WHAT IS THE EVIDENCE ON TOP-DOWN AND BOTTOM-UP

APPROACHES IN IMPROVING ACCESS TO WATER,

SANITATION AND ELECTRICITY SERVICES IN LOW-INCOME

OR INFORMAL SETTLEMENTS?

SYSTEMATIC REVIEW [NOVEMBER 2016]

The authors of this report are

Thillai Rajan Annamalai (Indian Institute of Technology Madras, India)

Ganesh Devkar (CEPT University, Ahmedabad, India)

Ashwin Mahalingam (Indian Institute of Technology Madras, India)

Solomon Benjamin (Indian Institute of Technology Madras, India)

Sudhir Chella Rajan (Indian Institute of Technology Madras, India)

Akash Deep (Harvard Kennedy School, Harvard University, US)

Funding

This is an independent report commissioned and funded by the Research and Evidence Division in the

Department for International Development. This material has been funded by UK aid from the UK

Government, however, the views expressed do not necessarily reflect the UK Government’s official

policies

Acknowledgments

We thank our host institutions; the EPPI-Centre; our funder, the South Asia Research Hub, Government

of UK; our peer reviewers, Dr Mukdarut Bangpan, Ms Kelly Dickson and Mr Jeff Brunton for regular

discussions; and our project associate, Mr M.S. Elayaraja.

Conflicts of interests

None of the authors has any financial interest in this review topic, nor have they been involved in the

development of relevant interventions, primary research, or prior published reviews on the topic.

Contributions

The opinions expressed in this publication are not necessarily those of the EPPI-Centre or the funders.

Responsibility for the views expressed remains solely with the authors.

Citation

Annamalai TR, Devkar G, Mahalingam A, Benjamin S, Rajan SC, Deep A (2016) What is the evidence on

top-down and bottom-up approaches in improving access to water, sanitation and electricity services

in low-income or informal settlements? London: EPPI-Centre, Social Science Research Unit, UCL

Institute of Education, University College London.

Picture

Photos by World Bank Photo Collection and SuSanA Secretarlat; permitted with licence

https://creativecommons.org/licenses/by/2.0/legalcode

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permission.

SUMMARY

This systematic review of urban planning studies in developing countries found that top-down efforts

are ineffective for connecting populations to centralised water, sanitation or electricity services.

Bottom up, participatory approaches are effective for local sanitation solutions, but not for water

supply or connectivity to other services.

Services provided by public or private agencies through centralised planning and implementation (top-

down) appeared effective in individual studies for connecting populations to water, sanitation and

electricity. However, where studies were sufficiently similar to justify pooling findings in a statistical

meta-analysis, this conclusion was not confirmed. Qualitative synthesis of contextual factors suggest a

need for the customisation of solutions to meet local needs, and better delivery of services by

alternative/non-government service providers.

Participatory (bottom-up) approaches adopted by NGOs and CBOs suit the construction and

maintenance of toilets, which can be standalone, and statistical meta-analysis confirms their

effectiveness for individual but not community toilets. Although studies of bottom-up approaches to

improving water access appeared positive more often than studies of top down approaches, this

difference was not statistically significant in a meta-analysis. Moreover, bottom-up approaches suffer

from problems of scaling-up. Replication of successful models may not always be possible, since the

same conditions may not be present in different locations.

Neighbourhoods without security of tenure are rarely served well top-down. Bottom-up approaches

are also limited in this context, and also in Africa where efforts may be hampered by particularly

modest levels of economic development. Public-private partnerships show promise for top-down

approaches to improving water supply. Bottom-up, NGO led initiatives for improving water supply

need the cooperation and support of the public sector.

INTRODUCTION

This systematic review examines the evidence on the effectiveness of different urban-planning

approaches in providing access to water, sanitation and electricity services in low-income or informal

settlements in Low- and Middle-Income Countries (LMICs). The study was funded by the Department

for International Development (DFID) of the UK government and conducted by the Indian Institute of

Technology Madras. The review addresses the following question: What is the evidence on what makes

an effective urban-planning framework for improved access to water, sanitation and electricity services

in low-income or informal settlements? More specifically, the review seeks answers to the following

questions:

1. How effective are the top-down and bottom-up approaches in improving access to water supply,

sanitation and electricity services in low-income or informal settlements in LMICs?

2. Under what circumstances do these approaches deliver better results? Why?

3. What are the strengths and limitations of these two approaches in respect of providing access to

basic services in low-income areas and informal settlements?

This brief is designed to provide an overview of the key evidence identified in the systematic review

and to assist policymakers and researchers in assessing the strengths and limitations of the different

service-delivery approaches in slums. For the purpose of this review, service-delivery approaches were

classified into two categories: top-down and bottom up. Services provided by the government or

government agencies, which are usually characterised by centralised planning and implementation,

were classified as top-down. Services provided by Non-Governmental Organizations (NGOs) and

Community-Based Organizations (CBOs), or other small-scale service providers, which are characterised

by a higher degree of decentralised planning and implementation, were classified as bottom-up. In

reality, there may be very few purely top-down or bottom-up approaches, since the majority of the

programmes fall in between these two polar-opposite approaches, with varying degrees of

decentralisation. However, classifying in a review the service provision as either top-down or bottom-

up clusters the evidence in terms of which service provider has played a dominant role.

SUMMARY CONCLUSIONS

The explorative and statistical analysis of quantitative evidence suggest a bottom-up approach can be

more effective in increasing access to water and sanitation, particularly in the provision of toilets

compared to a top-down approach. Although explorative analysis initially suggested that taking a top-

down approach can be more effective in increasing the supply of electricity, the finding was not

confirmed when statistically pooling the evidence. Qualitative synthesis of contextual factors

influencing improvement in the supply of water, sanitation and electricity, suggest a need for the

customisation of solutions to meet local needs, and better delivery of services by alternative/non-

government service providers. Evidence of approaches taking a bottom-up approach has shown some

improvement in outcomes across multiple dimensions of access, such as connectivity, adequacy and

affordability, whereas top-down approach has predominantly focused on connectivity. The impact of a

bottom-up approach has been least evident in Africa. This suggests that the success of planning

approaches can depend upon different social and political context. Such that, in relatively difficult socio-

economic environments, across different LMIC countries (often characterised by different levels of

poverty, inadequate infrastructure, weak economy and governance, poor institutional capacity, and

absence of civil-society participation) bottom-up approaches requires continued support from other

actors, such as the government, to ensure the delivery of more positive results.

Community participation and tenure security emerged as two important moderators affecting

outcomes. A bottom-up approach was more amenable in facilitating community participation and in

engaging with the poor settlements. They were even more effective when there was security of tenure.

Political commitment also played an important role in affecting outcomes. Strong commitment from

the government in the form of universal access, pro-poor policy reform, or specific schemes to improve

access to the poor, also played an important role in improving access to slums and low-income

settlements.

SYSTEMATIC REVIEW APPROACH

This review synthesises the evidence on access, since it forms an important element in achieving the

Millennium Development Goals (MDGs). While, traditionally, access has been synonymously used to

mean connectivity, we have adopted a more holistic definition of access that considers the following

dimensions: connectivity, affordability, adequacy, effort and time, and durability.

The steps followed for the review were:

 Formulating exclusion and inclusion criteria to determine the studies to be included in the

review.

 Deciding on the sources and the search methods (search phrases) to be used to identify the

studies.

 Managing the shortlisted and identified studies using EPPI-Reviewer.

 Quality appraisal of the studies identified for inclusion in the review.

 Synthesising the evidence in the included studies. Given the heterogeneity of the studies,

multiple methods were used in the synthesis: numerical summary, meta-analysis and textual

narration.

SUMMARY MAP OF EVIDENCE

A total of 104 studies met the exclusion, inclusion, and quality-appraisal criteria and were included in

the analysis. These studies covered six geographical regions, 34 countries, and 103 cities. Studies from

Asia were the most numerous, followed by those from Africa and South America. Dhaka occupied the

top slot in the list of cities, followed by Mumbai, Ahmedabad, Jakarta, and New Delhi. A total of 66% of

the studies were from journals, whereas 34% of the studies were from grey literature. The highest

number of studies was for water (77), followed by sanitation (64) and electricity (31).

OUTLINE OF THE EVIDENCE

Exploratory analysis

Findings from an exploratory analysis, suggest that overall, access to water can be improved when a

bottom-up approach is adopted, compared to a top-down approach. Prior to conducting a meta-

analysis, exploration of the data indicated that there was improvement in access in 40% of cases using

a top-down approach, whereas, in the bottom-up approach, it was 55%. Connectivity has been used as

the primary measure of access, as seen by the number of outcome data in both top-down and bottom-

up approaches. The number of outcome measures on other dimensions of access, such as adequacy,

affordability, effort and time, and durability, have been considerably lower. A bottom-up approach

indicated improvements across multiple dimensions of access, whereas the improvement in the top-

down approach was seen primarily on connectivity (see Figure 1, below). We tested these findings on

improvements to connectivity using statistical meta-analysis (see below) and made additional insights.

Fig 1: Proportion of findings that show improvement in different dimensions of access

Meta-analysis

Meta-analysis results provided an aggregate quantitative measure, based on the findings from the

individual studies. This aggregate measure, if it had a value greater than 1 and was statistically

significant, indicated an improvement in connectivity, comparing between bottom-up and topdown

approaches. However, if the aggregate measure was less than 1 and statistically significant, it indicated

a decline in connectivity. If it was not statistically significant, then there was no change to the status

quo in connectivity as a result of using a bottom-up approach.

Figure 2, below, shows the effectiveness of a bottom-up approach on connectivity across regions and

facilities. Among all the facilities, it can be seen that a bottom-up approach has also been effective only

in the provision of individual toilets. Except in the case of Africa, a bottom-up approach has led to an

improvement in access to individual toilets in all regions. A possible reason for this trend is the modest

level of economic development characteristics of some African countries as compared to other

geographical regions. Construction of individual toilets also requires substantial investment from

households, which is a deterrent in poor slum communities. However, the evidence in Asia, South

America and Central and North America suggests that a bottom-up approach help to create conditions

that result in a greater number of households constructing toilets. Analysis of the evidence by region

shows that a bottom-up approach has led to a decline in connectivity in Central and North America,

except in the case of individual toilets. However, the finding is limited by the low number of studies in

the region.

Overall, our findings help us to conclude that a bottom-up approach has been able to achieve

improvements in only a few instances, indicating the limitations of their effectiveness as an intervention

measure to improve connectivity.

53%

23%

25%

24%

20%

57%

52%

36%

72%

58%

10%

20%

30%

40%

50%

60%

70%

80%

Connectivity Adequacy Affordability Effort and time Durability

Evidences indicating improvement

Top-down approaches Bottom-up approaches

Legend

The numerical values show the aggregate quantitative measure obtained from meta-analysis. Blank

values indicate the absence of evidence in the respective regions and facilities

Fig 2: Connectivity and bottom-up approach: by type of facility and region

SUMMARY OF KEY FINDINGS

A narrative summary of the key findings by individual sector is provided in more detail below. This

summary draws on both quantitative evidence of impact from the exploratory numerical analysis and

statistical meta-analysis. Further analysis of qualitative evidence to provide an account of moderating

factors influencing implementation of top-down and bottom-up approaches is also presented.

WATER SECTOR

Multiple approaches prevail in water supply for urban slums — from public provision of supply, to

private and NGO-driven delivery of services. Water supply is characterised by the presence of both

individual and community connections. While there may be a preference for individual connections on

the part of policymakers and community members, spatial, legal and financial constraints limit the

extent of coverage.

The exploratory analysis revealed that there was a higher proportion of outcome measures indicating

an improvement in access to water using a bottom-up approach (53%) as compared to under a top-

down approach (42%). The finding from the meta-analysis also indicates a non-statistically significant,

but positive trend towards using a bottom-up approach in improving access to water.

Indicates improvement

Indicates decline

No change to status quo

Qualitative textual-narrative analysis shows that the key reasons behind the poor performance of the

top-down approach were government mismanagement, unclear responsibility among government

agencies, lack of a pro-poor policy, poor finances and weak legal mandate for network expansion in

slums, and inappropriate pricing policies, which affect the affordability of slum-dwellings The bottom-

up approach, however, was able to mobilise community members to participate, physically and

financially, in the service-delivery process. This afforded a sense of ownership over the infrastructure

by community members, which resulted in positive outcomes. For instance, NGO involvement with

slum communities in Zambia led to the creation of a Water Trust, which helped communities address

their water shortages. Similarly, studies have shown the intermediary role played by NGOs in

Bangladesh and Nepal in facilitating water connections in slums. However, scaling-up of successful

interventions and replication of them in other locations may not be possible, with bottom-up approach

which seek to address context-specific issues, which may not be present in different locations, limiting

their transferability.

SANITATION SECTOR

Access level to sanitation is the poorest among the three sectors. Sanitation services include sewerage

systems and access to toilets, neither of which is readily available in slums. Open defecation (such as

disposal of feces in means other than a toilet) are few of the common practices in slums that have a

detrimental impact on health and hygiene.

The effectiveness of the top-down approach has been the poorest in sanitation, with only 28% of the

evidence showing an improvement. However, in the bottom-up approach, 55% of the outcome

evidence have reported an improvement. Meta-analysis results confirmed this finding, showing that

the bottom-up approach has statistically significant improvement in access to sanitation.

Qualitative analysis reveals, that apart from the lack of government willingness to extend network

coverage in slums, there are three main factors which emerge as constraints on the provision of

sanitation in slums: 1) The issue of tenure security; 2) lack of maintenance of community infrastructure;

and 3) poor participation of stakeholders in the planning and design of facility. NGOs and CBOs have

been able to address the last two concerns by adopting a decentralised approach and engaging

community members in the planning, design and maintenance of community toilets. The Orangi case

study from Pakistan is an example of the benefits of community participation, which have resulted in

substantial improvements in water and sanitation infrastructure in slums. Residents of Orangi, with the

help of a local NGO, took the financial responsibility for the construction of smaller feeder pipes for

water and sewerage within the community, while the government agreed on connecting the slum to

the city-wide water and sewerage network. As a result of this partnership, residents could get

household-level connections, as well as connections to the city-wide network, which proved to be

beneficial to all stakeholders. Community-sanitation initiatives in the cities of Mumbai, and Trichy,

India, also highlight the efforts of NGOs and CBOs in the construction of community toilets in urban

slums.

ELECTRICITY SECTOR

Access levels to electricity have been the highest of the three basic services studied in this review.

However, most of the slum-dwellers access electricity through illegal connections, either because of

high up-front costs or the high cost of power.

The exploratory analysis, suggested that the incidence of using a bottom-up approach has been the

lowest in respect of the electricity supply: less than 10% of the outcome evidence in the bottom-up

approach were in electricity. When conducting meta-analysis, the results showed that involvement of

non-state service providers has not had the desired effect in terms of improving access to electricity;

despite the narrative analysis indicating that access to electricity can improve with tenure security and

strong political backing. Interventions that have a pro-poor approach and those that involve community

participation in the service-delivery process have shown an increase in connectivity. Case studies such

as the Depressed Area Electrification Program in Philippines, the accelerated electrification program in

Thailand, and the Slum Electrification Program in Ahmedabad, India, all point to the pro-poor approach

of the Government as improving access to electricity in slums. With the support of the Government and

by adopting innovative management practices and pricing methods, and by enlisting the support of

CBOs, utilities have addressed the problem of illegal connections, non-payment and theft.

MODERATING FACTORS

PARTICIPATION

Participation of the local community is an important moderator in influencing outcomes. The bottom-

up approach, however, does not automatically result in community participation. Project planning

should specifically include components that involve the local community in different stages of the

project life-cycle. Studies more often indicated an improvement in access when there was active

participation from the community. Meta-analysis results showed that the bottom-up approach, when

accompanied by active community participation, led to a significant improvement in access. In the

absence of community participation, a bottom-up approach was not effective. Community participation

helps service providers to understand the needs of the slum-dwellers and, subsequently, to tailor the

services to their requirements. This was clearly evident in the sanitation sector in several Asian

countries, such as Nepal, Bangladesh, India and Pakistan. Community participation, for example, helped

the service providers to factor in the needs of women and children during the construction of toilets

and subsequent maintenance, thereby leading to improved patronage of the facilities created.

TENURE SECURITY

Tenure security emerged as yet another moderator in impacting access to basic services. The legal

status of the slum determines the type of service provider and the service-delivery approach. Formal

slums, which are legally recognised and have security of tenure, enjoy a higher degree of connectivity

(56%), whereas informal slums, which lack legal recognition, have comparatively low levels of

connectivity (40%).

Figure 3, below, shows the meta-analysis results for the effectiveness of a bottom-up approach on

connectivity by type of settlement and extent of community participation. Improvement in connectivity

levels was seen neither in formal slums, nor in informal slums, when a bottom-up approaches was

deployed. However, in low-income non-slum settlements, use of a bottom-up approach led to a

significant decline in connectivity levels. A bottom-up approach becomes more effective only when

accompanied by community participation. Use of a bottom-up approach, along with community

participation, has led to a significant improvement in connectivity in informal slums, where there is no

security of tenure for the residents. This suggests that, when there are difficulties in creating tenure

security, a bottom-up approach, accompanied with community participation, are an appropriate

strategy to improve connectivity.

Narrative analysis shows that tenure security provides slum-dwellers the safety net to invest in

connectivity. Since informal slums are under the threat of eviction or demolition, slum-dwellers are

reluctant to invest in infrastructure improvements. Evidence from Jakarta, Indonesia, shows that

granting of tenure security to urban slums prompted slum-dwellers to invest in other housing

improvements, such as toilets, legal electricity connections, permanent roofs, and so on. Similar case

studies in slum improvement and slum up-grading in the cities of Dhaka, Mumbai, Ahmedabad (all

India), and Promeba and Rosario Habitat (Argentina), have included the importance of tenure security

in the programme implementation, along with access to new and improved facilities.

Legend

The numerical values show the aggregate quantitative measure obtained from meta-analysis.

Fig 3: Connectivity and bottom-up approach: by type of settlement and extent of

community participation

POLITICAL COMMITMENT

Political commitment, or a change in the government’s policy to adopt a pro-poor approach in delivery

of basic services to the urban poor, has had a positive impact on access in the top-down and a bottom-

up approach. This is mainly due to the removal of legal hurdles such as tenure security, which obviates

the need for slum-dwellers to provide proof of residence to seek new connections. A commitment from

Indicates improvement

Indicates decline

No change to status quo

the government in the form of universal access, pro-poor policy reform or a specific scheme to improve

access, provides a clear legal mandate to the public utility to extend coverage to poor consumers. It

may also include financial packages such as lower connection fees, which assist the poor in seeking legal

connections. The Depressed Area Electrification Program in Philippines, the accelerated electrification

program in Thailand and the Slum Electrification Program in Ahmedabad, are all examples of

government-led interventions that have improved access to electricity by bringing down connection

costs and granting tenure security.

The setting up of specialised agencies or cells that exclusively deal with the provision of basic services

in slums emerged as an enabling factor in improving access. Slums constitute a unique habitat that

comes with its own set of problems, which require inter-agency co-ordination and innovation in

operation, both of which may be stymied within existing institutional frameworks. In Brazil, two

electricity utilities, Rio LIGHT and Coelba, have set up community-based offices in their respective slum

areas in order to improve their outreach, payment collections and provide better customer service.

Similarly, the Bangalore Water Supply and Sanitation Board have created a social-development cell

within their office to focus exclusively on improving water connectivity to urban slums. Specialised

agencies or offices located within the slums facilitate closer interaction between the community and

the service provider, which, in turn, has a positive impact on access.

POLICY IMPLICATIONS

 Political commitment should be backed by appropriate institutional arrangements for a top-

down approach to work.

Political commitment, combined with a networked approach and deeper understanding of

prevailing conditions (which include the setting up of specialised agencies created exclusively to

work with slums) have shown improvements in access. Overseas development assistance (ODA)

and other funding agencies that seek to generate political commitment should recommend the

setting-up of such dedicated organisations or specialised cells within existing organisations in order

to obtain better results in delivery of basic services.

 A bottom-up approach is more effective in achieving an all-round improvement in access.

Access to basic services should not be seen as merely providing connectivity to taps, toilets or

electricity. A holistic approach to access helps to realise the benefits of improvements in access in

its entirety. A bottom-up approach lends itself very well to this scenario, as they have the necessary

elements to achieve improvements across multiple dimensions of access, due to beneficiary

participation, proximity of the service provider to slum-dwellers, sensitivity to community needs,

flexible payment options, consumer education, and community empowerment through training.

 As policy shifts from community to personal household facilities, a bottom-up approach will have

a greater relevance.

The desire among policymakers is to provide individual connections to slum residents, rather than

public connectivity. However, individual connections need more involvement from the household,

both in terms of effort and investment. Enlisting the support of alternative service providers or

adopting a bottom-up approach can foster a sense of commitment through community interaction

and behavioural change. NGOs and CBOs can also provide the necessary technical and financial

support in the form of loans to obtain individual, household-level connections.

 Addressing tenure-security issues plays an important role in effecting access.

Tenure security is critical to the provision of basic services in slum settlements. In order to

overcome the problems of tenure security, governments must accept their duty to provide access

to basic services in slums by: (i) removing land tenure as a prerequisite to seeking new connections;

(ii) amending the legal framework of government agencies to include informal settlements or

provide universal access; and (iii) use NGOs and CBOs as a medium to service informal slums by

engaging them in decentralised service delivery.

 Programmes that aim to improve basic services should incorporate components of inclusivity

right from the project-conception stage.

Inclusivity and community participation are practices that need to be built into the project right

from the conception stage, in order to identify: (i) community needs and priorities; (ii) existing

resources and constraints; (iii) ways to mobilise community support; and (iv) prolonged

maintenance, as well as upkeep of the infrastructure, all of which are important for successful

service delivery in slums. The strengths and limitations of each of the stakeholders involved must

be studied and understood at the stage of drafting the project document, and avenues for

community members to participate/contribute their ideas at various stages of the project must be

institutionalised.

RESEARCH GAPS

The strength of the review depends on the evidence base. The evidence base for this review lacks

studies using experimental designs, in controlled environments. Primary studies deploying such

research-design methodologies would help in furthering our understanding of the causal pathway

between intervention and outcomes. For example, it could provide a clearer view of how involvement

of alternative service providers helps to improve community participation, and how community

participation leads to better outcomes. Overall, there is a need for studies with a higher degree of rigour

in research design than found at present, to better inform policymaking.

Future work could involve in-depth, region-specific studies, to get a clear understanding of contextual

factors that prevail in different regions. A specific region of interest would be Africa, where neither of

the two approaches has made a significant impact.

CONTENTS

SUMMARY

1: BACKGROUND

2: METHODS USED IN THE REVIEW

3: IDENTIFYING AND DESCRIBING STUDIES: RESULTS

4: IN-DEPTH REVIEW: RESULTS

5: SUMMARY AND IMPLICATIONS

6. REFERENCES

APPENDIX 1: REPORT AUTHORSHIP

APPENDIX 2: METHODS USED IN THE REVIEW

APPENDIX 3: IDENTIFYING AND DESCRIBING STUDIES

APPENDIX 4: META-ANALYSIS RESULTS

LIST OF ABBREVIATIONS

1: BACKGROUND

1.1 BACKGROUND AND AIM OF THE REVIEW

The explosion of urban populations is a prominent

phenomenon observed in a large majority of

developing countries. There are numerous research

papers and policy documents highlighting the changing

urban dynamics in developing countries and the

implications for the policymaking processes of entire

countries. The United Nations Population Fund, which

published a report titled, State of World Population

2007 — Unleashing the Potential of Urban Growth,

mentions that, ‘While the world’s urban population

grew very rapidly (from 220m to 2.8bn) over the 20th

century, the next few decades will see an unprecedented scale of urban growth in the developing

world.....By 2030, the towns and cities of the developing world will make up 80% of urban humanity’

(UNFPA 2007). This report also predicts that Asia and Africa will account for the largest portion of the

global urban population.

This rapid urbanization has resulted in many benefits, such as economies of scale and agglomeration

making urban areas attractive investment destinations, wider and more diverse employment

opportunities, a blurring of social and cultural traditions, etc. However, there have also been several

unintended consequences of this urbanization process, such as overcrowding and congestion, increases

in crime and violence, growing inequality, absence of social and community unity, and a greater

incidence of urban poverty. In recent years, urban poverty has emerged as one of the biggest challenges

for national and sub-national governments. The challenge is further compounded because of the

multiple definitions and perceptions, across countries, of what constitutes ‘urban poverty’.

Urban poverty has been described by the World Bank as a multi-dimensional phenomenon, bringing

challenges such as 1) limited access to employment opportunities, 2) inadequate and insecure housing

and services, 3) violent and unhealthy environments, 4) little or no social-protection mechanisms, and

5) limited access to adequate health and education opportunities. Ravallion et al. (2007) analyse data

for 90 LIMCs. They find that an estimated one-third of all urban residents are poor and this figure

accounts for one-quarter of the world's total poor. Baker and Lall (2003) indicate that the incidence of

poverty is higher in small cities and towns than in large cities.

The urban poor face various challenges in their day-to-day life. Baker (2008) lists the following issues

as the most commonly mentioned/discussed in the literature: 1) limited access to income and

employment, 2) inadequate and insecure living conditions, 3) poor infrastructure and services, 4)

vulnerability to risks such as natural disasters, environmental hazards and health risks, 5) spatial issues

that inhibit mobility and transport, and 6) inequality, closely linked to problems of exclusion. The

prominent reasons behind these are: (i) a mismatch between official Master Planning and settlements

of mostly poor groups, designated as ‘slums’; and (ii) lack of availability of ‘infrastructure and services’

in these slums.

“If cities do not begin to

deal more constructively

with poverty, poverty

may begin to deal more

destructively with cities.”

- Robert McNamara, former President,

World Bank

The UN-HABITAT has analysed the urbanization phenomenon across the world and the report on the

state of the world's cities 2009/10 has presented the global assessment of slums. The report states that

828m, or 33% of the urban population of developing countries, resides in slums. This large proportion

of slum-dwellers has brought an intense focus on the ‘eradication of slums’ among leaders of both

developed and developing countries. The criticality of eradication of slums is recognised by the United

Nations under MDG 7, Target 11. The target is: ‘By 2020, to have achieved a significant improvement

in the lives of at least 100m slum-dwellers’ (MacPherson 2013).

As with the terms ‘urban’ and ‘poor’, ‘slum’ is defined and discussed from various perspectives. The

definition of ‘slum household’ by the UN-HABITAT broadly captures the concept discussed in the

literature, which is, ‘A slum household is a household that lacks any one of the following five elements:

1) access to improved water (access to a sufficient amount of water for family use, at an affordable

price, available to household members without being subject to extreme effort) 2) access to improved

sanitation (access to an excreta-disposal system, either in the form of a private toilet or a public toilet

shared with a reasonable number of people), 3) security of tenure (evidence of documentation to prove

secure tenure status or de facto or perceived protection from evictions), 4) durability of housing

(permanent and adequate structure in a non-hazardous location), and 5) sufficient living area (not more

than two people sharing the same room).’ There is also literature that links ‘slums’ to the legal status

of land — the non-recognition of tenure security to the dwellers.

The lack of physical infrastructure such as water supply, sanitation, waste collection, electricity, and

street lighting severely affects the health, quality of life and social well-being of slum-dwellers. The

impact of poor supporting infrastructure on the health of the urban poor has been investigated by

different agencies. The diseases common or prevalent in urban areas due to poor infrastructure are

diarrhoea, malaria, cholera and respiratory diseases.

Various policy interventions, such as slum up-grading, slum rehabilitation and resettlement, and so on,

are being adopted in various countries to improve housing conditions and delivery of urban services in

slums. The results of these interventions have been varied and there is a need to investigate the

evidence in order to understand the efficacy of various interventions and, based on these observations,

to design appropriate interventions for a particular situation.

1.2 DEFINITIONAL AND CONCEPTUAL ISSUES

SECTORS

This systematic review examines the evidence on the access to basic services in low-income or informal

settlements, under top-down and bottom-up approaches. Basic services generally include access to

water, sanitation, and energy. Energy comprises different sources, such as cooking fuel (kerosene,

cooking gas, etc.); electricity for heating, lighting, and operating lifestyle equipment; fuel for

transportation, etc. In the interest of keeping the systematic review focused, we considered only

electricity, and excluded all other forms of energy. In addition, the decision to focus on electricity was

also driven by the literature. Studies that have analysed energy services for the poor have invariably

focused on electrification (for example, Baruah 2010). Moreover, access to electricity provides a wide

range of economic, social and health benefits (Price 2000; World Energy Assessment 2000). The

benefits from access to electricity have been well identified with the achievement of the MDGs (Flavin

and Aeck 2006, Ha and Porcaro 2005).

COUNTRIES

This review will focus on evidence from LMICs, together referred to as ‘developing countries’ by the

World Bank

. The study was restricted to developing countries because of the substantial heterogeneity

in context between developed and developing countries, which can limit the validity of the synthesis.

While it is recognised that there is considerable heterogeneity even among developing countries, we

chose not to limit the countries to be included in the review because of the widespread problems of

slums and low-income informal settlements seen in these countries. For example the percentage of

urban populations living in slums in 2001 in developing countries was 43%, whereas the corresponding

percentage for developed countries was only 6% (UN-HABITAT 2003). Therefore, the topic of this

review is very relevant for a majority of the developing countries, and our strategy is to capture the

diversity by contextualising the analysis or incorporating the same as appropriate moderator variables

in statistical synthesis.

INTERVENTIONS

The interventions for this review can be broadly classified into two categories: the traditional top-down

approach (by centralised planning and implementation by the government – and sometimes private –

provision of services) and the bottom-up approach (by alternative service providers, such as NGOs and

CBOs). Categorising in this way also gives an indication of the degree of inclusivity, the bottom-up

approach being more inclusive than the top-down approach. Inclusive urban planning, for example,

takes into account the needs of the poor and formulates specific strategies to improve or redevelop

slums in ways that make the poor better off. In general, a top-down approach is less inclusive than a

bottom-up approach. If the framework is formal city-level planning, driven by the government, then it

constitutes a top-down approach. In contrast, if the approach is for micro-planning for individual slum

improvements, then it would be classified as a bottom-up approach. In between these two extremes,

there is a spectrum of approaches that involve varying levels of inclusivity. For example, the

involvement of NGOs, CBOs, and resident associations increases the element of inclusiveness in the

planning and implementation process.

In general, in the absence of clear information, we take government to be the default service provider.

Service providers that involve other providers are classified as alternative service providers. For

example, if there is no information on involvement of any alternative service provider, it is assumed

that the service provider in the slum was the government. If the services in the slum are provided by

non-government or private service providers, the slums are categorised as being serviced by alternative

service providers.

We considered the level of participation from the community as accounting for the degree of inclusivity.

Participation refers to the involvement of different stakeholders, such as community residents, officials

from government, and other institutions, such as NGOs and CBOs, in the delivery of basic services.

Possible forms of community participation are as follows (adapted from UN-HABITAT 2003, Kingston

1998):

Source: http://data.worldbank.org/about/country-and-lending-groups accessed on 24 June, 2014;

http://data.worldbank.org/about/country-classifications

Passive participation: Poor communities participate by being told about initiatives that are being

planned or have already been decided upon, without any attempt to elicit local opinion or knowledge.

Participation through giving information: Poor communities are asked about their needs through

surveys or similar instruments. The information is used anonymously in the decision-making process,

without feedback.

Participation through consultation: Poor communities are consulted as to what should be done to

improve the situation, but there is no obligation to take the residents’ views into account.

Participation through contribution: Poor communities are asked to provide labour or financial

contributions towards the provision of services and the residents agree to take primary responsibility

for the well-defined components of the project.

Participation through partnership: Poor communities and other key actors share resources, knowledge,

and risks in pursuit of commonly agreed-upon improvements. Partnership implies a long-term,

equitable relationship.

Participation through self-mobilisation: Poor communities work together to demand and/or implement

improvements in basic services. They develop contacts with experts, who will contribute with

managerial and technical skills, but community groups retain control over how the resources are used.

Since many studies do not give details of the level of participation, we broadly classified participation

into two levels: with and without participation. Passive participation was classified as ‘without

participation’ and the remaining five levels of participation were classified as ‘with participation’.

However, when summarising the studies numerically for the bottom-up approach, ‘with participation’

was further classified into two sub-categories to denote the extent of participation. Participating by

giving information, consultation and contribution were grouped into one sub-category, whereas

participating through partnership and self-mobilisation were grouped into a second sub-category.

We differentiate between inclusivity and participation because an inclusive urban-planning approach

may or may not be participatory. (Examples include the Basic Services for Urban Poor (BSUP)

programme implemented by the government of India). Similarly, high levels of participation do not

guarantee a higher degree of inclusivity. For this reason, these two dimensions were captured

separately when characterising the nature of the planning framework.

MODERATORS

The outcomes are dependent not only on the interventions, but on a lot of other variables. Together,

we refer to them as moderator variables. To facilitate analysis of these moderators, they were broadly

classified into one of three categories: context, content, and process (adapted from Pettigrew 1987,

Dawson 1994, and Nelson and Dowling 1998). Context refers to the wider social environment and the

individual setting of the slums. Content refers to the elements of the intervention. Process refers to the

actions, reactions and interactions of the various interested parties in the implementation of the

programmes/planning framework.

Based on the literature reviewed and the inputs from the advisory board, we classified the moderators

into the following categories:

Context: Type of slum (declared or undeclared slum); security of land tenure; and institutional form and

structure; spatial location of the slum, etc.

Content: Type of facility (for example, in the case of water supply, is it a household connection to piped

water, a connection to a public water outlet, or access to non-piped water, such as open or bore wells);

source and quantum of funding for the project.

Process: This includes implementation, maintenance and operations of the facility.

OUTCOMES

This review synthesises the evidence on top-down and bottom-up approaches in improving access to

basic services for the urban poor. Access is an important element in achieving the MDGs (Global Urban

Observatory 2003) and is the outcome under consideration in this review. In this review, we consider

access to have the following dimensions or outcomes: connectivity, affordability, adequacy, effort and

time, durability and sustainability. Assessments of effect (positive, negative, etc.) on the above

outcomes arising from the different delivery approaches have been synthesised in this review. While

the traditional definitions of access would mean connectivity to the service, it has been indicated that,

in the context of improvement of slums, the indicators of access would be more broad-based. The

different access indicators for the three sectors (UN-HABITAT 2002) are:

Water supply: Proportion (or number) of households with access to water supply, availability at an

affordable cost; at a sufficient quantity; and without excessive effort and time.

Sanitation: Proportion (or number) of households with access to adequate sanitation facilities.

Electricity: Proportion (or number) of households with electricity connections; availability of electricity

at an affordable cost; at specified voltages; and without excessive disruptions.

Based on the above, we define the different dimensions of access as follows:

Connectivity: This dimension seeks to study the proportion (or mean number) of households with

access to services such as water supply (public tap or individual in-house tap), sanitation facilities

(individual toilet or community toilet) or legal electricity connections at household level, provided

either by government or alternate channels.

Affordability: The proportion of households who found the services affordable (or) the mean cost

involved in accessing the services for the dwellers.

Adequacy: This dimension seeks to measure the proportion of households who found the services

adequate (or) the mean level of consumption of services.

Effort and time: Proportion of households who were able to access the services without excessive effort

and time (or) the distance from the households for accessing the services (mainly relevant for water

and sanitation) will be studied under this dimension.

Durability: This seeks to explore whether the improvements in access is temporary or of a more

permanent nature. While the definition of what is temporary or permanent is subjective and can differ

between contexts, our objective is to check whether the improvements are short-term or likely to be

long-term.

Sustainability: This dimension would analyse the environmental impact of the facilities created to

provide access.

In sum, our outcome indicators consist of the following components of access: connectivity,

affordability, adequacy, effort and time, durability and sustainability. Figure 1.1, below, gives the

conceptual overview of the review.

Figure 1.1: Conceptual overview of the review

Top-down

approach

City-level

plan

Government

Grant

agencies

NGOs

CBO

User

involvement

Bottom

approach

Micro-slum

development

program

Access

to s

ervices

Sectors



Water

supply



Sanitation



Electricity

Components of access



Connectivity



Affordability



Adequacy



Effort and time



Durability



Sustainability

Context

Content

Process

Type of

settlement



Notified



Informal

Institutional

form and

structure

Slum

features

(land

tenure,

location, etc.)

Type of

facility

Type and

uantum

funding

Implementati

on,

maintenance

and

operations



State



Community



Private



Dwellers

Interventions

Moderator

Outcomes

Passive

Participation

Information

Consultation

Contribution

Partnership

Self

mobilization

Planning

Implementation

elivery

Access to

basic

ervice

in slums and low

income

informal

settlements in urban areas

High Part icipative spectr um Low

Granularity of Pla nning

Low

1.3 POLICY AND RESEARCH BACKGROUND

The global urban population is growing, with 54% living in urban areas in 2011, and this is expected to

increase to 66% by 2050 (Heilig 2012). According to a 2008 study by UN-HABITAT, one-third of the urban

population in developing countries at this time lived in slums, the conditions being noticeably worse in

some regions than others. For instance, in Sub-Saharan Africa, 62% of the urban population resided in

slum areas (UN-HABITAT, 2013). These are low-income or informal settlements where housing and

living conditions are very poor. They are often characterised by lack of access to basic services and

infrastructure, such as roads, street-lighting, drinking water and sanitation, due to a lack of legal

recognition. Households in these areas end up paying many times more than the public-network fee

charged for poor-quality water and sanitation services, since they are not served by the formal services.

Inadequate access to safe water and sanitation are responsible for a high burden of communicable

disease in developing countries, especially diarrhoeal diseases (Prüss et Al. 2002). Children under the

age of five bear the highest burden in this regard, with diarrhoea being one of the leading causes of

child mortality (contributing to 11% of all child deaths in 2010) (UNICEF 2012). Treating these diseases

also incurs high economic costs: that is, direct costs, including expenditure on healthcare for treating

illnesses, and indirect costs, such as loss of productive labour time due to sickness and caregiving. Other

costs include effort and time spent on fetching water, indignities faced due to open defecation, lack of

safety, and so on — factors especially affecting girls and women. The total economic costs of lack of

access to water and sanitation has been estimated at US$260bn per year (Hutton and Haller, 2004).

Investment of US$1 in this sector is estimated to have a global economic return of US$5 (on average)

through time saved, reductions in morbidity and mortality rates and improvements in productivity. For

instance, Ghana’s Trachoma Control Programme reduced the prevalence of active trachoma from 9.7‒

16.1%, to less than 3% in endemic districts between 2000 and 2010 through interventions such as water

and school-latrine provision, sanitation promotion using the community-led Total Sanitation approach,

and hygiene promotion (WaterAid 2014). Globally, time savings associated with improved sanitation

were estimated to be 30 minutes per individual per day, and 30 minutes per household per day for

improved water supply.

With growing urban populations and the increasing urbanisation of poverty, provision of water and

sanitation services to low-income and informal settlements in urban areas is a serious challenge faced

by the governments of developing countries.

MDGS AND ACCESS TO WATER AND SANITATION

The MDG for sustainable development adopted international targets for provision of water and

sanitation services and improvement of slum conditions. The incorporation of these targets into MDGs

underscores the policy relevance accorded to this sector. The goals, targets, indicators and progress

achieved to date are explained below (United Nations 2013):

MDG 7: Ensure sustainable development

Under this goal, the relevant targets are listed below:

MDG Target 7.C: By 2015, reduce by 50% the proportion of the population without sustainable access

to safe drinking water and basic sanitation.

Indicators:

1) Proportion of population using an improved drinking-water source.

2) Proportion of population using an improved sanitation facility.

Progress: In 2012, the proportion of the world’s population with access to an improved drinking-water

source was 89%, up from 76% in 1990. Although the target of halving the proportion of people without

access to an improved source had already been achieved in 2010, there were 748m people still lacking

access to safe drinking-water sources in 2012. Also, between 1990 and 2012, almost 2bn people gained

access to an improved sanitation facility (one that separates people from faeces hygienically). Despite

the large increases in sanitation coverage, however, 2.5bn people still did not have access to an

improved sanitation facility in 2012, out of which 1bn people resorted to open defecation.

MDG TARGET 7.D: By 2020, to have achieved a significant improvement in the lives of at least 100m

slum-dwellers

Indicator: Proportion of urban population living in slum-like conditions.

Progress: Although this target was achieved long before its deadline, the number of slum-dwellers

continues to grow. The number of urban residents living in slum conditions (lack of access to water, lack

of access to sanitation, overcrowding, dwellings made of non-durable material) was estimated at 863m

in 2012, up from 760m in 2000, and 650m in 1990.

PROVISION OF WATER AND SANITATION

NATIONAL AND REGIONAL GOVERNMENTS

National and regional governments, historically, through taxes redistributed through the public-sector

budget budgeting, have accounted for the majority of the spending in the water and sanitation sector.

Following the adoption of MDGs across the world, governments have increased commitments to the

water and sanitation sector in order to achieve the MDG targets. In 2008, African Union Governments

signed the Sharm el-Sheikh declaration, committing to prioritise water and sanitation and improve

transparency and accountability. In the eThekwini declaration, African ministers committed to

allocate at least 0.5% of gross domestic product (GDP) to fund sanitation and create separate public

budget lines for sanitation and hygiene in their countries (WaterAid 2011). Similarly, in the third High

Level Meeting of Water and Sanitation for All, convened by UNICEF, ministers from 43 developing

countries made commitments relating to steps that will be taken to remove constraints on the

expansion of water and sanitation services (SWA 2014). In recent times, governments have also tried

innovative approaches to increase access to the poor, instead of the traditional one-size-fits-all

model, as seen in, for example, the provision of conventional pipe networks.

Often in the past, national governments planned investments in water and sanitation through

local/regional governments and public-private partnerships, which, in turn, did not adequately address

the needs of the poor (Belsky et al. 2013). However, in recent times, slum upgrading (provision of

housing and basic services) has been increasingly recognised as a strategy for improving the conditions

of the urban poor and catalysing private investments by residents (Cities Alliance 2006). Country and

city development strategies are becoming more inclusive (inclusive urban-planning approaches), by

taking into account, within their frameworks, the provision of basic services for the urban poor. For

instance, the government of India’s Jawaharlal Nehru National Urban Renewal Mission (JNNURM),

targeting 63 key cities and urban areas, focuses on services to the poor as one of its explicit missions.

Under JNNURM, it is mandatory for all local bodies to implement the following poverty reforms in order

to receive funding: local urban bodies should allocate funds to provide basic services to poor

households within local budgets; provision of these services to be implemented within a specific time

period, earmarking at least 20‒25% of developed land to low-income categories; and so on. When the

cities implement these reforms, it is expected that slum-dwellers will gain access to basic municipal

services, such as water supply, toilets, waste-water drainage, solid-waste management, power, roads,

and transport (CGG 2010).

