This Discussion Paper examines the theory and practice of supporting change processes in urban water and sanitation institutions – a chain of actors that includes local governments, water utilities, and a mix of private and public service providers – to help them reach all urban citizens, including the poorest, with water and sanitation services.

The report presents findings from a literature review of institutional change processes in the WASH sector, supplemented by case studies of WSUP’s work and interviews with WSUP staff that explore their personal experiences of participating in institutional change interventions.