid and liquid waste management (SLWM) as an important component under TSC. The Ministry of Drinking Water and Sanitation has been continuously updating technical notes on rural sanitation to reinforce the quality of interventions. The Hand Book on scaling up solid and liquid waste management in rural areas gives a very useful insight on the planning, construction, operation and maintenance of SLWM units in a sustainable way. The effort has been to make a comprehensive document that is user friendly for planning and executing agencies.

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).