OVERSEAS AID

Multilateral agencies such as the World Bank, the WHO and UNICEF, bilateral donors such as USAID,

DFID and the Swedish Development Cooperation Agency (SIDA), national and regional governments,

international and local NGOs have been engaged in improving access to water and sanitation services,

particularly to poor people across the world. The World Bank group is the largest source of external

financing for water-related interventions. During 2009‒13, financing to the tune of US$16.9bn was

approved for water- and sanitation-related projects supported by the bank. It is estimated that bank-

supported projects have provided 123m and 5.8m people with improved access to, respectively, water

and sanitation between 2002 and 2012 (World Bank 2014).

Following the adoption of water and sanitation targets in the MDGs, ODA commitments to this sector

have also increased. ODA to developing countries for the water and sanitation sector increased to over

five times 1990 levels (see Figure 1.2). ODA to the water-supply and sanitation sector amounted to

more than US$7.6bn in 2010‒11 (total annual aid commitments), representing 6% of total sector

allocable aid. This is targeted to regions that have poor coverage of water and sanitation services: Sub-

Saharan Africa received 25% of total aid and South and Central Asia 23% in 2010‒11. The poorest

countries received 33% of total aid to the sector (OECD 2013). Of total aid, 19% was contributed to

water-supply activities, 18% to sanitation and 42% to combined water-supply and sanitation activities.

Figure 1.2: Official Development Assistance to Water Supply and Sanitation

2000

4000

6000

8000

10000

12000

1971

1973

1975

1977

1979

1981

1983

1985

1987

1989

1991

1993

1995

1997

1999

2001

2003

2005

2007

2009

2011

USD (millions) current prices

Source: Organization for Economic Cooperation and Development Creditor Reporting System

database.

ODA is primarily directed to bilateral and multilateral organisations. For instance, DFID expenditure on

water, sanitation and the hygiene sector amounted to €245m in 2010‒11, and was concentrated on

Asian and Sub-Saharan regions (DFID 2012). Similarly, AusAid supports water and sanitation projects in

the Indo-Pacific region through partnerships with governments, NGOs, civil societies and multilateral

partners such as the World Bank, with an estimated expenditure of US$163.5m (DFAT 2014).

INNOVATIVE PARTICIPATION BASED APPROACHES TO DELIVER BASIC SERVICES

In recent times, effective community participation to design and implement water and sanitation

projects for the urban poor has been attributed importance by the governments and overseas donors.

This is essential for making these projects more demand-driven and for ownership, use and

sustainability of these assets (OECD 2013). Also, traditionally, infrastructure projects rely more on tariffs

for cost recovery. As an alternative, Winpenny and Camadeus’ (2003) recommend finding an

appropriate combination of tariffs, taxes and transfers (the 3Ts; primarily through ODA) for each

country, in order to finance water and sanitation projects sustainably. The report also recommends

sustainable cost recovery, rather than full-cost recovery, and recommends setting tariffs policies that

are affordable to all sections of society, including the poorest.

Table 1.1, below, provides some examples of different successful approaches that have been

implemented in various regions of the world, to provide access to water and sanitation to the urban

poor; the text following it gives a short description of these approaches.

Table 1.1: Illustrative approaches for giving water and sanitation access to urban

poor

Type

Policy/Project

Name

Country

Sector

Approach

Description

NGO-

Communities

Orangi Pilot

Project (OPP)

(WSP 2009).

Pakistan

Sanitation

Bottom-up, with

community

participation

through

contribution.

Micro-slum sanitation

project, completely

financed and built by the

community, while an NGO

provided technical

assistance.

http://stats.oecd.org/qwids/ accessed on 15 July 2014.

Type

Policy/Project

Name

Country

Sector

Approach

Description

National and

regional

governments,

CBOs,

communities

Water and

Sanitation

Program for

Low-Income

Urban

Population

(PROSANEAR I)

(Katakuraand

Bakalian 1998).

Brazil

Water and

sanitation

Top-down

approach, with

participation

through

consultation.

PROSANEAR teams went

into communities to ask

which kind of project the

community preferred, and

if they were willing to

contribute effort, time and

money to the project.

City

development

plan/strategy

Ger-area

(Informal

settlements)

Upgrading

Strategy (GUS)

(Cities Alliance

2010).

Mongol-

Water and

sanitation

Top-down

approach, with

community

participation

through

consultation/

giving.

Municipality of

Ulaanbaatar city, capital of

Mongolia, developed city-

wide pro-poor Ger-area

(informal settlements)

upgrading strategy, in

consultation with various

stakeholders.

ODA, NGOs,

CBOs, local

governments

Community-led

Infrastructure

Facility (CLIFF)

(Jack and Morris

2005).

India,

Kenya

Housing,

sanitation

Grant-based

approach.

CLIFF helps in leveraging

the financial resources of

slum-dwellers, so that they

can access capital from the

public and private sectors.

Orangi is Karachi’s largest informal settlement, with a population of more than 1m, and has faced a

huge sanitation and sewerage crisis. In this scenario, OPP (set up by the Bank of Commerce and Credit

International Foundation, with the social scientist, Dr Akhtar Khan) developed a low-cost sanitation

technology and convinced the residents of lack of funds with the local bodies to construct sewer system

for the community. They provided technical guidance to enable poor households to construct and

maintain their own sanitation systems. The residents were, in turn, responsible for the finances and

management of the construction work. In this way, improved sanitation was provided for

approximately 900,000 people and 94,122 houses, at the cost of only US$13 per household. This is an

example of a micro-slum project planned and implemented by an NGO and the local community.

PROSANEAR I is not a single project, but a group of different projects implemented in various

communities across different districts of Brazil. The project was jointly financed by the World Bank

(50%), the local water companies, state or municipal government (25%), and the Caixa Econômica

Federal (CEF, the Brazilian Government development bank (25%).

PROSANEAR I mandated low-cost

technology (investment ceilings were fixed at US$98 and US$140 for water and sewerage, respectively)

and community participation, through which it brought water and sewerage connections to 1m people

in low-income settlements across 17 cities. This is an example of a top-down approach with community

participation through consultation.

GUS is a citywide development strategy involving participation through consultation/giving for

upgrading the Ger areas

of Ulaanbaatar city. The city was supported with services like water supply

and electricity network, but Ger areas enjoyed limited access to these services due to a lack of legal

recognition and planning for upgrading, among other factors. GUS was then developed through

consultation with multiple stakeholders, including government agencies, the private sector, civil

societies, NGOs, Ger communities and international aid agencies. Accordingly, Ger areas were classified

into three types (Central, Middle and peri-urban areas), and specific strategies for upgrading were

developed. Since the adoption of these strategies in 2007, the design and implementation of national

and international programmes and projects for the upgrading and development of Ger areas are guided

by these strategies.

CLIFF in India was established by Homeless International, with funding from DFID and SIDA. CLIFF

provides loans and technical-assistance and knowledge grants, and guarantees to the community-led

slum-upgrading schemes that are taken up in partnership with city authorities. CLIFF kick-starts

community projects, initially with loans, while negotiations for funding from other sources, such as

banks, takes place. These resources are used for sustainable housing and basic services’ projects for

slum-dwellers (including sanitation), with potential for scaling-up. During Phase I (2002‒10), 29 projects

were taken up, of which sanitation was a component of four. This programme has now been expanded

to Kenya and Philippines (EUWI and SHARE 2012).

There are other examples of water and sanitation projects implemented for improving access to urban

poor through different partnerships. Although there have been various kinds of interventions to

improve access, there is little evidence as to which approaches are most effective and efficient in

delivering basic services to the urban poor. In a report on the bilateral aid review of the Water,

Sanitation and Hygiene (WASH) portfolio, DFID notes that ‘There is limited rigorous evidence regarding

the best choice of context-specific delivery models for programming.‘ (DFID 2012). The report attributes

two reasons for this: a lack of systematic data for evaluating the effectiveness of specific interventions,

and huge variations between approaches implemented across different settings. While lack of data and

variations in the context cannot be easily overcome, this review is an attempt to synthesise the

evidence through a systematic search of the literature.

SUMMARY

For project planners, policymakers and service providers, there is a pressing need to understand the

context-specific factors responsible for success or failure of different approaches to delivering basic

services to the urban poor, experimented with across different regions of the world. This will help to

The World Bank provided the loan to the CEF, which, in turn, loaned it, along with its contribution, to

the Municipality or other government agencies responsible for project implementation.

Ger areas are traditional low-density settlements that are not recognised as formal parts of the city.

identify barriers and propose practical solutions to improving access to basic services among the urban

poor. However, systematic reviews on water and sanitation interventions extensively focus on their

health-related effects, such as a reduction in diarrhoeal diseases (Fewtrell et al. 2005) in developing

countries and the nutritional status of children (Dangour 2013), while there is no such review on the

effectiveness of different approaches and their determinants. Consequently, a systematic review of

evidence on best urban planning practices to provide improved water and sanitation services to the

poor will help inform public policy and achieve further progress towards achieving MDGs.

1.4 AUTHORS, FUNDERS AND OTHER USERS OF THE REVIEW

The authors, funders and members of the study advisory board are given in Appendix 1. The study was

funded by DFID. The EPPI-Centre, Social Science Research Unit, Institute of Education, University of

London, provided the technology and advisory support for the review.

The results of this review will be particularly useful to multilateral and bilateral funding agencies, urban-

planning agencies, and governments and civil-society organizations.

1.5 REVIEW QUESTIONS

The review was initially conceptualised to synthesise the evidence on the effectiveness of different

urban-planning frameworks for improved access to water, sanitation and electricity services in low-

income or informal settlements. However, a review of the available evidence indicated that outcomes

cannot be attributed only to planning. The results are also dependent on the mode of implementation

and delivery of services. In addition, studies did not specifically analyse planning in isolation, but very

often treated planning-implementation-delivery as one continuous spectrum. Therefore, the review

synthesised the evidence on the entire delivery approach to provide basic services, and not just on

planning. This approach was supported by the study-policy advisory board as well, since efforts to

provide basic services were often not a part of city-level plans, but were bespoke, micro-level

implementations.

Secondly, studies indicated the prevalence of two polar-opposite approaches in the delivery of basic

services to slums — the first in which the effort was led by the government and the second in which

the effort was led by alternative service providers such as NGOs, CBOs, and the private sector. The

former was called the top-down approach and the latter was called the bottom-up approach. While it

may not be possible, in practice, to have a purely government-led implementation without any

involvement from the community, NGOs, CBOs, etc., or vice versa, the classification of a top-down or

bottom-up approach was based on who played the dominant role in the delivery of basic services. The

programme descriptions given in the studies was carefully reviewed when classifying as top-down or

bottom-up.

Given this context, the question that was taken up for this systematic review was:

‘What is the evidence on top-down and bottom-up approaches in improving access to water, sanitation,

and electricity services in low-income or informal settlements?’

More specifically, the objective of the review was to seek answers to the following:

1. How effective are the top-down and bottom-up approaches in improving access to water

supply, sanitation and electricity services in low-income or informal settlements in LMICs?

2. Under what circumstances do these approaches deliver better results? Why?

3. What are the strengths and limitations of these two approaches in respect of providing access

to basic services in low-income areas and informal settlements?

1.6 OUTLINE OF THE REPORT

The report is organised into five chapters. The current chapter introduces the report. Chapter 2

describes, in detail, the methodology adopted. Chapter 3 provides a description of the identified studies

using the methodology described in Chapter 2. Chapter 4 provides the results of the in-depth review of

the studies identified in Chapter 3. Chapter 5 highlights the key findings, implications and certain

limitations of the review.

2: METHODS USED IN THE REVIEW

2.1 OVERVIEW

This chapter provides the details of the search strategy, the methods used to identify the studies to be

included in the review, and the methods used to synthesise the results in the included studies. The

process comprises the following steps:

 Formulating exclusion and inclusion criteria to be used to determine the studies to be included

in the review

 Deciding on the sources and the search methods (search phrases) to be used to identify the

studies.

 Managing the shortlisted and identified studies using a review-management software.

 Synthesising the evidence in the included studies using the following methods: numerical

summary, meta-analysis and textual narration.

The entire search process was carefully documented and the number of studies identified was recorded

at each stage, so that the entire process can be replicated, if need be, by other research groups. In

addition, documenting the search process will also help in updating the review in the future to include

additional studies that might have been carried out. Documenting the search process and the use of

well-defined exclusion and inclusion criteria also helps to reduce the study selection bias that might

occur in non-systematic reviews.

2.2 USER INVOLVEMENT

APPROACH AND RATIONALE

Evidence-based policy making is emerging as a major imperative. In recent times, international funding

and development agencies have been increasingly using past evidence as one of the important

parameters in their funding and developmental-assistance decisions. The authors of this review clearly

understand this imperative and would, therefore, direct this review towards policymakers and

practitioners.

METHODS USED

The main users of this review will be policymakers, as well as funding and development agencies such

as DFID. To understand the imperative of policymakers and increase the relevance of this review, we

incorporated user involvement at four levels:

 First would be discussions with the funding agency. We had discussions with the policy team

of DFID during the protocol development and conceptualization stages of the review.

 Second, a policy-advisory board was constituted, with members drawn from the government

involved in policymaking, a civil-society organisation, and the private sector. The inputs from

the advisory board have been taken into account in developing the conceptual framework and

objectives for the study. The policy-advisory team also reviewed the study protocol and the

draft report of the study.

 Third, an academic advisory board was constituted to complement the inputs received from

the policy-advisory board. The academic advisory board provided inputs on the study design,

and also reviewed the draft report.

 Fourth, the study review co-ordinating agency, EPPI, also helped in arranging the review of the

protocol and the draft of the report.

User involvement at multiple levels and stages helped to provide a review that is more appropriate to

the end-users. Details of the advisory board are given in Appendix 1, on the authorship of the report.

USERS OF THE REVIEW

The study is relevant to organisations (research, consulting, training, etc.) that work in policy,

governance and related areas. It is also relevant for policymakers in government, international agencies

such as DFID, and civil-society organisations.

2.3 IDENTIFYING STUDIES

DEFINING RELEVANT STUDIES: INCLUSION AND EXCLUSION CRITERIA

Since this is a systematic review, the first step involved was the formulation of appropriate inclusion

and exclusion criteria to be used to identify the studies for inclusion in the review. Studies were

searched for and shortlisted, first by applying the exclusion criteria; those that were excluded were not

evaluated further. The studies that remained were then evaluated on the basis of the inclusion criteria.

Only those studies that met all the inclusion criteria were considered for further evaluation. Table 2.1,

below, gives the exclusion and inclusion criteria used for identifying the studies.

Table 2.1: Inclusion and Exclusion criteria

Inclusion criteria

Exclusion criteria

Description/Rationale

Studies published in

English

Studies not published

in English

Given the time limitations and the language

constraints on the research team, only those

studies that were published or translated into

English were included in the review. Since English

is one of the most common languages in which

research findings are globally disseminated, we

believe that our search is representative.

Studies published

after 1999

Studies published

before 1999

It was felt that more recent evidence would be

more compelling for policymakers. Therefore, we

used a cut-off date to exclude studies that were

published before that date. We have used a 15-

year timeframe to identify the studies, that is,

studies published during 1999‒2013.

Reporting outcomes

on access

Studies that did not

analyse access

outcomes

Studies that analyse the effects of different urban-

planning approaches on access to basic services

were included, whereas studies that do not

measure the impact on various dimensions of

access were not included in the review.

Inclusion criteria

Exclusion criteria

Description/Rationale

Studies on developing

countries

Studies on developed

countries

Studies that are only based on data from

developed countries or those that do not

distinguish between developed and developing

countries in the analysis were excluded from the

review.

Therefore:

• Only studies pertaining to developing countries

and the ‘transition’ or ‘emerging’ economies as

classified by the World Bank were considered.

Broadly, the review covers studies concerning:

African countries; countries belonging to parts

of South and Central America (Latin America);

Asian countries, excluding Japan and the four

‘Asian Tigers’ (Hong Kong, Singapore, South

Korea and Taiwan); and the transition and

emerging economies in Eastern Europe and

Central and East Asia.

Studies that indicate

the effect of forms of

planning on access to

basic services

Type of planning and

effect on access not

considered

Those studies that have specifically considered

the different attributes of planning in the

provision of basic services have been included in

the review.

Studies that have analysed the effect of various

mediating factors on access to the identified

services, but have not specifically considered the

different attributes of planning in the provision of

these services, were not included in the review.

Coverage of the study

should extend to

electricity, water, and

sanitation

Studies that did not

cover any of these

three sectors

Infrastructure segments comprising delivery of

water, sanitation and electricity services. Studies

that dealt with supply or distribution of these

services to the consumers would dictate the scope

of this review.

Studies that were outside the domain of the

review, such as demand for housing, access to

roads, telecommunication, solid waste

management in slums, etc., were excluded from

the review. Other forms of energy, such as gas,

kerosene, bio-mass, etc., were not included in the

review.

Inclusion criteria

Exclusion criteria

Description/Rationale

Original research

studies

Review studies

Studies that were reviews of existing studies were

not included in the review. However, these

reviews formed rich sources of studies for

inclusion in this review.

Minimum length of

the publication

should be four pages

Publications less than

four pages

Articles that were less than or equal to four pages

were not considered for the review, since we felt

that such short articles would not provide the

necessary information needed for quality

appraisal.

We decided not to specify in the inclusion/exclusion criteria whether the study was quantitative or

qualitative. Our initial database searches yielded a large number of hits. The quantitative studies

provide a stronger link between outcome and intervention; however, they do not necessarily highlight

the causal chain. In addition, these studies do not capture the richness of the context adequately.

Therefore, to complement the robustness of quantitative studies, we have included qualitative studies

as well since they capture the contextual differences and causal chain for evidence in a superior way.

IDENTIFICATION OF POTENTIAL STUDIES: SEARCH STRATEGY

HAND SEARCH

Firstly, the journals that extensively publish research on urban planning were identified and shortlisted

from the earliest issue in 1999 to the latest issue in 2013. The studies published in these journals were

manually examined. The citations of original research articles from these journals were exported into

EPPI-Reviewer and were subjected to further screening. The list of journals that were hand searched is

given in Appendix 2.1. Hand searching ensured that no relevant study from these journals was missed.

We started the study-identification process with a hand search, since it would give a good overview of

the different types of studies that were done in this area, the prominent authors and researchers who

published on this topic, and different keywords that could be used for subsequent automated searches.

WEBSITE SEARCH

After the hand search of journals, specific websites were searched that would potentially have various

unpublished studies and evaluation reports. The list of websites that were searched and the details of

the search process are given in Appendix 2.1. The website search further enhanced our understanding

of the literature in this area, which helped in sharpening the automated search process of the electronic

bibliographic databases.

ELECTRONIC DATABASES

The third step in the search process was to search for studies in the electronic bibliographic databases.

The different databases that were searched, and the search phrases that were used in the search, are

given in Appendix 2.1. Wild characters were used to capture possible variations in the search terms.

The hits were subsequently imported into EPPI-Reviewer, which was used to manage the search results.

REFERENCE SEARCH

As a next step in the search process, the references of all the studies that were included from hand

search and electronic databases for the review were checked for additional studies that might not have

been captured in the previous searches.

DIRECT CORRESPONDENCE

Finally, authors of papers obtained through electronic databases were contacted to obtain their inputs

on recent studies and working papers that they might have authored, but not yet published. Many of

them provided additional studies that they had authored, which were assessed against the exclusion

and inclusion criteria. In some instances, where access to the studies that were shortlisted from

electronic databases was not available, we corresponded directly with the authors requesting a copy of

their study.

The EPPI-Reviewer software was used to manage the entire search process. The citations, including the

abstracts and the document in PDF format, were imported into the Reviewer for screening. In some

cases, where the study details could not be directly imported to the Reviewer, it was entered manually

so that the entire repository of studies could be managed in the EPPI-Reviewer software.

IDENTIFYING ELIGIBLE STUDIES

After identifying and importing the eligible studies from the different sources to the Reviewer, each

study went through the inclusion and exclusion criteria at successive stages before its inclusion in the

review. The steps for screening of the studies included the following.

TITLE SCREENING

The first step involved a quick screening of the title of the article in order to establish its relevance for

review. Studies not found suitable at this stage were excluded from further evaluation. Those studies

for which a decision could not be made based on a review of the title were passed on for abstract

screening.

ABSTRACT SCREENING

Abstracts of the studies that were shortlisted from title screening were then reviewed to determine

their suitability for this study. If the abstract was found to be unsuitable, the article was not considered

any further. The studies were passed on for full-text review when a decision could not be made based

on the review of the abstract.

FULL-TEXT SCREENING

Full papers or reports were screened for those studies that were shortlisted after title and abstract

screening. Before full-text screening, duplicates were identified and deleted using the review-

management software. The inclusion and exclusion criteria were again applied to the full reports and

those that did not meet these criteria were excluded. Studies that qualified for inclusion based on the

review of the complete studies were appraised for quality (see below) to decide on their inclusion into

the review.

At each stage of the screening process, the decision to exclude the study or take it to the next stage

was taken by two reviewers, working independently. When there was a difference in the assessment

between the two reviewers, a third reviewer assessed the suitability of the study. The decision was then

based on the majority decision of the reviewers.

QUALITY-ASSURANCE PROCESS

Many of the studies included in the review were published in reputable peer-reviewed journals and/or

the studies were conducted by reputed organizations. In the next stage, the studies (both published

papers and unpublished reports) that conformed to the criteria indicated earlier were evaluated using

a critical-appraisal tool. Appendix 2.2 gives the appraisal tool used in this review.

Two members of the review team, working independently, appraised the studies for quality. Each paper

was assessed by two independent reviewers. Wherever the scores given by the two reviewers differed

significantly (that is, when there was a difference of two levels in the rating for each question), a third

reviewer assessed the paper. An average of all three scores was calculated to arrive at the overall study

rating. To ensure consistency, the team initially went through an internal-moderation phase, where

both members screened the same citations and compared the differences in judgements to arrive at a

common understanding on the assurance process.

CHARACTERISING INCLUDED STUDIES

The studies that remained after the application of the exclusion and inclusion criteria and the quality-

assurance process were included for the review (In fact, no study was excluded on the basis of quality

scores). Such studies were characterised on the basis of broad features, such as country of study;

sectors analysed; type of planning adopted; type of study; aims of study; data sources and data-

collection instruments; access outcomes and indicators analysed; methods used to analyse data,

including details of checks on reliability and validity; summary of results; conclusion; and the overall

assessment of the study findings relevant to the review, based on the critical-appraisal questions. This

helped to achieve a broad characterisation and overview of the included studies. Characterisation of

the studies included in the review is given in Appendix 2.3.

2.4 IN-DEPTH REVIEW: SYNTHESIS PROCESS

OVERALL APPROACH TO AND PROCESS OF SYNTHESIS

The studies that were identified for inclusion were characterised by substantial heterogeneity in terms

of the type of data, methodologies used, outcomes analysed, etc. It was felt that using a single synthesis

method would not adequately capture and explain the evidence in these studies. We have, therefore,

used three approaches to synthesise the results, and the inferences have been derived from a

combination of these procedures.

First, we used a count-of-evidence approach to provide a numerical summary of the evidence obtained

from all the studies included in the review. Second, we used meta-analysis techniques to synthesise the

evidence from those studies that could be synthesised using statistical techniques. Obviously, the

studies used for meta-analysis were only a subset of the total studies that were included in this review,

since not all the studies had information suitable for synthesis using this approach.

Third, a narrative approach was used to synthesise the evidence in all the studies included in this review,

since it is better suited for reviews that aim to describe the existing body of literature; identifying the

scope of what has been studied, and the strength of evidence available. In addition, this approach is

useful in synthesising evidence of different types, such as qualitative, quantitative, economic, etc.

(Lucas et al. 2007). Textual narrative also makes the context of the study clearer and is more likely to

make the heterogeneity between studies transparent (Barnett-Page and Thomas 2009). Since textual

narration helps to bring out the heterogeneity between studies, this method is also suitable for

synthesising evidence from the qualitative studies.

All studies selected for inclusion in the review were coded, and this was used to prepare the narrative

synthesis. The coding of the studies facilitated a common understanding among all the members, as

well as the knowledge that could be gleaned from them for inclusion in the textual narrative.

NUMERICAL SUMMARY OF THE EVIDENCE

Light and Smith (1971) described summarising studies numerically to gather the body of evidence

related to a theoretical relationship, by counting the percentage of tests that support the relationship,

and using that percentage as the basis for drawing conclusions about the state of the literature. While

there are some limitations to synthesising evidence by ‘vote counting’ (Combs et al. 2011), this

approach can complement the findings of other synthesis methods. While vote counting is generally

used to synthesise evidence from the statistical results of quantitative studies, in this review, we have

adopted this approach to synthesise results from both quantitative and qualitative evidence. The

objective of this exercise is to understand the state of the literature and provide a foundation for the

textual-narrative synthesis and, where studies can be combined statistically, compare the findings with

pooled measures of effect.

SYNTHESIS PROCESS

The procedure used for the numerical summary is as follows. For all the studies that qualified for

inclusion in the review, the relationships or associations between access outcomes, service provider,

and forms of urban planning were captured. The evidence on access was categorised as one of the

following: positive, negative, no impact, unclear, and inconclusive. In the synthesis process, the findings

of each study were extracted in a template covering: study sector (electricity, sanitation, water supply);

type of access within the sector if any (for example, individual private access or public, community-level

access); components of access for which the evidence was available (that is, connectivity, affordability,

adequacy, durability, effort and time, and sustainability); the type of slum (formal, informal, or low-

income); geographical region of the sample, study design and method, and so on. The numerical

summary synthesis done in this review differs from the traditional vote-counting method, which is used

for combining results only from statistical studies. The synthesis used in this review is based on all the

included studies, both quantitative and qualitative.

INDEPENDENCE OF STUDY OBSERVATIONS

While conducting the numerical summary (as in other forms of meta-analysis), it is important that the

observations from the different studies are independent, as non-independent findings from primary

studies can lead to bias in synthesis results. Non-independency or co-relations between findings of

various studies can occur from (Ringquist, 2013):

 studies analysing multiple interventions, but using the same control sample for all the

interventions;

 one or more studies using a common dataset;

 one or more studies having common research teams; and

 having multiple assessments of effect per study.

We used the following approach to minimise the occurrence of non-independence in the count-of-

evidence approach.

 We considered the most robust evidence available when there was more than one evidence

for the same outcome and study sample.

 We ensured that similar findings in different studies using a common dataset were not

considered.

META-ANALYSIS

Meta-analysis, a technique to synthesise effect sizes from multiple studies, is a systematic approach

to synthesise quantitative evidence from results of previously published studies in order to arrive at

conclusions on a body of research (Haidich 2010; Donna et al. 2000). Meta-analysis combines a

collection of evidence from independent studies on a particular topic to evaluate its magnitude and

the statistical significance of the summary effect. In this way, it plays a major role in effectiveness

research by providing coherent and statistically significant results to identify the strongest evidence,

based on the study's objective.

Over the four decades, the use of meta-analysis has grown extensively, not only in medical and social

sciences, but also in economic and public-policy research. Typically, clinical randomised controlled

trials (RCTs) are used in meta-analysis, but recent statistical approaches and tools have made meta-

analysis possible for observational studies, as well. The advantage of meta-analysis is that it provides

a more organised and quantifiable review of the literature and it also provides a defined precision

and objectivity to the summary estimate (Rosenthal 1991). However, there are possibilities that the

conclusion is less vibrant when the included studies have differing results. In order to overcome this

pertinent obstacle, a statistical test for heterogeneity is used to assess the variation across studies

(Higgins et al. 2003).

In our review, we have used meta-analysis to examine the effect of involving government and

alternative channels as service providers in improving the level of access to basic services in slums

and low-income or informal settlements in developing countries.

In performing meta-analysis, quantitative evidence was obtained from variables that provided evidence

on the level of access. The evidence from the treatment group was compared to the evidence from the

control group. The rationale for the choice of treatment and control group is as follows. The focus of

this review is to analyse the level of access in slum areas. Therefore, the natural tendency is to consider

the slum population as the treatment group. The comparable population is the control group. In the

top-down approach/government provisioning of services, access levels in slums were compared to the

levels in non-slum areas. Therefore, the non-slum population formed the control group. In contrast, in

the bottom-up approach, access levels are compared with the levels in the top-down approach. Since

the purpose of the review is to analyse the access levels from bottom-up implementation, the

population of slums serviced by alternate service providers is taken as the treatment group, whereas

the population of slums in government provisioning is taken as the control group. Table 2.3, below,

presents the predefined variables that were used to synthesise the evidence from the included studies.

Table 2.2: Variables used to synthesise the evidence

Component of access

Predefined variables of interest

Connectivity

Proportion (or mean number) of households with access to improved

connectivity services such as water supply (public tap or individual in-house

tap), sanitation facilities (individual toilet or community toilet) or legal

electricity connections at household level, provided either by government

or alternate channels.

Affordability

Proportion of households who found the services affordable (or) the mean

cost involved in accessing the services for the dwellers.

Adequacy

Proportion of households who found the services (or) the mean level of

consumption of services adequate.

Effort and time

Proportion of households who were able to access the services without

excessive effort and time (or) the distance from the households for

accessing the services (mainly relevant for water and sanitation).

These measures formed the dataset which was created in Microsoft Excel. The dataset also included

various characteristics such as sample size, sector (water, sanitation or electricity), type of access

(individual or community), level of participation (some level of participation or passive participation),

intervention provider (government or alternative channels), type of evidence (before-after intervention

or cross-sectional survey), regions (Asia, Africa, South America or Central and North America), method

of data collection (primary survey or secondary data) and type of slum (informal, formal or low-income).

The study characteristics were used to analyse the data under appropriate groupings or as covariates

for running a meta-regression.

The Excel database was then analysed using STATA. Since most of the data were reported in

proportions, calculating odds-ratio would be the most appropriate measure to synthesise the results.

Hence, we extracted or calculated odds ratios for each outcome reported in the studies when available.

Odds ratio is the ratio of odds of success in the treatment group, relative to the odds of success in the

comparison or control group. The odds ratio is calculated as follows: Assume there are ‘a’ successes

and ‘b’ failures in the treatment group, and ‘c’ successes and ‘d’ failures in the comparison group. The

odds ratio is calculated as given in Equation (1).



 

 

(1)

We also illustrate the calculation using the data from one of the included studies. For example, in Zaki

and Amin (2009), measures were obtained from the primary survey conducted to assess the number of

slum households with access to a water connection. In the intervention group, 24 respondents reported

having a water connection, whereas 62 reported not having a water connection. In the comparison

group, 72 respondents reported having a water connection, whereas 14 reported not having a water

connection. The odds-ratio calculation for this evidence is given in Equation (2):



  

  



(2)

For the meta-analysis, the odds ratio was converted to the log odds ratio by taking the natural

logarithm of the odds ratio; that is, 









The Standard Error (SE) of the log odds ratio was calculated as given in Equation (3):













































(3)

Applying (3) to our example, gives the SE of the log odds ratio. Equation (4) gives the calculation:













































(4)

The effect size was subsequently calculated in STATA using the log odds ratio and SE{ln(odds ratio)}.

When the studies reported effect sizes in mean and standard deviation (for example, the distance

travelled to a community water outlet), the odds ratio would not be a relevant measure. In such cases,

the effect sizes were converted to Standardised Mean Difference (SMD) by calculating the mean

difference between the slum and control group. The SMD was calculated based on the method

suggested by Julian et al. in the Cochrane Handbook for Systematic Reviews of Interventions, version

5.1.0 (updated March 2011). Equations 5‒6 give the expression for calculating the SMD.







(5)







   





 



   









 



 



(6)

The Standard Error for SMD was calculated using Equation (7):

















 







 









 







 





(7)

We illustrate the calculation of SMD for one of the included studies. In Tukahirwa and Oosterveer

(2011), primary survey data on mean cost for accessing community toilet was taken as the evidence for

assessing the outcome on ‘affordability’ between the informal slums where service was provided by

the private sector (treatment group) and the control group, which did not receive any benefit. The study

details are summarised in Table 2.4, below. The calculations are given in Equations 8‒10.

Table 2.4: Study details from Tukahirwa and Oosterveer (2011) for calculation of

SMD

No. of

participants in the

survey in

intervention

(treatment) group

Mean cost

(shilling) to

access toilets in

the

intervention

group

treatment

No. of

participants in the

survey in control

group

Mean cost

(shilling) to access

toilet in the

control group

control

100.0

6.4

117

99.5

17.9



    



    



   



(8)



  





(9)













  

  







 



  





(10)

Subsequently, SMD was converted into the log odds ratio using the formula dictated by Equations 11‒

12. This ensured that all the effect sizes were analysed using a common metric: that is, the log odds

ratio.















 

(11)





















 

(12)

The log odds ratio for the above example was, therefore, calculated as 0.053 and SE{ln(OR)} was

calculated as 0.4973. The effect sizes were later analysed in STATA.

Using relevant commands in STATA to conduct meta-analysis, we calculated the pooled effect sizes (ES)

as a measure of the odds ratio by analysing the log odds ratio and its standard error. To ensure that the

pooled ES were appropriate, we did separate sub-analyses for effect sizes that can be appropriately

grouped together. We hypothesised that, if the effect size was significantly greater than 1, then the

intervention (type of delivery) had a significant effect on provision of connectivity to slum residents, as

compared to the control group. We used the random effects model in our analysis because of the

heterogeneity across the included studies, and the true effect size also varied from study to study. We

summarised pooled ES based on the sub-analysis using random effect models with the DerSimonian

and Laird Method to identify the between-study variance. Heterogeneity was analysed from I

as it

presents observed dispersion in proportions. However, heterogeneity was inevitable included in our

review due to the inclusion of studies with a sampling variation of small and larger studies, diverse study

populations, different study methodologies and different methods used for collecting primary data.

Publication bias occurs when the published studies are not systematically representative of the

population they assess and, in meta-analysis, if the sample of studies retrieved for review is biased,

then the validity of the results is in question (Rothstein et al. 2006, Egger et al. 2000). Visual examination

of asymmetry in the funnel plot revealed elements of publication bias in the evidence taken for meta-

analysis. However, in our review, the study estimates showed a small-study effect, so a funnel-plot

asymmetry test was used to examine whether the association between intervention ES (log odds ratio)

and study size (se) measure is greater than might be expected to occur by chance (Sterne, Gavaghan

and Egger 2000). We have used Egger’s test (Egger et al. 1997) and Begg’s test (Begg and Mazumdar

1994) to assess publication bias. While the former uses linear regression, but is based on the efficient

score and its variance, the later uses rank correlation test. These tests were performed in STATA and a

significance of p<0.05 in any one of the tests indicates publication bias in the sub-analysis of meta-

analysis.

META-REGRESSION

Since the studies included for meta-analysis were characterised by substantial heterogeneity, we did a

meta-regression analysis to control for the variation across studies. In meta-regression, we estimated

the relationship between covariates and the treatment ES by controlling for variation across studies

and determining which study-level covariates were a significant factor in effect size. Random effects

meta-regression of the log odds ratio with covariates (Sharp 1998; Morton et al. 2004) model was used

for analysis. The log odds ratio was regressed on various study-level covariates.

The equation estimated in random effects meta-regression of the log odds ratio with covariates is given

below:



























 



 



























(13)

In our review, we estimated multiple observations from the included studies and it would lead to

dependency issues during meta-regression. To reduce the dependency issue among multiple

observations, a panel-data approach was used in the analysis by interpreting each study as a panel of

observations and thereby forming an unbalanced panel.

Finally, we estimated our equation as:









 







 

























 







 







 

























 



 



(14)

where, the sub-script ij represents the ith estimation in the jth study. This equation was estimated using

the usual panel-data estimation technique in STATA.

TEXTUAL NARRATION

Since the studies were first analysed through various processes, such as application of

inclusion/exclusion criteria, title screening, abstract screening, full-text screening and study

characterisation, we had sufficient information on the variables analysed in the studies, the theories of

change reported, and the factors that led to the success or failure of the delivery approach in

improvement of access to basic services. On the basis of this information, we began the analysis of the

qualitative studies. The thematic synthesis helped to synthesise the evidence based on the

identification of major/recurrent themes in literature and summarise the findings of primary studies

under these thematic headings (Dixon-woods et al. 2004). The narrative description in the thematic

synthesis makes the context of the study clearer, highlights the heterogeneity between studies, and

helps to capture the strength of the evidence available (Barnett-Page and Thomas, 2009).

Three stages would be followed for conducting thematic synthesis of qualitative studies, as described

by Thomas and Harden (2008): 1) Coding of text ‘line by line’, 2) development of descriptive themes

and 3) generation of ‘analytical themes’.

The first two stages involve examining the studies, and coding each line of relevant text from qualitative

studies according to its meaning and content. The constructs or themes observed in a study were

identified and represented in the form of short textual descriptions, called ‘nodes’. The coding can be

carried out in two ways: i) if a researcher has knowledge about the themes to be looked into in an

article, then the node structure can be created before the start of the coding process; or ii) a researcher

can create nodes during the process of coding.

We prepared a node framework for coding relevant information in a study. During the process of

coding, we took care not to confine the emerging concepts from a study to our node framework.

Whenever a new construct emerged in a study, which was not covered in the existing node framework,

we added a new node to cover this. In that way, our node framework was dynamic, and evolved during

the process of coding. While preparing a node, we ensured that it was neither too specific, based on a

one-off phenomenon observed in a study, nor so generic as to restrict enrichment of the description of

a concept observed in a study.

The software tool NVivo was used in this process. The coding process resulted in the generation of new

codes across different qualitative studies and/or renaming of existing codes. It was an iterative process

of ‘axial coding’, as termed in the grounded theory (Barnett-Page and Thomas 2009). Before

completion of these two stages, the codes and related text were examined to ensure consistency of

interpretation. We then created visual representation of the constructs discussed in the study. We also

created models to visualise, explore and present the connections between themes.

The third step focused on ‘third-order interpretations’; this involved development of analytical themes

based on judgement and insights of the reviewers. The systematic review question provides guidance

for development of analytical themes, which was developed first by each reviewer and then reviewed

by the team. Each visual model was studied in detail for variables and the linkages discussed in the

study. Often, studies had more than one linkage. This was followed by the identification of

commonalities between models from different studies. We primarily looked into causal links repeating

across different models.

Finally, consolidated models were prepared by aggregating different causal links observed in a single

model. These consolidated models comprised different, nodes which highlighted a

concept/phenomenon of interest and the studies wherein the phenomenon was observed. These

different nodes were connected by the directional arrows representing relationships between nodes.

The analysis helped to identify appropriate factors that could improve outcomes from different

planning approaches.

2.5 SUMMARY

This chapter describes the methods used in the review. Methods can be broadly divided into two

categories: (i) the methods used to identify the studies for the review; that is, the searching, screening,

and selection process; and (ii) the methods used to synthesise the evidence from the studies identified

for inclusion in the review. We followed an exhaustive process to identify the studies for inclusion in

the review. We used multiple approaches to synthesise the evidence in the included studies. The

numerical summary of the evidence, although we arrived at it through what is considered a

conservative approach, gave a holistic view of the evidence. Meta-analysis involves a more rigorous

synthesis of evidence using quantitative tools and techniques. Textual narration helped to bring out the

causality between interventions and outcomes in greater detail.

3: IDENTIFYING AND DESCRIBING STUDIES: RESULTS

3.1 OVERVIEW

In total, 104 studies qualified for inclusion after applying the inclusion and exclusion criteria. We did

not eliminate studies based on quality appraisal, but chose to highlight the synthesis results of high

and medium-quality studies separately, wherever appropriate. Although the number of studies that

qualified for inclusion was higher than that usually seen in conventional systematic review, we chose

to include all the studies in the synthesis because of the strong heterogeneity across the studies. Since

sampling might not be representative, evidence from all the studies were included in the synthesis.

This chapter provides description of the studies that have been included in this review, and the

quality-appraisal results.

3.2 STUDY IDENTIFICATION AND SYNTHESIS PROCESS

A holistic approach to the study-identification process was adopted to identify relevant studies for the

review. A schematic overview of the study-identification and synthesis process is given in Figures 3.1

(a) and 3.1 (b). The database for identification of studies was divided into two groups: 1) Hand search

and electronic-database search and 2) website search of leading think-tanks and policy groups

relevant to the study, cross-references from identified studies, author correspondence and

Google/Google Scholar searches. The hand search and electronic database search yielded 22,010

studies, which were put through the process of title screening, abstract screening and full text

screening. A total of 56 studies that met the inclusion criteria were identified and appraised for

quality. The website database yielded 48 studies, which were also checked for quality. In total, there

were 104 studies shortlisted from both the databases. Since the electronic database was large, an

elaborate process was followed. However, a few steps were bypassed for the website searches, since

we obtained the documents directly from the authors or used the references from shortlisted studies.

Figure 3.1 (a): Study identification and inclusion for hand search and electronic-

database search.

Search methods for identification of studies

other than electronicdatabses

and hand searches

Sources

Hits obtained

Included studies

3,566

potential studies

identified by the 19 website

searches

studies identified

246

studies identified

Website search

(IADB, City Alliance, UN-Hábitat

, World Bank, UNDP, 3ie

ADB, Aus

AID, DFID, EPPI, R4D

Cochrane, Campbell, Water

Aid, ESMAP, GNSED, Practical

Action, CLIFF and SUF)

Author correspondence

Cross references

Google & Google scholar

1,246

studies identified

21 studies included for

systematic review

5 studies included

8 studies included

14 studies included

48 studies to meet the inclusion

criteria for systematic review

Figure 3.1 (b): Search methods for identification of studies other than electronic-

database and hand searches.

21,106 studies excluded

after title screening

683 studies excluded

after abstract screening

165

studies excluded

after full-text

screening

Search and review process

Hand s

earch

18,782 potentially relevant

studies identified

Electronic s

earch

3228 potentially relevant studies

identified

Title s

creening

Total 22,010 potentially relevant studies identified for title screening

Abstract screening

904

studies included for abstract

screening

Full-text screening

221 studies

were included for

full-text

screening

56 studies

meet the inclusion criteria for

systematic

review

3.3 QUALITY APPRAISAL OF SELECTED STUDIES

All the studies that were selected based on the inclusion criteria were checked against a quality-

appraisal checklist. Two members of the review team, working independently, appraised all the papers

to determine the overall quality (refer to section 2.3.4 for a detailed description of the process). There

were a total of 24 parameters that were rated on a Likert-type scale with scores ranging between 3

(high) and 0 (low). Those papers that scored highly on more than 13 out of 24 parameters were

considered to be high-quality studies (scoring 61 out of 72); papers that scored between 35 and 60 were

of medium quality; and those papers that scored less than 35 were low-quality studies. As can be seen

from Table 3.1, below, 101 of the 104 studies were rated as either high- or medium-quality. This

indicates the soundness of the evidence base.

