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

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.

Reliable evidence on the quality of current WSS service conditions is scarce and consumer experience and views and voices are not systematically collected and used for policy development. International experience suggests that poor drinking water and sanitation services can cause households to incur high costs for dealing with this situation. However, in Uzbekistan and other Central Asian countries, there is a lack of data on service quality and on such coping costs. Together with limited feedback from consumers to those that design WSS policies and programs this makes it difficult to design effective reform measures and assess their ex-ante impact on households, in particular for those at the bottom of the income distribution. This study assesses consumer experiences with current WSS services across a range of selected sites in Uzbekistan and determines consumer readiness for reform. First of all, the study analyses how surveyed consumers currently meet their drinking water and sanitation needs and what proportion of their household budget is spent on meeting their WSS needs. Second it assesses the interaction between consumers and service providers. Third it examines stakeholder views and positions on service modernization needs and assesses consumer willingness to pay for quality networked WSS services. Comparisons are made across consumers in a selection of cities, small towns and rural areas, between consumers that are connected to a networked service and those that are not, and between households in the bottom 40 percent and top 60 percent of the income distribution (as estimated through a wealth index).

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

Nigeria has enough surface and ground water to meet domestic demand, but as of 2004 half of its urban population did not have access to piped water. And for those who did have access, water taps flowed only a few hours a day. Rapid urban population growth of 5.7 percent per year heightened the difficulties faced by State Water Agencies (SWAs) in meeting the need for piped water and expanding production capacity. Poorly maintained and aging pipes were subject to frequent leakages, and some newly built pipes carried no water owing to intermittent power supply. Nigeria’s water sector performance contrasts with that of smaller countries in West Africa, such as Niger and Burkina Faso, which, with fewer resources, have undergone major institutional reforms and made significant progress in the urban water sector. The case study is part of a series on Doing Development Differently in Nigeria. This series seeks to support the World Bank’s Nigeria country team in strengthening its effectiveness by tailoring interventions to the local context using World Bank support to leverage system wide change and systematically learn by doing. This case study is also part of the Science of Delivery case study program that is contributing to the Global Delivery Initiative’s Library of Delivery Case Studies. The Global Delivery Initiative is collaboration across the international development community to forge a new frontier in development efforts worldwide.

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

Sanitation services are beneficial for communities at large. They generate strong positive health and environmental benefits to society ('externalities'). Public financing is an important way to stimulate the provision of these services, but there are serious issues with the way public subsidies for sanitation have been delivered up to now. Recent estimates show that the sanitation millennium development goals (MDGs) will simply not be met in a number of countries if 'business-as-usual' continues. The study looks at how such Output-Based Aid (OBA) schemes might be designed by analyzing the sanitation value-chain, and what institutional, financing and risk mitigation measures would be required for each type of OBA scheme. Questions discussed include 'what' outputs should be subsidized and 'who' are the most likely candidates to provide output-based sanitation services.

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

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