Marginalised urban communities are often characterised by three things: complexity, interdependence of challenges, and constant evolution.

The sheer numbers of people living close together in poorly planned communities can make improving the quality of life extremely difficult. The rapid rate of urbanisation – by 2050, the number of people living in African cities will double to 1.5 billion – means that there is no such thing as the status quo. Every month, every year, unplanned urban settlements get larger, and more complex.

In urban environments, issues such as water access, drainage, health, street design and solid waste management are all inextricably linked. Poor drainage leads to flooding, causing damage to flimsy sanitation facilities. Rubbish collected in drainage canals can exacerbate the issue and lead to stagnant water which becomes a breeding ground for disease. Sanitation facilities cannot be safely emptied if poor road access makes it impossible for emptying services to operate.

Tackling these issues in an integrated manner makes intuitive sense – but too often it just doesn’t happen, due to significant barriers such as cost, complexity, and the siloed nature of the development sector.

This report by Water & Sanitation for the Urban Poor (WSUP) and Arquitectura sin Fronteras (also known as ASF-España, referred to in the report as ASF-E), examines how to overcome this immense challenge, from the perspective of water and sanitation services.

The report demonstrates why water and sanitation improvements can be more effective when combined with other areas of urban development, and analyses how, in practice, this integration can occur.

Drawing on evidence from cities such as Maputo, Accra, Nairobi and Antananarivo, the report finds that integrating WASH with wider slum development can improve the overall impact, and the ease of delivery, of WASH services.

Improving sanitation conditions in low-income communities is a major challenge in rapidly growing cities of the developing world.

To determine the degree through which market forces can promote safe fecal sludge removal in low-income neighbourhoods of Kisumu, Kenya, this research compared household willingness-to-pay for formal pit emptying services with the prices charged by service providers.

The results suggest that improving fecal sludge management in these neighbourhoods via the private sector will require large subsidies to address the gap between willingness-to-pay and market prices.

Raising and administering subsidies of this scale will require the development of a city wide sanitation master plan that includes investment, management, and regulatory procedures for fecal sludge management.

CS Water Inspects handwashing points

How can the global WASH sector respond better in future crises?

By Kariuki Mugo, Director of WASH Sector Support The global WASH sector has laudably responded to the Covid-19 pandemic. Most of the actions have been in supporting the public health domain in handwashing with soap by way of ensuring adequate water is available in most households. There has also been a great deal of investment […]


Handwashing station in Accra, Ghana

Covid-19 and crowded urban settlements: how can we stop the spread?

By Sam Drabble, Acting Head of Evaluation, Research & Learning For the one billion people living in informal urban settlements in the Global South, the spread of coronavirus poses an imminent threat that could prove catastrophic. A range of factors makes transmission of the virus in these contexts more likely, and the potential impacts even […]


Capacity building versus hand-holding: how to avoid dependency syndrome

Capacity building has the power to transform organisations into stronger and more resilient service providers. However, it can be difficult to strike the right balance between being supportive and inadvertently making yourself indispensable. By Sibongile Ndaba, Business Development Lead, Zambia One of the major impediments to improved water, sanitation and hygiene (WASH) is low capacity […]


Destroyed property in Beira, Mozambique

Moving towards the recovery phase in Beira

How to rebuild after the crisis? The devastating impacts of Cyclone Idai in early March were widespread across five of Mozambique’s eleven provinces, affecting 1.5 million people. The city of Beira was hardest hit, and thousands of families are still struggling to get their lives back together. After a major relief operation which saw families […]


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.

The pathogen problem

In many cities, people’s living and working environments are contaminated by huge amounts of untreated faecal waste. We know that excreta (human and non-human) is incredibly dangerous for health. But the pathogens found in faecal waste (i.e. the micro-organisms that cause diseases like diarrhoea, typhoid and hepatitis) have very complex patterns of movement through the […]


Citywide Inclusive Sanitation: perspectives from Manila

By Yaver Abidi, Managing Director, WSUP Advisory         Last week I was in Manila, at an annual meeting organised by Bill & Melinda Gates Foundation on Citywide Inclusive Sanitation. Citywide Inclusive Sanitation is the notion that current approaches to sanitation are too small in scale and too focused on infrastructure to genuinely […]


The devastating impact of poor wastewater management

Ahead of World Toilet Day, our CEO looks into the impact of poor wastewater treatment and highlights ways in which cities can improve sanitation management. By Neil Jeffery, Chief Executive When people in the most developed cities flush the toilet, they have the luxury of not having to wonder where the wastewater goes to next. […]