Table 3.1: Summary of quality-appraisal scores of included studies

Quality of Study

Number of Studies

Percentage

High

15%

Medium

82%

Low

Total

104

100%

3.4 DESCRIPTION OF THE INCLUDED STUDIES

Table 3.2, below, provides the number of studies, when classified by the source from which they were

obtained. The largest proportion of the studies was obtained from the electronic-database search.

Figures 3.1(a) and 3.1(b) also indicate that the evidence was not restricted to journal publications, but

also covers grey sources, such as organisational websites and google scholar etc. Together, studies from

these grey sources accounted for 34% of total studies. References from included studies obtained

through the electronic-database search and personal requests to authors provided 13% of the total

studies. In sum, Table 3.2, below, reflects the extensive search process in identifying the included

studies.

Table 3.2: Studies classified by source

Study source

No. of studies

Percentage

Electronic database

54%

Website search

20%

Cross Reference

Author Correspondence

Google Scholar

12%

Google

Total studies

104

100%

Table 3.3: Studies classified by type

Type of Publication

No. of studies

Percentage

Journal publication

66%

Report

30%

Working paper

Book chapter

Total studies

104

100%

Table 3.3 classifies the included studies by type of publication. Publication type was classified into four

categories: (i) journal publication, if the study was published in an academic journal; (ii) reports, if these

were documents published by agencies such as the World Bank, Asian Development Bank (ADB), and

so on; (iii) working paper, if the study was a work-in-progress document, as cited by the authors; and

(iv) book chapter, if it was a chapter of an edited book. The table shows that close to two-thirds of the

study was journal publications. Since journal publications undergo a peer-review process before they

are published, we assume that the quality of the study would be of a reasonable standard. Reports are

normally prepared for a policy audience, and, therefore, we expect to have evidence that would be of

interest to policymakers. Since the reports were obtained only from those organizations that are known

for their robust evaluations, we expect the evidence from the reports to be of a reasonably high

standard. Reports formed 30% of the total studies. Journal publications and reports together

constituted 96% of the total.

Table 3.4, below, gives the proportion of studies when classified by year of publication. Since

policymakers are the target segment for this review, it helpful would be helpful for the review to

synthesises more recent evidence. It can be seen that more than two-thirds of the studies included in

this review were published in 2006 or later. The review, therefore, includes a high proportion of studies

that have been published recently.

Table 3.4: Studies classified by year of publication

Year of publication

No. of studies

Percentage

2000 & earlier

2001‒05

25%

2006‒10

42%

After 2010

25%

Total studies

104

100%

Table 3.5: Studies classified by sector

Sector

No. of studies

Percentage

Water

74%

Electricity

30%

Sanitation

64%

Total studies

104

100%

The scope of the review covers these broad sectors: water supply, sanitation and electricity supply.

Table 3.5, above, gives the number of studies in each of the sectors. Since many studies cover more

than one sector, they have been included in each of the sectors; therefore, the summation of the

studies in all the sectors is more than the total number of studies. It can be seen that studies on water

supply account for the highest proportion of the studies, followed by the studies on sanitation. This, in

a way, also reflects the situation on the ground: while electricity connections are widely available to

slum-dwellers and low-income groups, it is not the case as far as water supply and sanitation are

concerned. Therefore, literature has a higher number of studies that focus on access to water supply

and sanitation, which is also reflected in our evidence base.

Table 3.6 shows the classification based on the data used in the studies. Seventy four percent of the

studies have used primary data, which can be surveys, interviews, focus-group discussion, and so on.

Secondary sources include use of existing data sources, such as various national surveys, household and

demographic surveys, and so on. We felt that having a large number of primary studies would help us

to put the findings into context, in the narrative synthesis.

Table 3.6: Studies classified by data source

Data source

No. of studies

Percentage

Primary

74%

Secondary

Both

18%

Total studies

104

100%

Table 3.7: Studies classified by type

Study type

No. of studies

Percentage

Quantitative

26%

Qualitative

36%

Mixed-method

38%

Total studies

104

100%

Table 3.7 shows the results when the classification is conducted on the basis of study type. Twenty-

seven studies were classified as quantitative, because they provide data that could be synthesised using

meta-analysis techniques. The remaining studies were classified as either qualitative or mixed-methods

studies. Studies that use interviews, case studies or focus-group discussion in the data-collection

process were classified as qualitative studies. Studies that use survey responses and secondary data

analysis in addition to interviews, case studies, and focus-group discussions were classified as mixed-

methods studies. Since the qualitative and mixed-methods studies provided data that could not be

synthesised appropriately using quantitative techniques, thematic and textual-narrative synthesis was

employed.

Table 3.8: Studies classified by research design

Research design

No. of studies

Percentage

Cross-sectional

61%

before-and-after studies

39%

Total studies

104

100%

Table 3.8 provides details of the included studies when classified on the basis of research design. Studies

were broadly classified into two categories: cross-sectional and before-after/longitudinal studies.

Although a greater number of before-and-after studies would have been desirable for this particular

systematic review, we found a greater number of cross-sectional studies in our list. However, the

appropriateness of the control or comparison sample in the cross-sectional studies has been assessed

in the quality criteria.

Table 3.9, below, lists the studies on the basis of geographical location of the slum or low-income group.

Locations were classified into six geographical regions. Studies were classified as belonging to one or

more of the regions, depending on the location of the slum or low-income locality. When a study was

based on data from slums in different regions, it was counted in each of the regions. However, if a study

used data from more than one slum, and if the slums are in the same region, the study was counted

only once for the respective region. A majority of the studies were based on slums in Asia. Studies that

were based on slums in Africa accounted for the second-highest proportion, followed by studies that

focused on South America.

Table 3.9: Studies classified by regional focus

Table 3.10: List of top 5 countries in the selected studies

Country rank

Top 5 countries

Study count

Percentage

India

35%

Bangladesh

13%

Indonesia

South Africa

Bolivia

Ghana

Philippines

Total studies

104

Region

No. of studies

Percentage

Asia

61%

Africa

27%

South America

19%

Central and North America

Oceania

Eastern Europe

Total studies

104

In terms of number of countries, the included studies were based on data from 34 countries. Table 3.10,

above, lists the top 5 countries and the study count for each of them. India occupies the top slot, as 36

of the 104 studies were based on data from Indian cities. This was followed by Bangladesh, with 13

studies. The other countries in the top 5 are: Indonesia, South Africa, Bolivia, Ghana, and the

Philippines. Table A3.1 in Appendix 3 provides the complete list of 34 countries and the number of

studies on each country.

Table 3.11: List of top 5 cities in the selected studies

City rank

Top 5 cities

Study count

Percentage

Dhaka

13%

Mumbai

Ahmedabad

Jakarta

New Delhi

Kolkata

Total studies

104

In terms of number of cities, a total of 103 cities were covered in the list of included studies. Table 3.11

lists the top 5 cities and the count of studies for each of the cities. Dhaka occupies, the top slot, with 13

studies in the list covering the city. The other cities in the top 5 lists are Mumbai, Ahmedabad, Jakarta,

New Delhi and Kolkata. Table A3.2 in Appendix 3 provides the complete list of 103 cities and the number

of studies on each city. Given the large number of countries and cities covered by the studies included

for this review, it is felt that the synthesis would be fairly extensive.

3.3 SUMMARY

This chapter provides an identification and description of the studies that have been included in this

review. The results of the in-depth review and synthesis of the evidence obtained from these studies is

given in Chapter 4.

4: IN-DEPTH REVIEW: RESULTS

4.1 OVERVIEW

This chapter provides the results of the review. As indicated in Chapter 2, a multi-pronged approach to

synthesis has been used in this review. This chapter presents the results of synthesis from the three

approaches used in the review: numerical summary using a count of evidence approach, meta-analysis

and textual narration.

4.2 NUMERICAL SUMMARY OF EVIDENCE

This section gives the numerical summary of the evidence on access from the 104 studies included in

this review. A total of 568 eassessments of were obtained from all the studies, whether quantitative,

qualitative or mixed methods. Interventions leading to these effects were classified into two groups,

based on the service provider: a top-down approach when government was the primary service

provider, and a bottom-up approach when alternative service providers, such as NGOs, CBOs and the

private sector, delivered the service. There were a total of 270 assessments of effect for the top-down

approach and 298 assessments of effect for the bottom-up approach.

The outcome of the interventions was classified into five categories, as defined below.

1) Positive: Outcomes that resulted in an improvement (from the status quo) in access to basic

services (in either top-down or bottom-up approaches). For example, the following evidence was

classified as positive outcomes:

When there has been an improvement in connectivity as compared to the status quo. For example,

the connectivity coverage increased from x % to y % after a bottom-up intervention.

The effort and time needed to access the service has been reduced. For example, if the effort and

time has been reduced in slum A (the intervention site) as compared to slum B (the control site).

2) Negative: Outcomes that indicate a decline in access. For example, the following evidence would

be classified as a negative outcome:

a) When there has been an increase in the cost of services as a result of a bottom-up approach.

For example, the affordability or cost of service increased from x % to y % after a bottom-up

intervention.

b) The effort and time needed to access the service has increased. For example, if the effort and

time increases in slum A (the intervention site) as compared to slum B (the control site).

3) No impact: When the intervention led to no positive or negative change and the status quo is

maintained, the intervention was considered to have had ‘no impact’. For example, the following

evidence would be classified as having no-impact:

a) When there has been no change in levels in connectivity under either forms of service delivery.

For example, the connectivity coverage remained at the same level of x %, under both top-

down or bottom-up delivery approaches.

b) The effort and time required to access the service remains the same after the intervention as

compared to the control site. For example, if the effort and time in slum A (the intervention

site) remains the same as in slum B (the control site).

4) Inconclusive: When the study did not indicate a clear positive, negative, or no impact, and if the

researcher was unable to draw a clear conclusion from the result, the outcome was classified as

‘inconclusive’.

5) Unclear: In a few studies, the outcomes may be unclear due to inadequate analysis or imprecise

articulation of results. In such situations, the outcome is classified as ‘unclear’.

It has to be understood that an intervention may have a varying impact on the different dimensions of

access. For instance, a positive improvement in connectivity may result in a negative outcome in

affordability, indicating that the new (or improved) connection comes at a higher cost. Similarly, while

connectivity may have improved, the effort and time taken to access the service may have increased.

Therefore, the outcomes or impact were captured separately for each dimension of access for which

the evidence was available.

Section 4.2.1 provides a summary of evidence from top-down approaches and section 4.2.2 summarises

the evidence from bottom-up approaches.

SUMMARY OF EVIDENCE UNDER TOP-DOWN APPROACH

EVIDENCE BY SECTOR

On a very broad level, it was seen (Table 4.2.1) that the proportion of positive effects on outcomes of

access across the three sectors are lower than that of the negative effects in the top-down approach.

This result substantiates the existing claims of inadequate provision of basic services in urban-poor

settlements by governments of LMICs (Water Aid 2008, UN-HABITAT 2003, UN 2013).

Table 4.2.1: Summary of evidence by sector in the top-down approach

Sector

Positive

Negative

No impact

Unclear

Inconclusive

Total

Water

42%, 24

51%, 29

3%, 2

4%, 3

133, 39

Sanitation

28%, 15

61%, 20

9%, 2

1%, 1

67, 32

Electricity

49%, 16

43%, 12

9%, 4

70, 24

Total

40%, 36

51%, 43

4%, 2

4%, 8

270, 59

(Legend: Effects are described as Positive, Negative, No impact, Unclear or Inconclusive. The results are given as

X%, Y, where X% indicates the percentage assessments of effects in that category, and Y indicates the number of

studies that contributed those assessments. Total results are given as P, Q, where P indicates the number of

assessments of effect and Q indicates the number of studies from which those assessmentswere obtained. Since

a single study may contain both positive and negative effects on access, the number of studies for different

effects may not add up to the figure in the Total column.)

Table 4.2.1, above, shows that there are differences in the effectiveness of the top-down approach

between the three sectors. If we go by the proportion of positive effects, government has been

relatively more effective in delivery of electricity, as compared to that of water supply and sanitation.

This could be because, traditionally, the electricity sector is more tightly regulated. It has to be a part

of a network, unlike water and sanitation, which can be standalone facilities. The evidence on sanitation

is the poorest, indicating that the traditional top-down approach has not been very effective in

addressing the sanitation needs of urban-poor communities, due to several factors, such as tenure

security (Winyanti and Lang 2004), lack of connectivity to sewerage mains (Hasan 2006), ownership and

maintenance of infrastructure (Burra et al. 2003), etc., which are discussed further in this section.

We infer from the trend seen in Table 4.2.1 that the scope of developing decentralised facilities is

inversely correlated with the effectiveness of the top-down approach. Among the three sectors, the

sanitation sector has the highest scope for localised facilities (such as standalone household toilets or

community toilets not connected to any sewerage network) and electricity supply has the least scope

for decentralisation because of the need for grid connectivity. However, the proportion of positive

effects is the highest for electricity and the least for sanitation.

EVIDENCE BY DIFFERENT COMPONENTS OF ACCESS

Table 4.2.2 provides the summary of evidence for different components of access under the top-down

approach. It can be seen that the largest number of assessments of effect are on connectivity.

Nevertheless, there are also a reasonable number of assessments for adequacy, affordability, and effort

and time. An interesting pattern could be seen in Table 4.2.2. While there has been a high proportion

of positive effects on the connectivity dimension, it has not been the case on others dimensions of

access. This shows that, while government accords a high priority to connectivity, the track record is

often poor on other dimensions of access (Burra et al. 2003). This can be seen as one of the failures in

governmental mode of delivery — access is largely considered as provision of connectivity, with less

importance accorded to other components of access. Poor access may also be the result of ad hoc

provisioning of basic services by the government, with little or no planning as regards the location,

number of units, cost of service, and so on, which are crucial for the longevity of the infrastructure and

its use (Kifanyi et al. 2013, Devas and Korbe 2000, McFarlane 2009, Chauhan and Lal 1999, Joshi 2005).

While the numbers of negative assessments of effect are quite high in all other components of access,

they are noticeably higher for adequacy and effort and time. These two components of access are more

relevant in the water and sanitation sectors. The urban poor are forced to travel long distances to

collect water or use a toilet and, often, these access points are so few and overcrowded that it further

affects the availability and quality of service. In the case of toilets, overcrowding results in open

defecation (Kifanyi et al. 2013, Burra et al. 2003). Unlike electricity, where the slum dweller is able to

use alternative forms of energy, such as kerosene, firewood, coal, etc., for cooking and lighting

purposes, alternatives to water and sanitation facilities are not available to the slum dweller.

The results from Table 4.2.2 lead us to infer that, in a top-down approach, connectivity occupies a

priority role as compared to other outcomes of access. The numbers of assesments of effect on

durability and sustainability are very low, indicating that effects on these dimensions are studied less

frequently than those of connectivity.

Table 4.2.2: Summary of evidence under top-down approach for different

components of access

Dimension of Access

Positive

Negative

No impact

Unclear

Inconclusive

Total

Connectivity

53%, 32

46%, 30

1%, 2

158, 54

Adequacy

23%, 8

66%, 18

2%, 1

9%, 3

44, 22

Affordability

25%, 7

55%, 9

8%, 2

13%, 4

40, 19

Effort and time

24%, 3

71%, 9

6%, 1

17, 12

Durability

20%, 2

60%, 1

10, 5

Sustainability

100%, 1

1, 1

Total

40%, 36

51%, 43

4%, 2

4%, 8

270, 59

(Legend: Effects are described as Positive, Negative, No impact, Unclear or Inconclusive. The results are given as

X%, Y, where X% indicates the percentage assessments of effects in that category, and Y indicates the number of

studies that contributed those assessments. Total results are given as P, Q, where P indicates the number of

assessments of effect and Q indicates the number of studies from which those assessmentswere obtained. Since a

single study may contain both positive and negative effects on access, the number of studies for different effects

may not add up to the figure in the Total column.)

EVIDENCE BY TYPE OF SLUM

Table 4.2.3, below, presents the evidence by type of slum under the top-down approach. It can be seen

that the highest number of assessments of effect is for the informal slums. This indicates that the theme

of informal slums has attracted strong research interest. While formal slums may have recourse to

various channels to seek access to services, informal and illegal slums may not have such opportunities.

Table 4.2.3: Summary of evidence for different slum types under a top-down

approach

Type of slum

Positive

Negative

No impact

Unclear

Inconclusive

Total

Slum - formal

56%, 12

37%, 12

7%, 1

75, 17

Slum - informal

40%, 21

55%, 30

4%, 2

2%, 3

139, 39

Low-income

households

21%, 8

63%, 7

16%, 5

56, 14

Total

40%, 36

51%, 43

4%, 2

4%, 8

270, 59

(Legend: Effects are described as Positive, Negative, No impact, Unclear or Inconclusive. The results are given as

X%, Y, where X% indicates the percentage assessments of effects in that category, and Y indicates the number of

studies that contributed those assessments. Total results are given as P, Q, where P indicates the number of

assessments of effect and Q indicates the number of studies from which those assessmentswere obtained. Since a

single study may contain both positive and negative effects on access, the number of studies for different effects

may not add up to the figure in the Total column.)

Table 4.2.3, above, also shows that the proportions of positive effects are the highest for formal slums

and the lowest for low-income households. A possible reason for the low percentage of positive

evidence in the informal slums could be the reluctance by the government agencies that provisioning

of basic services could lead to claims on legal status and tenure security of the slums (Winyanti and

Lang 2004, Burra et al. 2003, Baruah 2010). Alternative service providers and slum-dwellers themselves

are also hesitant to invest in infrastructure in informal/unrecognised slums, for fear of eviction or

demolition (Kranti and Rao 2009, Ghafur 2000). Studies show that occupants in informal slums refrain

from spending on home improvements due to eviction/demolition (Winayanti and Lang 2004). In the

case of the low-income group, the low proportion of positive evidence could be attributed to the

disaggregated and unorganised nature of the settlements, resulting in the absence of a strong

representation to demand access to basic services.

EVIDENCE BY REGION

Table 4.2.4, below, provides the evidence for top-down approaches for different regions. The highest

number of effects has been for Asia, followed by Africa and South America, in that order. The

prevalence of slums is the highest in these regions and our evidence is, therefore, representative of

that prevailing situation.

Table 4.2.4: Summary of evidence by region under top-down approach

Region

Positive

Negative

No impact

Unclear

Inconclusive

Total

Africa

19%, 7

73%, 11

8%, 4

59, 16

Asia

49%, 25

43%, 30

5%, 2

2%, 3

186, 38

Central and North

America

100%, 1

6, 1

Eastern Europe

100%, 1

3, 1

Middle East

Oceania

100%, 1

2, 1

South America

43%, 4

36%, 3

21%, 1

14, 6

Total

40%, 36

51%, 43

4%, 2

4%, 8

270, 59

(Legend: Effects are described as Positive, Negative, No impact, Unclear or Inconclusive. The results are given as

X%, Y, where X% indicates the percentage assessments of effects in that category, and Y indicates the number of

studies that contributed those assessments. Total results are given as P, Q, where P indicates the number of

assessments of effect and Q indicates the number of studies from which those assessmentswere obtained. Since a

single study may contain both positive and negative effects on access, the number of studies for different effects

may not add up to the figure in the Total column.)

The results in Table 4.2.4, above, show strong variation across regions. The proportion of positive

evidence is markedly low for the African region as compared to that of Asia and South America. This

indicates that the track record of the governments in Africa in providing basic services to slums and

low-income groups has been poor. However, studies show this shortcoming in government provisioning

has been addressed to some extent with the involvement of external actors, such as ODA, NGOs and

the private sector in provisioning basic services, especially in the water sector in Africa (Kagaya and

Franceys 2008). However, governments in Asia and South America have been more successful in

adopting innovative models to provide access to the poor (Connors 2005, Ahmed and Sohail 2003,

Hardoy and Schusterman 2000).

EVIDENCE BY TYPE OF FACILITY

Access to basic services was also analysed by type of facility: (i) private, household facility, or (ii) public,

community facility. Table 4.2.5, below, provides the evidence summary by type of facility under a top-

down approach. The highest number of assessment of effects is for household facilities, indicating that

study of the provision of private access has been the focus for a large number of studies in the evidence

base. It can also be seen that the proportion of positive evidence is higher for access to community

facilities as compared to access to household facilities. There may be several reasons for a higher

prevalence of community-level connections. Low-income and slum settlements are often not

connected to the main water supply and sewerage network due to legal and land-titling problems. As

a result, extending household-level connections in these areas requires large investments in the

creation of new networks in already congested locations. Large investments lead to high connections

costs, which prohibit users from taking individual connections and seeking group connections (Hardoy

and Schusterman 2000, Weitz and Franceys 2002). In the case of sanitation, due to space constraints,

construction of individual toilets in slums may not be possible. Therefore, it is common practice to share

toilets among a few neighbours and/or use community toilets constructed by CBOs or the government

(Burra et al. 2003).

Table 4.2.5: Summary of evidence by type of facility under a top-down approach

Type of facility

Positive

Negative

No impact

Unclear

Inconclusive

Total

Household

39%, 29

54%, 35

2%, 1

5%, 7

209, 49

Community

46%, 10

43%, 10

10%, 2

2%, 1

61, 16

Total

40%, 36

51%, 43

4%, 2

4%, 8

270, 59

(Legend: Effects are described as Positive, Negative, No impact, Unclear or Inconclusive. The results are given as

X%, Y, where X% indicates the percentage assessments of effects in that category, and Y indicates the number of

studies that contributed those assessments. Total results are given as P, Q, where P indicates the number of

assessments of effect and Q indicates the number of studies from which those assessmentswere obtained. Since a

single study may contain both positive and negative effects on access, the number of studies for different effects

may not add up to the figure in the Total column.)

EVIDENCE BY LEVEL OF PARTICIPATION

Table 4.2.6, below, provides the evidence by level of participation of the slum-dwellers in the planning

and implementation of the projects. It can be seen that the numbers of assessments of effect are

substantially higher for those instances where there has been no or very limited involvement of the

slum-dwellers. This indicates that the top-down approach has not been very conducive to community

participation, despite the theoretical benefits associated with such participation. However, where there

has been some level of involvement, the results have been encouraging. Sites that have some level of

involvement on the part of dwellers have a higher percentage of positive evidence as compared to sites

where there has been no participation from the dwellers (38%). This shows that even government

provisioning of services can be more successful if the planning and implementation of projects is

undertaken in consultation with the beneficiaries or involves beneficiary participation (Connors 2005,

McFarlane 2009).

Table 4.2.6: Summary of evidence by level of participation under top-down

approach

Level of

participation

Positive

Negative

No impact

Unclear

Inconclusive

Total

Limited or no

participation

38%, 32

57%, 41

5%, 8

227, 54

Active community

participation

53%, 5

23%, 7

23%, 2

43, 10

Total

40%, 36

51%, 43

4%, 2

4%, 8

270, 59

(Legend: Effects are described as Positive, Negative, No impact, Unclear or Inconclusive. The results are given as

X%, Y, where X% indicates the percentage assessments of effects in that category, and Y indicates the number of

studies that contributed those assessments. Total results are given as P, Q, where P indicates the number of

assessments of effect and Q indicates the number of studies from which those assessmentswere obtained. Since a

single study may contain both positive and negative effects on access, the number of studies for different effects

may not add up to the figure in the Total column.)

EVIDENCE BY STUDY DESIGN

Research design of the studies included in the review can be broadly classified into two categories: (i)

longitudinal studies and (ii) cross-sectional studies. While cross-sectional studies compare the evidence

with respect to non-slums, before-and-after (or longitudinal) studies compare the evidence on access

over time, or after the intervention. Table 4.2.7, below, provides evidence by research design for

provisioning of services under a top-down approach. The proportion of negative effects in cross-

sectional studies is higher than those reporting positive effects, with the overal level of access to basic

services lower in slum and poor areas than in non-slum and better-off neighbourhoods. However, the

proportion of positive effects is relatively higher in longitudinal studies. It may be that, over time, access

has improved in slums, even under government provision of services. However further exploration via

sub-group analysis would be required to confirm this.

Table 4.2.7: Summary of evidence by study design for top-down approach

Type of study

Positive

Negative

No impact

Unclear

Inconclusive

Total

Longitudinal

55%, 11

30%, 6

14%, 2

3%, 1

69, 13

Cross-sectional

35%, 25

59%, 37

6%, 8

201, 46

Total

40%, 36

51%, 43

4%, 2

4%, 8

270, 59

(Legend: Effects are described as Positive, Negative, No impact, Unclear or Inconclusive. The results are given as

X%, Y, where X% indicates the percentage assessments of effects in that category, and Y indicates the number of

studies that contributed those assessments. Total results are given as P, Q, where P indicates the number of

assessments of effect and Q indicates the number of studies from which those assessmentswere obtained. Since

a single study may contain both positive and negative effects on access, the number of studies for different

effects may not add up to the figure in the Total column.)

EVIDENCE BY STUDY TYPE

We also present the evidence by study type. Table 4.2.8, below, provides the evidence by study type

for the top-down approach. The percentage of positive effects is lower for quantitative studies. The

number of positive assessments of effect is likely to be lower. A significant proportion of the evidence

base (22%) is from quantitative studies..

Table 4.2.8: Summary of evidence by study type for top-down approach

Study type

Positive

Negative

No impact

Unclear

Inconclusive

Total

Quantitative

40%, 8

52%, 12

8%, 3

60, 15

Qualitative

53%, 14

36%, 12

11%, 2

89, 19

Mixed-methods

31%, 14

63%, 19

6%, 5

121, 25

Total

40%, 36

51%, 43

4%, 2

4%, 8

270, 59

(Legend: Effects are described as Positive, Negative, No impact, Unclear or Inconclusive. The results are given as

X%, Y, where X% indicates the percentage assessments of effects in that category, and Y indicates the number of

studies that contributed those assessments. Total results are given as P, Q, where P indicates the number of

assessments of effect and Q indicates the number of studies from which those assessmentswere obtained. Since

a single study may contain both positive and negative effects on access, the number of studies for different

effects may not add up to the figure in the Total column.)

SUMMARY OF EVIDENCE FOR BOTTOM-UP APPROACH

EVIDENCE BY SECTOR

In comparison to the evidence for the top-down approach, the proportion of positive effects is higher

across all the three sectors in the bottom-up approach. This result shows that poor communities, which

are often neglected by the government, can be better served by alternative service providers such as

NGOs, CBOs, the private sector, and so on. Where governments have failed to intervene due to lack of

political commitment, legal hurdles, or lack of finance, the alternative service providers have stepped

in to provide services (Hasan 2006, Burra et al. 2003, Chauhan and Lal 1999, Hobson 2000).

Table 4.2.9: Summary of evidence under bottom-up approach

Sector

Positive

Negative

No impact

Unclear

Inconclusive

Total

Water

53%, 37

43%, 28

1%, 1

3%, 5

145, 44

Sanitation

55%, 41

43%, 32

1%, 1

131, 44

Electricity

64%, 6

36%, 3

22, 7

Total

55%, 56

42%, 47

1%, 2

0%, 1

2%, 5

298, 66

(Legend: Effects are described as Positive, Negative, No impact, Unclear or Inconclusive. The results are given as

X%, Y, where X% indicates the percentage assessments of effects in that category, and Y indicates the number of

studies that contributed those assessments. Total results are given as P, Q, where P indicates the number of

assessments of effect and Q indicates the number of studies from which those assessmentswere obtained. Since a

single study may contain both positive and negative effects on access, the number of studies for different effects

may not add up to the figure in the Total column.)

Table 4.2.9, above, shows a significant increase in the proportion of positive effects in sanitation (from

28% in the top-down approach to 55% in bottom-up approach), indicating that the bottom-up approach

that involves the private sector and other organizations may play an effective role in improving access

to sanitation. The proportion of positive effects has also increased for water supply and electricity, but

not in the same way as seen in the case of sanitation. Since provision of sanitation facilities have been

grossly neglected in several LMICs, there has been greater thrust in involving alternative service

providers to address this problem using innovative and low-cost technology, as well as community

participation (Weitz and Franceys 2002, Khandekar and Badrunnessa 2006). The results also show that,

as the scope for decentralised facilities increases, the effectiveness of the bottom-up approach also

increases.

EVIDENCE ON DIFFERENT DIMENSIONS OF ACCESS

Table 4.2.10, below, gives the evidence on different dimensions of access. The proportion of positive

effects is higher for all dimensions of access, except affordability, indicating initial effectiveness of the

bottom-up approach in improving access. It can be seen that alternative service providers, or use of a

bottom-up approach, resulted in an improvement, not only in connectivity, but also in other dimensions

of access. The proportion of the positive evidence for adequacy, which was 23% under a top-down

approach, increased to 52% under a bottom-up approach. The proportion of positive evidence for

affordability increased from 25% to 36%. In the case of effort and time, the increase was from 24% to

72%. On the dimension of durability, the proportion of positive evidence increased from 20% to 58%.

However, the proportion of effects on durability is considerably less. Our results show that involvement

of NGOs, CBOs, and other forms of private-sector participation lead to a more holistic improvement in

access to basic services. Studies show that alternative service providers aim to understand the problems

faced by poor communities before offering the solution. Hence, the involvement of the community in

planning, design and implementation phases of the infrastructure aids in improving not only

connectivity, but also other dimensions of access (Burra et al. 2003; Water Aid India 2008, Hobson,

2008).

Table 4.2.10: Summary of evidence for bottom-up approach for different

components of access

Dimension of Access

Positive

Negative

No impact

Unclear

Inconclusive

Total

Connectivity

57%, 57

41%, 27

2%, 4

193, 62

Adequacy

52%, 16

48%, 11

31, 21

Affordability

36%, 9

55%, 20

5%, 2

2%, 1

2%, 5

42, 27

Effort and time

72%, 9

22%, 3

6%, 1

18, 11

Durability

58%, 6

42%, 3

12, 9

Sustainability

100%, 1

2, 1

Total

55%, 56

42%, 47

1%, 2

0%, 1

2%, 5

298, 66

(Legend: Effects are described as Positive, Negative, No impact, Unclear or Inconclusive. The results

are given as X%, Y, where X% indicates the percentage assessments of effects in that category, and Y

indicates the number of studies that contributed those assessments. Total results are given as P, Q,

where P indicates the number of assessments of effect and Q indicates the number of studies from

which those assessmentswere obtained. Since a single study may contain both positive and negative

effects on access, the number of studies for different effects may not add up to the figure in the Total

column.)

EVIDENCE BY TYPE OF SLUM

Table 4.2.11, below, gives the findings by type of slum. The proportion of positive effects is higher than

that of the negative effects for all slum types, indicating the higher impact of a bottom-up approach in

general. The number of effects pertaining to formal slums is, however, considerably lower, indicating

that most of the bottom-up initiatives have focused on informal slums and low-income households.

Table 4.2.11: Summary of evidence for different slum types under bottom-up

approach

Type of slum

Positive

Negative

No impact

Unclear

Inconclusive

Total

Slum - formal

62%, 7

31%, 4

4%, 1

26, 9

Slum - informal

51%, 34

47%, 31

1%, 1

2%, 3

187, 43

Low-income

households

61%, 19

36%, 14

1%, 1

85, 19

Total

55%, 56

42%, 47

1%, 2

0%, 1

2%, 5

298, 66

(Legend: Effects are described as Positive, Negative, No impact, Unclear or Inconclusive. The results are given as

X%, Y, where X% indicates the percentage assessments of effects in that category, and Y indicates the number of

studies that contributed those assessments. Total results are given as P, Q, where P indicates the number of

assessments of effect and Q indicates the number of studies from which those assessmentswere obtained. Since a

single study may contain both positive and negative effects on access, the number of studies for different effects

may not add up to the figure in the Total column.) The magnitude of the increase in the proportion of positive

effects (when compared to a top-down approach) differs between three segments. The highest increase

was observed for low-income households (about 40%), followed by informal slums (about 11%). For

formal slums, the increase in the proportion of positive evidence has been only about 6%. This shows

that alternative approaches to delivery of services have been more effective in informal slums and low-

income groups. Since formal slums can seek legal access to basic services based on tenure security, the

need for intervention by alternative service providers is lower. Whereas informal and low-income

groups are unable to seek legal connections from the government and, therefore, access services

provided by NGOs, CBOs and other local service providers play an important role.

EVIDENCE BY REGION

Table 4.2.12, below, shows the results in different regions for a bottom-up approach. Although there

has been a strong increase in the percentage of positive effects in Africa when compared to a top-down

approach, the percentage of negative effects is still higher. This highlights the difficulties involved in the

provision of basic services in the African region. Between Asia and South America, a bottom-up

approach has yielded better results in the latter then in the former. The proportion of positive effects

increased to 67% in South America under the bottom-up approach, as compared to 43% under a top-

down approach. This could be a result of increasing privatisation of water services in South America

(Almansi 2009, Foster and Araujo 2004, Hardoy and Schusterman 2000). The corresponding

percentages for Asia are 56% and 49%, respectively. Our results highlight that the impact of using a

bottom-up approach has not been uniform across regions.

Table 4.2.12: Summary of evidence by region in bottom-up approach

Region

Positive

Negative

No impact

Unclear

Inconclusive

Total

Africa

43%, 16

56%, 16

2%, 1

61, 18

Asia

56%, 40

41%, 29

1%, 2

1%, 1

2%, 2

178, 40

Central and North America

44%, 1

56%, 1

9, 1

Eastern Europe

Middle East

100%, 1

1, 1

Oceania

South America

67%, 10

29%, 7

4%, 1

49, 12

Total

55%, 56

42%, 47

1%, 2

0%, 1

2%, 5

298, 66

(Legend: Effects are described as Positive, Negative, No impact, Unclear or Inconclusive. The results are given as

X%, Y, where X% indicates the percentage assessments of effects in that category, and Y indicates the number of

studies that contributed those assessments. Total results are given as P, Q, where P indicates the number of

assessments of effect and Q indicates the number of studies from which those assessmentswere obtained. Since a

single study may contain both positive and negative effects on access, the number of studies for different effects

may not add up to the figure in the Total column.)

EVIDENCE BY TYPE OF FACILITY

Table 4.2.13, below, shows the evidence by type of facility. There has been a substantial increase in the

percentage of positive effects for community-level access under a bottom-up approach (67%); this

compares with the top-down approach of 46%. However, the increase in positive evidence for

household-level access has been more modest (from 39% to 50%). Our results indicate that the dense

agglomeration of dwellings in slums make it difficult to provide household-level connections to basic

services, as compared with community-level access (Devas and Korbe 2000, Ghafur 2000, Joshi 2005).

Besides this, alternative service providers (with the exception of private-sector companies) often do

not have the necessary capital for network expansion, or the legal mandate to provide individual

household connections. Therefore, community connections are more feasible under the bottom-up

approach.

Table 4.2.13: Summary of evidence by type of service under bottom-up approach

Level of access

Positive

Negative

No impact

Unclear

Inconclusive

Total

Household

50%, 36

48%, 35

0%, 1

2%, 3

208, 44

Community

67%, 29

30%, 18

1%, 1

90, 27

Total

55%, 56

42%, 47

1%, 2

0%, 1

2%, 5

298, 66

(Legend: Effects are described as Positive, Negative, No impact, Unclear or Inconclusive. The results are given as

X%, Y, where X% indicates the percentage assessments of effects in that category, and Y indicates the number of

studies that contributed those assessments. Total results are given as P, Q, where P indicates the number of

assessments of effect and Q indicates the number of studies from which those assessmentswere obtained. Since a

single study may contain both positive and negative effects on access, the number of studies for different effects

may not add up to the figure in the Total column.)

EVIDENCE BY LEVEL OF PARTICIPATION

Table 4.2.14, below, shows the evidence for community participation. In interventions where there has

been more active participation by the beneficiaries (slum-dwellers), the proportion of positive effects

is higher. It shows that involving the beneficiaries in the planning and implementation lead to better

results. If we look at the evidence in terms of community participation, there are proportionately more

positive assessments of effect for a bottom-up approach than for a top-down approach. Only 43 out of

the 270 assessment of effects (15%) show some degree of participation on the part of the beneficiaries

under a top-down approach, but, in the case of a bottom-up approach, 114 out of the 298 assessments

of effect (that is, 38%) show some degree of participation on the part of the beneficiaries. This shows

that alternative and non-governmental forms of service provision lead to better participation from the

beneficiaries.

Table 4.2.14: Summary of evidence by level of participation under bottom-up

approach

Level of participation

Positive

Negative

No impact

Unclear

Inconclusive

Total

Limited or no

participation

52%, 38

46%, 31

1%, 1

2%, 3

184, 44

Consultation,

Contribution and

Providing information

64%, 21

32%, 10

2%, 1

53, 18

Partnership and

Self-mobilisation

56%, 10

41%, 15

1%, 1

2%, 1

61, 21

Total

55%, 56

42%, 47

1%, 2

0%, 1

2%, 5

298, 66

(Legend: Effects are described as Positive, Negative, No impact, Unclear or Inconclusive. The results are given as

X%, Y, where X% indicates the percentage assessments of effects in that category, and Y indicates the number of

studies that contributed those assessments. Total results are given as P, Q, where P indicates the number of

assessments of effect and Q indicates the number of studies from which those assessmentswere obtained. Since a

single study may contain both positive and negative effects on access, the number of studies for different effects

may not add up to the figure in the Total column.)

Several case studies from Asia and Africa provide ample evidence to substantiate the effectiveness of

community participation in provision of basic services (Weitz and Franceys 2002, Hassan 2006,

McFarlane 2009, WaterAid 2008, Kagaya and Mwanamwambwa 2006). However, one major drawback

of this approach is the scalability of efforts and sustained participation of the community members in

maintaining the infrastructure created, even after the exit of the NGO from the community (Kifanyi et

al. 2013, Tukhairwa and Oosterveer 2011, Russ and Takahashi 2013).

EVIDENCE BY STUDY DESIGN

Table 4.2.15, below, provides the evidence by research design under a bottom-up approach. Before-

after/longitudinal studies show the result of deploying a bottom-up approach over time. In before-and

after studies where there has been no change in the service provider, the level of access is compared

over time in a bottom-up implementation. In longitudinal studies, the level of access is compared before

and after the implementation of a bottom-up approach. In both cases, the proportion of positive

evidence is significantly higher, indicating that the effect of changing over to a bottom-up approach

from top-down provisioning has been positive. Additionally, the level of access in the bottom-up

approach has also improved with time. However, the evidence from cross-sectional studies indicates a

slightly higher proportion of negative effects. Cross-sectional studies compare the level of access

between slums, with one slum having top-down provisioning and the other bottom-up provisioning.

The lower level of positive effects could be attributed to the following: slums not serviced by the

governmental agencies start with a handicap in terms of a difficult contextual environment. Providing

basic services to such slums can be a lot more difficult as compared to slums that are already serviced

by government agencies. Therefore, cross-sectional studies could have a higher proportion of negative

effects because of the inherent features of the research design.

Table 4.2.15: Summary of evidence by study design for bottom-up approach

Type of study

Positive

Negative

No impact

Unclear

Inconclusive

Total

Before-after/

Longitudinal

68%, 23

29%, 19

2%, 2

1%, 1

115, 28

Cross-sectional

46%, 33

51%, 28

3%, 4

183, 38

Total

55%, 56

42%, 47

1%, 2

0%, 1

2%, 5

298, 66

(Legend: Effects are described as Positive, Negative, No impact, Unclear or Inconclusive. The results are given as

X%, Y, where X% indicates the percentage assessments of effects in that category, and Y indicates the number of

studies that contributed those assessments. Total results are given as P, Q, where P indicates the number of

assessments of effect and Q indicates the number of studies from which those assessmentswere obtained. Since a

single study may contain both positive and negative effects on access, the number of studies for different effects

may not add up to the figure in the Total column.) However, the higher proportion of positive evidence

under non-government provision in the table above shows that improvement in access can be much

faster with the involvement of NGOs, CBOs and the private sector.

SUMMARY OF EVIDENCE BY STUDY TYPE

Table 4.2.16, below, provides the evidence by study type for a bottom-up approach. As expected, the

percentage of positive evidence is lower for quantitative studies. However, when compared to the

evidence for the top-down approach (Table 4.2.8), it can be seen that bottom-up provisioning of

services has led to an increase in the percentage of positive effects for all study types. More than one-

third of the assessments of effect (34%) are from quantitative studies, which indicates the strength of

the evidence base.

Table 4.2.16: Summary of evidence by study type for bottom-up approach

Study type

Positive

Negative

No impact

Unclear

Inconclusive

Total

Quantitative

45%, 16

52%, 15

3%, 2

100, 18

Qualitative

64%, 22

34%, 16

1%, 1

107, 24

Mixed-methods

54%, 18

42%, 16

1%, 1

3%, 3

91, 24

Total

55%, 56

42%, 47

1%, 2

0%, 1

2%, 5

298, 66

(Legend: Effects are described as Positive, Negative, No impact, Unclear or Inconclusive. The results are given as

X%, Y, where X% indicates the percentage assessments of effects in that category, and Y indicates the number of

studies that contributed those assessments. Total results are given as P, Q, where P indicates the number of

assessments of effect and Q indicates the number of studies from which those assessmentswere obtained. Since a

single study may contain both positive and negative effects on access, the number of studies for different effects

may not add up to the figure in the Total column.)

SUMMARY OF EVIDENCE BASED ON QUALITY APPRAISAL

As mentioned in Chapter 2, all the studies selected for the review were appraised for quality. Table

4.2.17, below, provides the quality-appraisal ratings of the evidence base. It can be noted that the bulk

of the evidence was from studies that were rated as medium in the quality appraisal. The number of

reported effects from studies that were rated low is much less (less than 5% of the total assessments

of effects). An interesting trend that could be seen is that the proportion of positive effects is more or

less the same for high, medium and low ratings.

Table 4.2.17: Summary by strength of evidence: Overall evidence base

Strength of

evidence

Positive

Negative

No impact

Unclear

Inconclusive

Total

High

47%,14

47%,15

7% ,3

86,16

Medium

48%,65

47%,62

0% ,2

2% ,2

3% ,8

457,85

Low

48%, 1

40%,2

8% ,1

4% ,1

25,3

Total

48% ,80

47% ,79

0% ,2

2% ,3

3% ,12

568 ,104

(Legend: Effects are described as Positive, Negative, No impact, Unclear or Inconclusive. The results are given as

X%, Y, where X% indicates the percentage assessments of effects in that category, and Y indicates the number of

studies that contributed those assessments. Total results are given as P, Q, where P indicates the number of

assessments of effect and Q indicates the number of studies from which those assessmentswere obtained. Since a

single study may contain both positive and negative effects on access, the number of studies for different effects

may not add up to the figure in the Total column.)

Table 4.2.18 summarises the strength of evidence separately for a top-down approach. On the whole,

it can be seen that the proportion of the positive effects from studies rated high is more or less equal

to that of studies rated medium. More robust studies, in general, are expected to show a more

conservative estimate of positive impact and our strength-of-evidence results are consistent with this

expectation. Since there are very few studies with a low rating, we do not comment on the trends seen

for assessments of effect with a low rating.

