Abstract:
Rural water supply and sanitation in low and middle income countries face the same
challenges now as in the 1970s. Despite massive efforts in providing communal
“borehole with handpump” and “improved latrines” to improve the lives of millions of
people, this traditional approach to development is failing to deliver long lasting
improved services - even if for the last 40 years many attempts have been made to
solve problems in the approach.
The main research question is “Can low-income rural families pay for rural water
supply and sanitation?” This thesis has analysed household poverty and costs on
water and sanitation services in Mozambique and Ghana based on 3,049 surveys
collected between 2009-2010 by the IRC International Water and Sanitation Centre
WASHCost project.
Evidence shows that even extreme poor households can and do pay for improved
water and sanitation services. However, households prefer to pay for more expensive
services to reduce the distance required to collect water instead of paying for the
cheaper maintenance of communal (further away) sources. For sanitation, without
targeted support towards the poorest, improved latrines might be unaffordable. Also,
without follow up support, behaviour change and health impact will not be sustained.
Small increases in the wealth of the poorest have a large impact on the services
demanded in terms of quantity, distance and time spend as well as an increase in the
level of capital and maintenance expenditure.
Ultimately, the world now is not the same as in the 1970s and for achieving universal
sustainable coverage for water and sanitation we need to rethink the failed traditional
approach to development in low income countries with a deeper understanding of the
market segmentation in the lowest quintile of the population and their real aspirations
and demand.