Table 4.2.18: Summary by strength of evidence: top-down approach

Strength of

Evidence

Positive

Negative

No impact

Unclear

Inconclusive

Total

High

41% ,4

41%,5

17% ,2

29, 6

Medium

40%,31

54%,36

4% ,1

3% ,6

224,51

Low

47%,1

41%, 2

12% ,1

17,2

Total

40%, 36

51%, 43

4%, 2

4%, 8

270, 59

(Legend: Effects are described as Positive, Negative, No impact, Unclear or Inconclusive. The results are given as

X%, Y, where X% indicates the percentage assessments of effects in that category, and Y indicates the number of

studies that contributed those assessments. Total results are given as P, Q, where P indicates the number of

assessments of effect and Q indicates the number of studies from which those assessmentswere obtained. Since a

single study may contain both positive and negative effects on access, the number of studies for different effects

may not add up to the figure in the Total column.)

Table 4.2.19, below, summarises the strength of evidence separately for a bottom-up approach. The

pattern seen for evidence from a bottom-up approach is very similar to that of a top-down approach.

In summary, the standard of the quality of the evidence is good and the findings for high and

medium-quality studies are as expected.

Table 4.2.19: Summary by strength of evidence: bottom-up approach

Strength of

Evidence

Positive

Negative

No impact

Unclear

Inconclusive

Total

High

49% ,11

49%, 11

2%,1

57,11

Medium

56% ,44

41%, 35

1%,2

0% ,1

42%,3

233, 53

Low

50%, 1

38%, 1

13%,1

8, 2

Total

55%, 56

42%, 47

1%, 2

0%, 1

2%, 5

298, 66

(Legend: Effects are described as Positive, Negative, No impact, Unclear or Inconclusive. The results are given as

X%, Y, where X% indicates the percentage assessments of effects in that category, and Y indicates the number of

studies that contributed those assessments. Total results are given as P, Q, where P indicates the number of

assessments of effect and Q indicates the number of studies from which those assessmentswere obtained. Since a

single study may contain both positive and negative effects on access, the number of studies for different effects

may not add up to the figure in the Total column.)

SUMMARY OF THE NUMERICAL DESCRIPTION

The numerical summary of the 568 assessments of effect obtained from the 104 studies included in this

review shows interesting trends. The findings from the studies investigating the impact of using bottom-

up or alternative approaches for delivery of basic services to urban slums has suggested a positive

impact, as seen in the higher proportions of positive impact for the bottom-up approach (55%), as

compared to a top-down approach (40%). While connectivity is accorded priority under a top-down

approach, involvement of alternative channels in the bottom-up approach results in improvement

across other dimensions of access, such as adequacy, affordability, effort and time and durability. The

positive impact of adopting a bottom-up approach is also higher in informal slums and unorganised

low-income neighbourhoods. In terms of region, the maximum impact of a bottom-up approach was

seen in South America and Africa, whereas, in the case of Asia, the impact has been marginal. In terms

of access, involvement of NGOs and CBOs has been more effective when the access was for public and

community facilities, rather than private and household facilities. The proportion of positive evidence

increases when there is some form of participation from the beneficiaries. Based on the number of

assessments of effect present, it suggests that use of a bottom-up approach facilitates community

participation more than does the use of top-down government provision of services. While access to

basic services has improved in slums, even under top-down provision of services, over time, a bottom-

up approach can accelerate improvement.

4.3 META-ANALYSIS RESULTS

Among the 104 studies included in the review, data that could be synthesised using meta-analysis

techniques was obtained from 27 studies. These 27 studies yielded 100 assessments of effect.

Depending on the data available, they were synthesised either as odds ratio (when the effect was

measured in proportion) or SMD (when the data was available as mean with standard deviation). Table

4.3.1 gives the number of measures for proportion and mean and standard deviation.

Table 4.3.1: Listing of evidence used for meta-analysis by type of measurement

S. No.

Type of measurement

No. of evidence

Proportions

Mean and Standard deviation

Total

100

Multiple measures were obtained from each study, depending on the type or number of services,

segments, component of access being measured, and so on. Table 4.3.2, below, provides the number

of measures obtained from each of the 27 studies. In five studies, we had more than seven measures

each; six studies provided between four and six measures; and the remaining 16 studies provided fewer

than three measures each. If there was more than one evidence on an outcome using the dataset, only

the most robust evidence was taken for analysis. Avoiding multiple measures for the same outcome

using the same dataset ensured independence of observations. This section presents the results of

meta-analysis.

Table 4.3.2: Number of measures from each study

S. No.

Studies included for meta-analysis

No. of evidence

Ahmad, Choi and Ko (2013)

Daniere and Takahashi (1999)

Das, A (2012)

Das, M (2011)

Field (2005)

Foster and Araujo (2004)

Galiani et al. (2013)

Gulyani, Talukdar and Mukami (2005)

S. No.

Studies included for meta-analysis

No. of evidence

Hailu, Osorio, and Tsukada (2012)

Hanchett (2003)

Islam and Khan (2013)

Israel (2007)

Issaka (2007)

Kayaga and Kadimba-Mwanamwambwa (2006)

Kifanyi et al. (2013)

Kranthi and Rao (2009)

MdAdbul et al. (2013)

Mimmi and Ecer (2010)

Mustafa and Reeder (2009)

Sankar (2005)

Shrestha et al. (2008)

Smith and Hanson (2003)

Stanwix (2009)

Subbaraman et al. (2012)

Snyder et al. (2013)

Tukahirwa et al.(2011)

Zaki and Nurul (2009)

Total

100

Description of studies used in meta-analysis is given in Table 4.3.3, below. Panel A in Table 4.3.3 shows

the evidence by sector. More studies are for water supply, followed by sanitation and electricity. The

pattern of evidence for meta-analysis more or less follows the trend seen in the overall numerical

summary of the evidence of the review. Panel B gives the number of measures of effect for different

components of access. Seventy five percent of the measures are for connectivity, indicating that

connections to basic services is the most frequently measured outcome in various studies. Panel C gives

the evidence by region, where it can be seen that Asia contributes to more than half the number of

measures. Separating the evidence by service-delivery approach, 70 of the measures pertained to

bottom-up approach using alternate service providers and the remaining 30 were for a top-down

approach delivered by government service providers.

Table 4.3.3: Description of the evidence used for meta-analysis

Service approach

Total

Top-down

Bottom-up

Panel A: Evidence by sector

Water

Sanitation

Electricity

Total

100

Panel B: Components of access

Connectivity

Affordability

Adequacy

Effort and time

Total

100

Panel C: Evidence by region

Asia

Africa

South America

Central and North America

Total

100

Given the heterogeneity in the studies, it would not be appropriate to pool it for analysis. We therefore

conducted several subgroup analyses after grouping the evidence under the relevant parameters. The

results are as follows.

EVIDENCE FOR TOP-DOWN APPROACH

In this section, we present the meta-analysis results for the evidence on the top-down approach/service

from public agencies. A top-down or government-led approach is considered as the default approach

for delivery of basic services and the findings of this section help us to conclude whether there are

significant differences in the levels of access between slum and non-slum areas. Meta-analysis has been

carried out only for connectivity and adequacy, as there was just one evidence for affordability and no

evidence for effort and time.

CONNECTIVITY

Figure 4.3.1, below provides the summary forest plot of the meta-analysis for connectivity. Subgroup

analyses for different sectors and by type of facility are also provided in the same graph. The synthesis

compares the evidence on connectivity in slums vis-à-vis non-slums. If the effect size is 1, or not

statistically different from 1, then we interpret that there is no difference in connectivity levels between

slums and non-slums. Our results show that the overall pooled effect size is only 0.63, indicating that

connectivity to basic services in slums is lower than that of non-slum areas. This is as expected, since

the general level of connectivity to basic services in slums would be expected to be poorer than those

of non-poor and non-slum areas. Since the confidence interval of the overall ES does not include 1, it

can be said that the connectivity in slums is significantly lower than for non-slums.

However, the pooled ES from the sub-analysis indicates the variation across different sectors and

facilities. In the case of electricity, the pooled ES indicates that electricity connectivity (legal

connections) in slums is significantly lower than that of non-slums. A possible reason for this could be

the low load demands, low incomes and high connection costs for slum-dwellers (Baruah 2010, Scott

et al. 2013). Electricity utilities are hesitant to supply electricity to slums due to high risks and low

profitability (USAID 2004). The presence of illegal suppliers and illegal connections and the use of

alternative fuels, such as kerosene and liquefied petroleum gas (LPG), to meet energy needs could also

explain the low level of legal electricity connections in slums (Baruah 2010, Shresta et al. 2008).

In the case of water supply and sanitation, the effect size is less than 1 for individual and household

level connectivity, whereas the ES is more than 1 for community connectivity. This shows the greater

prevalence of community-level access to basic services in slums. The topography of slums, often

characterised by narrow streets and alleys, which pose a problem for individual connections, could be

a reason for poor connectivity to individual households (Baruah 2010). It is possible that slum-dwellers

favour group or community connections to individual connections, as the cost of individual connections

are much higher than for community connections, which are often shared among various households

(Weitz and Franceys 2002). However, the confidence intervals for both water supply and sanitation

connectivity indicate that connectivity levels are not significantly different from that of non-slums.

On the whole, therefore, it can be said that, except for electricity connectivity, connectivity to basic

services in slums is not significantly different from that of non-slums under a top-down approach. As

expected, the I-square values indicate that studies are characterised by considerable heterogeneity,

except in the case of community toilets.

Figure 4.3.1: Summary results for connectivity under top-down approach

To find out whether there are differences between regions, we analysed the ES after separating the

evidence by regions. Figure 4.3.2 presents summary forest plots by region. As can be seen, evidence

was not available for all the facilities for each region. Only the evidence that was available for each

region has been summarised. The absence of I-square and p-values for some of the regions indicated

that there was only evidence in that category.

The results indicated that there is significant variation in connectivity levels across regions. For example,

connectivity to individual water pipelines was lower in Africa than in South America and Asia. Further,

in the case of Africa and South America, there was significant difference in the connectivity levels

between slums and non-slums. The evidence for community water connections was available only for

the Asian region. The summary ES for the same was 1.13, which indicated that a higher proportion of

those living in Asian slums have community-level connections, as compared to those of non-slums.

However, the confidence interval indicated that the difference was not statistically significant.

Comparing the ES for sewerage connections shows that connectivity levels in South America are

significantly lower in slums, whereas, for Asia, the ES is closer to 1, indicating that connectivity to

sewerage in slums is no different from that of non-slums. ES on community toilets again show that

access is better in Asia (effect size of 1.74) as compared to that of Africa (effect size of 0.36). In general,

connectivity to basic services is higher in Asia (except in the case of electricity) as compared to other

regions across different types of facility. Therefore, a top-down approach has been more effective in

NOTE: Weights are from random effects analysis

Overall (I-squared = 97.1%, p = 0.000)

Subtotal (I-squared = 94.9%, p = 0.000)

Water - Community Tap

Subtotal (I-squared = 92.4%, p = 0.000)

Sanitation - Sewerage

Electricity

Subtotal (I-squared = 54.9%, p = 0.137)

Subtotal (I-squared = 92.2%, p = 0.000)

Subtotal (I-squared = 87.5%, p = 0.000)

Sanitation - Community Toilet

Water - Individual Tap

Evidences

0.63 (0.58, 0.69)

0.71 (0.39, 1.31)

0.71 (0.40, 1.29)

1.12 (0.28, 4.43)

1.13 (0.61, 2.11)

0.42 (0.26, 0.67)

ES (95% CI)

0.63 (0.58, 0.69)

0.71 (0.39, 1.31)

0.71 (0.40, 1.29)

1.12 (0.28, 4.43)

1.13 (0.61, 2.11)

0.42 (0.26, 0.67)

ES (95% CI)

1.226 1 4.43

Ratio favours intervention

some regions (particularly Asia). A possible reason for this could be the overall social and economic

environment in Asian cities that have enabled governments to be more effective in service delivery

when compared to their counterparts in other LMICs. Another factor could be the political significance

of the urban poor, which results in the governing political parties in these regions being keener to

provide them with better facilities. I-square values, however, indicate the heterogeneity of the

evidence, except in the case of evidence pertaining to individual water connections in Africa.

We have also analysed connectivity levels by type of slum under a top-down approach. There were nine

evidence for formal slums, 16 for informal slums, and one for low-income households. Figure 4.3.3,

below, shows the results, which indicate that, in informal slums, the top-down approach has not been

very effective. The connectivity levels are significantly lower in slums than in non-slums. This is as

expected, since tenure insecurity is known to have a direct impact on access to basic services (Almansi

2009). Lack of tenure security is often used by the government as a reason to restrict services

(government programmes and donor-assisted programmes) to the poor, which results in an absence of

investment in poor communities (Winayanti and Lang 2004). Our results are consistent with previous

studies, which show that informal slums that do not have de-facto tenure security have lesser access

to basic services when compared to formal slums that are recognised and enjoy de jure tenure security

(see, for example, Chandrasekar 2005). The government rationale to restrict basic services to informal

slums could, however, be attributed to the need to curb such illegal settlements.

The ES (0.94), as well as the associated confidence interval for formal slums, shows that the process of

recognising the slums as legal settlements leads to better connectivity — a possible reason for this could

be that the process of recognition results in the slums’ being included in the urban-planning process,

which, in turn, leads to better connectivity to basic services. Low-income households show a higher

connectivity compared to informal slums, but a lower connectivity compared to formal slums. While

low-income households are not illegal, as is the case with informal slums, they are dispersed and are

not located in a defined boundary, as are formal slums. Therefore, they might not benefit from the

collective organisation that can exist in slums, which results in lower connectivity. However, our search

has provided only one evidence for low-income households.

We could not analyse the effectiveness of a top-down approach when categorised by level of

community participation, since there was no participation from the slum-dwellers and the community

for any of the evidence.

Fig 4.3.2: Summary results for connectivity in different regions under top-down

approach

NOTE: Weights are from random effects analysis

Overall (I-squared = 97.1%, p = 0.000)

Water - Individual Tap - Africa

Subtotal (I-squared = 74.0%, p = 0.050)

Subtotal (I-squared = .%, p = .)

Sanitation - Sewerage - Asia

Sanitation - Community Toilet - Africa

Evidences

Subtotal (I-squared = .%, p = .)

Electricity - Asia

Subtotal (I-squared = 83.0%, p = 0.003)

Water - Community Tap - Asia

Subtotal (I-squared = 92.2%, p = 0.000)

Electricity - South America

Water - Individual Tap - Asia

Subtotal (I-squared = .%, p = .)

Sanitation - Sewerage - South America

Sanitation - Community Toilet - Asia

Water - Individual Tap - South America

Subtotal (I-squared = .%, p = .)

Subtotal (I-squared = 96.2%, p = 0.000)

Subtotal (I-squared = 94.8%, p = 0.000)

Subtotal (I-squared = 0.0%, p = 0.805)

0.63 (0.58, 0.69)

0.57 (0.36, 0.90)

0.36 (0.05, 2.81)

ES (95% CI)

0.54 (0.54, 0.55)

0.28 (0.12, 0.69)

1.13 (0.61, 2.11)

1.74 (1.36, 2.21)

0.54 (0.53, 0.55)

1.13 (0.38, 3.29)

1.01 (0.24, 4.34)

0.15 (0.08, 0.32)

0.63 (0.58, 0.69)

0.57 (0.36, 0.90)

0.36 (0.05, 2.81)

ES (95% CI)

0.54 (0.54, 0.55)

0.28 (0.12, 0.69)

1.13 (0.61, 2.11)

1.74 (1.36, 2.21)

0.54 (0.53, 0.55)

1.13 (0.38, 3.29)

1.01 (0.24, 4.34)

0.15 (0.08, 0.32)

1.0473 1 21.1

Ratio favours intervention

Figure 4.3.3: Summary results for connectivity by type of slum under top-down

approach

ADEQUACY

Figure 4.3.4, below, summarises the evidence for adequacy. Adequacy was measured by amount of

consumption (water and electricity). Quantity of consumption was measured in kilowatts for electricity

and in litres for water. For both water and electricity, the ES shows that consumption levels in slums

are significantly lower than in non-slums. This is consistent with the prevailing situation: affluent and

non-slum areas would generally have higher levels of consumption, because of the relatively higher

quality of service levels in non-poor areas. However, an interesting finding of our study is the difference

between the electricity and water-supply sectors. The ES show that the difference between slum and

non-slum is much less for electricity, whereas, for water supply, it is quite large. This shows that the

top-down approach has not been as effective in the water sector as in the electricity sector. Poor

performance of government in the water sector can be attributed to various factors, such as

government mismanagement and conflict (Devas and Korboe 2000), poor accountability of local

governments (Devas and Korboe 2000), and unclear responsibilities among government agencies for

service delivery in poor settlements (Connors 2005; Ahmed and Sohail 2003).

Juxtaposing the evidence on connectivity and adequacy shows an interesting result. While the overall

connectivity levels for water supply are not significantly different for slums and non-slums, there is a

significant difference in terms of adequacy. This points to the possibility that a top-down approach

NOTE: Weights are from random effects analysis

Overall (I-squared = 97.1%, p = 0.000)

Slum - informal

Low income households

Subtotal (I-squared = 97.5%, p = 0.000)

Subtotal (I-squared = 96.8%, p = 0.000)

Slum - formal

Subtotal (I-squared = .%, p = .)

Evidences

0.63 (0.58, 0.69)

0.94 (0.36, 2.47)

0.55 (0.50, 0.60)

0.78 (0.48, 1.26)

ES (95% CI)

0.63 (0.58, 0.69)

0.94 (0.36, 2.47)

0.55 (0.50, 0.60)

0.78 (0.48, 1.26)

ES (95% CI)

1.359 1 2.79

Ratio favours intervention

emphasises providing connectivity, with limited attention paid to subsequent downstream activities

(that is, ensuring adequate and regular supply of water for the connections provided). However, the

small number of studieswe have obtained for adequacy limits the strength of the results.

Figure 4.3.4: Summary results for adequacy under top-down approach

EVIDENCE FOR BOTTOM-UP APPROACH

In this section, we present the meta-analysis results for the evidence on the bottom-up approach. The

studies here compare the impact on access after the implementation of a bottom-up approach from

the default top-down approach. The results of this analysis, therefore, help to estimate the efficacy of

using a bottom-up approach in improving access. Given the number of the studies, we have been able

to conduct meta-analysis for all dimensions of access: connectivity, affordability, adequacy, and effort

and time. However, since connectivity has the largest number of studies, we could conduct a meta-

analysis for different parameters of the operating context, such as the type of slum and level of

participation.

CONNECTIVITY

Figure 4.3.5, below, provides a summary of forest plots for different sectors. The overall ES (1.05)

indicates that use of a bottom-up approach has not resulted in a significant increase in connectivity as

compared to the top-down approach. However, since the ES is greater than 1, there has been some

level of improvement, but, given the range of the confidence interval, the improvement has not been

statistically significant.

NOTE: Weights are from random effects analysis

Water - Individual Tap - Adequacy

Subtotal (I-squared = .%, p = .)

Electricity - Adequacy

Subtotal (I-squared = .%, p = .)

Evidences

0.01 (0.00, 0.03)

0.84 (0.78, 0.90)

ES (95% CI)

0.01 (0.00, 0.03)

0.84 (0.78, 0.90)

ES (95% CI)

1.00257 1 389

Ratio favours Intervention

However, a subgroup analysis by type of facility shows that the impact varies by sector and type of

facility. For example, in the case of sanitation (individual sewerage connections and toilets), there has

been a statistically significant improvement after a bottom-up approach. In the case of community

sanitation facilities, there has been no significant impact, with the ES close to 1 (0.96). In water supply

(community taps), there has been an increase in connectivity following bottom-up implementations.

However, in the case of individual water connections, there has been a reduction in connectivity. In

both the cases, the ES is not statistically significant from 1. Among all the sectors, the impact has been

the least in electricity. A possible reason for the low impact could be due to the centralised nature of

electricity supply, which is more suitable for a top-down approach. Government involvement in policy

formulation, financing and monitoring of electrification programmes is needed in order to play a

significant role in improving access (Baruah 2010, Manzetti and Rufin 2006, Scott et al. 2005, Shrestha

et al. 2008).

Figure 4.3.5: Summary results for connectivity under bottom-up approach

To identify if there are any differences between regions, we conducted a meta-analysis after grouping

the evidence by region. The results are given in Figure 4.3.6, below. In the electricity sector, the ES

indicates that the introduction of a bottom-up approach has not yielded results. Connectivity levels are

lower under the bottom-up approach in all the regions. In water supply (individual connections), the ES

is the highest for the Africa region (1.5), indicating that a bottom-up approaches has been beneficial. A

possible reason for this could be the very low level of connectivity in the control group and, in Africa,

the urban government is largely absent from provision of water and sanitation services and poor

households are serviced by small-scale independent providers or take care of their own needs (Scott

2013). In South America and Asia, the ES was closer to 1, indicating that there has been no appreciable

difference from implementing a bottom-up approach. This could be due to the reasonably high level of

existing connectivity in these regions as compared to that of Africa, and the fact that making any further

improvements is not easy. In Central and North America, the connectivity is significantly lower for a

NOTE: Weights are from random effects analysis

Overall (I-squared = 100.0%, p = 0.000)

Subtotal (I-squared = 98.8%, p = 0.000)

Subtotal (I-squared = 97.0%, p = 0.000)

Subtotal (I-squared = 54.8%, p = 0.065)

Sanitation - Community Toilet

Water - Community Tap

Sanitation - Sewerage

Electricity

Subtotal (I-squared = 98.4%, p = 0.000)

Subtotal (I-squared = .%, p = .)

Subtotal (I-squared = 99.7%, p = 0.000)

Sanitation - Individual Toilet

Water - Individual Tap

Evidences

1.05 (0.73, 1.52)

0.96 (0.53, 1.75)

0.89 (0.61, 1.30)

1.18 (0.96, 1.45)

2.53 (2.22, 2.87)

1.15 (1.00, 1.34)

0.30 (0.05, 1.71)

ES (95% CI)

1.05 (0.73, 1.52)

0.96 (0.53, 1.75)

0.89 (0.61, 1.30)

1.18 (0.96, 1.45)

2.53 (2.22, 2.87)

1.15 (1.00, 1.34)

0.30 (0.05, 1.71)

ES (95% CI)

1.0514 1 19.5

Ratio favours intervention

bottom-up approach. However, there was only one evidence for the Central and North America region.

For community water-supply connections, the evidence was available only for the Asian region. The ES

of 1.18 shows that a bottom-up approach has led to improved connectivity. However, the range of the

confidence interval showed that the improvement is not statistically significant.

A bottom-up approach has shown a significant improvement in individual toilets in all the four regions:

Asia, South America, Africa, and Central and North America. However, in the case of Africa, the increase

was not statistically significant. A possible reason for this trend could be the modest level of economic

development in Africa as compared to other regions. Construction of individual toilets requires

investment from the households as well, and, if the poor economic condition of households makes it

difficult for them to make that investment, the impact of using a bottom-up approach is going to be

limited. However, the evidence in Asia, South America, and Central and North America suggests that a

bottom-up approach helps to create conditions that result in a greater number of households

constructing toilets.

In the case of community toilets, the effect of a bottom-up approach has been ambiguous. While the

ES is 1.05 in Asia (although not statistically significant), for the Central and North American region, it is

only 0.31, and it is also significantly lower as compared to connectivity levels seen in a top-down

approach. Incorporating the regions into the meta-analysis has shown that a bottom-up approach has

led to an increase in connectivity to sanitation, especially individual toilets in all regions. On the

contrary, a bottom-up approach has not worked well for electricity, as indicated by ES of less than 1.

For other sectors and facilities, there have been both positive and negative impacts, indicating that

contextual factors could play a role in influencing the effectiveness of a bottom-up approach.

Figure 4.3.6: Summary results for connectivity for different regions under bottom-

up approach

Figure 4.3.7, below, shows the results for connectivity by type of slums. Among the 49 measures for

connectivity, six measures were from formal slums, 38 from informal slums, and five from low-income

groups. It can be seen that a bottom-up approaches has been the most effective in formal slums. The

main reason for this is the reluctance of NGOs and CBOs to invest in a slum that may be evicted or

demolished. Improvements to notified slums were implemented much faster than those to non-

notified slums and NGOs were more active in notified slums (Chandrasekhar 2005, Kranti and Rao

NOTE: Weights are from random effects analysis

Overall (I-squared = 100.0%, p = 0.000)

Electricity - Asia

Sanitation - Individual Toilet - South America

Electricity - Central and North America

Water - Individual Tap - Africa

Subtotal (I-squared = .%, p = .)

Water - Individual Tap - Central and North America

Subtotal (I-squared = 68.9%, p = 0.073)

Subtotal (I-squared = 99.8%, p = 0.000)

Subtotal (I-squared = .%, p = .)

Sanitation - Community Toilet - Central and North America

Electricity - South America

Subtotal (I-squared = 78.3%, p = 0.000)

Sanitation - Individual Toilet - Central and North America

Subtotal (I-squared = .%, p = .)

Sanitation - Community Toilet - Asia

Sanitation - Individual Toilet - Asia

Water - Individual Tap - Asia

Sanitation - Sewerage - Asia

Subtotal (I-squared = .%, p = .)

Sanitation - Individual Toilet - Africa

Subtotal (I-squared = 3.7%, p = 0.402)

Subtotal (I-squared = .%, p = .)

Water - Community Tap - Asia

Subtotal (I-squared = 54.8%, p = 0.065)

Subtotal (I-squared = 98.5%, p = 0.000)

Subtotal (I-squared = .%, p = .)

Subtotal (I-squared = 86.0%, p = 0.000)

Water - Individual Tap - South America

Subtotal (I-squared = 52.7%, p = 0.120)

Evidences

1.05 (0.73, 1.52)

0.34 (0.34, 0.34)

1.50 (0.55, 4.08)

0.22 (0.00, 19.48)

0.31 (0.30, 0.31)

1.05 (0.83, 1.32)

0.23 (0.22, 0.23)

2.12 (2.12, 2.13)

0.87 (0.67, 1.12)

1.15 (1.00, 1.34)

1.18 (0.96, 1.45)

2.61 (1.91, 3.57)

0.88 (0.69, 1.12)

1.11 (0.41, 3.04)

0.88 (0.60, 1.31)

2.47 (2.37, 2.57)

ES (95% CI)

1.05 (0.73, 1.52)

0.34 (0.34, 0.34)

1.50 (0.55, 4.08)

0.22 (0.00, 19.48)

0.31 (0.30, 0.31)

1.05 (0.83, 1.32)

0.23 (0.22, 0.23)

2.12 (2.12, 2.13)

0.87 (0.67, 1.12)

1.15 (1.00, 1.34)

1.18 (0.96, 1.45)

2.61 (1.91, 3.57)

0.88 (0.69, 1.12)

1.11 (0.41, 3.04)

0.88 (0.60, 1.31)

2.47 (2.37, 2.57)

ES (95% CI)

1.00259 1 386

Ratio favours intervention

2009). This shows that de facto or de jure tenure security is an important factor in determining access

to basic services. However, in the case of informal slums, the ES is closer to 1, and the confidence

interval range shows that there has been no significant differences in connectivity in either of the

approaches. The effect on low-income households has been the least, indicating that, when households

are not concentrated in a defined location like a slum, the involvement of NGOs and CBOs have not

been effective. Nevertheless, the results show that legal recognition of slums facilitates access to basic

services, either with government provision or with alternative service providers. The I-square values

indicate that the evidence for both formal and informal slums is characterised by considerable

heterogeneity.

Figure 4.3.7: Summary results for connectivity by type of slum in bottom-up

approach

We also conducted a meta-analysis by level of participation from the community. The top-down

approach is characterised by poor participation from the community due to various factors, such as

governments’ lack of understanding of communities’ needs, inadequate consultation with

beneficiaries, and so on (Ghafur 2000, McFarlane 2009, Burra et al. 2003, Kifanyi et al. 2013). However,

a bottom-up approach can attract greater participation from the community, since the NGOs and the

CBOs tend to work much more closely with the community. This is also seen in the evidence. While

none of the 26 evidence for connectivity under top-down approach had a significant level of

participation, 16 of the 49 evidence in the bottom-up approach had a significant level of participation.

It can also be noted that not every instance of a bottom-up approach involves significant participation

from the community.

Figure 4.3.8, below, gives the summary results on connectivity with and without community

participation. The results show that, when there has been some level of community participation, the

impact on access has been significant. The ES when there has been community participation was 1.92,

NOTE: Weights are from random effects analysis

Overall (I-squared = 100.0%, p = 0.000)

Slum - informal

Subtotal (I-squared = 100.0%, p = 0.000)

Subtotal (I-squared = 98.8%, p = 0.000)

Low income household

Evidences

Subtotal (I-squared = 0.0%, p = 0.494)

Slum - formal

1.05 (0.73, 1.52)

0.96 (0.63, 1.46)

2.11 (0.98, 4.54)

ES (95% CI)

0.65 (0.45, 0.95)

1.05 (0.73, 1.52)

0.96 (0.63, 1.46)

2.11 (0.98, 4.54)

ES (95% CI)

0.65 (0.45, 0.95)

1.22 1 4.54

Ratio favours Intervention

and the difference is statistically significant. When there has been no community involvement, the

results are less impressive. The ES was only 0.79.

One of the main reasons for NGOs and CBOs to intervene in the provision of basic services to slums

stems from their understanding that slum-dwellers’ needs have been unmet by the government, which

has resulted in the proliferation of unsanitary practices and health problems, and hinders economic

activity (Burra et al. 2003, Bapat et al. 2003, McFarlane 2009). Therefore, alternative service providers

encourage community participation in planning, design and maintenance of infrastructure, which yields

better results. The answer to why community management of infrastructure is better than other forms

of management, lies in recognising the value in the process that goes beyond financial management to

hygiene education, imbues a sense of ownership of community assets, and provides a much-needed

social space for community members to come together and discuss various issues (Water Aid India

2008).

Figure 4.3.8: Summary results for connectivity analysed by level of participation in

a bottom-up approach

To identify the impact of participation across different type of slums, we conducted a meta-analysis by

type of slum, after classifying the evidence by level of participation. The results are shown in Figure

4.3.9, below. While there were no evidence with participation in low-income groups, for both formal

and informal slums, the results are impressive when there is community participation. Particularly in

the case of informal slums, the impact of participation on connectivity has been statistically significant.

The result of participation on formal slums was also positive, with an ES of 4.06. However, the wide

confidence interval puts a limitation on the statistical significance. It can also be said that the tenure

NOTE: Weights are from random effects analysis

Overall (I-squared = 100.0%, p = 0.000)

Subtotal (I-squared = 98.0%, p = 0.000)

Active community participation

Limited or no participation

Evidences

Subtotal (I-squared = 100.0%, p = 0.000)

1.05 (0.73, 1.52)

1.92 (1.62, 2.27)

ES (95% CI)

0.79 (0.48, 1.29)

1.05 (0.73, 1.52)

1.92 (1.62, 2.27)

ES (95% CI)

0.79 (0.48, 1.29)

1.44 1 2.27

Ratio favours intervention

security in formal slums enhances participation, which can be in the form of willingness to invest in

infrastructure on the part of the slum-dwellers, as well as participation in better design, implementation

and monitoring.

Figure 4.3.9: Summary of evidence for connectivity by slum type and participation

in bottom-up approach

Affordability

Studies included in this review contained evidence for affordability for water supply only. The indicators

of affordability in our review were two: (i) the proportion of households that indicated that the services

were affordable; and (ii) the average per-unit cost of consumption. Figure 4.3.10, below, gives the forest

plot for the evidence available in terms of proportion.

NOTE: Weights are from random effects analysis

Overall (I-squared = 100.0%, p = 0.000)

Informal slums, with participation

Formal slums, no participation

Subtotal (I-squared = 99.7%, p = 0.000)

Subtotal (I-squared = 51.9%, p = 0.101)

Evidences

Informal slums, no participation

Subtotal (I-squared = 0.0%, p = 0.494)

Low income household, no participation

Subtotal (I-squared = 96.9%, p = 0.000)

Formal slums, with participation

Subtotal (I-squared = 100.0%, p = 0.000)

1.05 (0.73, 1.52)

4.06 (0.76, 21.60)

1.28 (1.02, 1.61)

ES (95% CI)

0.65 (0.45, 0.95)

1.70 (1.47, 1.97)

0.69 (0.39, 1.22)

1.05 (0.73, 1.52)

4.06 (0.76, 21.60)

1.28 (1.02, 1.61)

ES (95% CI)

0.65 (0.45, 0.95)

1.70 (1.47, 1.97)

0.69 (0.39, 1.22)

1.0463 1 21.6

Ratio favours Intervention

The pooled ES (1.11) shows that there is a slight increase in the proportion of households who found

the services affordable under a bottom-up approach. However, the increase was not statistically

significant. Within the water sector, data were analysed separately for individual and community taps.

The evidence was more impressive in the case of community taps as compared to individual, household

taps. There are three reasons to which the preference for community taps can be attributed. Firstly,

individual connection costs are prohibitively high for slum-dwellers. Therefore, it is economical for a

group of households to secure a common connection, rather than a single family’s bearing the high

one-time expenditure (Hardoy and Schusterman 2000; Weitz and Franceys 2002; Sohail 2003).

Secondly, the laying of pipeline networks in low-income settlements poses engineering and

construction bottlenecks due to narrow roads and congested layouts. Community or public standpipes

provide a solution to these engineering challenges. Thirdly, NGOs and CBOs prefer to provide

community or public facilities, as they caters to a larger number of residents, and also address the

engineering challenges discussed above (Bapat and Agarwal 2003, Burra et al. 2003). Our results

indicate that a bottom-up approach has been able to leverage the expertise of NGOs and CBOs in

making community water supplies more affordable. TheI-square values also indicate low heterogeneity,

further enhancing the validity of the results.

Figure 4.3.10: Summary results for affordability under bottom-up approach

We also analysed the evidence on affordability by type of slum. Figure 4.3.11, below, shows the results.

The ES shows that a bottom-up approach has the maximum benefit on informal slums in terms of

affordability. This could possibly be explained by the unavailability of basic services (poor/low

connectivity) in informal slums, which forces residents to purchase these services at a much higher price

from private or illegal monopolies. Private vendors and illegal vendors make the most of this scarcity of

resources by charging exorbitant prices, which are brought down after the intervention of NGOs and

NOTE: Weights are from random effects analysis

Overall (I-squared = 73.1%, p = 0.000)

Evidences

Water - Individual Tap - Affordability

Subtotal (I-squared = 81.1%, p = 0.000)

Water - Community Tap - Affordability

Subtotal (I-squared = 0.0%, p = 0.668)

1.11 (0.67, 1.83)

ES (95% CI)

0.82 (0.33, 2.06)

1.42 (1.02, 1.97)

1.11 (0.67, 1.83)

ES (95% CI)

0.82 (0.33, 2.06)

1.42 (1.02, 1.97)

1.33 1 3.03

Ratio favours intervention

CBOs, who supply at a more affordable price (Devas and Korboe 2000, Hossain 2012). The I-square

values also indicate the absence of heterogeneity, thereby augmenting the validity of the findings.

There has also been an increase in the affordability proportion for formal slums, but there was only one

evidence related to this. For the low-income households, the mean ES is lower than 1 (although the

difference is not statistically significant), thereby indicating that the bottom-up approach has not been

effective in increasing affordability to this group.

Figure 4.3.11: Summary results for affordability by type of slum

Figure 4.3.12, below, gives the meta-analysis results evidence in terms of the mean cost incurred for

unit consumption. The results also compare the evidence for top-down and bottom-up approaches. It

can be seen that a bottom-up approach has had a significant impact in making water supply more

affordable to slum residents. The ES (0.39) shows that the mean cost incurred in accessing the services

has reduced with the involvement of alternative service providers. This is interesting in the sense that

involvement of alternative service providers has resulted in the creation of facilities that can be

accessed at affordable rates, as compared to those provided under top-down regimes. This can be

explained by the absence of government provisioning in slums, which gives rise to private or illegal

suppliers who charge exorbitant amounts for the water supplied (Devas and Korboe 2000, Hossain

2012). Involvement of NGOs and other alternative service providers helps to fill this void by providing

innovative solutions that improve affordability for the poor. The ES when service provision was by the

government shows that the average cost was lower (although the difference was not statistically

significant) in slums than in non-slums. Subsidies provided to make available connectivity to slum

residents could be one possible explanation for this reduced cost.

NOTE: Weights are from random effects analysis

Overall (I-squared = 73.1%, p = 0.000)

Subtotal (I-squared = .%, p = .)

Slum - informal

Slum - formal

Low income household

Subtotal (I-squared = 81.1%, p = 0.000)

Subtotal (I-squared = 0.0%, p = 0.535)

Evidences

1.11 (0.67, 1.83)

1.28 (0.74, 2.24)

0.82 (0.33, 2.06)

1.50 (0.99, 2.26)

ES (95% CI)

1.11 (0.67, 1.83)

1.28 (0.74, 2.24)

0.82 (0.33, 2.06)

1.50 (0.99, 2.26)

ES (95% CI)

1.33 1 3.03

Ratio favours intervention

Figure 4.3.12: Summary results for mean cost for per unit consumption for top-

down and bottom-up approaches

ADEQUACY

The adequacy dimension can be measured either in terms of mean consumption level or the availability

of the services without any interruptions or failures. In our evidence, adequacy had been measured as

follows: (i) proportion of households that indicated that the availability of services was adequate; and

(ii) the mean level of consumption of the services. The evidence for the top-down approach was

available only for the latter (Figure 4.3.13). Here, we analyse the evidence that was available as a

proportion for the bottom-up approach. In the same meta-analysis, we have also included one evidence

from the top-down approach, where the evidence was available as a proportion. Figure 4.3.13, below,

shows the results. The results indicate that, in the bottom-up approach, the average proportion of

households who found the services adequate was lower than that in the top-down approach. However,

the difference was not statistically significant and the ES was also closer to 1. This indicates that

involvement of alternative service providers has not substantially increased the adequacy levels of the

service. Additional studies may be needed to understand the reasons for the indifferent results on

adequacy outcomes. However, the ES for government provision is 2.09, and has statistical significance.

This shows that a higher proportion of households in slums have reported adequate levels of traditional

government provision of service, as compared to those in non-slum areas. Although we had only one

evidence under this category, this was contrary to expectations. A possible explanation for this is that

slum residents had lower expectations as regards what was an appropriate level of adequacy compared

to non-slum residents. Therefore, a higher proportion of slum residents would have reported an

adequate level of service, whereas many non-slum residents would have reported an inadequate level

of service for the same level of availability.

NOTE: Weights are from random effects analysis

Bottom-up / Service by alternate agencies

Subtotal (I-squared = 83.4%, p = 0.000)

Top-down / Service by public agencies

Subtotal (I-squared = .%, p = .)

Evidences

0.39 (0.14, 1.08)

0.83 (0.53, 1.29)

ES (95% CI)

0.39 (0.14, 1.08)

0.83 (0.53, 1.29)

ES (95% CI)

1.144 1 6.94Ratio favours Intervention

Figure 4.3.13: Summary results for adequacy

EFFORT AND TIME

The dimension of effort and time is applicable to community water supply and sanitation facilities,

where the dwellers have to go to a common point to access the service. Effort and time in the literature

has been measured either as the distance to be travelled or the time spent to access the facility. The

four evidence that we had for this dimension were grouped into two categories, based on the

measurement used: (i) As a proportion of households who indicated that the level of effort was reduced

in the bottom-up approach; and (ii) the distance travelled to access the services. The summary results

are given in Figure 4.3.14 and Figure 4.3.15, below.

NOTE: Weights are from random effects analysis

Bottom-up / Service by alternate agencies

Subtotal (I-squared = 0.0%, p = 0.416)

Top-down / Service by public agencies

Subtotal (I-squared = .%, p = .)

Evidences

0.92 (0.71, 1.19)

2.09 (1.66, 2.61)

ES (95% CI)

0.92 (0.71, 1.19)

2.09 (1.66, 2.61)

ES (95% CI)

1.382 1 2.61

Ratio favours Intervention

Figure 4.3.14: Summary results for proportion of households who have indicated less

effort in bottom-up approach

The mean ES in Figure 4.3.14, above, shows that a higher proportion of households have indicated that

they required less effort to access the services in the bottom-up approach (the difference was, however,

not statistically significant). This shows that the involvement of alternative service providers has had a

beneficial effect in terms of making access easier for slum-dwellers. This could be because of the

alternative service providers’ greater understanding of community needs and the problems faced by

them (such as distance to facility) in accessing services (Weitz and Franceys 2002, WaterAid India 2008,

Burra et al. 2003). The ES in figure 4.3.15, below, shows that there has been a reduction in distance

travelled to access services when they are provided by alternative service providers. However, given

the range of the confidence interval, the null hypothesis that there is no difference in the distance

travelled in the instances of a bottom-up approach cannot be rejected. The low I-square values indicate

that the results are not affected by heterogeneity, possibly because of the lower number of evidence

on this dimension.

NOTE: Weights are from random effects analysis

Bottom-up / Service by alternate agencies

Subtotal (I-squared = 0.0%, p = 0.617)

Evidences

1.06 (0.77, 1.47)

ES (95% CI)

1.06 (0.77, 1.47)

ES (95% CI)

1.682 1 1.47

Ratio favours Intervention

Figure 4.3.15: Summary results for distance to be travelled for accessing the services

SUMMARY OF RESULT BASED ON QUALITY OF EVIDENCE

Meta-analysis based on quality-appraisal ratings has been presented for connectivity only, because the

largest number of studies was for connectivity. On other dimensions of access, there were no

differences in quality-appraisal ratings for the studies. Figures 4.3.16 and 4.3.17, below, show the

summary ES for connectivity based on the quality-appraisal criteria for top-down and bottom-up

approaches. It can be seen that the effect size is lesser for high-quality studies than for medium-quality

studies. The trend is consistent for both top-down and bottom-up approaches. Since high-quality

studies in general would provide a more conservative estimate of the intervention, our results are as

expected.

NOTE: Weights are from random effects analysis

Bottom-up / Service by alternate agencies

Subtotal (I-squared = 0.0%, p = 0.402)

Evidences

0.70 (0.43, 1.13)

ES (95% CI)

0.70 (0.43, 1.13)

ES (95% CI)

1.428 1 2.34

Ratio favours Intervention

Figure 4.3.16: Summary results for connectivity by strength of evidence for top-

down approach

Figure 4.3.17: Summary results for connectivity by strength of evidence for bottom-

up approach

NOTE: Weights are from random effects analysis

Quality of evidence - High

Subtotal (I-squared = 99.1%, p = 0.000)

Quality of evidence - Medium

Subtotal (I-squared = 90.9%, p = 0.000)

Evidences

0.61 (0.55, 0.68)

0.82 (0.52, 1.27)

ES (95% CI)

0.61 (0.55, 0.68)

0.82 (0.52, 1.27)

ES (95% CI)

1.525 1 1.91

Ratio favours Intervention

NOTE: Weights are from random effects analysis

Quality of evidence - High

Subtotal (I-squared = 100.0%, p = 0.000)

Quality of evidence - Medium

Subtotal (I-squared = 97.9%, p = 0.000)

Evidences

0.79 (0.42, 1.50)

1.25 (0.99, 1.57)

ES (95% CI)

0.79 (0.42, 1.50)

1.25 (0.99, 1.57)

ES (95% CI)

1.42 1 2.38

Ratio favours Intervention

Figure 4.3.18, below, shows the evidence by type of slum for high- and medium-quality studies for the

bottom-up approach. Except for the low-income group, the results are consistent with expectations for

formal and informal slums. High-quality studies show a lower ES as compared to medium-quality

studies. For the low-income group, high-quality studies show a higher ES than for medium-quality

evidence. However, the results suffer from a lower number of studies for the low-income group (six for

high and two for medium).

Figure 4.3.18: Summary results for connectivity based on strength of evidence and

analysed by type of slum for bottom-up approach

NOTE: Weights are from random effects analysis

Slum - formal - High

Subtotal (I-squared = .%, p = .)

Slum - formal - Medium

Subtotal (I-squared = 98.9%, p = 0.000)

Slum - informal - High

Subtotal (I-squared = 100.0%, p = 0.000)

Slum - informal - Medium

Subtotal (I-squared = 97.6%, p = 0.000)

Low income household - High

Subtotal (I-squared = 0.0%, p = 0.522)

Low income household - Medium

Subtotal (I-squared = .%, p = .)

Evidences

1.73 (1.57, 1.91)

2.21 (0.75, 6.55)

0.70 (0.34, 1.47)

1.15 (0.92, 1.45)

0.87 (0.45, 1.66)

0.56 (0.35, 0.90)

ES (95% CI)

1.73 (1.57, 1.91)

2.21 (0.75, 6.55)

0.70 (0.34, 1.47)

1.15 (0.92, 1.45)

0.87 (0.45, 1.66)

0.56 (0.35, 0.90)

ES (95% CI)

1.153 1 6.55

Ratio favours Intervention

Figure 4.3.19, below, shows the evidence by type of participation for high- and medium-quality studies

for alternative service providers. When there has been no active participation from the beneficiaries

(that is, passive participation), the results are consistent with the earlier trends: that is, high-quality

studies show a lower ES than medium-quality studies. However, when there is some level of active

participation, high-quality studies show a larger ES than do medium-quality studies. A possible reason

for this could be the low number (four) of high-quality studies when there has been some active

participation.

Figure 4.3.19: Summary results for connectivity based on strength of evidence and

analysed by level of community participation for bottom-up approach

NOTE: Weights are from random effects analysis

Limited or no participation - High

Subtotal (I-squared = 100.0%, p = 0.000)

Limited or no participation - Medium

Subtotal (I-squared = 77.2%, p = 0.000)

Active community participation - High

Subtotal (I-squared = 94.0%, p = 0.000)

Active community participation - Medium

Subtotal (I-squared = 98.4%, p = 0.000)

Evidences

0.58 (0.27, 1.24)

1.02 (0.88, 1.19)

2.28 (2.03, 2.55)

1.77 (1.29, 2.43)

ES (95% CI)

0.58 (0.27, 1.24)

1.02 (0.88, 1.19)

2.28 (2.03, 2.55)

1.77 (1.29, 2.43)

ES (95% CI)

1.269 1 3.72

Ratio favours Intervention

TESTS FOR PUBLICATION BIAS

Publication bias can affect the validity of results in meta-analysis and systematic reviews. We have

assessed for publication bias using a funnel asymmetry test for small-study effects. The two tests used

to assess publication bias were Egger’s test (Egger et al. 1997) and Begg’s test (Begg and Mazumdar

1994) in STATA. The results of these tests are given in Table 4.3.4. The relevant forest plots are provided

in Appendix 4. The p-values of the test results were not statistically significant, indicating that the results

of the review do not suffer from publication bias.

Table 4.3.4: Publication-bias test results

Evidence

Egger’s Test

Results (p-value)

Begg-Mazumdar Test Results

(p-value)

Top-down, connectivity

0.163

0.643

Bottom-up, connectivity

0.097

0.109

Bottom-up, affordability

(proportion)

0.320

0.152

Bottom-up, affordability (mean

unit consumption costs)

0.796

0.806

Bottom-up, adequacy

(proportion)

0.332

1.000

Bottom-up, adequacy

(mean consumption)

1.000

Bottom-up, effort and time

(proportion)

1.000

Bottom-up, effort and time

(mean distance travelled)

1.000

META-REGRESSION ANALYSIS

The i-square values in the summary meta-analysis results indicate substantial heterogeneity. This is

expected, because the studies were from different countries, different contexts and different

methodologies. Therefore, to control for the various study-level characteristics, we conducted a meta-

regression to examine the effect of covariates on the ES. The estimated meta-regression equation to

assess the impact of different study characteristics on the reported treatment ES is as follows:



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The dependent variable (ES) is the ES on the level of access to basic services. The explanatory variables

of the meta-regression equation, also called the covariates, are particular characteristics of the included

studies in the meta-analysis. These covariates represent the observed source of heterogeneity among

the included studies for analysis. The statistical significance and positive sign of the coefficient of the

covariates indicates that the studies that possess that particular characteristic are more likely to

demonstrate positive impacts on the ES. Similarly, a statistically significant and negative coefficient

indicates that studies that possess this characteristic are more likely to demonstrate negative impact

on the effect size.

In our review, sample size was a common meta-regression covariate. Findings from large samples are

considered to be more robust as compared to studies with smaller sample sizes. Statistical significance

of the coefficient of sample size can indicate the presence of a systematic empirical effect. Given the

wide variation in sample sizes across studies, we used log (sample size) in the regression estimations.

Dummy variables were used to capture the differences in study characteristics. Since each study yielded

more than one measure, to avoid the possibility of bias, the estimations were made using a panel

method, rather than a simple meta-regression. We used an unbalanced panel, random-effects GLS

regression, using STATA to analyse the impact of study-level covariates on the ES and in the presence

of heterogeneous groups across studies.

The estimations were made only for connectivity and affordability outcomes, since the number of

measures for other elements of access were very low. For connectivity outcome, the estimations were

made separately for top-down (service provision by government/public agencies) and bottom-up

approaches (alternate service providers), since the control group was different in each case. In the case

of affordability, we have used only the evidence for the bottom-up approach in making the estimation,

since there was only one evidence for government. Out of the 14 measures on affordability for the

bottom-up approach, only 10 that measured the outcomes as proportions were used in the estimation.

Table 4.3.5, below, gives the descriptive statistics of the covariates. Results of the random-effects (GLS)

regression using the unbalanced panel data are given in Table 4.3.6 (for connectivity) and Table 4.3.7

(for affordability).

Table 4.3.5: Descriptive statistics of the covariates used in meta-regression

Regression estimation

Variables

Connectivity

(Bottom-up

approach or

alternative

service providers)

Connectivity (Top-

down approach —

Public/government

agencies)

Affordability

(Bottom-up or

alternative service

providers)

Continuous variables

Sample size

Mean

726,13.33

248,300.5

2,51.8

Standard deviation

241,674.6

698135.2

307.44

Minimum value

Maximum value

874,892

214,3810

1,101

Dummy variables

Sector: Water

(water = 1, others = 0)

Sector: Sanitation

(sanitation = 1, others = 0)

Sector: Electricity

(electricity = 1, others = 0)

Type of Access

(household = 1, community = 0)

Type of Evidence

(longitudinal = 1,

cross-sectional = 0)

Region: Asia

(Asia = 1, others = 0)

Region: Africa

(Africa = 1, others = 0)

Region: South America

(South America= 1, others = 0)

Region: Central and North America

(C & N America = 1, others = 0)

Method of data collection

(Primary =1, Secondary = 0)

Type of Slum – Informal

(informal = 1, others = 0)

Type of Slum: Formal

(formal= 1, others = 0)

Type of Slum – Low-income household

(low-income= 1, others = 0)

Participation

(Yes = 1, No = 0)

Table 4.3.6: Random effect estimations for connectivity

Covariates

Dependent Variable: Connectivity (ES)

Bottom-up approach

(alternate service

providers)

Top-down approach

(Government/public agencies)

Sample Size (Logged)

0.023 (0.203)

0.119 (0.486)

Sector: Water

1.143 (0.700)

1.889 (1.085)*

Sector: Sanitation

1.517 (0.765)**

2.093 (1.161)*

Type of Access

(household = 1, community = 0)

0.553 (0. 512)

- 0.192 (0.741)

Type of Evidence

(longitudinal = 1,

cross-sectional = 0)

-0.595 (0.725)

1.277 (2.054)

Region: Asia

0.866 (1.545)

0.519 (3.798)

Region: Africa

0.902 (1.629)

-1.416 (4.390)

Region: South America

0.723 (1.613)

Method of data collection

-0.062 (0.714)

0.574 (0.809)

(Primary = 1, Secondary = 0)

Type of Slum: Informal

-0.566 (1.036)

-2.019 (3.995)

Type of Slum: Formal

0.038 (1.248)

-1.496 (3.970)

Participation (Yes = 1, No = 0)

0.273 (0.532)

Intercept

-1.957 (2.978)

-1.512 (4.238)

Wald chi2

13.05

7.71

Note: Standard errors in parentheses; *** implies significance at 1%; ** significance at 5%; and *

significance at 10%. Reference variables: Sector: Electricity; Region: Central & North America; Type of

Slum: Low-income.

The statistical significance of the coefficient of sample size indicates an underlying systematic empirical

effect between ES and intervention. The rationale is that the results of the studies with larger sample

sizes tend to be closer to the true effect. However, in both the estimations in Table 4.3.6, above, the

coefficient of sample size was not statistically significant. In the estimation of alternative service

providers, the coefficient of sanitation was significant at the 5% level. This showed that alternative

service providers had a higher effect in the sanitation sector in terms of improving connectivity than in

the electricity sector. The same effect was not seen for the water sector. None of the other variables

was significant. In the estimation on government service providers, it was seen that the coefficient of

water and sanitation sector dummy variables was significant at the 10% level. This showed that these

sectors had a positive effect on the ES — indicating that connectivity to water and sanitation services

was higher than connectivity to electricity in the slums. These results are consistent with the summary

results given in Figure 4.3.1 and Figure 4.3.2, above. None of the other variables was significant. The

Wald chi2 statistic indicates the joint significance of the variables used in the model, and the higher

probability value for the same showed that the regression was a poor fit. The poor fit could be

attributed to the heterogeneous nature of the evidence. Consequently, while the meta-regression

results were in line with the summary results of the meta-analysis, it did not yield any new insights.

Table 4.3.7, below, provides the meta-regression results for the affordability component. Since there

were only 10 observations, the fit of the regression estimation was poor. Only the coefficient for Asia

was significant at the 5% level. This showed that evidence from Asia had a positive impact on ES as

compared to the base region. This indicated that alternative service providers in Asia were more

effective in addressing the affordability of the services as compared to those in other regions. None of

the other variables was significant. On the whole, the meta-regression did not result in estimations with

a good fit because of the lower number of observations and the heterogeneity of the data. The results

of the meta-regression were, however, consistent with the results of the meta-analysis.

Table 4.3.7: Random effect estimations for affordability

Covariates

Dependent Variable: Affordability (ES)

Alternative service providers

Sample Size (Logged)

-0.801 (0.448)

Type of Access

(household = 1, community = 0)

-2.166 (1.216)

Type of Evidence

(longitudinal = 1, cross-sectional = 0)

Region: Asia

0.922 (0.456)**

Region: Africa

Region: South America

Method of data collection

(Primary = 1, Secondary = 0)

Type of Slum: Informal

Type of Slum: Formal

Participation (Yes = 1, No = 0)

Intercept

5.864 (3.204)*

Wald chi2

5.39

Note: Standard errors in parentheses; *** implies significance at 1%, ** significance at 5 %; and *

significance at 10%. Reference variables: Sector: Electricity; Region: Central & North America; Type of

Slum: Low-income.

SUMMARY OF META-ANALYSIS RESULTS

One hundred measures of effect from 27 studies formed the evidence base for the meta-analysis. The

data were analysed under various subgroups. The overall pooled effect indicates that, under a top-

down approach, connectivity to basic services in slums is lower than that in non-slum areas. However,

there was substantial variation across different sectors and facilities. For some of the sector-region-

facility combinations, connectivity to the services was significantly lower in slums. Such combinations

are individual water connections in Africa and South America, individual sewerage connections in South

America, electricity connections in South America and Asia. The overall ES indicates that involvement

of alternative service providers in the bottom-up approach has led to some improvements in mean

increase in connectivity, as compared to government provisioning. The increase is not statistically

significant; however, the impact of using a bottom-up approach varies by sector and type of facility. In

the case of individual toilets, sewerage connections, and community water taps, there has been a

significant improvement in connectivity with the involvement of alternative service providers.

However, for individual water taps and community toilets, there has not been any improvement in

connectivity as compared to the control group. Among all the sectors, the impact has been the least in

the electricity sector.

In terms of affordability, there has been a slight increase in the proportion of households who found

the services affordable after the involvement of alternative service providers in the bottom-up

approach. The ES on adequacy showed that there has not been an improvement in the bottom-up

approach when service is delivered by alternative service providers. On effort and time, the results are

positive in respect of the bottom-up approach, although not statistically significant. Our analysis also

shows the positive effect of community participation on access to basic services. Analysing the data by

type of slum has shown that giving legal status to the existence of slums results in increased access to

basic services to residents living in these slums. This shows that addressing tenure-claim issues can be

an important step in providing basic services to slums.

Since the studies are characterised by considerable heterogeneity, we also conducted a meta-

regression analysis to establish the impact of study-level covariates on ES. However, because of the

small number of measures of effect in each category, we were not able to establish significant

regression estimates. However, wherever the coefficient of regression variables was significant, the

results were consistent with those obtained from meta-analysis.

4.4 TEXTUAL NARRATION

OVERVIEW

In a textual narration, it is very difficult to generalise the findings from a variety of studies, because the

factors that are present in one are not necessarily found in the others. From 104 studies selected in this

review, various combinations of outcomes emerge. While restricting the scope of this review to

developing countries has reduced the heterogeneity of context, there is, nevertheless, some level of

diversity. We have, therefore, attempted to identify the recurrent themes seen across multiple contexts

in this textual narration. A description of these themes by sector is given below.

ELECTRICITY SECTOR

A large proportion of the urban poor in low- and middle-income countries access electricity through

illegal means. Residents of slums and low-income areas value access to electricity highly and often risk

prosecution while securing electricity connections to their homes. Although quality and reliability are

not homogeneous (with those offered by legal connections), illegal connections prevail (Baruah 2010).

Despite frequent disconnections and the high cost of illegal connections, electricity is a necessity for

slum-dwellers to provide lighting, cooling and cooking facilities (Scott et al. 2005, Moulik 1999).

Although electricity seems to be available in most urban slums, there are several factors that affect

provision of legal connections. As Scott et al. (2005) point out, ‘Governments are reluctant to provide

electricity to unauthorised/illegal/informal slums, as it may confer a certain legitimacy on the

settlement.’ From the supply side, the utility providers

shy away from slums, because it is not profitable

to extend coverage to them. Since slum households consume less electricity, transaction costs

(including cost of monitoring and collection of payments) for electricity companies are high (USAID

2004). However, poor households also face several hurdles in securing legal, metered electricity

connections. High up-front deposits and connections costs to be paid to the utility (Scott et al. 2013), a

lack of legal documents proving security of tenure in non-notified slums, and the fear of eviction from

these informal slums force slum-dwellers to resort to illegal connections. Although electricity supplied

through illegal connections costs more for every unit consumed (Shrestha et al. 2008), in the absence

of access to legal electricity, illegal connections are preferred mainly for the flexible payment options

that allow poor households to (i) pay only for what they consume or (ii) based on the number of

household appliances used (Baruah 2010).

Synthesising the evidence from the studies in the review, four broad themes emerge. First, we discuss

the change that can be brought about when there is a political commitment to address the needs of

the poor. The traditional top-down approach can be implemented better when the government of the

day shows strong commitment, either by way of pro-poor policy change or by the creation of specialised

agencies that implement pro-poor projects. Secondly, innovative approaches in service delivery, that

are attuned to the socio-economic problems of the poor and accompanied by a change in attitude on

the part of the utility towards the poor, can improve access. The third theme discusses the advantages

of a multi-stakeholder approach, where there is involvement of NGOs and community participation,

support from the government, and utilities that deliver the services. The fourth and last theme

emphasises the importance of inclusive planning and tenure security in improving access to slums.

Top-down approach when backed by political commitment to the poor, combined with the creation

of specialised implementation agencies for pro-poor projects, can help in improving access.

Governments play a significant role in the policy formulation, financing and monitoring of electrification

programmes (Baruah 2010, Manzetti and Rufin 2006, Scott et al. 2005, Shrestha et al. 2008). Alleviating

urban poverty through electrification of low-income and slum communities has been the primary

objective for several governments, and facilitating the creation of new agencies or partnerships with

the private sector for providing electricity access to the urban poor has been instrumental in achieving

this objective (USAID 2004, Baruah 2010). Evidence from six case studies has been summarised below

to describe the various political changes that have catalysed an improvement in access to slums.

In Manila, Philippines (USAID 2004), it was the Presidents Commission on Urban Poor (PCUP) that

assisted in securing funding for the Depressed Area Electrification Program (DAEP) from the Japanese

Bank for International Co-operation (JBIC). The primary aim of the PCUP was to upgrade and regularise

slums by resolving land tenure and by providing electricity in slums that had no access to electricity or

were serviced by illegal operators. It was under the leadership of PCUP that collaboration between

Manila Electric Company (MERALCO) and the National Electrification Agency (NEA) was set up. PCUP

also asked other agencies, such as the National Housing Authority and the Housing and Urban

Development Co-ordinating Council, to contribute to the programme design and implementation.

Governments and Utility providers are used interchangeably in this narrative since in some countries

where the electricity sector has not been unbundled, government is still the service provider.

However, there are different reasons for why the governments and private utilities have not extended

access to poor communities and these distinctions have been maintained.

Similarly in Cape Town, South Africa, a change in government was an important factor that spurred the

electrification programme. PN Energy, which was set up as a community-based distribution company,

not only reflected the government’s focus on safety and provision of electricity to neglected

communities, but also met the objective of universal access to electricity (USAID 2004). The

Government of National Unity endorsed the targets set by the previous government, which remained

unattained. Support from the Department of Mineral and Energy and the Energy White Paper that

recommended ‘energy for all’, provided much-needed impetus to set up PN Energy as a community-

based distributor.

In Brazil, two electricity utilities, Rio LIGHT and Coelba were permitted to access an efficiency

investment fund set up by the government to improve the demand-side efficiency of the utilities. Rio

LIGHT set up the Program for Normalisation of Informal Areas (PRONAI) whereas COELBA, using the

PRONAI approach, set up a community-agent model to extend coverage to informal areas (USAID 2004).

Initially, the private utilities were allowed the use of this fund to undertake slum-electrification projects.

With a change in presidency, greater emphasis was placed on a good-quality electricity supply for all,

and inclusion of all marginal economic groups through subsidy.

In Thailand (Shrestha et al 2008), electrification and extending electrification to all parts of the country

received high priority in the government’s development strategy in the 1970s. As a result of the

accelerated electrification programme, household access to electricity supply had increased to 97% by

2000. Subsidies for small residential consumers have also made electricity more affordable to poor

households. The Thai government’s commitment to improving the quality of infrastructure for the poor

was mainstreamed into the slum-upgrading programmes implemented by the National Housing

Authority, which provided low-cost housing in slums with access to electricity connections. This enabled

people to buy houses with electricity connections instead of applying for new connections separately.

Co-operation of the government could also be in the form of supporting an NGO or CBO initiative in the

urban slums. For instance, in the Slum-Electrification Program in Ahmedabad, India, the co-operation

of Ahmedabad Municipal Corporation (AMC) in issuing a no-objection certificate for a 10-year period,

providing immunity to the slum residents against eviction, was an important assurance that prompted

several slum residents to take up new connections (Baruah 2010).

Another instance of a public-private partnership in Ahmedabad was the Slum Networking Project (SNP),

which was undertaken jointly by an NGO and the corporate sector (Chauhan and Lal, 1999). The

initiative to improve the infrastructure conditions of the urban slums in Ahmedabad came from one of

the leading corporate companies in the city, which brought in an NGO highly familiar with working in

slum communities to lead the project and carry out community-development activities. In order to

include more slums and make the project city-wide, the NGO-private sector partnership approached

the AMC for their support. The commissioner immediately agreed and a formal approval for the project

was granted. The AMC not only provided the actual supply of service through its feeder infrastructure,

but also contributed to the cost of the project and agreed to build certain amenities free of cost.

Although the AMC was to take a back-seat role and has also been reported as an impediment to the

successful implementation of the project, AMC’s involvement was critical to the city-wide scaling-up of

the SNP. Slums and slum households that took part in the SNP were able to secure legal electricity

connections with help from the NGO, as the latter took responsibility for underwriting residents’

contribution for individual connections.

Political commitment and a policy framework that is pro-poor are of the utmost importance for

electricity utilities (public or private) to engage in slum-electrification programmes. The evidence

100

presented above suggest that governments in developing countries must provide an enabling

environment for utilities to extend access to the urban poor. Financial assistance in the form of

subsidies and legal support in terms of tenure security are the safety net that private utilities seek from

the government. Pro-poor policies, such as universal service obligation, forces private/government-

owned utilities to recognise the urban poor as customers entitled to service. Without the support of

pro-poor government policies, slum-dwellers of ambiguous legal status will be denied the chance to

access electricity legally. However, political commitment alone will not be sufficient to catalyse change.

Innovative approaches to tackle the specific problems that hinder access are also important. The

following section discusses these innovations.

In addition to public-sector and government commitment, regulatory oversight can also lead to a

positive impact on improving access. While the studies in this review did not explicitly discuss the role

of regulation, it is widely argued that regulators need to be aware and show understanding of the

various challenges faced by the urban poor in accessing electricity, and play a pro-active role in

ensuring that utilities provide better services to the poor and government policies are pro-poor

(Gessler et al. 2008).

TOP-DOWN APPROACHES THAT ARE SENSITIVE TO THE NEEDS OF THE URBAN POOR

CAN HELP IN IMPROVING ACCESS.

Electricity providers have two main reasons to get involved in slum electrification. One is to set right

the financial losses that they have been experiencing due to electricity theft and non-payment of bills.

The second is the conditionality imposed on them during the course of privatisation: to universalise

access or, specifically, to target the poor.

In order to address both of the reasons mentioned above, electricity companies have had to adopt

innovative techniques in management, pricing, community engagement and customer satisfaction. Due

to the lack of trust between utilities and the urban poor, utilities have had to revamp their attitude

towards slums and gain the confidence of slum-dwellers in order to overcome non-payment and theft.

Private operators need to convince users that a charged-for service programme improves the quality

of the service provided (Manzetti and Rufin 2006).

Since service delivery in slum areas is largely unexplored terrain for private providers, utility companies

have had to seek the help of local associations, community-based organisations and NGOs to make in-

roads into the community, as well as to understand the consumption patterns of slum-dwellers (USAID

2004). Encouraging pro-poor management practices, such as dealing reasonably with customers,

implementing a transparent and easy-to-use billing system, door-step collection of payments, firing of

corrupt employees, etc., are a few management changes that have improved the performance of

utilities in slum areas. Consumer-education programmes that help end-users understand their

consumption patterns and improve energy efficiency have yielded results in all the case studies

discussed in the USAID report. PN Energy in Cape Town, South Africa, had appointed staff from the local

community and set up community-level collection centres, a customer hotline, and easily accessible

prepayment-card vendors to make customer service more accessible.

Using an innovative pricing policy is another step towards improving access to electricity.

Understanding the consumption patterns of slum-dwellers and their ability to pay, utilities have

designed easier payment options, such as pre-payment meters, monthly bills, subsidised connection

costs, loans for internal wiring from meter walls, etc. (USAID 2004, Baruah 2010).

101

Achieving greater customer satisfaction was also a major driver for the electricity utilities. As mentioned

earlier, due to a poor service track record, slum-dwellers resisted from applying for legal connections

and instead relied on illegal connections at higher cost (Scott et al. 2008, Baruah 2010, Shreshtha et al.

2008). As a remedy, several utility companies have made customer satisfaction a priority area. Coelba

conducted a customer-satisfaction survey in targeted neighbourhoods that indicated a high degree of

satisfaction (mostly over 90%) as a result of improved technical support, quicker response times to

complaints and less frequent outages. The main suggestions for improvements were in respect of

lowering tariffs and taxes (USAID 2004).

Due to several legal, economic and social constraints in providing access to electricity for slum-dwellers,

what works in high-income areas may not work with low-income communities. Therefore, an

understanding of consumption patterns, a willingness and ability to pay, household-income levels, and

the mindset of the urban poor, are essential to tailor-make effective packages/deals for the urban poor.

Convincing the poor that a charged-for-service programme will deliver a quality service and supporting

it with customer service is also important to gaining the confidence and participation of the poor. The

case studies described above have shown that NGOs and CBOs can play as mediators between the

community and the utility. Both the government and the private utility provider must be aware of the

dynamics that exist in urban slums and need to innovate in the areas of management, pricing and

implementation, in order to sustain slum-electrification efforts in the long run.

TOP-DOWN APPROACH WHEN SUPPORTED BY NGO INTERVENTION AND

COMMUNITY INVOLVEMENT YIELDS BETTER CONNECTIVITY AND COVERAGE.

Data gathered from six case studies of Slum Electrification Programmes (SEP) presents electrification

programmes, led by the electricity companies and supported by the government, that have enlisted the

participation of various community groups and NGOs to increase access to electricity for slums dwellers.

Traditionally, the poor have been underserved due to three main reasons: (a) informal/illegal status of

the settlement (Scott et al. 2005); (b) high cost of service provision and low returns due to low

consumption (USAID 2004); and (c) physical constraints presented in the form of narrow lanes, poor

housing materials and unsafe wiring, which make installations challenging (USAID 2004).

In all six case studies discussed below, the utility companies have adopted a participatory approach to

service provision. Engaging all the stakeholders (that is, government, electricity companies,

communities, service recipients, and intermediaries in the programme) allowed the concerns of all

stakeholders to be addressed. Communities benefited from the improvement in social and economic

conditions, electricity companies were able to reduce non-technical losses and increase revenue,

consumers were able to obtain legal connections and NGOs/CBOs believed they could disseminate their

learning in other areas.

Baruah (2010), in a detailed account of the SEP in Ahmedabad, underscores the importance of NGOs in

motivating and mobilising the slum communities to participate in the SEP. NGO’s facilitated the

formation of CBOs to represent the residents’ interests. NGOs also played a pivotal role in negotiating

a pricing policy with the Ahmedabad Electricity Company (AEC), by undertaking a willingness-to-pay

survey among slum-dwellers. Based on this survey, the AEC worked out a variable-price scheme, which

substantially brought down the connection fee per household (during the pilot phase), which was

further shared between the household, AEC and USAID. Due to the positive response from households

in the form of an increase in the number of connections, the reduced connection fee was offered to

households even after the pilot phase had ended. Billing was also made monthly instead of bi-monthly,

which enabled slum residents to pay bills in smaller amounts. At the request of the CBO, AEC also set

102

up a special Slum Electrification Cell on its premises, to serve the economically weaker sections.

Electrification loans were also arranged with the SEWA Bank, in order to facilitate access to

electrification. NGOs played a strategic role in sensitising other stakeholders to the realities of the urban

poor, by convincing the AEC not to cut off access to the illegal power lines until the legal lines are

installed. As a result, the maximum number of electricity connection was provided in the slums of

Ahmedabad.

In Cape Town, South Africa, PN Energy — a joint-venture pilot project between ESKOM (South African

Utility), Électricité de France (EDF) and East Midlands (UK), was established as a community-based

distribution company to provide electricity to the Khayelitsha slum on the outskirts of Cape Town

(USAID 2004). Khayelitsha had a track record of non-payment and electricity theft, which was also, in

part, a result of the poor service provided by the existing provider. The formation of a community-based

distribution company as the interface between the community and ESKOM bridged the existing gap in

service by taking the service provider closer to the customer. A major shift in approach towards

electrification of slums was PN Energy and the City of Cape Town’s involvement of the community from

the beginning of the project. At all stages of implementation, the utility liaised with civic and political

organisations, including women’s and religious organisations, in order to understand their needs and

difficulties, which has led to increased buy-in of the local residents into the project. PN Energy also

innovated by installing a pre-payment meter and selling pre-paid cards, which gave the poor consumer

control over their electricity consumption, based on their ability to pay, rather than allowing them to

get into debt in the form of mounting electricity bills. All these efforts helped to increase the number

of connections to 60,000 (1994‒2003) from 6,000 in 1994, and reduce non-payment from 70% to 5% in

1998.

The Depressed Area Electrification Program (DAEP) in Manila, Philippines (USAID 2004), which was a

result of the PCUP, was exclusively designed to provide electricity to inhabitants in 229 depressed areas

(slums) in metro Manila. As a result of the political changes that took place at that time, leading to the

formation of the PCUP, which synchronised with the transformation of the State Utility into a market-

based utility, the DAEP received the fillip it needed. The Manila Electric Company’s (MERALCO) main

objective was to improve fiscal discipline, reduce theft and improve payments. PCUP collaborated with

MERALCO to provide a direct electricity service to areas that did not have electricity at all. DAEP was

able to undercut the prices charged by illegal providers by waiving much of the cost of connection by

extending the distribution lines up to the meter walls. The ‘meter-wall’ option was a salient feature of

the DAEP, where all the meters were placed on a wall at the edge of the slum. Meeting the cost of

extending distribution lines from the house to the DAEP meter walls at the edge of the slum was the

responsibility of the customer. Loans were provided for internal wiring, which were repayable to

MERALCO over 60 months. DAEP’s success was dependent on each household’s actively participating

in the programme by making the initial payment for the connection, timely payment of bills and

repayment of loans given by MERALCO. Community associations were also formed to monitor

distribution lines and manage payment, and were responsible for the functioning of the system within

the slums.

Rio LIGHT’s PRONAI is another successful case study that has enabled the regularisation and connection

of 250,000 slum households in Rio de Janeiro (USAID 2004). Rio LIGHT, the utility company that

launched PRONAI, adopted a strategy that involved changing the attitude of slums dwellers towards

paying for electricity, as opposed to stealing electricity. Intense interaction with the community through

‘LIGHT Agents’, economic incentives for participation that included subsidised connection fees, easy

payment and amnesty from previous debts, all led to an increase in connections within the slum. Free

energy-efficient light bulbs, tamper-proof meters, replacement of inefficient and unsafe electrical

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wiring, and education on energy conservation, also led to an improvement in energy efficiency and

greater buy-in from community members. In order to overcome the difficulties in working with slum

communities, 200 local students were trained to be LIGHT Agents and the help of local NGOs was sought

to help community members access credit and participate in social programmes, training, etc.

Coelba, the electricity utility operating in Salvador, Brazil (USAID 2004), launched SEP (along similar

lines to LIGHT’s PRONAI) with the primary aim of reducing its losses from illegal connections and non-

paying legal connections, and to normalise illegally connected customers. Coelba’s SEP also involved

the use of NGOs to set up and operate intermediary operations, including recruitment and selection of

community agents, who collect payments and dues from customers. Installation of energy-efficient

light bulbs, upgrading of internal wiring, subsidised connection fees, and improving response time and

outages, are also some of the features common to COELBA and LIGHT’s PRONAI. The success of Coelba’s

intervention can be gauged by the customer-satisfaction survey, which indicated that more than 90%

of the customers were satisfied with the service.

In Colombia, Union Fenosa was also faced with problems similar to those suffered by the utilities

mentioned above. Legal, political, social and regulatory problems, combined with electricity theft and

poor profitability, led the utility to adopt a different approach to each group of consumers. For the poor

consumers, Union Fenosa created local micro-enterprises for metering and collection, community

responsibility for payment, and the creation of a separate legal entity (Energía Social) to manage the

different organisational needs of the community-led approach (Manzetti and Rufin 2006).

Although there seems to be a handful of innovative approaches, a significant observation common to

all of the cases described above is that the planning aspect of slum electrification continues to remain

top-down. Perhaps owing to the high infrastructure costs involved, only the implementation of the

programme has been made participative, involving NGOs, CBOs and the community. The demand for

slum electrification is also not bottom-up, as is evident from the popularity of illegal connections in

slums. That utilities need to improve fiscal discipline, by curtailing losses due to power theft, seems to

be the main evidence provided in the case studies detailed above (USAID 2004). Universal-access

obligation as a result of the privatisation of electricity or the government’s commitment to the poor,

has also been a driving force for slum electrification in some countries (Baruah 2010, Manzetti and Rufin

2006, Scott et al. 2005). For such a top-down approach to be successful, the commitment of the

government/private utility to extend coverage to the slums is of as much importance as the

involvement and participation of the community (Scott et al. 2005). Despite the best efforts of the

service providers (government or private utility) and NGOs, if the community continues to default on

the payment of bills and repayment of loans, or prefers illegal connections to legal connections, slum-

electrification programmes will neither be successful, nor will they be beneficial to the poor.

INTEGRATING ELEMENTS OF INCLUSIVE PLANNING HELPS TO IMPROVE ACCESS

RATES IN SLUMS. TENURE SECURITY IS CRITICAL FOR HOUSEHOLDS TO SEEK LEGAL

CONNECTIONS.

Tenure insecurity is known to have a direct impact on access to basic services. ‘Informal settlements

and insecure land tenure are the result of an exclusionary planning and urban-management system,

which fails to provide legal and practical conditions for lower-income groups to access basic services’

(Almansi, 2009). Tenure security is often used by the government to deny services (government and

donor-assisted programmes) to the poor, which result in an absence of investment in poor communities

(Winayanti and Lang, 2004). Lack of legal recognition, on the one hand, prevents service providers from

104

venturing into slum communities for service provision (Scott et al. 2005) and, on the other hand,

prevents the urban poor from investing in housing improvements (Scott et al. 2013). The fear of eviction

is very real for both the slum dweller and the private utility provider who stands to lose their investment

in the community. Informal slums that do not have de facto tenure security have lesser access to basic

services than formal slums that are recognised and enjoy de jure tenure security (Chandrasekar 2005).

Evidence from six case studies is used to stress the importance of tenure security in provision of basic

services to slums.

In Jakarta, Indonesia, the government’s granting security of tenure has prompted slum-dwellers to

execute several housing improvements, which included investing in electricity lines (Winayanti and

Lang 2004). Similarly, granting of land title to programme beneficiaries as part of the settlement-

upgrading programme in Promeba and Rosario habitat in Argentina resulted in thousands of poor

families gaining access to electricity connections (Almansi 2009).

In Ahmedabad, the NGOs and CBOs facilitated negotiations between the Municipal Corporation and

the AEC to find a solution to the illegality of land occupied by the slum-dwellers (Baurah 2010). It was

agreed that the Municipal Corporation would issue a ‘no objection’ certificate that provided immunity

from eviction to the SEP beneficiaries for a period of 10 years. The AMC introduced an indemnity bond

in other non-networked slums that protected it from legal action if slum-dwellers were evicted or

relocated by the Municipal Corporation any time after the electricity connections were provided

(Baruah 2010).

In the case of the Rio LIGHT PRONAI project, access to electricity provided the slum residents with proof

of residence, which was a highly valued necessity for obtaining phone connections, establish credit, etc.

(USAID 2004). Local government was encouraged to extend land tenures, which legitimised occupancy

and was also an incentive to pay bills regularly. Recognising the ‘citizenship right’ of the slum dweller

to an address and proof of residence was among the most invaluable benefits in participating in the

PRONAI project.

In Thailand, household registration was made compulsory for obtaining electricity connections

(Shrestha et al. 2008). Since this meant that non-registered households could not produce the ID

required for electricity connections, the government issued a quasi-household ID, which enabled the

household to apply for a connection, but at a higher cost than fully registered households. It has been

found that the quasi-household ID cards have substantially reduced the number of illegal electricity

connections in Thailand. The authorities in Philippines and New Delhi have taken a liberal stand:

although residences are not officially recognised and the dwellings are illegal, the government extends

basic services, simply because these communities are well established and tolerated (Scott et al. 2005).

The availability and supply of electricity to slum settlements is closely linked to the urban-planning

process, which often excludes informal slum communities in the cities. ‘Allocation of land for the urban

poor has not received appropriate attention from governments’ (Winayanti and Lang 2004). Evicting

slums-dwellers or relocating slums merely moves the problem from one location to another, instead of

arriving at a sustainable solution. By denying land tenure, poor communities are not only excluded from

the planning process, but are also denied their right to citizenship. Tenure insecurity also has several

economic disadvantages to both the government/service provider and the poor, as it gives rise to illegal

service providers, who gain from the loopholes in the planning and legal framework. The onus,

therefore, is on national and local governments to provide an enabling environment by granting land

tenure that not only strengthens beneficiaries’ feeling of inclusion, but also stimulates private

investment in urban poor settlements (Almansi 2009, USAID 2004).

105

SUMMARY

Provision of electricity has, by and large, followed a top-down approach, often provided either by

government-owned or privately owned utilities. Although alternatives such as kerosene, firewood and

LPG, are used for cooking needs, demand for electricity for lighting, heating and entertainment

purposes in slums is high (Moulick et al. 1999). High connection cost; lack of security of tenure; poor

service and frequent disconnections; a lack of trust between the service provider and the slum-

dwellers; reluctance among private players to enter into slums; non-payment and theft; high

prevalence of illegal connections; and poor-quality wiring and infrastructure, are a few of the reasons

attributed to poor access in slums.

However, there is recognition among governments that slums and squatter settlements can no longer

be ignored and their citizenship rights to basic services must be addressed in order to reduce their

vulnerability to poverty. There is also the recognition that a new and bold approach is needed, one

where the needs and means of the poor are understood and services tailored to suit their needs, instead

of a one-size-fits-all approach. NGOs and CBOs have been used as an effective mechanism to enter into

slums, to listen to the voices of slum-dwellers, and in the roll-out of services. NGOs have also played

the role of mediator in negotiations between the government/utility and the community members.

Private utilities that have been successful in providing access to slums have used innovative approaches

in management and pricing, often combining this with consumer education to have a longer-lasting

impact on the urban poor. Slum communities have also shown their interest in accessing legal electricity

by participating in SEPs, often investing/contributing their funds towards wiring, installing meters and

monitoring the community for theft and non-payment.

Notwithstanding, the success of these efforts can be replicated and sustained only if all stakeholders

are involved in a partnership approach (USAID 2004). Although the planning and finance for SEPs may

be top-down, the implementation must be bottom-up. A clear commitment from all stakeholders and

a partnership based on trust are essential to success.

106

Figure 4.1 Top-down approach, backed by political commitment to the poor and the creation of specialised implementation agencies for pro-

poor projects, can help in improving access.

Change in political and

economic context of a country

(Baruah 2010, Manzetti and

Rufin 2006, Scott.N et.al 2005,

Shrestha et.al. 2008, USAID

2004)

Priority of

government towards

the urban poor

(Shrestha et al. 2008,

USAID 2004)

Creation of

specialized agencies

for coverage/access

to the poor (Shrestha

et.al 2008, USAID

2004)

Focus on access

for all/ Universal

Service obligation

(Shrestha et al

2008)

Partnership with

government owned

utility or private utility

for slum

electrification

(Baruah 2010,

USAID 2004)

Facilitates better co-

ordination between

different agencies

Electrification integrated

with other programs

such as housing or slum

re-development

Simplified

procedures- avoids

additional paper

work and

bureaucracy

Minimizes risk of

eviction

Granting of de-

facto tenure

security (Baruah

2010)

Incentive for

households to

invest in legal

connections

(Baruah 2010)

Priority given to

poor connections

Connections to the

poor a source of

revenue rather

than loss

Incentives for poor

connections

Improvement in

Access

Better

understanding of

the context and

requirements

Private sector

investment

Private sector

efficiency

Customization to

meet the needs of

the poor

Increased

willingness to

apply for

connections

Fiscal discipline

minimise losses

Reduce costs

Ability to provide

more connections

Improves

adequacy

Improves

affordability and

connectivity

Improves

affordability

107

Inclusive and sensitive

approach

(USAID 2004, Baruah 2010,

Manzetti and Rufin 2006)

Utility

Traditional approach

(Parikh et al 2012, Scott et al

2003)

Community engagement

(USAID 2004, Baruah 2010)

Commercial practices

(Manzetti and Rufin 2006,

Baruah 2010, USAID 2004)

Management Practices

(Scott et al 2003, USAID

2004)

Limited customisation

Technical areas

Business areas

Reduced

connection costs

More frequent

billing cycles

Expenditure

control schemes

Consumer

education

Creates trust

High upfront costs

Lack of controls

on electricity

spends

Illegal

connections

End of month bill

doesn’t allow to

track usage

high bills leading

to default/non-

payment

Inadequate and

poor supply

Disconnections

Reduces access

Improved internal

wiring

Remove corrupt

employees

Prioritize customer

care

Prioritize customer

care

Setting up office

within community

Improves access

Improves

affordability and

reduces illegal

connections

Improves

customer

satisfaction

Reduces

consumption and

Improves

affordability

Easier payment

options and

improved

collection

Increased

participation by

households

Figure 4.2: Top-down approach that is sensitive to the needs of the urban poor can help in improving access.

108

Figure 4.3 Top-down approach, supported by NGO intervention and community involvement, yields better connectivity and coverage.

Legal, political, regulatory and

social problems faced by

government/private utility in

service provision to the urban

poor

Poor service to

slums

High transaction costs

(Baruah 2010)

Lack of security of tenure

(Scott N et.al 2005)

Theft and non payment of

electricity bills

Physical constraints such as

poor housing material,

unplanned layout, dense

grouping of houses, narrow

lanes and unsafe wiring

(USAID 2004)

Slum electrification

program/ slum up

gradation program

Involvement of

NGOs and CBOs

(Baruah 2010,

USAID 2004)

Act as intermediaries between

slums and government for land

tenure (Baruah 2010, USAID

2004)

Conduct willingness to pay

study (Baruah 2010)

Consumer education programs

Staff recruited from local

community

Community agents motivate

residents to seek legal

electrification

Community agents/local micro

enterprise for collection of

payments

De facto tenure security as a

result of legal electricity

connections

Improved affordability

Improved wiring and efficient

energy consumption

Improved access

Innovative pricing

methods (Scott

et.al 2003)

Innovative

community

engagement

methods (Baruah

2010, USAID

2004)

Monthly bills instead of bi-

monthly bills. Based on

affordability criteria

Setting up of meter walls

instead of in-house connections

Reduced transaction costs

Trust building with the slum

dwellers and better response to

complaints

Regular payment of bill/

repayment of loans

Loans for internal wiring and

payment of connection costs,

and reduced connection cost

Prepayment meters and pre-

paid cards

Involve CBOs, local

associations and religious

groups

109

Legal Status of Slums/

Tenure security

(Scott et.al.2005, Manzetti

and Rufin 2006)

Formal or recognised

slums (Chandrasekar

2005)

De-jure land tenure Proof of residence

Government or private

utility willing to provide

electricity connections

Poor households

willing to invest

capital and pay for

new connection

(Winyanti &Lang

2004

Improvement in Access

Informal or unrecognised

slums

(Parikh et al 2012)

Government engages in informal

slum due to slum upgradation/

new scheme to reduce urban

poverty/ Universal service

obligation/ political pressure

(Baruah 2010)

Government willing to

overlook legal status or

provide conditional access

(Shresta et al 2008, Scott et

al 2005)

No Objection Certificate for a

fixed period (Baruah 2010)

Quasi household IDs

(Shresta et.al., 2008)

Illegal or squatter

settlement

No proof of residence

Government/private utility

unwilling to provide

connections due to

absence of legal

mandate

Poor households

unwilling to invest

due to risk of

demolition or eviction

Poor Access

Illegal and unreliable

connections

Improves connectivity

Improves

connectivity

Figure 4.4: Integrating elements of inclusive planning helps to improve access rates in slums. Tenure security helps households seek

legal connections.

110

WATER SUPPLY

Water supply infrastructure typically comprises components such as water-treatment plants, trunk

networks and distribution networks. These components are often conceptualised in the form of

network and centralised infrastructure, created for delivering water-supply services to the consumer

or users. However, there also exist decentralised forms of water-supply infrastructure, which are

substantially different from network infrastructure. The decentralised form consists of water-supply

service at either household or community level, through bore wells, open wells, water tanks, hand

pumps and alternative water-service providers. A large number of studies reviewed indicate that the

network view of water-supply infrastructure is usually promoted and used for expanding water-supply

services to low-income settlements. However, some studies indicate that the public water supply and

sanitation (WSS) utilities are increasingly realising the importance of decentralised WSS infrastructure

in low-income settlements. Following analysis, we observe that there is a rich diversity in models/forms

adopted for service delivery in low-income settlements. This diversity was reflected in the different

approaches seen in the sector (top-down approach vs. bottom up approach) and participation (passive

vs. active participation). Further investigation revealed that these diverse studies can be categorised

based on the type of actor driving the process of service delivery. These categories represent three

different modes of service delivery: 1) public-sector driven, 2) private-sector driven, and 3) NGO-driven.

We observed that the initial two modes reflect the top-down approach, while the last one reflects the

bottom-up approach. Three themes related to these categories are discussed below:

PUBLIC WSS UTILITIES HAVE TO REFORM THE TOP-DOWN APPROACH, WITH ADDED

FOCUS ON INCLUSIVITY, PARTICIPATION AND INSTITUTIONAL NORMS IN SERVICE

DELIVERY TO THE URBAN POOR.

Studies have discussed various reasons behind the poor state of water-supply services in low-income

settlements: These can be categorised as:

1) Government stability and accountability: government mismanagement and conflict (Devas and

Korboe 2000), poor accountability of local governments (Devas and Korboe 2000), and unclear

responsibilities among government agencies for service delivery in poor settlements (Connors

2005; Ahmed and Sohail 2003);

2) Legislative shortcomings: absence of a legal mandate for network expansion in unplanned

areas (Devas and Korboe 2000; Ahmed and Sohail 2003), and exclusion of slums outside the

ambit of formal legal mandate (Hossain 2012);

3) Public-sector shortcomings: neglect of service delivery to the urban poor by powerful and

statutory authorities (Hossain 2012), financial crunch faced by water utilities and lower

financial allocation for service delivery to the urban poor (Ghafur 2000), and lack of knowledge

on the part of public water utilities about community resources and service delivery to the

urban poor (Connors 2005; Ahmed and Sohail 2003);

4) Community awareness: Absence of knowledge among slum residents about their rights, water-

supply system and avenues available for service improvement (Ghafur 2000).

111

The studies have indicated that the public WSS utilities require either external or internal stimuli for

reforming the top-down approach, with the aim of addressing the above-stated bottlenecks in the

service delivery to the urban poor. Water utilities lacking these stimuli do not make any progress on

addressing the reasons behind poor service delivery, resulting in the maintenance of the status quo.

The situation of disinterest in the public sector towards service delivery to the urban poor is the result

of the combination of reasons listed above. For example, two studies have indicated that the WSS utility

failed rectify the absence of a legal mandate for network expansion in informal settlements (Devas and

Korboe 2000; Hossain 2012). The results showcase the fact that the lack of water supply from the public

WSS utility forced the slum households to rely on alternative water sources, such as ground water and

alternative water-service providers. The use of ground water jeopardises sustainability, as it results in

stress on ground-water sources, lowering of the ground-water level and salinity ingress. The water

sourced from the alternative water-service providers is costly and of questionable quality, affecting

both affordability and adequacy of water services.

Devas and Korboe (2000) discuss how the distance between the decision making of the public WSS

utility and on-the-ground realities in low-income settlements adversely affects the water-supply

infrastructure (). Some of the negative effects are: 1) discontinuation of public standpipes affecting the

access to water supply for vulnerable sections of slum communities, which cannot afford individual or

group connections; 2) arriving at connection charges without analysing the ability of the urban poor to

pay, resulting in a lesser number of individual connections; and 3) using a graduated block-tariff

structure for individual, as well as group ,connections, resulting in higher water charges for group

connections. Hossain (2012) describes a community that had to resort to illegal water services provided

by local men. This community has come together to form an organization to facilitate access to legally

supplied water. Although the community organization was recognised by the government to avoid the

possibility of eviction due to the insecure tenure of their settlement, they could not get access to a legal

water supply. Finally, the community was forced to tap water from an existing household, and run an

illegal water-supply network. The water services charges were also exorbitantly high in comparison with

water charges levied by the public WSS utility. Also, the durability of the water supply was questionable,

as the illegal water sourcing led to undue influence from politicians and corrupt public WSS utility staff.

We have come across different external stimuli, such as ODA with a focus on service delivery to the

urban poor, unrest and dissatisfaction among the urban poor over the state of WSS services, and

societal pressure to include slum-dwellers in participatory governance (Ahmed and Sohail 2003;

Connors 2005).

The studies have indicated that the funding programmes by sources of ODA have substantially

influenced the WSS service delivery in poor settlements. The access to these funds was contingent upon

addressing the reasons behind the poor state of service delivery. As a result, the WSS utilities were

forced to find solutions to the legislative, institutional and technical issues mentioned above. The

culmination of these efforts has resulted in the extension of water-supply networks in low-income

settlements in certain cases (Connors 2005; Almansi 2005). However, these programmes may be

confined to a pilot level and there is a need to sustain efforts in the direction of water supply to the

urban poor.

The public WSS utilities typically have a legal mandate to deliver water supply to notified or legally

recognised low-income settlements. Land tenure is one of the fundamental parameters that decide the

legal recognition of low-income settlements. Therefore, the low-income settlements that do not meet

the requirements of land tenure fall outside the purview of the public WSS utility. In some cases, donor

agencies have made funding contingent on utilities looking for alternative mechanisms for addressing

112

the constraint of land tenure (Connors 2005). The removal of this constraint has led to improved

connectivity in informal settlements. However, the sustainability of these improvements is very

important. Connors (2005) indicates that the public WSS utility was impressed with these

improvements and there was societal pressure to include the slum community in participatory

governance. The result was that the WSS utility continued efforts in this direction through mechanisms

such as 1) rephrasing the connections to slum households as an additional source of revenue, 2)

appointment of NGOs as entry points in slums, and 3) encouraging community participation in the

decision-making process. These all-round efforts not only led to sustained gain in the direction of

connectivity, but also ensured affordability of services.

The dissatisfaction over the state of water-supply services in low-income settlements may lead to social

unrest, and force the government to intervene and reform its top-down service-delivery approach with

utmost priority. Ahmed and Sohail (2003) discuss the programme for provision of water supply in low-

income settlements in Karachi, Pakistan. This programme was formulated by government agencies in

response to community unrest and dissatisfaction over the state of the water supply. The government

has explored a wider participative spectrum, involving consultation and partnership with the

community. In the first stage, a survey was carried out among households in low-income settlements

in an effort to understand their service requirements, and, subsequently, a decision was made to set

up water tanks at different places in low-income settlements. The water tanks were owned either by

the government or the community. The government provided water to these tanks, which was further

distributed with the help of community. This programme has brought positive improvements in access

and affordability of water supply.

The top-down approach does not always require external impetus to bring the public sector’s attention

towards water supply to the urban poor. For instance, in the case of the water supply and sanitation

services in Lusaka city (Kayaga and Franceys 2008), the sector had undergone reforms that involved a

slew of important pro-poor measures, such as 1) the creation of a water-supply and sanitation

regulator; 2) a legal mandate for the WSS regulator to ensure service provision for the urban poor; 3)

creation of a Devolution Trust Fund (DTF) for providing financial support to service providers for

network expansion in low-income settlements; 4) advisory support by the WSS regulator to the DTF;

and 5) preparation of guidelines on performance-assessment criteria, cost recovery and community

participation. This all-round effort bore fruit with the usage of a water-kiosk model. This model has

enabled improved access to water supply in low-income settlements with the help of financial support

from DTF and community mobilisation. The improvement in water-supply services brought by the

influence and involvement of external organisations such as ODAs, NGOs and communities indicates

the necessity of partnership for effective delivery of services in slums. This partnership can be with the

private sector, under PPP arrangements, or by collaborating with NGOs. The partnership between the

public and private sector is the focus of the next theme.

PUBLIC-PRIVATE PARTNERSHIP MODEL, WITH BUILT IN PRO-POOR CONTRACTUAL

FEATURES AND INSTITUTIONAL FLEXIBILITY, CAN SERVE AS AN EFFECTIVE

MECHANISM FOR IMPROVED WATER-SUPPLY SERVICES IN LOW-INCOME

SETTLEMENTS.

The partnership between the public sector and private sector (corporate for-profit entities) has been

gaining prominence in developing countries as a mechanism to improve and upgrade infrastructure.

The interests in PPP arrangements stem from their potential to address financial, policy and technical-

capacity challenges faced by public-water utilities. We have positioned the PPP arrangements as a part

113

of the top-down approach to the parameter of degree of inclusivity. This is based on the practice of

minimal involvement of community or NGOs in crafting PPP arrangements, and the subsequent phases

of infrastructure creation and service delivery. There are various factors that create pitfalls in the use

of the PPP model: location and layout of slums, and alternative water-service providers.

Low-income settlements are often located far away from the existing water-supply network in peri-

urban areas or beyond service-area boundaries. Similarly, low-income settlements within the municipal

boundaries are served by illegal water connections or alternative water-service providers. The water

service provided by these two means fares very poorly on the criteria of affordability, effort and time

required to access the service, and sustainability. Therefore, it necessitates the laying of new

distribution networks. This results in high investments in the creation of water-distribution networks

and, consequently, higher connection charges to the user. Considering the inability of the poor to pay

high connection charges, the private sector, driven by the profit motive, finds the network expansion

in low-income settlements to be a financially unviable proposition. The high connection charges can

deter the poor from connecting to the water-supply network. In addition, the low level of consumption

by users in low-income settlements further reduces its financial attractiveness. Under this scenario, it

becomes necessary to include in the concession agreements the specific mandate of extension of

services to poor areas. The inclusion of extension targets in the concession agreement forces the private

sector to search for innovative ways of meeting these targets. This innovativeness, which is also backed

by the incentive to generate more revenues from service delivery, is often lacking in public WSS utilities.

The laying of pipeline networks in the low-income settlements can cause engineering and construction

bottlenecks due to narrow roads and congested layouts. Also, the requirements of the urban poor on

the parameters of adequacy, effort and time, and connectivity are different. Therefore, a one-size-fits-

all standard cannot be enforced on all water-supply users; customisation is required, especially for the

urban poor.

The low-income settlements lacking a public water-supply network and slum households that remain

unconnected to the public water-supply network, owing to higher connection charges and water tariffs,

rely on ground-water sources or alternative water-service providers. The operations of these

alternative water-service providers are beyond the ambit of the water-supply regulator or

governmental legislations. The urban poor are forced to buy the water, which is of questionable quality,

from these alternative water-service providers at exorbitant rates (Ioris 2012, Sohail 2003, Gerlach and

Franceys 2010). The alternative water-service providers often have political clout and linkages with the

staff of the public water utility. Apart from this, alternative water-service providers have invested

substantial resources in water-supply vehicles and supporting infrastructure over a period of time.

Therefore, the appropriate mechanisms for involvement of these alternative water-service providers

have become an important aspect of service delivery to the urban poor.

The public water utilities face not only technical and financial, but also legal, obstacles to the delivery

of water supply to low-income settlements. In most cases, the public water utility has a monopoly

mandate to provide services in the formal or legally recognised slums. Often, the land title for a slum

household is stressed as a legal requirement for provision of water supply; as a result, informal slums

remain outside the policy ambit of the water utility. The public sector has to provide flexibility in the

PPP concession agreements to address pitfalls in the areas of engineering and construction of network,

legal hurdles and involvement of alternative water service providers.

We have observed two categories of studies that discuss experiences with PPP arrangements: 1) studies

in which the PPP model has in-built pro-poor contractual features and/or the public sector provides

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flexibility to the private sector to customise service delivery in low-income settlements, to address

pitfalls associated with the use of the PPP model (Weitz and Franceys 2002, Gerlach and Franceys 2010,

Hardoy and Schusterman 2000, Chauhan and Lal 1999, Laurie and Crespo 2007, Sohail 2003), and 2)

studies in which the public sector failed to recognise pitfalls associated with the use of the PPP model,

resulting in a lack of pro-poor contractual features and/or the public sector showing a rigidity or

unwillingness to deviate from set/traditional practices in service delivery (Gerlach and Franceys 2010;

Laurie and Crespo 2007; Ioris 2012). These two sets of studies allowed us to compare and contrast the

working of PPP arrangements for water-supply services in low-income settlements.

The elements observed in the first category of studies that have implications for service delivery to the

urban poor are: 1) flexibility in the payment of connection charges, 2) a contractual requirement to

extend services to poor areas, 3) engineering and design standards, 4) alternatives to fulfilling legal

norms for service delivery in informal/low-income settlements, 5) involvement of non-governmental

and community organizations and 6) recognition of alternate water-service providers.

We have observed that the private sector has taken systematic measures to ease the burden on the

urban poor, due to the connection charges (Hardoy and Schusterman 2000, Weitz and Franceys 2002,

Sohail 2003). This involves understanding the ability of users to pay connection charges and allowing

the urban poor to pay the connection charges in instalments. The private sector, in many instances, has

played an instrumental role in convincing the public sector to provide financial resources in the form of

grants and subsidies to bear cost, in whole or part, for network expansion (Weitz and Franceys 2002,

Laurie and Crespo 2007). The studies have indicated that the lowering of connection charges and the

possibility of payment in instalments have a positive effect on connectivity of water-supply services.

We came across few studies indicating that the prevalent technical standards are ‘high’ on the

parameters of individual water connection, water pressure and network layout, considering the slum-

dwellers’ capacity to pay and service expectations (Weitz and Franceys 2002). The studies show that, if

the government agency is flexible and appreciates the economics of the poor, this allows the private

sector to ensure connectivity with mechanisms such as water supply through water tankers, water

tanks, water hand pumps, reselling of water by alternative water-service providers, and so on (Weitz

and Franceys 2002, Sohail 2003, Gerlach and Franceys 2010). These mechanisms were effective in

improvement of ‘connectivity’ of water supply in congested and unreachable low-income areas, which

would have remained ‘unconnected’ owing to the perceived inability to adopt engineering standards.

The studies have not reported any specific reasons that deter the public WSS utilities from using similar

flexibility in the purely ‘public-sector driven’ approach to service delivery. Although, the close readings

of these studies indicate that the probable missing element in the public WSS utility could be the ability

to create and manage these decentralised and innovative service-delivery mechanisms.

The private sector can be allowed to provide either group connections or individual connections. The

urban poor who have the capacity to bear connection charges singlehandedly can opt for individual

connections, while others can opt for group connections. The group connections formed with an

organic process of ‘self-mobilisation’, which involves communication and consultation among

households, and then approaching the concessionaire for the required number of group connections,

fares well on the parameter of ‘adequacy’ (Weitz and Franceys 2002). This necessitates the

concessionaire’s willingness to reach the ‘consultation’ level of the participative spectrum (Gerlach and

Franceys 2010). However, if the group connection is used as a normative performance measure in the

concession agreement for fulfilment of the ‘connectivity’ objective, it leads to negative effect on

‘adequacy’. A study has indicated that the private sector overestimates the number of users served per

connection, resulting in lesser water availability per household (Gerlach and Franceys 2010).

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We have observed in a study that the private sector has convinced the government to use other

documents, of which slum householders will be in, or will be able to gain, possession, as proof of identity

and residence (Weitz and Franceys 2002), thereby allowing the private sector to provide water

connections in the informal slum.

Studies indicate that, in certain cases, the concessionaire has involved the alternative water-service

providers in water supply by allowing the reselling of water. The experiences of their involvement are

mixed. Gerlach and Franceys (2010) discuss the ‘commercial kiosk-management model’, which provides

an appropriate margin for the bulk water supplier, and water-kiosk operator, and regulates the water

tariff. This results in improved connectivity in low-income settlements that are not served by a piped

water-supply network and ensures affordability of water supply. However, there are studies that

indicate the outcome of unregulated water tariffs and reselling of water by alternative water-service

providers. It is observed in these studies that the alternative water-service providers sell the water at

their discretion, and this results in an adverse effect on affordability (Gerlach and Franceys 2010, Weitz

and Franceys 2002).

The adoption of the PPP model as a top-down approach by the public water utility does not necessarily

inhibit the participation of community and NGOs in service delivery. We have come across studies that

show the involvement of NGOs in areas such as conducting information, education and communication

(IEC) campaigns, provision of microfinance, community mobilisation and serving as an intermediary

between the private service provider and the community (Weitz and Franceys 2002; Hardoy and

Schusterman 2000; Chauhan and Lal 1999). This involvement of NGOs is normally not a part of the

concession agreement, but, rather, results from the willingness of the private service provider to tap

the social and community skills of NGOs for service delivery to low-income settlements. The systematic

involvement of NGOs has brought positive improvements in project outcomes.

Effective involvement of NGOs can result in the right balance being found between technical, social

and financial resources required for service delivery.

Two themes discussed earlier focus on top-down approaches, with service delivery by public WSS utility

and usage of PPP arrangements, respectively. In the studies associated with these two themes, we have

observed that the government and/or the private sector was in the driving seat to decide the planning

and execution of pro-poor urban service-delivery programmes. Even though the involvement of NGOs

is reported in few studies related to these two themes, the NGOs primarily facilitated the agenda

decided by the government and/or the private sector.

There are another set of studies that indicate the central role played by the NGOs in the delivery of

water-supply services to low-income settlements (Bapat and Agarwal 2003, Rena 2011, Gessler et al.

2008, Kayaga and Kanimbla-Mwanamwambwa 2006, Weitz and Franceys 2002). In these studies, NGOs

played varied roles based on the local settings of a project. Kayaga and Kanimbla-Mwanamwambwa

(2006) discuss the experiences of the Water Trust system established by an NGO in the low-income

settlement in Lusaka, Zambia (). The NGO involved in this system had a longstanding association with

the low-income settlements in Lusaka and it helped to identify water supply as a t critical issue faced

by the community. This NGO then developed the Water Trust model with funding from an ODA, and

this model has the following distinct features: 1) mobilisation of community members to participate

physically and appreciate the importance of cost recovery; 2) promotion of participation at grassroots

level by formation of residents and zonal-development committees; 3) phased approach to community

involvement with elements such as provision of necessary construction materials, conducting artisan

training for community members; 4) fulfilment of legal requirements associated with the water-supply

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sector by representation to government entities in the decision-making process; and 5) formation of a

management team for service delivery with provision of technical staff, formation of service contract

with vendor and tap attendant, collection of user charges and creation of a service-monitoring

mechanism.

These well-rounded and distinct features captured different dimensions of water supply to the urban

poor and brought about a positive effect on service delivery. An increased population was served

through the standpipe and yard-tap connections; there was a reduction in distance travelled and time

to collect water, an increase in number of hours of operation, and reduction in drawing of ground-water

from shallow wells.

Along similar lines, there are two more studies indicating leadership of NGOs. One study relates to the

improvement of water supply in slums in Kathmandu, Nepal, with the involvement of an NGO (Weitz

and Franceys 2002). The public WSS utility in Kathmandu refused to provide water connections in

informal slums, citing the fact that the households did not have house-ownership certificates. After the

intervention of the NGO, the municipal ward committee agreed to remain as a guarantor for the two

unmetered public taps in the informal slums. This made the public water supply accessible to the

informal slums. The water-supply network was extended further with the community’s contributing to

laying and connecting pipes, collection of connection charges from the community, and the formation

of a water-user group for monitoring and funding by ODA for the laying of main water lines. The

extension of the network, apart from increased connectivity, ensured adequacy of water supply by

providing a sufficient number of community taps.

Weitz and Franceys (2002) share the experiences of a water-supply project in Dhaka, Bangladesh (). In

this project, the NGO served as an intermediary between the slum communities and public WSS utility.

The NGO involvement positively addressed different dimensions of service delivery: 1) affordability: the

water tariff was decided by the community to cover the public WSS utility’s bills after taking into

consideration prices charged by private water vendors; 2) effort and time: water points were installed

within the slum settlements; and 3) durability: creation of institutional mechanisms, such as the

formation of a water management committee (WMC), bringing financial management of the water-

supply initiative under the purview of the WMC, including collection of water charges from users, and

construction of water points on municipal land. Another study highlights the need for cooperation

between NGOs and the public WSS utility (Bapat and Agarwal 2003). In this study, a group of slum-

dwellers came together under the championship of an NGO and installed household water connections

at their own cost. However, the public WSS utility did not connect these households to the water-supply

network, forcing these households to buy water from alternative water-service providers at a high

price.

SUMMARY

The analysis of studies pertaining to water supply indicated three modes of service delivery, namely: 1)

public-sector-driven, 2) private-sector-driven and 3) NGO-driven. The initial two modes reflect a top-

down approach, while the last one reflects a bottom-up approach. We observed that the low degree of

inclusivity and participation in the top-down approach resulted in ineffective service delivery to the

urban poor. However, whenever there existed external or internal stimulus for the reforms in the top-

down approach and a willingness on the part of the public sector, it resulted in a higher degree of

inclusivity and participation. This consequently translates into effective service delivery to the urban

poor. The path towards the higher degree of inclusivity and participation requires partnership with able

actors, such as private-sector entities and NGOs. The PPP model is a mechanism that brings together

117

public and private actors for service delivery. We have observed that the PPP model holds the potential

to address the bottlenecks faced in the ‘purely public’ service-delivery model. The ‘private-sector-

driven’ mode of service delivery is motivated by the financial incentives to the private sector and, as a

result, the private sector takes the leadership role in reforming the top-down approach in order to

create better revenue streams. Therefore, the pro-poor concession agreement and willingness of the

public sector to provide flexibility to the private sector to meet the service-delivery needs of the urban

poor are essential elements. The ‘NGO-driven’ mode of service delivery represents a high degree of

inclusivity and participation. It results in an effective service delivery; however, the cooperation and

support of the public sector is essential to the success of this mode.

118

Public sector driven “Top Down

Approach” to service delivery

Poor state of water supply

services in low income

settlements

Government instability and

unaccountability

(Devas and Korboe 2000; Connors

2005; Ahmed and Sohail 2003)

Legislative hurdles in supplying

water to urban poor

(Devas and Korboe 2000; Ahmed

and Sohail 2003; Hossain 2012)

Policy vacuum about how to solve

challenges faced by urban poor

(Hossain 2012)

Financial crunch faced by WSS

utilities and lower financial

allocation for service delivery to

urban poor

(Hossain 2012)

Lack of community knowledge in

WSS utilities

(Ghafur 2000)

Poor community awareness about

urban governance and service

delivery

(Connors 2005; Ahmed and Sohail

2003)

Funding programs by ODAs

Pro-poor aid conditionalities

WSS utilities decided to find

solutions to reasons behind

poor WSS services

Land tenure - deciding legal

recognition of slums and

service delivery

Low income settlements

falling outside the purview

of WSS utility

(Connors 2005)

Use of alternate mechanisms to

meet the purpose served by land

tenure

Improved connectivity

in informal

settlements

Lack of impetus to reform

the “Top Down Approach”

Absence of legal mandate

for network expansion in

informal settlements

Failure of WSS utility to

come out of legal quagmire

(Devas and Korboe 2000;

Hossain 2012)

Slum households forced to

rely on alternate water

sources

Lowering of ground water

and salinity ingress

Compromise the

sustainability in WSS

service delivery

Costly and poor quality

water supply

Adverse effect on

affordability and adequacy

of water services

Disconnect between between

decision making of WSS utility

and ground realities in low income

settlements

(Devas and Korboe 2000)

Lack of willingness to

reform the “Top Down

Approach”

 Discontinuation of public

standpipes

 Higher connection charges for

individual connections

 Higher water charges for group

connections

Adverse effect on

connectivity and

affordability of WSS

services

Community came together

to facilitate access to legal

water supply

Community resorted to illegal

water services provided by

local musclemen

(Hossain 2012)

Community successfully

convinced the government to

avoid eviction, but, failed to

secure legal WSS service

Community created illegal

water supply network from

nearby legal water source

Higher water charges

Undue influence from

politicians and corrupt WSS

utility staff

Adverse effect

on affordability

of water supply

Adverse effect

on durability of

water supply

Community unrest and

dissatisfaction over state of

water supply

(Ahmed and Sohail 2003)

Forced the government

to intervene and reform

“Top Down Service

Delivery” approach

Consultation and

partnership with the

community

Creation of government /

community owned water

tanks

Operation and maintenance

of water tanks by

community

Improvements in access

and affordability of water

supply

Willingness of government to

improve “Top Down

Approach” to service delivery,

with focus on pro-urban poor

measures

(Kayaga and Franceys 2008)

improved access to water

supply in low income

settlements

Creation of WSS regulator

Entrusted responsibility of

ensuring service provision

in slums to WSS regulator

Financial support for

network expansion in low

income settlements

Encouragement to

community participation

WSS impressed with

the improvements

Societal pressure to

include slum

community in

participatory

governance

WSS impressed with

the improvements

Fig 4.5: Public WSS utilities have to reform the top-down approach, with an added focus on inclusivity, participation and institutional

norms in service delivery to the urban poor

119

Disinterest of WSS utility

towards network expansion

in LIS

Inability of urban poor to

pay higher connection

charges

Low-income settlement

(LIS) located far away

from existing WS network

LIS located within service

areas boundaries lack

WS network

Higher investments in

laying new distribution

network

Higher connection charges

Lower level of consumption

in LIS

Weak revenue potential for

WSS utility

Poor state of WSS services

in urban areas

Decision of the government

to adopt PPP model for

service improvement

PPP model with in-built pro

poor contractual features

Inclusion of extension

targets in the concession

agreement

(Hardoy and Schusterman

2000; Weitz and Franceys

2002; Sohail 2003)

Measures taken by the

private sector to meet

extension targets

Reduction in financial

burden on the urban

poor

Improvement in

connectivity and

affordability of

WS services

Engineering and

construction challenges

posed in network expansion

in LIS

Proposal by the private

sector to adopt innovative

service delivery

mechanisms and ease

technical parameters, to

connect urban poor

Public sector provided

flexibility to the private

sector to customize service

delivery in LIS

Water supply by water

tankers, water tanks and

water hand pumps

(Weitz and Franceys 2002;

Sohail 2003; Gerlach and

Franceys 2010)

Improvement of

“connectivity” of

water supply in

congested and

unreachable low

income areas

Allowing private sector to

provide group connections

Communication and

consultation among

households in LIS for

arriving at number of

group connections

Adequacy of water

supply services

Private sector interprets the

number of users served per

connection more

generously

Group connection used as

a normative performance

measure for fulfillment of

connectivity objective

(Gerlach and Franceys

2010)

Lesser water availability per

household

Inadequate water

supply

Reselling of water by

alternate water service

providers

Appropriate margin for the

bulk water supplier, and water

kiosk operator, and regulated

the water tariff

(Gerlach and Franceys 2010)

Improved connectivity

and ensured

affordability of water

supply

Unregulated water tariff

(Gerlach and Franceys

2010; Weitz and Franceys

2002)

Adverse effect on

affordability of water

users

Involvement of NGOs for

tapping social and

community knowledge

(Weitz and Franceys 2002)

PPP model lacking pro poor

contractual features

Discrepancy between municipal and service area

boundaries in concession agreement

(Gerlach and Franceys 2010)

Lesser number of new

connections in LIS

Lacunae in PPP model with

lack of clarity on concession

area

(Laurie and Crespo 2007)

Lesser number of

connections in LIS

Private sector convinced

the public sector to waive

requirement of land title

as a proof of identity and

residence

(Weitz and Franceys

2002)

Private sector provided

connections in informal

slums

 Understanding the ability of urban poor to

pay connection charges

 Allowing the payment of connection

charges in installments

 Convincing the public sector to provide

grants and subsidies to bear costs of

network expansion

(Weitz and Franceys 2002; Laurie and Crespo

2007)

Fig 4.6: PPP model, with built-in pro-poor contractual features and institutional flexibility, can serve as an effective mechanism for improved WS

services in LIS

120

Poor state of

WSS services in

low income

settlements

(LIS)

Leadership position

taken by NGOs for

service

improvement, with

adoption of “Bottom

Up Approach”

 Community mobilization for constructing service infrastructure

 Improvement of community awareness about cost recovery in service delivery

 Representation to government entities in the decision making process

 Community capacity building for creation and maintenance of infrastructure

 Creation of community teams for collection of user charges and service

monitoring

(Kayaga and Kadimba-Mwanamwambwa 2006)

 Improved connectivity: Increased population

served by stand pipe and yard tap connections.

 Reduction in distance travelled and time to collect

water

 Improved adequacy: increase in number of hours

of operation

 Improved sustainability: Reduction in drawing of

ground water from shallow wells

Initiation of dialogue with

public WSS utility that was

refusing water connections

in informal slums

(Weitz and Franceys 2002)

NGO convinced municipal management committee to remain guarantor for

two unmetered public taps

Water supply accessible in

informal slums

 Facilitation of funding by ODA for network expansion in informal

slums

 Community contribution in burying and connecting pipes

 Collection of connection charges from the community

 Formal of water user group

Increased connectivity

Ensured adequacy of water

supply by providing

sufficient number of

community taps

NGO served as an

intermediary between the

slum communities and

public WSS utilities

(Weitz and Franceys

2002)

Water tariff was decided by community,

considering payment of public WSS utility's

bills and prices charged by private water

vendors

Installation of water points

within slum settlements

Formation of water

management committee

(WMC)

Entrusted financial

management of WS

initiative to WMC

Collection of user charges

Construction of water points

on municipal land

Ensured affordability in WS sevices

Ensured durability in WS services

Reduction in effort and time

 Formation of community

groups

 Installation of household water

connections

(Bapat and Agarwal 2003)

Public WSS utility did not

connect households to the

WS network

Householders had to buy

water from vendors at

higher costs

Lack of co-operation

between NGO and public

WS utility

Fig 4.7: Effective involvement of NGOs can result in achievement of the right balance between technical, social and financial resources

required for service delivery

121

SANITATION SECTOR

‘Lack of basic sanitation and adequate water for bathing and washing clothes is an acute problem and

an infringement of human dignity and rights. Governments lack sensitivity to these issues and, as towns

and cities grow, they do not seem to be prepared to tackle this looming crisis’ (Water Aid India 2008).

Since sanitation is closely linked to health and productivity, there is a heavy price to pay for ignoring

the sanitation needs of the urban poor. While high-income households have the capacity to construct

their own toilets and link them to the existing sewerage system, in contrast, most urban-poor

communities practise open defecation or use unhealthy and unsanitary make-shift toilets that are

perilous to both their community and the environment. Waterlogging and stagnation stemming from

poor sanitation are also problems that exacerbate the health risk.

Provision of sanitation in cities has predominantly been a government service — that is, provided by

the municipal or local government. Sanitation can be bifurcated into two types of infrastructure: (a) a

sewerage and/or drainage system including sewerage mains and feeder systems; and (b) toilet facilities.

While planning, design and construction of sewerage systems has predominantly been the

responsibility of local or municipal governments, toilets, which are at built at household level, are often

constructed by individuals using their own capital. However, poor communities do not have access to

either city-level sewerage systems or individual toilets (Bapat and Agarwal 2003, Hasan 2006). Since

many slum communities are unplanned/illegal settlements to start with, they are often excluded from

city planning. Hence, slum settlements are provided with connections to either public/community

toilets or sewerage mains on an ad hoc basis — without much planning or understanding of community

needs (Kifanyi et al. 2013, Burra et al. 2003, McFarlane 2009, Chauhan and Lal 1999, Joshi 2005).

Spatial constraint also poses a major problem in provision of sanitation in slums. Availability of sufficient

land within the slum to construct community toilets is a challenge, and space within the individual

house to construct a toilet is a luxury (Bapat and Agarwal 2003, Burra et al. 2003, Hobson 2000). As a

result, slum residents are forced to share their toilets with neighbours, use public or community toilets

that are badly maintained, travel long distances and wait in serpentine queues to use those toilets or

defecate in open/plastic bags, buckets, etc. Overall, very little attention has been paid to three key

aspects: planning, construction and maintenance of sanitation infrastructure for the urban poor.

As mentioned earlier, since the responsibility for sanitation has primarily rested with governments,

provision of services to slums has been top-down, characterised by lack of sufficient planning,

innovations in design/construction and poor maintenance, which have exacerbated the problems of

the poor (Bapat and Agarwal 2003, Burra et al. 2003, Hobson 2000).

Private-sector efforts have also failed, as private providers are interested in the middle-class, rather

than the poor, who do not have the means to pay the high user charges (Kifanyi et al. 2013). NGOs and

CBOs, however, have experienced some success in sanitation efforts, as they have focused on

community involvement in planning, design, implementation and maintenance (Burra et al. 2003,

McFarlane 2009, Chauhan and Lal 1999). Interestingly, there has been a recent paradigm shift, where

we see the coming together of all stakeholders — that is, government, NGOs and the community, in a

joint public-private and community partnership that has important lessons for widening the sanitation

coverage in slums (Burra et al. 2003, McFarlane 2009, Chauhan and Lal 1999, Weitz and Franceys 2002,

Kifanyi et al. 2013, Khandaker and Badrunnessa 2006, Gold 2013). The following sections discuss these

themes in greater detail.

122

Governments’ top-down approach lacks planning, focuses attention only on ad hoc creation of

infrastructure (capital costs) and pays little attention to design and maintenance (D&M costs).

International perspectives on sanitation show that provision of sanitation services to the poor have

suffered due to the (a) lack of consultation/participation of users in identifying, planning and

implementing their sanitation needs and (b) government’s lack of financial resources, sensitivity in

understanding the sanitation needs of the urban poor and a commitment to address their basic

entitlement (Ghafur 2000, McFarlane 2009, Burra et al. 2003, Kifanyi et al. 2013). Overall, sanitation

lags behind water provision because open defecation, and flying or platform toilets are options unlike

water and electricity, for which a service provider is needed (Joshi 2005).

In the traditional top-down approach of service provision, slum-dwellers and low-income households

have been provided with some, albeit rarely adequate, connectivity by the government. Due to the

limitations of this approach, such as lack of consultation, poor design and, more importantly, little

attention to maintenance of infrastructure, the longevity of the result of these efforts has been affected

(Burra et al. 2003). Data on sanitation often understate the problems. Since access to sanitation is

measured mostly in terms of connectivity, an explicit distinction between households with toilets and

households that use community/public toilets is absent (Adubofour et al. 2012, Osumanu 2007).

As can be seen from the evidence presented earlier in this chapter, connectivity accounts for the highest

number of assessments, and shared or community connections are more numerous. Due to lack of

participation in planning and implementation of sanitation efforts, community connections provided

by the government using the top-down approach have not shown results, as there is no ownership of

the infrastructure within the community (Ghafur 2000). When combined with insufficient resources

(after donor assistance has ended), the community eventually stops using the infrastructure altogether

(Roma and Jeffrey 2011).

Burra et al. (2003) also point out that, until recently, even international funding agencies (who fund

state and central government’s poverty-alleviation programmes, which include sanitation measures)

were reluctant to accept public or community toilets as a solution to sanitation deficiencies in slums.

However, the attitude of ODA providers has changed in the recent past, resulting in a slew of slum-

sanitation projects that have been undertaken by various governments. For example, UNICEF in

Bangladesh (Ghafur 2000), the Canadian International Development Agency (CIDA), UNDP, DFID and

the World Bank in Kumasi, Ghana (Devas and Korboe 2000) and in Mumbai, India (McFarlane 2009).

The Slum Improvement Project (SIP) in Bangladesh is an interesting case study that highlights a top-

down model that provided connectivity, but failed in addressing the needs of the community. The SIP

was a state sponsored, donor-assisted government intervention, begun as a pilot in 1985 and covering

36,000 households in 200 project sites in 25 municipal towns and city corporations. The government of

Bangladesh was persuaded to pursue and implement the UNICEF-Bangladesh-funded SIP (whose main

role was to encourage governments to address the problems of the poor), as it did not have the

necessary financial means to implement the project, and UNICEF was willing to offer financial support.

The SIP targeted women by providing income-generating loans, supporting day-care centres,

healthcare, tube wells and sanitary latrines (Ghafur 2000).The SIP followed a four-tier implementation

structure (with inputs from UNICEF) that included all stakeholders, including ministers, funding-agency

representatives, NGOs and, the Local Government Engineering Bureau (LGEB) ,which was given the task

of nationwide co-ordination.

123

Primarily a top-down approach, although the SIP was claimed to be a success in improving the living

conditions in the project areas, it reached less than 4% of the poorest families and less than 2% of urban

poor households (Ghafur 2000). With the funding from UNICEF coming to an end, implementation of

the SIP was also discontinued, since the Bangladesh government could not find the resources to

continue the project. The problems in this model included a hierarchy-patronage relationship, where

the authorities were making all the decisions, instead of encouraging local communities to claim their

entitlements. The ‘felt-needs’ of the community were spelt out by the providers, rather than the

recipients, thereby denying communities a chance to articulate their collective needs. Since the SIP was

implemented entirely by the government, there was no ownership of the infrastructure created.

Community members became passive-recipients. who were not allowed to air their views or participate

in decision-making. Despite these shortcomings, the Bangladesh SIP is considered best practice in the

top-down approach, as it demonstrated the ability and willingness of the government to get involved

in providing sanitation to the poor, under challenging circumstances (Ghafur 2000).

Apart from maintenance, location of toilets and the time/distance travelled to access toilets are also an

important factor that determines use of the facility, especially by women and children, who are often

ignored in the top-down approach (Joshi 2005, Bapat and Agarwal 2003, Sohail 2009, Gessler et al.

2008). Allocation of toilet seats in community toilets is tilted in favour of men, leaving few seats for

women and almost none for children. As a result, women use toilets early in the mornings or defecate

in the open, late at night, which poses not only a risk to their personal safety, but also causes gastro-

intestinal disorders (Joshi 2005, Bapat and Agarwal 2003). Due to the distance to toilets, mothers are

unable to spend time taking children to toilets that are not child-safe and, consequently, also encourage

children to defecate in the open (Joshi 2005, Bapat and Agarwal 2003, Burra et al. 2003).

The concept of public toilets built by the Indian Government is an example of a failed top-down

approach (Burra et al. 2003). Several municipalities in India have provided ‘public’ toilets, some of which

are located within slums or near slums, which slum-dwellers also use. However, many of these public

toilets have failed to achieve their purpose, due to insufficient numbers of toilet seats, the long distance

travelled to access the toilets, poor maintenance by municipal (appointed) staff/contractors,

affordability (that is, the high user charges), and exclusion of children (Burra 2001, Joshi 2005,

McFarlane 2008).

In Africa, the situation is slightly different. Urban government is largely absent in the provision of

sanitation services, and households are serviced by small-scale independent providers, or take care of

their own needs (Scott 2013). Private-sector involvement has also not succeeded; its problems include

the absence of a regulatory framework in implementing countries, lack of transparency in awarding

contracts, the weak link between service charges for contractors and cost of service, and high interest

rates (Weitz and Franceys 2002). Exploring the public-private arrangement in Queenstown and Dolphin

Coast in South Africa, Sohail and Cavill (2009) claim that sanitation is a ‘particularly difficult service to

provide under a PPP. While costs/user charges are high, poor users are not involved in the initial

decision to engage in a PPP.’ The private sector has been disappointing in the provision of sanitation,

as it could not succeed in bringing new sources of investment and was interested in targeting middle-

class neighbourhoods that could pay than the poorer settlements, who lived without adequate means

(Kifanyi et al. 2013). In Ghana, post-decentralisation, sanitation services were privatised, but quality of

service remained unimproved in Accra, Sekondi-Takoradi and Kumasi, as private contractors were not

held accountable for the poor quality of their work (Owusu and Kotey 2010, Devas and Korboe 2001).

As a result of the inadequate number of toilets, distance travelled, high user fees, heavy usage and poor

maintenance, people reverted to open defecation or flying toilets (Osumanu 2007).

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Similar experiences have been reported in La Paz and El Alto, Bolivia (Laurie and Crespo 2007), where

privatisation of water and sanitation was hampered by lack of participation by the community, no

transparency in private concessionaire agreements, and higher costs to the community. In summary,

given that the ‘right to sanitation is fundamental, leaving the government agencies responsible for

supplying it might not necessarily have the envisaged results’ (Gold et al. 2013).

NGO/CBOs (bottom–up approach) adopt a participatory approach, which results in better planned,

constructed and maintained infrastructure. However, government support is needed for scaling-up.

The bottom-up approach (that is, partnerships with local CBOs and NGOs to improve sanitation) has

provided some important lessons and insights into provision of sanitation. One of the main reasons for

NGOs and CBOs to intervene in the provision of sanitation to slums stems from the understanding that

slum-dwellers’ sanitation needs have been unmet by government, which has resulted in a proliferation

of unsanitary practices and health problems, and hinders economic activity (Burra et al. 2003, Bapat et

al. 2003, McFarlane 2009). NGOs’/CBOs’ methodology or approach is bottom-up, whereby the

community and its members are partners in the creation and maintenance of the infrastructure.

An Indian NGO that has been working with slum- and pavement-dwellers since 1984, identified lack of

access to water and toilets as major concerns of slum-dwellers, which posed serious health risks.

Government-provided public toilets were overused and badly maintained, and the contractors/staff

responsible for maintenance were not held to account (Burra et al. 2003). Using the information on

community needs, the NGO constructed integrated community pour-flush baths and toilets in slums in

various Indian cities. Slum-dwellers contributed their time and effort, and women’s self-help groups

(SHGs), formed with the help of the NGO, were eventually entrusted with the management and

maintenance of the toilets. The user fee charged was nominal (Rs.10/month or 0.16 US cents/month),

and covered the entire family, as compared with the government public toilets, which charged one

rupee (0.02 US cents) per person, per use. The caretaker employed by the SHG for cleaning and

maintenance was provided with accommodation above the toilet block itself, as an added incentive to

perform his/her job, as finding accommodation in the city was difficult and expensive. Since the SHG

members were also users of the toilet block, they ensured maintenance by close monitoring.

By breaking the conventional cycle of contractor’s monopoly in construction, and by using low-cost

technology and community labour, the NGO proved that community toilets were not necessarily an

expensive proposition to implement (Burra et al. 2003). They also paid special attention to the

sanitation needs of children (building smaller toilets) and women by increasing the number of toilet

seats available to them. Certain design changes that were child-friendly, including locating the

children’s toilets within or next to the women’s section, encouraged mothers to bring their children to

the community toilets, where they could monitor them and not fear the children’s falling into the

toilets. In addition, the NGO also empowered the SHGs by providing them with the know-how in terms

of community-toilet construction, thereby facilitating transfer of knowledge between and among SHGs

in slums across the city. The success of the NGO’s community-designed, built and managed toilet blocks

led to the Mumbai Municipal Corporation’s (BMC) extending an invitation to the NGO to become of the

partners in the Slum Sanitation Program (SSP) (McFarlane 2009).

Another successful NGO intervention in sanitation is the Orangi Pilot Project-Research and Training

Institute (OPP-RTI) in Orangi and other informal settlements in Pakistan. OPP-RTI’s low-cost sanitation

programme supports communities in developing their own ‘internal’ sewerage development, which can

then be linked to ‘external’ development, ideally built by local government (Hasan 2006). After mapping

and survey of informal settlements, OPP-RTI uses the information gathered to finance, manage and

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build internal sewerage development by organising the community and providing the necessary

training and support. OPP-RTI has demonstrated that, with technical and managerial support,

communities can build and finance the construction of sewers and drains within the community. OPP-

RTI’s success in mobilising the community to take care of its own sanitation needs has even prompted

local governments to support these efforts by building external sanitation and by in adopting the OPP-

RTI concept and methodology in their sanitation efforts (Hasan 2006).

Lumanti in Nepal is yet another NGO that started a toilet programme and sewerage project, in Lonhla

in 1986, and successfully replicated their model in 70 communities of the Kathmandu Valley (Weitz and

Franceys 2002). Although the NGO’s main focus was credit programmes for the poor, it partnered with

local communities and municipalities to lay communal sewer lines, drainage facilities, and connection

of private latrines to main sewers. Lumanti also promoted the use of public, communal and private-

toilet facilities through subsidy, and negotiated with municipal authorities to provide guarantees,

facilitated the provision of alternate sources for services, and raised community awareness regarding

effective use of resources. In addition, Lumanti provided the communities with the necessary

management skills and technical support (Weitz and Franceys 2002).

The success of NGO/CBO-driven community-sanitation programmes depends mainly on the ability and

willingness of the community to participate in and, in the long run, take charge of the maintenance of

the infrastructure created. The efficiency of the community-based approach depends on the efficiency

of the management team within the slum, since communities must be willing to take up responsibility

to operate and maintain the sanitation system; participatory planning and training of community

members are important facets of a bottom-up approach (Kifanyi et al. 2013). Maintenance of

infrastructure by the community is the most important aspect of community-led sanitation efforts,

which sets it apart from public toilets provided by government (McFarlane 2009, Khandaker and

Badrunnessa 2006, Weitz and Franceys 2002, Burra et al. 2003).

However, few studies point out the difficulties in the bottom-up approach. When NGOs are involved in

large, time-bound projects, participation by the community may be neglected. ‘The loudest voice will

be heard’ (McFarlane 2009). Tukhairwa and Oosterveer (2011) claim that the ‘spatial proximity’ of the

service provider to the residents determine whether the poor access these services or not. Larger

distances between the NGO offices and poor households discourage access of these households and,

since NGOs operate on a local and small scale, households far from the NGO’s offices may lack

information about the organisation’s services. In addition, ‘social proximity’ — bonding through social

networks and the implication of social relationships as a factor in the provision of and access to services

— also plays a crucial role in access. A high level of trust is needed to access the services of NGOs/CBOs,

and NGOs were perceived to have better technical skills and capacity than CBOs. Even those who didn’t

access sanitation services at all indicated that they believed NGOs offered better services. The higher

the level of co-operation with an NGO, the more an individual household is likely to access services by

the NGO (Tukhairwa and Oosterveer 2011, Chauhan and Lal 1999).

Replication or scaling-up of successful models is not always possible, as the same conditions may be

prevalent, as demonstrated in the OPP-RTI project (Hasan 2006). Although, the Indian NGO had

successfully implemented several community sanitation projects, it was unable to perform as

effectively as the two engineering firms who were co-contractors in the SSP in Mumbai. One of the

reasons provided by the author is that the NGO may have been stretched beyond its operating capacity

(McFarlane 2009).

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Resident participation in slum-improvement projects is also linked to project satisfaction. In

participatory service provision, continued loyalty and participation are needed to maintain community

support to sustain quality over time (Russ and Takahashi 2013). In addition to community participation,

the support from the government is also critical to the success of NGO/CBO-driven-initiatives. Due to

the illegality of land tenure, in several cases, the sanitation infrastructure is demolished or the slum-

dwellers are evicted by the municipal or local government (Burra et al. 2003, Bapat and Agarwal 2003,

Winayanti and Lang 2004, McFarlane 2009). With adequate support or legal sanction from the

government, NGO/CBO efforts may have a better chance at success.

Public-private-community partnership has a higher chance of success, as it involves all key

stakeholders

As mentioned earlier in this section, there has been a recent paradigm shift towards public-private-

community partnerships in sanitation provision for the poor. This is a result of the realisation by the

government in a few cities of the importance of improved infrastructure for supporting diverse informal

economies that provide livelihoods to the poor (Weitz and Franceys 2002). There are an increasing

number of case studies (described below) that show the benefits of a tripartite partnership between

the government, the private or NGO provider and the community.

In Bangladesh, the Population Services and Training Center (PSTC), with funding from WaterAid,

initiated a water and sanitation (WatSan) programme in Aynal’s Bastee — a slum with 20‒25 hanging

toilets that were poorly maintained and posed serious risks to the users (Khandaker and Badrunnessa

2006). PSTC raised the community’s awareness on sanitation, trained resources persons and formed a

Community Management Committee (CMC) to lead the overall development and maintenance of the

neighbourhood. Two Sanitation Block Management Committees (SBMCs) were formed to manage day-

to-day operations of the two sanitation blocks that were constructed. The PSTC provided the technical

and managerial guidance to the committees, financed the construction with a three-year interest-free

loan and also negotiated with the Dhaka Water and Sanitation Authority (DWASA) to obtain land for

construction and water connection to the toilet block (Khandaker and Badrunnessa 2006).

The impact of this effort by PSTC was not only in improving the sanitation access of the community, but

also in empowering/mobilising them to voice their needs and place them before the authorities by

building a working relationship with the officials. Important lessons from this case study are: (i) ‘Low-

income residents are willing and able to pay for sanitation; (ii) Mediation by NGOs is an effective

strategy; (iii) Co-operation of government functionaries and elected representatives is vital; and (iv)

community ownership and management of infrastructure leads to sustainability’ (Khandaker and

Badrunnessa 2006).

Tiruchirappalli in Tamil Nadu, India, shows the way by demonstrating how effectively basic community

infrastructure and pro-poor solutions can work at city level when supported by city authorities and

NGOs, instead of leaving it to contractors to manage these complexes. The answer to why community

management of infrastructure is better than other forms of management, lies in recognising the value

in the process that goes beyond financial management to hygiene education, imbues a sense of

ownership of community assets, and provides a much-needed social space for community members to

come together and discuss various issues (Water Aid India 2008). This project shows that achieving

clean and healthy slums does not require huge financial investment; it requires a city authority sensitive

to the problems faced by slum communities and supportive of community and NGO action (Water Aid

India, 2008).

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Sulabh International, a successful Indian NGO, has been providing nationwide sanitation services since

1970. Sulabh’s twin-pit-pour flush toilets are an example of innovative construction management that

reduces long-term maintenance costs and increases building quality. Built and maintained by Sulabh,

these toilets provide access to water, soap powder, bathing and locker facilities, for low-income and

poor communities. Caretakers are appointed by Sulabh for round-the-clock maintenance and a user fee

is charged. The poor, the homeless, disabled, the elderly and street children are allowed free use of the

toilet facilities. Sulabh’s success has been recognised by governments around the country, who have

come forward to collaborate by providing land, utilities, and capital for community toilets (Weitz and

Franceys 2002).

Shelter Associates, an NGO based in Pune, India, was engaged in a partnership with the municipal

corporation to construct community toilets in 13 informal slums in Pune. The project was initiated by

the then Municipal Commissioner, who had been a key official in an earlier sanitation drive, where he

was involved in the construction of around 100 toilets blocks by NGOs. After taking up office in Pune,

with his prior experience, the Commissioner prioritised sanitation and construction of toilets by calling

for proposals from local NGOs. The municipal corporation was responsible for providing the funds, land,

electricity, water supply and connection to municipal sewers, in addition to co-ordinating the overall

project. The NGO was responsible for the demolition of old toilets, and construction and maintenance

of the new toilet block for a period of 30 years. The NGO was ultimately responsible to the Corporation

for the implementation of the project. There were several firsts in this project. ‘Sanitation and other

issues related to the environment in low-income settlements had not previously been taken up by the

municipality on this scale … and the Corporation’s decision to work in partnership with NGOs on a

project of this scale was a new approach to urban development’ (Hobson, 2000). ‘This partnership also

stems from the Corporation’s recognition that the contractor built and Corporation maintained toilets

have failed (Hobson, 2000). By working with the NGOs, the Corporation was able to realise a lower cost

of construction than the contractors, and transfer responsibility for maintenance to the NGO or the

community/resident. This partnership augured well for the Corporation, as it was able to overcome its

incapacity in construction and maintenance of community toilet blocks. For the NGO, this partnership

presented an opportunity to improve the much-ignored area of sanitation for the slum-dwellers, as well

as involve members of the community in improving their own living conditions.

However, these partnerships have both pros and cons. Due to the pace at which the Corporation

wanted the construction to proceed, Shelter Associates was not able to engage the community in

extensive participation in design and implementation of the toilet blocks. Working with the government

was also a time-consuming endeavour, due to the bureaucratic delays in securing water and electricity

connections (Hobson 2000). Similar experiences were encountered in the SIP in Ahmedabad and

Bangladesh and the SSP in Mumbai (Lal and Chauhan 1999, McFarlane 2009).

Public-private-community partnerships will not be successful unless all the stakeholders involved fulfil

their roles. The government must provide an adequate legal framework, define a pro-poor policy that

aims to achieve universal coverage that includes serving the poor. It is increasingly accepted that,

beyond the physical infrastructure, social infrastructure is needed to sustain service system (Weitz and

Franceys 2002). Government involvement in sanitation projects in illegal or informal slums plays a

pivotal role, because it symbolises de facto security of tenure. In sanitation, unlike water and electricity,

tenure status is associated with a greater disparity in the level of service accessible to the poor (Scott

et al. 2013).

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Communities are unwilling to invest in sanitation infrastructure without secure tenure, as they fear

demolition or eviction. However, they end up paying a substantial fee to service providers for removal

and disposal of sludge from septic tanks (Scott et al. 2013). Improvements in notified slums were

implemented much faster than in non-notified slums, and NGOs were more active in notified slums

(Chandrasekhar 2005, Kranti and Rao 2009), pointing to the fact that de facto or de jure tenure security

is an important factor in determining access to sanitation services. It is also true that those communities

that do not have tenure security have also managed to acquire basic services, but by bribing officials or

using political support. Nevertheless, the fear of eviction or demolition is a constant threat (Burra et al.

2003, Kranti and Rao 2009, Ghafur 2000). Therefore, greater involvement of the government in public-

private-community partnerships or PPPs offers some form of tenure security, which is sufficient for

NGOs, CBOs and households to invest in sanitation (Sohail and Cavill 2009). Government involvement

also reflects a change in the attitude of government agencies that could have a long-term impact on

successful provision of sanitation in informal and squatter settlements (Khandaker and Badrunnessa

2006; TARU-WEDC 2005; Kifanyi et al. 2013). Where community toilets are constructed and managed

by the community, governments could show their support by providing the toilet blocks with

free/subsidised water, and links to sewerage mains and electricity connections, which directly impacts

use and long-term sustainability of the toilet blocks (WaterAid 2008).

NGOs/CBOs play multiple roles in community-led sanitation programmes. A primary function

performed by the NGOs is in mobilising the community and understanding their needs. Poor

communities tend to trust NGOs over the government, as they believe NGOs provide the same service

to everyone in the community (Tukhairwa and Oosterveer2011). NGOs use a multi-pronged approach

that includes lending their expertise in technology, raising or arranging for capital by way of soft loans,

group loans or bank credit, building the capacity and management skills of community members to take

on the future needs of the community, and also imparting hygiene education targeting changes in

defecation habits (Hanchett et al. 2003, Chauhan and Lal 1999, Hasan 2006). In some cases, NGOs also

act as mediators between the community and the government, often using their public image to gain

audiences with senior bureaucrats in order to present the needs of the community, an important role

that has been recognised by both the government and local communities (Khandaker and Badrunnessa

2006, Burra et al. 2003, Weitz and Franceys 2002, Winyanti and Lang 2004).

The role played by community members as key participants in seeking basic services is unquestionable.

Without a pro-active community, one where the poor are able to organise themselves in order to

articulate to the government their demands, either directly or indirectly, through NGOs, sanitation

provisions will be inadequate (Khandaker and Badrunnessa 2006). The bottom-up approach followed

by NGOs and CBOs has been able to achieve a certain level of success in improving access only because

of encouragement from NGOs for poor households to participate in the creation and maintenance of

sanitation infrastructure (Burra et al. 2003). Examples of slum sanitation and SIPs, quoted earlier in this

section, from India, Bangladesh, Pakistan, Indonesia, Senegal, Zambia and Ghana (to name just a few)

have shown that poor communities are willing to pay (in cash or through contribution of labour) for

improvements in sanitation infrastructure. With adequate training and capacity building, slum-dwellers

are able to engage both in the actual construction of the toilets and their maintenance (either through

a CBO or by the formation of a sanitation committee) (Burra et al. 2003, WaterAid 2008). Disaggregation

of capital and operational costs helps slum-dwellers take care of smaller internal piping costs, but they

expect the government to provide the larger external connection to main sewers (Hasan 2006, Roma

and Jeffery, 2011). Notwithstanding, ‘Community efforts can be scaled up nationally only if there is a

clear progressive partnership approach, which involves households as co-actors and not as

beneficiaries’ (Gold 2013). Where the bottom-up approach has the support of the government, the

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results have been encouraging (WaterAid 2008, Khandaker and Badrunnessa 2006, Kifanyi et al. 2013,

Ghafur 2000).

Integrate sanitation in the larger urban-planning framework: Sanitation is narrowly interpreted as

toilets. Access to drainage and sewers must be included.

‘Differences between the poorest and the richest residential areas clearly exist in any city, but upper-

class inner-city areas, industrial zones, slums and low-income housing estates often border one another

and are interconnected in many ways. What people do in one residential area may affect those in an

adjacent area and infrastructure like streets…water lines and sewerage channels visibly link different

parts of the city’ (Obrist et al. 2006).

The sanitation needs of a slum community must be placed within the larger urban-planning framework,

as slums are very much a part of the city and do not exist in isolation. The interconnectedness between

communities in cities leads to a spill-over of the ill effects of poor sanitation on the entire

neighbourhood (Obrist et al. 2006). The existing gaps in urban-planning approaches, as outlined in the

themes above, need to be bridged in order to alleviate the inhumane sanitation conditions in several

slums, and governments must find ways to leverage the strengths of community-led sanitation projects

by integrating them into the large city master-plans. In Orangi, Pakistan, the success of the community-

financed sanitation system was undermined when the government diverted households’ sewer

connections to a communal septic tank, instead of the natural watercourse. This prompted several

neighbourhoods to disconnect themselves and revert to the earlier practice of discharging sewerage

into the natural storm-water drain, since the septic tanks were not regularly de-sludged. As a solution

to this problem, the government proposed to superimpose the Greater Karachi Sewerage Plan on the

existing plan, by-passing the numerous community-led sewage systems installed in various parts of the

city (Weitz and Franceys 2002).

‘Sanitation provision happens under the radar of formal city planning and urban management, via

multiple formal or informal service providers. Policy and strategic planning for sanitation need to be…

integrated into wider city-development strategies’ (Scott et al. 2013). Instead of tackling the sanitation

problem in slums as a standalone problem, integrating the needs of the poor into the larger urban-

planning framework of a city will contribute towards achieving universal access to sanitation.

The integration of slum sanitation into city planning can take place only if there is an acknowledgement

of the right to sanitation of slum-dwellers by city authorities (Bapat and Agarwal 2003). In addition, a

pro-poor sanitation policy that explores low-cost sanitation options, de-links tenure security to provide

conditional access to sanitation, and invites community participation and an overarching political will,

are other steps towards fulfilling sanitation goals.

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SUMMARY

The analysis of studies pertaining to sanitation revealed the low involvement of government in

sanitation provision in LMI countries. The top-down approach has failed, primarily due to the lack of

recognition of the right to sanitation of the urban poor who live in settlements that may not have

security of tenure. In addition, governments’ lack of financial resources, sensitivity in understanding the

sanitation needs of the poor, lack of community participation and ad hoc service provision are few other

contributing factors. Poor planning also increases the effort and time in using government-provided

sanitation services. As a result, infrastructure provided in the top-down approach falls into disuse due

to lack of maintenance.

Since NGOs and CBOs have now adopted a participatory approach, this might have resulted in the

better-planned, construction and maintenance of toilets. However, the bottom-up approach suffers

from problems of scaling-up. Replication of successful models may not always be possible, since the

same conditions may not be present in different locations. The bottom-up approach is also limited in

scope when there is no security of tenure.

The tripartite arrangement of public-private-community partnerships shows that, when community-

level, pro-poor solutions are supported by city authorities and local NGOs/CBOs, there is greater

ownership of the infrastructure, and legal hurdles can be addressed at a reasonable financial cost.

However, public-private-community partnerships will not be successful unless all the stakeholders

involved fulfil their roles. Governments must provide an adequate legal and policy framework to

achieve universal coverage; communities must be willing to participate and take ownership of the

improvements in sanitation infrastructure; and NGOs and CBOs must facilitate the transfer of

knowledge and technology, as well as broker a partnership between the community and the

government for the fulfilment of the sanitation needs of the urban poor.

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Inadequate Sanitation

Ad-hoc provision by government.

Slum sanitation is a demand

driven approach. Only when there

is demand from slums,

government provides the

infrastructure (Burra et al., 2003,

Mc Farlane 2009,Joshi 2005,

Water Aid India 2008 )

Poor planning, design/

construction and implementation

of sanitation projects (Burra et al.,

2003, Mc Farlane 2009)

Government lacks finance to

undertake slum sanitation (Ghafur

2000, Kifanyi et. al., 2013, Burra

et al.2003)

Government unwilling to provide

access to slums as they are

considered illegal and/or

temporary (Scott.P et.al., 2013,

Chandrasekhar 2005, Kranti and

Rao 2009)

Private sector not successful as

they target middle income

households who can pay. and not

poor household (Weitz and

Franceys 2002, Sohail and Cavill

2009, Kifanyi et. Al., 2013, Owusu

and Kotey 2010, Devas and

Korboe 2001))

Poor understanding of

community needs. Lack of

community participation

Demand for government provided

sanitation is hindered by low education

levels, lack of awareness about rights.

Only those with political connections

make demands (Ghafur 2000, Mc

Farlane 2009)

Piece-meal approach. Poor

quality and inadequate

number of toilets per slum

population

Forced eviction a possibility.

Distance to toilets –

increases time and

effort

Lack of maintenance by

government. Poor

accountability from contractors.

(Burra e al. 2003)

Lack of ownership from the

community – no

maintenance (Burra et.al.,

2003, Joshi 2005,

Mc.Farlane 2009)

Poor access

Women and children affected

most (Joshi 2005, Bapat and

Agarwal 2003, Sohail.M. 2009,

Gessler et.al., 2008)

Safety, Privacy,

health and unhygenic

practices

Fig 4.8: Governments’ top-down approach lacks planning, focuses attention only on ad hoc creation of infrastructure (capital

costs) and pays little attention to design and maintenance (O&M cost).

132

Governments failure in

providing sanitation (Burra

et.al 2003, Mc Farlane

2009, Hasan, 2006, Kifanyi

et.al.2013)

Unmet needs of poor

community leading to

unsafe and unhealthy

practices (Khandaker and

Badrunessa, 2006, Burra

et.al., 2003, Bapat and

Agarwal 2003)

Inadequate sanitation

brought up during

discussions with community.

Stumbling block to well-

being and economic

progress (Bapat and

Agarwal 2003)

NGO’s

involvement in

sanitation –

building of

community toilets

Raise resources from international and national funding agencies

Research on design and use of low cost materials (Hasan 2006,

Burra et.al. 2003)

Mobilise community to identify land, contribute labour and capital

(Kifany et. al.,2013, Weitz and Franceys 2002, Burra et.al. 2003,

Hasan 2006)

Break the monopoly of contractor led construction (Burra et al.,

2003)

Focus on sanitation needs of women – separate toilets for women

and child friendly toilets (Burra et.al., 2003)

Negotiate with government to provide land, water and electricity.

Subsidize connection costs (Weitz and Franceys 2002)

Negotiate for legal tenure/de facto security (Winyanti and Lang

2004, Chauhan andLal 1999)

Arrange for loan/credit for construction (Chauhan and Lal 1999,

Burra et al., 2003, Khandaker and Badrunnessa, 2006)

Improved Access

Connection to sewerage mains essential for sustainability (Weitz and

Franceys 2002, Hasan 2006)

Scaling up of success is a problem as NGO’s operate in smaller

geographical spread (Tukairwa and Oosterveer 2011, Mc Farlane

2009)

Residents participation is not a given. Replication of model contingent

upon replication of various factors (Hasan, 2006)

Participation is a long drawn process and not always fair. The loudest

voices will be heard (Mc. Farlane 2009, Kifanyi et.al 2013, Russ and

Takahashi, 2013)

Factors affecting improvements in access in NGO driven approach

Fig 4.9: NGO/CBOs (bottom-up approach) understand the sanitation needs of the community by adopting a participatory approach.

Infrastructure created is better planned, constructed and maintained. However, government support is needed for scaling up.

133

Governments realize their

failure in providing

sanitation, importance of

sanitation and need to

involve community/NGO

(Weitz and Franceys

2002, Hobson 2000, Mc

Farlane 2009)

ODA pressure on

government to adopt

participatory approach

(Ghafur 2000)

Public private

community

partnership

Community

(Khandaker and Badrunnessa 2006, Burra et al.,

2003, WaterAid 2008, Hasan 2006, Roma and

Jeffery 2011, Gold 2013, Ghafur 2000)

 Ownership and maintenance of infrastructure

 Willingness to pay for quality service and

readiness to invest in capital cost

 Empowered to meet authorities and articulate

their demands

 Build their own capabilities

Government

( Scott. P et.al., 2013, Sohail and Cavill 2009, Water

Aid 2008, Kranti and Rao 2009, Chandrasekar

2005, Hobson 2000, TARU-WEDC 2005)

 Facilitate co-ordination between various

agencies for water, land, electricity

 Government support builds confidence within

the community

 Connection to city level sanitation networks

 Calls for bids/proposal

 Broad guidelines for construction and

execution of project

NGO

(Weitz and Franceys 2002, Khandakar and

Badrunnessa 2006, Water Aid 2008, Hobson 2000,

Lal and Chauhan 1999, Tukhairwa and Oosterveer

2011, Hatchett et al 2003 )

 Works closely with community to understand

and identify needs

 Form sanitation committee or CBOs

 Provide management training and assistance

 Seek community contribution i.e labour or

capital to increase involvement and ownership

Improved Access

NGO’s realizing

the need to work in

partnership with

the government to

overcome legal

and regulatory

barriers (Burra et

al., 2003, Hobson

2000)

Paradigm shift

Fig 4.10: Public-private-community partnership has higher chance of success, as it involves all key stakeholders.

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Unmet sanitation needs of

the urban poor

Governments un-involved

due to lack of finance to

expand network coverage

in slums

Providing access linked to

tenure security –

governments constrained

to provide access

Unchecked growth of

slums

Interconnected between

slums and the rest of the

city. Interlinked

ecosystems.

Environmental damage

and pollution

Poltitical or citizen led

pressure – Ad-hoc

provision by government.

Lack of ownership, poor

maintenance and neglect.

Poor households, with the

help of NGOs and CBO’s

invest in community toilets

and other smaller pipeline

costs.

Towards improved slum

sanitation

Integrate slum sanitation in urban planning

Acknowledge right to sanitation of

slum dwellers

Conditional access – delink

sanitation from tenure security.

Integrate the efforts taken by slum

dwellers into the large sanitation

network

Use low cost technology options

Invite community participation

including financial contribution

Political will and pro-poor policy in

sanitation

Fig 4.11: Integrate slum sanitation in urban planning.

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SUMMARY OF TEXTUAL NARRATION

The narrative synthesis of studies revealed several interlinkages between sector-specific issues and

urban-planning approaches. There are a few common barriers that need to be overcome, irrespective

of the type of approach adopted (top-down or bottom-up). One of these barriers was tenure security.

We observed that the slum households were deprived of access to water supply, sanitation and

electricity services wherever there had been lack of clarity on tenure security. Legally, this aspect comes

under the ambit of the government, and studies indicated that the government took steps to address

issues related to unclear land tenure, either on its own account or with driven and supported by ODA,

NGOs and CBOs. The political and administrative commitment to the cause of the urban poor has

emerged as a key element for improvement of access, be it in the form of 1) creating alternatives for

addressing the issue of tenure security; 2) connecting the sewerage network constructed by NGOs or

CBOs to the citywide sewerage network; 3) providing water connections to toilet blocks constructed by

NGOs or CBOs; 4) provision of financial resources for construction, and operation and maintenance of

infrastructure; or 5) involving NGOs or CBOs in the process of service delivery, and so on.

We observed few sector-specific issues that influence the roles of various actors in service delivery and

the potential for service improvements. The technological complexity associated with the electricity

sector results in a rather smaller role for NGOs and CBOs in the creation and maintenance of

infrastructure. Their role is focused more on the ‘soft’ side of infrastructure, such as educating the

customers about legal connections, improving understanding of customers’ requirements, and so on.

However, the water supply and sanitation sector has seen the involvement of NGOs and CBOs in the

‘hard’ side of infrastructure, such as installation of water tanks, construction of water and sewerage

networks, toilet blocks and septic tanks, and maintenance of infrastructure. This indicates the central

role to be played by the government in the improvement of electricity services and greater potential of

cooperation and involvement of NGOs and CBOs in the water supply and sanitation sector.

Finally, we observed that there is a need to draw on the strengths of both bottom-up and top-down

approaches for improving access to water supply, sanitation and electricity services. These strengths

can be drawn upon by exploring and focusing on cooperation and partnerships between slum-dwellers,

NGOs, CBOs and government. We observed that access to services had improved considerably

wherever these actors cooperated and partnered, as the top-down approach opens the door for

governmental legitimacy, resources and probity, while the non-governmental actors garner grassroots

involvement, community knowledge, education and awareness, and sustenance.

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5: SUMMARY AND IMPLICATIONS

5.1 REVIEW QUESTION AND CONTEXT

The overall question guiding this review was:

‘What is the evidence on top-down and bottom-up approaches in improving access to water, sanitation,

and electricity services in low-income or informal settlements?’

The above question was further divided into three sub-questions:

1. How effective are the top-down and bottom-up approaches in improving access to water supply,

sanitation and electricity services in low-income or informal settlements in LMICs?

2. Under what circumstances do these approaches deliver better results? Why?

3. What are the strengths and limitations of these two approaches in respect of providing access to

basic services in low-income areas and informal settlements?

Several approaches have been used to deliver basic services to the urban poor. Broadly, these

approaches can be classified as top-down and bottom-up. This review synthesises the evidence on the

effectiveness of these two approaches to improve access to basic services. This review analysed access,

not just as connectivity to the services, but also in terms of its other dimensions, such as affordability,

effort and time, adequacy, durability and sustainability. However, connectivity was the most common

outcome analysed in most studies. Since the contexts of the studies were heterogeneous, we used

factors such as the type of slum, the details of the service provider, type of facility, and level of

community participation as moderators and context-specific factors in our analysis.

5.2 METHOD

‘Systematic reviews are a rigorous and transparent form of literature review. They involve identifying,

synthesising and assessing all available evidence, quantitative and/or qualitative, in order to generate

a robust empirically derived answer to a focused research question’ (ODI 2012). Details pertaining to

the methods used in the review are given below:

Study sources: Eight electronic databases, hand search of 13 journals for a 15-year period, 19 website

searches, Google and Google Scholar searches, personal communication with authors and cross-

references of identified studies

In-depth review: 104 studies that met the exclusion and inclusion criteria were included in the analysis.

All the studies included in the review were appraised for quality.

Synthesis method: Given the heterogeneity of the studies, multiple methods were used in the

synthesis: numerical summary, meta-analysis and textual narration.

 Numerical summary: The type of delivery approach and the evidence on the impact of access

were detailed from all the studies included in the review. The pattern of assessments on

various outcomes (positive, negative, and so on) was used as the basis for drawing conclusions.

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The evidence from all the 104 studies were used for the numerical summary. A total of 568

assessments from the 104 studies were used in the analysis.

 Meta -analysis: Out of the 104 studies, 27 provided evidence that could be synthesised using

meta-analysis. These 27 studies yielded 100 observations in total. Depending on the

observations, they were synthesised either as odds-ratio (when the evidence was measured in

proportion) or standardised mean differences (when the evidence was available as mean with

standard deviation).

 Textual narration: Useful in the identification of recurrent themes in the included studies,

narrative analysis helped us to understand the theory of change and the causal pathway.

Given the multiple modes used to synthesise the evidence, the review not only gives the results on

what approaches have worked, but, importantly, it also highlights why it has worked (the causal

pathway). The studies were not conducted in a controlled environment, but the evidence is however,

characterised by considerable heterogeneity.

5.3 RESULTS

Using the findings from the meta-analysis, numerical summary and the textual narration, the results

of the review are organised to address the three specific objectives set out for this review.

(i) How effective are the top-down and bottom-up approaches in improving access to water

supply, sanitation and electricity services in low-income or informal settlements in LMICs?

We answer this question from the findings of the numerical summary and meta-analysis. The

differences in the effectiveness of the two approaches have been analysed by sector, region and the

dimensions of access.

The top-down approach

Overall results indicate that the government-driven top-down approach has not been very effective in

the delivery of basic services to the urban poor. Both the explorative numerical summary and the meta-

analysis show consistent results in that aspect. The numerical summary had a higher proportion of

negative effects for the top-down approach, and the meta-analysis also indicated an overall effect size

of 0.63 (for connectivity), indicating the poor levels of access. However, it was seen that the

effectiveness of the top-down approach has been comparatively better in sectors that favoured a more

centralised or network approach. For example, the proportion of positive evidence was noticeably

higher in the electricity and water-supply sectors, as compared to the sanitation sector. The sanitation

sector, which largely involves construction of toilets with standalone septic tanks, had the highest scope

for developing decentralised facilities. It also had the highest proportion of negative evidence. The two

main reasons that stand out for this poor performance are: (a) governments have not been

acknowledging the right to sanitation of the poor and, consequently, the sector was not accorded

priority; and (b) the interventions demanded a more participatory approach, which could not be

accommodated in a traditional top-down framework.

The effectiveness of the top-down approach also varied considerably across regions. Among the three

major developing regions, Africa, Asia, and South America, the performance of the top-down approach

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has been better in Asia and South America. Africa had the highest proportion of negative evidence

under the top-down approach. Meta-analysis results also confirm this trend. The effect sizes for Africa

are smaller than for the other two regions. These results indicate the weak capacity (possibly both

institutional and financial) of the governments in Africa to deliver basic services to the poor.

The bottom-up approach

Explorative numerical summary evidence shows that the proportion of positive evidence is higher than

the negative evidence when a bottom-up approach was used. Meta-analysis results also indicate an

overall effect size of 1.05 (for connectivity alone), indicating that deploying a bottom-up approach has

resulted in an improvement in access levels. However, the range of the confidence interval shows that

the improvement cannot be considered as statistically significant. Between the three sectors, the

proportion of evidence for electricity is the lowest for the bottom-up approach. This shows that the

deployment of a bottom-up approach has been predominant in the water-supply and sanitation

sectors. Between water supply and sanitation, the bottom-up approach has been more effective in

sanitation. We attribute this to the improvement in sanitation access involving a lot more than just

creating a physical facility; it involves behavioural and attitudinal changes among the slum-dwellers.

The bottom-up approach is able to include components that enable more involvement and ownership

in the project on the part of residents, which could explain the positive impact. Analysing the evidence

by region shows that the impact of the bottom-up approach has been the poorest in Africa, while the

impact was positive in Asia and South America. This suggests that the success of the bottom-up

approach also depends upon the social context. In the relatively difficult socio-economic environments

seen in several African urban areas, the bottom-up approach requires a lot of support from other actors,

such as the government, to deliver more positive results.

Dimensions of access: Top-down vs. bottom-up approaches

Traditionally, access is largely measured in terms of connectivity to facilities. However, the MDGs

demand a broader perspective on access. Therefore, we have expanded the traditional ‘connectivity

only’ notion of access and have considered the following dimensions of access: connectivity,

affordability, adequacy, effort and time, durability and sustainability. The number of assessments on

durability and sustainability are lower, indicating that the focus on these aspects has been very limited

in the various studies so far. Numerical summary of the evidence in the top-down approach shows that,

among the different dimensions of access, the proportion of positive assessments are higher only for

connectivity. However, for the bottom-up approach, the proportion of positive assessments is higher

for all dimensions, except for affordability. This shows that deployment of a bottom-up approach has

resulted in an all-round improvement of access, whereas the top-down approach has taken a more

narrow view of access. A possible reason for this is the way in which the achievements are measured.

In general, there is limited follow-up on project performance in the operational phase in top-down

approaches. The focus, therefore, tends to be limited to connectivity. However, in bottom-up

approaches, NGOs and CBOs are extensively involved, even during the operational phase of the project.

Therefore, the improvements could be seen across a broader set of parameters than just connectivity.

(ii) Under what circumstances do these approaches deliver better results? Why?

We specifically studied three major factors and their role in improving access to basic services in slums.

They are: (i) participation, (ii) tenure security and (iii) political commitment. The findings pertaining to

the interplay of these factors in both the top-down and bottom-up approaches are presented here:

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Participation: Participation of community members in some form or other in the service-delivery

process resulted in a positive effect, as compared to instances where there has been no participation.

The number of assessments for participation in the numerical summary as well as meta-analysis

indicates that a bottom-up approach is more amenable in facilitating participation. Essentially,

community participation helps to incorporate the needs of the residents in the features of the project

by interacting closely with the slum residents. The NGOs and CBOs are able to understand the needs

and problems of the urban poor better and, consequently, tailor the services to suit their needs and

situational constraints. In the water and sanitation sectors, involvement of community members has

resulted in the use of appropriate design, construction, technology, and maintenance of the facility that

has significantly improved not only connectivity, but also other dimensions of access, such as adequacy

and effort and time. Specifically in the case of sanitation, involvement of the beneficiaries has led to

better maintenance of the toilets. A numerical summary of evidence shows that even the top-down

approach has produced a higher proportion of positive outcomes when there has been community

participation. For instance, we have examples in the electricity sector where the electricity utility has

adopted several innovative steps to reach out to community members, seek their feedback, and also

using community members as local agents to improve service delivery. These steps not only resulted in

an increase in the number of new connections in slums, but also reduced electricity theft and non-

payment of electricity bills. Therefore, in interventions where there has been participation, the impact

on access has been positive.

Tenure security: Tenure security emerges as yet another key factor in ensuring access to basic services.

Our results show that the proportion of positive evidence has been the highest for formal slums in both

top-down and bottom-up approaches, indicating that security of tenure plays an important role in

access to basic services in slums. The legal status of the slum determines the type of service provider

and the service-delivery approach. Formal slums, which are legally recognised and have security of

tenure, enjoy a higher degree of connectivity, whereas informal slums, which lack legal recognition,

have comparatively low levels of connectivity. This is because government agencies are often restricted

in extending coverage to informal slums, as these are considered to be illegal settlements with no

security of tenure. Even alternative service providers hesitate before investing in informal slums due to

the threat of possible demolition/eviction of slums, which, in turn, affects the willingness of service

providers and slum-dwellers to invest in infrastructure improvements. The meta-analysis shows that

there has been no significant difference in connectivity in informal slums in both top-down or bottom-

up approaches. However, the highest number of assessments for informal slums indicates a strong

research interest in informal slums.

In order to overcome the problems of tenure security, governments must accept their duty to provide

access to basic services in slums. There are several options to achieve this outcome, such as, (i)

removing land tenure as a prerequisite to seeking new connections; (ii) amending the legal framework

of government agencies to include informal settlements as target populations, or provide universal

access; and (iii) use NGOs and CBOs as a via media to service informal slums by engaging them in

decentralised service delivery. NGOs and CBOs can also play an important role in mobilising

communities and strengthening the demand side for basic services, thereby reiterating the

government’s duty in providing basic services to the poor.

Tenure security and participation, together, have a multiplier effect on connectivity in slums. The meta-

analysis results show that formal slums, where the residents have actively participated in the service-

delivery process, show significant improvement in access (effect size of 4.06). However, formal slums

without community participation also enjoy improved access, albeit not at the same level as formal

slums with participation.

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Political commitment

The contextual factors such as the political context, government policy on slums, legal status of the

slum, and extent of community participation, play a crucial role in delivery of basic services to the urban

poor. Our results show that, when there is political commitment or a change in the government’s policy

to adopt a pro-poor approach in delivery of basic services to the urban poor, there has been a positive

impact on access in both the top-down and bottom-up approaches. This is mainly due to the removal

of legal hurdles such as tenure security, which obviates the need for slum-dwellers to provide proof of

residence to seek new connections. A commitment from the government in the form of universal

access, pro-poor policy reform or a specific scheme to improve access also provides a clear legal

mandate to the government service provider to extend coverage to poor consumers. It may also include

financial packages such as lowered connection fees that facilitate the poor’s seeking legal connections.

The change in political commitment may be a result of a combination of socio-political factors or, in

some cases, aid conditionality. Results have shown a pro-poor transformation in the government

service provider due to the following reasons (i) ODA conditionality, (ii) change in political leadership,

(iii) internal reform within the service-provisioning agency and/or (iv) pressure from civil society/urban-

poor communities for better access. One or a combination of these factors has a positive influence on

access in slums.

The setting-up of specialised agencies or cells that deal exclusively with the provision of basic services

in slums emerges as an enabling factor in improving access. Slums are a unique habitat that comes with

its own set of problems, resolution of which requires inter-agency co-ordination and innovation in

operations, which may not be possible within existing institutional frameworks. Specialised agencies or

offices located within the slums facilitate closer interaction between the community and the service

provider, which, in turn, has a positive impact on access.

(iii) What are the strengths and limitations of these two approaches in respect of providing

access to basic services in low-income areas and informal settlements?

The evidence from both the top-down and bottom-up approaches have been synthesised in this review.

The effectiveness of each of these approaches depends on the context. It is not the purpose of this

review to claim that one is better than the other, but to identify the strengths and limitations of both

these approaches and to understand the context within which these approaches deliver the best

results.

Top-down approach: strengths: Evidence suggest that the top-down approach works best when the

service-delivery process is characterised by a high degree of centralisation, such as in the electricity

sector. With the right policy and implementation agency in place, a top-down approach may lead to

quicker implementation of services. Initiatives implemented under the top-down approach also has the

possibilities of scaling up faster as inter-agency co-ordination, as well as requisite finances may be more

easily available to government agencies when compared to a decentralised bottom-up approach.

Bottom-up approach: strengths: Some elements in the bottom-up approach that contribute to

increased effectiveness in service delivery are: proximity of the alternative service provider to slum-

dwellers, sensitivity to community needs, flexible payment options, setting up of office within the

community, and consumer education and community empowerment through training. For instance, a

bottom-up approach in sanitation pays specific attention to the needs of women and children by

providing them with separate facilities that offer privacy and safety. As a result of community

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participation, there is greater ownership of the facility by the community, which results in better

maintenance and durability of the infrastructure itself.

Top-down approach: limitations: One of the main criticisms of the top-down approach in terms of

service provision in slums is the lack of community involvement in planning and sensitivity towards the

specific needs of the community. In the top-down approach, there is very little room for customisation

to meet community needs. Evidence points to the fact that, although connectivity has been given

importance, other dimensions of access are grossly ignored. Government provisioning has also been ad

hoc, with programmes also implemented with a political agenda in mind. The primary reason for this

could be that slums and their legal status constitute a point of contention with several LMIC

governments. Service provision in slums are entangled in several legal problems that restrict

governments to provide them with basic services. While these constraints need to be overlooked in

light of the socio-economic and health costs of not having these services at all, government-led top-

down approaches are constrained by administrative constraints. Traditional top-down approaches also

suffer from the lack of beneficiary participation, which results in weak ownership and maintenance of

the infrastructure created. However, with increased commitment in the form of pro-poor policies and

some level of community involvement, government-driven top-down approaches can yield positive

results.

Bottom-up approach: limitations: A major limitation of the bottom-up approach is the restricted scope

for scaling up of operation. For example, the familiarity of most alternative service providers may be

restricted to the few slums in which they are active. While they may be effective in those specific slums,

they might not be able to achieve the same level of effectiveness in a different locality. Therefore,

scaling up of the programme in different geographical regions would be difficult. Apart from the above,

alternative service providers have the arduous task of interfacing with government authorities to seek

clearances and permission, which may lead to unwanted tension and delays. This, in turn, could delay

the provision of infrastructure and cause financial losses as well. One of the main elements of the

bottom-up approach is community participation. Mobilising the community to come forth with their

contribution or share ideas in a consultation can be a long, drawn-out process and can run into

community-level politics, which has the potential to derail the initiative. Projects that mandate

community participation are more likely to face delays in the initial stages than a top-down approach.

The limitations of both these approaches can be overcome when there is a synergy by adopting a

partnership approach where the government, community and the alternative service providers work

together to improve access in slums.

5.4 IMPLICATIONS

POLICY

Political commitment should be backed by appropriate institutional arrangements for top-down

approaches to work.

In the government-led top-down approach, improving access in slums requires strong political

commitment towards fulfilling the basic rights of slum-dwellers. However, our review shows that

political commitment alone will not be sufficient to improve access. Delivering services in slums

requires a networked approach and a deeper understanding of prevailing conditions, which may not be

satisfied by the existing institutional arrangements. Instances where specialised agencies have been

created exclusively to work with slums have shown improvements in access, because these agencies

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act as the interface between the slums and the existing government machinery entrusted with the task

of supplying water, sanitation and electricity. ODA and other funding agencies that seek to generate

political commitment should also recommend the setting up of such dedicated organisations or

specialised cells with existing organisations for better implementation.

The bottom-up approach is more effective to achieve an all-round improvement in access.

Access to basic services should not be seen as merely providing connectivity to taps or toilets or

electricity. There are several instances where connectivity has been provided, but the facility falls into

disrepair or disuse in a short span of time, simply due to lack of attention to the other dimensions of

access. A holistic approach to access helps to realise the benefits of improvements in access in its

entirety. A bottom-up approach lends itself very well to this scenario. This is mainly because a bottom-

up approach has the necessary elements to achieve improvements in the overall levels of access due

to beneficiary participation, proximity of the service provider to the slum-dwellers, sensitivity to

community needs, flexible payment options, consumer education and community empowerment

through training. However, engagement of NGOs and CBOs in the service-delivery process should be

accompanied by clear goals on various dimensions of access.

As policy shifts from community to personal household facilities, the bottom-up approach will have

a greater relevance.

Community facilities have served to provide access to basic services in several slum and low-income

settlements across LMICs. But, increasingly the shortcomings of community connections — namely,

lack of ownership and poor maintenance — have led policymakers to prefer individual connections as

an option and individual connections need more involvement from the household, both in terms of

effort and investment. Enlisting the support of alternative service providers or adopting a bottom-up

approach can foster a sense of commitment through community interaction and behavioural change.

NGOs and CBOs can also provide the necessary technical and financial support in the form of loans to

obtain individual household-level connections.

Addressing tenure-security issues enables access in a big way.

It is evident from some of the studies in this review that tenure security need not always be de jure. De

facto tenure security is sometimes more than efficient to improve access in slums. De facto tenure

encourages alternative service providers and the community to undertake infrastructure

improvements without the fear of demolition. While eviction may still be a possibility, the chances of

demolition under the pretext of illegality are reduced. In some instances, conditional tenure security

has also been given to certain communities to facilitate access to basic services, which reflects the

political commitment towards fulfilling the basic needs of the urban poor. In the absence of tenure

security, illegal services thrive, especially in the electricity and water sectors. However, sanitation

remains neglected as construction of a toilet requires a large capital investment, which slum-dwellers

are not willing to undertake at the risk of demolition or eviction.

Programmes that aim to improve basic services should incorporate components of inclusivity right

from the project-conception stage.

Inclusivity and community participation are practices that need to be built into the project right from

the conception stage, in order to: (i) identify community needs and priorities; (ii) understand existing

resources and constraints; (iii) mobilise community support; and (iv) enhance project life by

maintenance, as well as upkeep of the infrastructure, all of which are important for successful service

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delivery in slums. The strengths and limitations of each of the stakeholders involved must be studied

and understood at the stage of drafting the project document, so that there is clarity of responsibility

for each of the actors. Avenues for community members to participate and contribute their ideas at

various stages of the project must be institutionalised. Similarly, a grievance-redressal system would

also be beneficial to solicit feedback for mid-course corrections.

PRACTICE

Focusing on maintenance is the key to sustainability of the infrastructure created: Adequate attention

must be paid to the maintenance of infrastructure. Although this is applicable more for sanitation than

for water and electricity, leaking pipes and faulty meters also lead to disuse over a period of time. Just

as planning for a project is important, maintenance is critical for the durability of the facilities created,

which prolong the access to these services for the community.

Creation of special units for implementation within the slum can help build trust within the

community and provide better customer service: Creation of special units for implementation within

the slum, or setting up a local office within the slum, can help build trust within the community and

provide better customer service. Availability of officials or agents within the slum not only encourages

community members to demand better responses, but also helps the service provider monitor the

community’s usage.

Consumer-education programmes targeting behavioural change can benefit both the community and

the service provider: Several studies in the electricity and sanitation sectors indicate the effectiveness

of consumer-education programmes in reducing consumption, electricity theft, more efficient usage,

adoption of healthy practices and reduced dependency on informal/illegal service providers. Although

more evidence relates to the electricity than to the sanitation sector, there is overall merit in enhancing

the community’s knowledge through outreach.

RESEARCH AND SCOPE FOR FUTURE WORK

Region-specific studies to reduce heterogeneity would be desirable for understanding country-specific

factors that influence or hinder access. There may be differences in the capacity of all stakeholders

involved, which would be brought out by such studies and would affect the way the service is delivered

and accessed. One such region is Africa, where the capacity of the government and the socio-economic

context of several African countries varies widely from that of other LMICs. In addition, enlarging the

scope of the study by including (non-English) studies in other languages may offer insights into specific

socio-cultural factors, as well as providing evidence from researchers who are comfortable writing in

their regional languages.

Studies included in this review are primarily observational in nature. Use of experimental approaches

in controlled environments would help in furthering our understanding of the causal pathway between

intervention and outcomes. For example, we can understand how involvement of alternative service

providers helps to improve community participation and how community participation leads to better

outcomes.

The results of systematic reviews reflect the quality of studies available in a particular domain, as they

provide the evidence base for synthesising the results. Therefore, the research design of selected

studies must be of rigorous and of good quality. For example, systematic reviews in the health sector

are rigorous only because of the quality of studies selected for review. Similarly, there is a need for

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rigorous research design in the infrastructure sector, which can provide more accurate and convincing

results.

The type of community participation in service delivery in urban slums needs further investigation.

While we have identified different forms of community participation, we could not study the

differences in detail in this review, because of a lack of clear categorisation of the type of community

participation in the studies. Future studies could distinguish between the different forms of community

participation.

The grouping of alternative service providers includes different actors, with different motives and

capabilities. In this review, we have grouped together all providers other than government as

alternative providers. However, there is a need to differentiate between NGOs, CBOs and local private

operators, as the motivations of each of these providers to improve access vary. For example, NGOs

may adopt a philanthropic approach in service delivery, whereas the private sector may be motivated

by profits. Therefore, there is a need to undertake research on the differences between the different

agents who constitute ‘alternative service providers’, so that policymakers can draw on the strengths

of each of them while designing a bottom-up service delivery mechanism.

5.5 STRENGTHS AND LIMITATIONS OF THIS SYSTEMATIC REVIEW

STRENGTHS OF THE REVIEW

This is one of the first systematic reviews to synthesise evidence on access to basic services to the urban

poor in low-income countries. While there are other studies that have looked at access in low-income

communities, this is perhaps the first systematic review to look at which of the urban-planning

approaches is best suited to delivering basic services to the urban poor. This study also looks at

participation of the community in the urban-planning approach and its impact on access.

This synthesis captures multiple dimensions of access and not just connectivity. As the findings from

the analysis point out, providing the infrastructure is only one aspect of improving access. Service

providers must ensure that the service delivered satisfies other dimensions of access, such as adequacy,

affordability, effort and time, durability and sustainability, in order to have a meaningful impact on the

lives of the urban poor.

A rigorous methodology was used to select the studies that would be included in the review. Since this

review was based on only the evidence that met the inclusion criteria, it is felt that the validity of the

findings is also strong. More importantly, multiple modes of synthesis have been used. Not only were

the findings from these different modes consistent, but they also complemented each other, thereby

increasing the robustness of the results, while providing a more holistic perspective on the evidence.

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LIMITATIONS OF THE REVIEW

Heterogeneity is one of the main limitations of this review. Studies included in the review have used

diverse methods and differ in their contexts. Studies have used different methods, such as case studies,

statistical and qualitative analysis, and have varied sample sizes. Synthesising results from several

studies across different sectors and regions, using different methodologies, gives rise to an array of

results. To be able to address the heterogeneity, we have conducted various sub-analysis in meta-

analysis, where only appropriate variables that can be grouped together were grouped for the analysis.

To be able to address heterogeneity, we have also included a fairly large number of studies as the

evidence base.

Only English-language studies were included in the review. There is a possibility that appropriate studies

could exist in languages other than English, which we have not been able to include in the evidence

base.

The greatest evidence was found in Asia as the majority of the studies focused on slums in Asian cities.

Therefore, evidence from other low-income countries have not been amply represented, which further

limits the findings of this systematic review.

146

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157

APPENDIX 1: REPORT AUTHORSHIP

Authorship of this report

 Thillai Rajan Annamalai (Indian Institute of Technology Madras, India)

 Ganesh Devkar (CEPT University, Ahmedabad, India)

 Ashwin Mahalingam (Indian Institute of Technology Madras, India)

 Solomon Benjamin (Indian Institute of Technology Madras, India)

 Sudhir Chella Rajan (Indian Institute of Technology Madras, India)

 Akash Deep (Harvard Kennedy School, Harvard University, US)

Research Team

 Elayaraja M.S.

 Keerthana Sundar

 Sriharini Narayanan

 Paul Jebaraj

 Venkata Santosh Kumar

Policy Advisory Board

 Shri. Vikram Kapur, Commissioner, Corporation of Chennai

 Shri. Raj Cherubal, CEO, CitiConnect

 Shri. S. Prakash, COO, IL&FS Water

Academic Advisory Board

 Prof. Dinesh Mehta, CEPT University, Ahmedabad

 Prof. Meera Mehta, CEPT University, Ahmedabad

 Prof. Manvita Baradi, CEPT University, Ahmedabad

Funding-agency policy experts

 Abhijit Ray and Francis Rathinam, DFID

Corresponding author:

Thillai Rajan Annamalai

Associate Professor

Department of Management Studies

Indian Institute of Technology Madras

Chennai 600 036. India

Email: [email protected]

Telephone: +91 94449 26442

Fax: +91 44 2257 4552

158

APPENDIX 2: METHODS USED IN THE REVIEW

APPENDIX 2.1: STUDY IDENTIFICATION

Table A2.1: List of journals taken for hand search

S. No

Hand-searched journals

Publisher

Hits

Geoforum

Elsevier

1,413

Environment & Planning (A, B, D)

Pion

2,826

Urban Studies

Sage publication

2,144

World Development

Elsevier

2,024

Environmental &Urbanization (inc. their Asia edition)

Sage publication

515

International Journal of Urban and Regional Research (IJURR)

Wiley-Blackwell

1,226

Review of Urban & Regional Development

Wiley-Blackwell

201

Cities

Elsevier

886

Progress in Planning

Elsevier

138

Energy Policy

Elsevier

6,143

Habitat International

Elsevier

779

Utility Policy

Elsevier

322

Water Policy

Elsevier

165

Total

18,782

159

Table A2.2 Details of electronic-database search

S.NO

Database

Search phrase

Subjects

Fields search

Hits

Wiley Online Library

(slum*) AND (water OR sanitation OR electricity)

• Business, Economics,

Finance & Accounting

• Social & Behavioural Science

Abstract

ProQuest

(slum*) AND (water OR sanitation OR electricity)

• All covered in the database

All fields

1,974

Science Direct

(slum*) AND (water OR sanitation OR electricity)

• Arts and Humanities

• Economics, Econometrics and Finance

• Social Sciences

Abstract

Emerald

(slum*) AND (water OR sanitation OR electricity)

• All covered in the database

All fields

370

EBSCO

(slum*) AND (water OR sanitation OR electricity)

 EBSCO host Research Database

 All covered in the database

 Business source complete

Abstract

Springer Link

(slum*) AND (water OR sanitation OR electricity)

• Social Sciences

• Economics

• Energy

• Business & Management

All fields

361

SSRN

(slums) AND (water OR sanitation OR electricity)

• All covered in the database

All fields

JStor

(slums) AND (water OR sanitation OR electricity)

• Economics

• Urban Studies

Full-text

363

160

Table A2.3: Details of websites searched

S. No.

Website

Search phrase used

Subjects/Research publications

Relevant

studies

Hits

obtained

Results

Inter-American Development Bank

(IADB)

(www.iadb.org)

(slums) AND (water OR

sanitation OR electricity)

• Subjects

• Water & Sanitation

• Urban Development

• Private Sector & Partnership

• Energy

City Alliance

(www.citiesalliance.org)

(slums) AND (water OR

sanitation OR electricity)

• All covered in the database

Nil

357

None of the

studies relevant

for our inclusion

criteria

UN-Habitat

(www.unhabitat.org)

(slums) AND (water OR

sanitation OR electricity)

• Subjects

• Urban Development and Management

• Water Sanitation and Infrastructure

• Urban Economy and Financing Shelter

• Social Inclusion

143

World Bank

(www.worldbank.org)

(slums) AND (water OR

sanitation OR electricity)

• All covered in the database

United Nations Development

Programme (UNDP)

(www.in.undp.org)

(slums) AND (water OR

sanitation OR electricity)

• All covered in the database

Nil

189

No relevant

studies are

identified

161

S. No.

Website

Search phrase used

Subjects/Research publications

Relevant

studies

Hits

obtained

Results

Asian Development Bank (ADB)

(www.adb.org)

(slums) AND (water OR

sanitation OR electricity)

• Subjects

• Water

• Urban Development

• ADB Funds and Products

• ADB Administrative & Governance

• Governance and Public Sector

Management

• Data and Research

• ADB Economic working paper series

• ADB Regional economic integration

working papers

• Asian Development Review

• e-Quarterly Research Bulletin

AusAID

(www.aid.dfat.gov.au)

(slums) AND (water OR

sanitation OR electricity)

• All covered in the database

Nil

No relevant

studies could be

identified

Department of International

Development (DFID)

(www.gov.uk)

(slums) AND (water OR

sanitation OR electricity)

• All covered in the database

No relevant

studies could be

identified

EPPI

(www.eppi.ioe.ac.uk/cms/)

(slums) AND (water OR

sanitation OR electricity)

• All covered in the database

Nil

No relevant

studies could be

identified

162

S. No.

Website

Search phrase used

Subjects/Research publications

Relevant

studies

Hits

obtained

Results

International Initiative for Impact

Evaluation (3ie)

(www.3ieimpact.org)

(slums) AND (water OR

sanitation OR electricity)

• Publications

• 3ie Impact Evaluation Reports

• 3ie Systematic Review Series

• 3ie Replication Paper Series

• 3ie Working Paper Series

Cochrane Systematic Review

(www.cochrane.org)

(slums) AND (water OR

sanitation OR electricity)

• All covered in the database

Nil

No relevant

studies could be

identified

Campbell Systematic Review

(www.campbellcollaboration.org)

(slums) AND (water OR

sanitation OR electricity)

• All covered in the database

Nil

No relevant

studies could be

identified

Research for Development (R4D)

(http://r4d.dfid.gov.uk)

(slums) AND (water OR

electricity OR sanitation)

• Advanced search

• Search for R4D site, and

• Search other sites

1,340

WaterAid

(http://www.wateraid.org)

(slums) AND (water OR

electricity OR sanitation)

• All WaterAid publications

Search of the

website

generated 100

hits, but finally

obtained 74

documents

Energy Sector Management

Assistance Program (ESMAP)

(https://www.esmap.org)

(slums) AND (water OR

electricity OR sanitation)

• All ESMAP publications

Nil

806

No relevant

studies could be

identified

163

S. No.

Website

Search phrase used

Subjects/Research publications

Relevant

studies

Hits

obtained

Results

Global Network on Energy for

Sustainable Development (GNESD)

(http://www.gnesd.org)

(slums) AND (water OR

electricity OR sanitation)

• Publications

• Urban peri-urban

• Energy security

• Energy Access

• Other GNESD Publication

• Advanced search

Nil

No relevant

studies could be

identified

Practical Action

(http://practicalaction.org)

(slums) AND (water OR

electricity OR sanitation)

• Advance search

• Publications

• Energy access

• Water & Sanitation solution

Nil

393

No relevant

studies could be

identified

Community-Led Infrastructure

Finance Facility (CLIFF)

(https://www.gov.uk/international-

development-funding/community-

led-infrastructure-finance-facility)

(slums) AND (water OR

electricity OR sanitation)

Also searched with DFID main website

Nil

No relevant

studies could be

identified

Slum Upgrading Facility (SUF)

(http://ww2.unhabitat.org/suf)

(slums) AND (water OR

electricity OR sanitation)

Also searched on UN-HABITAT main

website

Nil

No relevant

studies could be

identified

164

Table A2.4: Details of Google and Google Scholar search

Search Limits

Searches using Google and Google Scholar cover under all subjects and published and unpublished

materials using the search term of (slums) AND (water OR sanitation OR electricity). In Google and

Google Scholar, the search generated a large number of results. In Google, using the above search

phrases in the advanced search feature generated 4,160,000 results. When the search was limited

by the following: year (1999-2013), language (English) and file type (Adobe Acrobat PDF), it

generated 562,000 hits, but it finally displayed only 28 pages with 274 hits. In this same way, we also

searched in Google Scholar, whereby the search generated 81,300 hits, which, when limited by year,

language and file type, resulted in 27,600 hits, but it finally displayed 98 pages with 972 hits.

Data sources

Search phrase used

Relevant

studies

Hits obtained

Search Limits

Google

(slums) AND (water OR sanitation OR

electricity)

274

English and 1999‒2013, PDF

Google

Scholar

(slums) AND (water OR sanitation OR

electricity)

972

1999‒2013, relevance only

Total

1,246

165

APPENDIX 2.2 QUALITY-APPRAISAL TOOL

Study code:

Authors:

Year of publication:

Journal:

Title of the Study:

Source:

Description

Score

Rating category

Given

rating

Given

score

CONCEPTUAL FRAMING

a) Does the study

acknowledge existing

research and theory?

Elaborate (high)

Simple or partial (medium)

Author’s own idea and articulation of need.

(low)

Not clearly acknowledged (can’t tell)

b) Does the study construct a

conceptual framework?

Strongly Agree (high)

Agree (Medium)

Disagree (Low)

Not clearly mentioned (can’t tell)

c) Does the study pose a

research question or

outline a hypothesis?

Clearly outlined (high)

Partially outlined (medium)

Unclear (low)

Not outlined (can’t tell)

TRANSPARENCY

a) Have the data sources

been clearly mentioned?

Strongly Agree (high)

Agree (medium)

Disagree (low)

Not clearly mentioned (can’t tell)

Strongly agree (high)

Agree (medium)

166

Description

Score

Rating category

Given

rating

Given

score

b) Does the study present or

link to the raw data it

analyses?

Disagree (low)

Could not be identified (can’t tell)

c) Does the study declare

sources of

support/funding? Is there a

potential conflict of

interests (funding bias)?

Clearly declared and no conflict of interests

(high)

Clearly declared; conflict of interests

(medium)

Not clearly declared (low)

No information provided (can’t tell)

APPROPRIATENESS

a) Does the study identify a

research design?

Clearly outlined (high)

Partially outline (medium)

Unclear (low)

Not outlined (can’t tell)

b) Does the study identify a

research method?

Clearly outlined (high)

Partially outline (medium)

Unclear (low)

Not outlined (can’t tell)

c) Does the study justify the

chosen design and method

as well suited to the

research question?

Clearly outlined (high)

Partially outlined (medium)

Unclear (low)

Not outlined (can’t tell)

CULTURAL SENSITIVITY

a) Does the study explicitly

consider any context-

specific cultural factors

that may bias/affect the

analysis/findings?

Clearly mentioned (high)

Partially mentioned (medium)

Unclear (low)

Not mentioned (can’t tell)

VALIDITY

a) To what extent does the

study demonstrate

measurement validity?

Appropriate (high)

Partially appropriate (medium)

Unclear (low)

Not outlined (can’t tell)

b) To what extent is the

causal conclusion arrived

at in the study valid?

Strong evidence reported (high)

Partial evidence reported (medium)

Low evidence reported (low)

No evidence/conclusions by the author (can’t

tell)

167

Description

Score

Rating category

Given

rating

Given

score

c) To what extent can the

results of the study be

generalised to cover other

situations?

Yes, can be generalised (high)

Yes, to some extent (medium)

No, cannot be generalised (low)

Unclear (can’t tell)

d) To what extent are the

findings of the study biased

by the research activity?

No bias (high)

Partial bias (medium)

Strong bias (low)

Unclear (can’t tell)

SAMPLE

a) Has the sample design and

target selection of cases

been explained and

justified clearly? (sampling

bias)

Very clear and satisfactory (high)

Clear, but needs further explanation (medium)

Unclear (low)

Not mentioned (can’t tell)

RELIABILITY

a) To what extent are the

measures used in the study

stable?

Very stable (high)

Partially stable (medium)

Unstable (low)

Can’t judge (can’t tell)

b) To what extent are the

measures used in the study

internally reliable?

Very reliable (high)

Somewhat reliable (medium)

Unreliable (low)

Can’t judge (can’t tell)

c) To what extent are the

findings likely to be

sensitive/changeable,

depending on the

analytical technique used?

Not sensitive (high)

Sensitive (medium)

Very sensitive (low)

Can’t assess (can’t tell)

Description

Score

Rating category

Given

rating

Given

score

ANALYSIS

a) Have the approach and

formulation to analysis been

clearly conveyed?

Very clear (high)

Clear, but require further explanation

(medium)

Unclear (low)

168

Not mentioned (can’t tell)

b) Have the depth and complexity

of data been clearly captured?

Very clear (high)

Clear, but require further explanation(medium)

Unclear (low)

Not mentioned (can’t tell)

COGENCY

a) Does the author ‘signpost’ the

reader throughout?

Very clear (high)

Clear, but inconsistent (medium)

Unclear (low)

Not mentioned (can’t tell)

b) To what extent does the author

consider the study’s limitations

and/or alternative

interpretations of the analysis?

(reporting bias)

Explicitly stated (high)

Implicit (medium)

Unclear (low)

Not mentioned (can’t tell)

c) Are the conclusions clearly

based on the results of the

study?

Explicitly stated (high)

Implicit (medium)

Unclear (low)

Not mentioned (can’t tell)

AUDITABILITY

a) Has the research process been

clearly documented? (reporting

bias)

Very clear (high)

Clear, but with omissions (medium)

Unclear (low)

Not mentioned (can’t tell)

Overall quality assessment of the study: HIGH/MEDIUM/LOW

The rating criteria are as follows: Total score >60 = high-quality; >35 = medium-quality and; ≤ 35= low

quality

Total

Score

169

APPENDIX 2.3: CHARACTERISATION OF STUDIES INCLUDED IN THE REVIEW

R 1 / A21

I. Study Details

Authors

Adubofour, K, Obiri-Danso, K and Quansah, C

Year

2013

Title

Sanitation survey of two urban Muslim slum communities in the Kumasi

metropolis, Ghana

Journal

Environment and Urbanization

Source

Electronic database

II. Study coverage

Basic service

Water and sanitation

Country

Ghana

Cities

Asawase (Kumasi)

III. Context and intervention

Type of settlement/slum

Informal settlement

Nature of agencies

involved in planning and

service provision

Water: others

 Private provision of water supply

Sanitation: user involvement

 Self-construction of shared, on-plot latrines

 Self-construction of toilets

Sanitation: government

 Public toilet for the community

Form of user

participation

Sanitation

 User involvement: participation through self-mobilisation

Project /intervention

funding agency

Water: state government/central government

Sanitation: private sector/state government

170

IV. Research design

Aim of the study

This paper presents the findings of a field study conducted to ascertain

the extent of improved water and sanitation coverage in two densely

populated urban slums, Aboabo and Asawase, in the Asawase

constituency of Kumasi, Ghana.

Type of study

Quantitative

Research design

Observational

Methodology used for

data analysis

Quantitative

V. Data and sample

Data sources

Primary data

A field survey was conducted in two urban slums in the Asawase

constituency of Kumasi, Ghana

Data period

27 January to 17 April 2009

VI. Results and evidence

Evidence on outcomes

Water

Connectivity: moderately negative

 Proportion of households connected to private, in-house, piped

water supply

Effort and time: moderately positive

 Time spent at water source (waiting)

Sanitation

Connectivity: moderately positive

 Proportion of households with shared on-plot latrines

Connectivity (user involvement/government): Moderately negative

 Proportion of households with unshared on-plot latrines

 Proportion of households having private toilet facility

 Proportion of households accessing public toilet facility

Effort and time (government): Moderately negative

 Estimated distance to public toilet (meters)

Summary of results

 The two communities of Aboabo and Asawase have been

adequately catered for in the provision of improved water

171

coverage (pipe-borne water and protected wells), although not

to a level that is convenient and easily affordable.

 Although most households use pipe-borne water for drinking

and other domestic chores, the number of private connections

to the metropolitan water-supply network is very low.

 As a result, most households purchase pipe-borne water from

neighbouring homes at considerably higher unit prices.

 Few of the households have private toilet facilities, and most of

those are shared between two or more households. The only

provision available to 58% of the population is the few heavily

patronised public toilets, which are poorly maintained.

Brief theory of change

 Due to the extensive water-supply network, women and children

in the two communities must only cover relatively short

distances to access water sources. However, in order to provide

adequate water provision to the study communities, the

municipal authorities and the Ministry of Housing and Water

Resources should continue with the provision of public

standpipes, and at a lower cost than purchases made from

neighbours.

 Although the two communities have been relatively well catered

for in the provision of improved water supply, there is an

extremely low level of provision for improved sanitation.

R 2 / E 4

I. Study Details

Authors

Adam, A

Year

2013

Title

Perceptions of slum-dwellers and municipal officials on factors impacting the

provision of basic slum services in Accra, Ghana

Journal

International Institute of Social Studies Research Report

Source

Google scholar

II. Study coverage

Basic service

Water and Sanitation

Country

Ghana

Cities

Accra

172

III. Context and intervention

Type of settlement/slum

Slum — informal

Nature of agencies

involved in planning and

service provision

Government

Form of user

participation

Project/intervention

funding agency

Government

IV. Research design

Aim of the study

 The main aim of the research is to explore the key factors

determining socio-economic, institutional and political factors

that determine the delivery of basic services to slum

communities under AMA.

 This study understands the levels and challenges to basic service

provision in slums, the views of both the demand (slum-

dwellers) and supply (AMA) sides are considered to overcome

the limited services provided.

Type of study

Mix method

Research design

Observational

Methodology used for

data analysis

V. Data and sample

Data sources

Primary data

 Household questionnaire/In-depth exploratory study/FDG/

transect walk observations

Data period

Not mentioned

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity

 Outcome

Moderately negative

173

 Access to water

 Access to sanitation service

Summary of results

 The survey showed 36% and 35% of respondents had access to

water and sanitation, respectively.

 An overall average of 69.5% of the 50 respondents agreed that

AMA (including CG, donors and decentralised agencies) play

major role in the delivery of basic services such as potable water

and sanitation. This was further buttressed by key informants

and discussants during focus-group discussions (FGDs).

Brief theory of change

Donors and decentralised agencies are able to enhance the water and

sanitation infrastructure to the slum-dwellers to some extent.

R 3 / A17

I. Study Details

Authors

Ahmad, S, Choi, M and Ko, J

Year

2013

Title

Quantitative and qualitative demand for slum and non-slum housing in Delhi:

Empirical evidence from household data

Journal

Habitat International

Source

Electronic database

II. Study coverage

Basic service

Water and sanitation

Country

India

Cities

New Delhi

III. Context and intervention

Type of settlement/slum

Informal settlement

Nature of agencies

involved in planning and

service provision

Government

User involvement

174

Form of user

participation

Participation through self-mobilisation

Project /intervention

funding agency

State government

Private (self-financed)

IV. Research design

Aim of the study

This study aims to estimate housing demand based on empirical

evidence, using household-survey data in New Delhi. Housing demand

comprises both quantitative and qualitative components, where, for the

first time, the latter is estimated by demand for housing attributes for

the local housing market in New Delhi.

Type of study

Quantitative

Research design

Observational

Methodology used for

data analysis

Quantitative

V. Data and sample

Data sources

Secondary data

 This study employs the data extracted from the 58th round

National Sample Survey (NSS) on the ‘housing condition of India’,

conducted by NSSO

Data period

2002

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately negative

 Proportion of households with tap-water facility

 Proportion of households with in-house piped-water connection

 Proportion of households with independent latrine

Summary of results

 The estimation results of housing demand show that housing

demand is inelastic with price and income.

 Overall, the degree of price elasticity is smaller than that of

income in absolute term, which indicates that housing demand

is less responsive to change in the prices of dwelling than

household income, except in slums.

175

 Taking into consideration that the current level of housing

consumption in New Delhi is close to the minimum level of basic

needs, this implies that there is little room to reduce housing

consumption further, despite rises in rent levels.

 However, this also implies that the increase in household income

is relatively effective in improving housing consumption.

 Therefore, economic growth of India in general, and particularly

of New Delhi, or any specific income-improvement program, is

expected to boost housing consumption.

Brief theory of change

 In sum, a policy combination is desirable for slum dwellings:

provision of low-cost dwellings, primarily facilitated by use of

low-cost land, as well as promotion of incremental dwelling.

These two may also be combined in the context of traditional

site and service, and a self-help housing approach.

 In comparison, housing qualities are important determinants of

dwelling value for non-slum households. Therefore, in sum,

provision of adequate infrastructure is also necessary, in

addition to an increase in income, in order to enhance housing

consumption for non-slum households.

 In this context, since it is generally expected that, by observing

the current economic scenario in India, and particularly in New

Delhi, income is bound to increase, there should be sufficient

housing supply in New Delhi in order to cope with an increase in

housing demand, coupled with income growth in non-slum

households.

 This, in turn, requires sufficient urban-land supply. Therefore,

government policies need to be focused commonly and

ultimately on enabling and encouraging strategies to increase

urban land supply for both non-slum and slum households. It is

necessary to increase dwelling stocks equipped with adequate

infrastructures to cope with increasing housing demand, derived

from income growth for non-slum households, on the one hand;

it is also, on the other hand, necessary to provide low-cost

serviceable land for slum households, coupled with an

incremental dwelling strategy.

R4 / A38

I. Study Details

Authors

Ahmed, N, Sohail, M

Year

2003

Title

Alternate water-supply arrangements in peri-urban localities: Awami (people's)

tanks in Orangi township, Karachi

Journal

Environment and Urbanization

Source

Electronic database

176

II. Study coverage

Basic service

Water

Country

Pakistan

Cities

Orangi (Karachi)

III. Context and intervention

Type of settlement/slum

Formal

Nature of agencies

involved in planning and

service provision

Local government — Karachi Water and Sewerage Board (KWSB)

Pakistan Rangers (a paramilitary force usually deployed for border

security)

User involvement ‒ Community

Form of user

participation

Participation by partnership and contribution

Project /intervention

funding agency

Local government ‒ Karachi Water and Sewerage Board (KWSB)

Pakistan Rangers (a paramilitary force usually deployed for border

security)

IV. Research design

Aim of the study

The aim of this paper is to show:

 How community-managed public tanks (Awami tanks) have

been used in Orangi, Karachi’s largest informal settlement, to

cope with the situation.

 The paper explores the partnerships between service

providers, recipients of the service and other related

stakeholders.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative analysis

177

V. Data and sample

Data sources

Primary data — Information was collected from various stakeholders,

including tanker operators and owners, KWSB staff, staff from the

Pakistan Rangers and municipal representatives. In addition, focus-group

meetings were held with tanker operators and area residents, and

interviews held with KWSB staff, Rangers, elected councillors and political

activists.

Secondary data — KWSB (2001), Basic Facts, Departmental Report,

Karachi Water and Sewerage Board, Karachi.

Data period

Not clearly mentioned

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately positive

 Pakistan Rangers and KWSB come together to supply water for

free through tankers, to community tanks in Orangi settlement.

Community members access water from these tanks for drinking

purposes.

Affordability: moderately positive

 Water is supplied free of charge

Adequacy: moderately negative

 Water is not available during the day as tankers supply water at

night only

Sustainability: moderately negative

 Quantity of water supplied is the bare minimum. These tanks are

only a temporary solution. If Pakistan Rangers withdraw from

the community, the supply of water will stop.

Effort and time: moderately negative

 Water has to be manually lifted and carried to the houses from

the community tanks.

Summary of results

 The study of Awami tanks shows that communities, with support

from government agencies, can generate cooperative action to

address their basic needs. It is significant that, in Orangi

township, despite acute water shortages, the low economic

status of its households and an overall feeling of desperation,

there has been no communal conflict in the routine operation of

Awami tanks. However, the relatively infrequent supply of water

to the tanks has adversely affected their expansion, and

communities are concerned about the lack of water from the

source itself.

178

 The design and construction of Awami tanks needs to be

improved in order to prevent water loss due to seepage.

 The reality of the situation concerning the lack of performance

of the piped-water supply needs to be clearly communicated to

the people of Orangi, so that they can consider other options.

Unfortunately, the authorities and elected representatives have

been unwilling to do this, as they are concerned with maintaining

their political and administrative hold on the communities.

Brief theory of change

 The study of Awami tanks shows that communities, with support

from government agencies, can generate cooperative action to

address their basic needs. It is significant that, in Orangi

township, despite acute water shortages, the low economic

status of its households and an overall feeling of desperation,

there has been no communal conflict in the routine operation of

Awami tanks. However, the relatively infrequent supply of water

to the tanks has adversely affected their expansion, and

communities are concerned about the lack of water from the

source itself.

R 5 / A37

I. Study Details

Authors

Almansi, F

Year

2009

Title

Regularizing land tenure within upgrading programmes in Argentina; the cases of

Promeba and Rosario Hábitat

Journal

Environment and Urbanization

Source

Electronic database

II. Study coverage

Basic service

Water and sewage

Country

Argentina

Cities

Promeba and Rosario

III. Context and intervention

Type of settlement/slum

Both formal and informal

179

Nature of agencies

involved in planning and

service provision

Government

 Settlement Upgrading Programme is a countrywide programme

now implemented in 21 provinces, with the involvement of

national, provincial and local authorities.

 Rosario Habitat is a local programme implemented by the

government in the city of Rosario.

Form of user

participation

Participation through contribution

Project /intervention

funding agency

Official development assistance

 Both programmes benefit from IDB co-funding schemes. Both

focus on informal urban settlements and, in the case of

Promeba, on peri-urban settlements.

IV. Research design

Aim of the study

The aim of this paper is to describe two large-scale upgrading

programmes in Argentina that sought to transfer land tenure to the

inhabitants of informal settlements as part of a larger process that

provides good-quality infrastructure and services and other measures to

strengthen their social inclusion in the wider city. The paper discusses

the constraints on such programmes, including the long, complex

process of getting land titles.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Secondary data

Data period

Not clearly mentioned

VI. Results and evidence

Evidence on outcomes

Water: connectivity: moderately positive

 1,013 relocated families received houses with connections to

drinking water and 2,138 families stayed in the original

180

settlements, which were provided with drinking-water

connections.

Sanitation: connectivity: moderately positive

 1,013 families received houses with connections to sewers and

storm-water drains and 2,138 families stayed in the original

settlements, which were provided with a sanitation network,

storm drains and sewers.

Electricity: connectivity: moderately positive

 1,013 families received houses with electricity and natural-gas

networks and 2,138 families stayed in the original settlements,

which were provided with electricity and gas services.

Summary of results

The two programmes described in this paper have shown that upgrading

with land-tenure regularisation strengthens beneficiaries’ feelings of

inclusion and stimulates private investment. In addition, it has been

demonstrated that most beneficiaries go on living in the upgraded

settlements and have made numerous improvements to their houses

since the programme interventions.

Brief theory of change

The transformation of irregular settlements into formal neighbourhoods

was achieved through the following actions:

 New urban planning of the villas, the opening of roads and urban

regularisation, ensuring the provision of basic infrastructure

(water and electricity supply, sewers, storm drains, gas, paved

roads) and community facilities.

 Housing upgrading, ensuring satisfactory sanitary conditions

through the construction of a sanitary unit.

 Building of houses with infrastructure for families relocated as a

consequence of the new urban planning (not to exceed % of the

total number of houses).

 Legal regularisation by delivering property titles to all

beneficiaries.

 Strengthening of social networks, including the beneficiaries’

direct participation in the decision-making process: planning,

performance and consolidation of interventions.

 Integrated assistance to children and adolescents and their

families: stimulating learning and psychomotor skills in children

aged two to five, nutrition, self-production of food, recreation,

family counselling and social education for children aged 10 to

14.

R 6 / A 55

I. Study Details

Authors

Amis, P and Kumar, S

Year

2000

181

Title

Urban economic growth, infrastructure and poverty in India: lessons from

Visakhapatnam

Journal

Environment and Urbanization

Source

Electronic database

II. Study coverage

Basic service

Water

Country

India

Cities

Visakhapatnam

III. Context and intervention

Type of settlement/slum

Informal settlement

Nature of agencies

involved in planning and

service provision

Government

 Municipal Corporation implements the project, which involves

improvements in physical infrastructure: water supply, drains,

communal latrines, paved roads and community halls in 170

slums, with an estimated population of 20,000.

Form of user

participation

Project /intervention

funding agency

Official development assistance

 DFID provided capital of £9m = (Rs 29 Crore) for a slum-

improvement project.

IV. Research design

Aim of the study

 This paper aimed to discuss the rapid economic growth in the

city of Visakhapatnam. It highlights how the city’s further

growth is constrained by inadequate investment in

infrastructure and discusses the political and institutional

reasons for this.

 It then presents the findings of participatory research on

poverty, and the many dimensions of poverty that are

emphasised by urban-poor groups, including inadequate

incomes, lack of assets (‘no shelter, no property, no gold’), lack

of support (especially for widows, deserted women and the

handicapped), illness and debt.

182

 It discusses the direct and indirect impacts on poverty of a DFID

SIP, showing which improvements low-income groups

particularly appreciated.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V Data and sample

Data sources

Primary data

 Focus group and in-depth interviews.

 Research was carried out by Thinksoft Consultants, with a group

of eight researchers in two teams, primarily split by gender.

Secondary data

 Database developed by the World Bank: Database on poverty

and growth in India.

Data period

1996

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately positive

 48% of residents noted a reduction in flooding and 55% reported

reduction in water stagnation.

Effort and time: Moderately positive

 In respect of water, 62% of the households interviewed reported

a reduction in the burden for women, and 68% reported savings

in time.

Summary of results

The DFID’s project involved,

 Improvements in physical infrastructure (water, drains,

communal latrines, paved roads and community halls in 170

slums (estimated population of around 200,000).

 The infrastructure components of the project, which helped

improve the overall environment were greatly appreciated by

the inhabitants (by reducing flooding, making roads passable and

reducing the burden of collecting water), in particular by

women.

 With regard to water, 62%of households reported a decline in

the burden for women while 68% reported a time saving. Forty-

eight percent noted a reduction in flooding and 55% a reduction

in water stagnation.

183

Brief theory of change

 First, Visag’s success is already being constrained by the lack of

investment in urban infrastructure.

 This case study shows that, even in the boom towns, it remains

a problem, and possibly one that is greater than currently

estimated, as any growth rapidly pushes up against

infrastructure constraints.

 The second concern is workers’ physical inability to fully

participate in the buoyant labour market, due to weakness and

ill-health.

 Because of the low levels of human capital, urban economic

growth will not be sufficient, despite increasing wage levels. This

again emphasises the importance of human capital in economic

development in India.

 On the positive side, the success of the DFID interventions,

especially in improving the quality of life for low-income

households, does show what can be done through capital

spending on infrastructure.

R 7 / B 4

I. Study Details

Authors

Asian Development Bank (ADB)

Year

2007

Title

Delivering piped water on a small scale: Results of ADB’s water-supply-service

market survey in Manila

Journal

Asian Development Bank (ADB) Report

Source

Website search

II. Study coverage

Basic service

Water

Country

Philippines

Cities

Manila

III. Context and intervention

Type of settlement/slum

Low-income

184

Nature of agencies

involved in planning and

service provision

Private

Form of user

participation

Project /intervention

funding agency

 ADB

 Philippines involved collaboration with Metro Manila’s two

concessionaires: Manila Water Company, Inc. and Maynilad

Water Services, Inc.

IV. Research design

Aim of the study

The study focused on how households access water, how much this

water costs, and if it is safe and reliable.

Type of study

Mixed-methods

Research design

Observational

Methodology used for

data analysis

Simple percentage analysis

V. Data and sample

Data sources

Primary data

Data period

March and April 2006

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity, adequacy

 Outcome

Moderately positive and moderately negative

 Private provision of piped-water supply

 Water consumption from piped-water connection

 Private provision of non-piped water supply

 Hours of water supply in piped-water connection

Summary of results

 Only 28% of the households have piped-water connections from

SSWPs, while a staggering 72% rely on non-piped water sources

— the huge gap indicating just how much work is still needed to

connect the poor.

185

 People with piped connections consume 4–5 times more water

than those who depend on non-piped water sources: about

13.5% of households depend on multiple water sources; 48%

rely on only one source; and 38.5% depend mainly on one

source, together with bottled water.

 Interestingly enough, almost half of those with a piped water

supply, mostly belonging to higher-income households, still buy

bottled water for drinking purposes. In fact, 95% of households

prefer bottled water for drinking and cooking. Affordability,

however, is an issue, since bottled water costs the most,

averaging (0.13 US cents) PhP6.42 per gallon.

 Among SSWPs, water from PWPs is cheapest, at 7 centavos

(US$0.0015) per gallon.

 Regardless of the water source, however, 24-hour water supply

remains a development goal. Piped-water availability averages

only 15 hours daily, and can be as little as four hours.

Brief theory of change

ADB believes that small piped-water networks (SPWN), a system used by

SSWPs, offer a temporary ‘building-block’ solution to the water problems

of slum communities. In 2005, ADB designed pilot projects to

demonstrate the use of SPWN for speedy piped-water delivery. These

pilot projects aim quickly to connect selected urban poor communities in

India, the Philippines, and Vietnam to piped-water supply on an interim

basis, until such time that the water utility is able to connect them

permanently. ADB’s pilot projects in the Philippines involved

collaboration with Metro Manila’s two concessionaires: Manila Water

Company, Inc. and Maynilad Water Services, Inc. To date, roughly 1,650

households in 10 urban-poor communities have been connected. While

this number is promising, a large segment of Manila’s urban poor remains

unconnected.

However, in the case of Metro Manila, Philippines, ADB and two

concessionaires have intervened to service the water supply to the slum

community. This study found that the only positive effect of the

intervention was due to the adequate amount of water supply provided.

R 8 / A16

I. Study Details

Authors

Bakker, K, Kooy, M, Shofiani, N and Martijn, E

Year

2008

Title

Governance failure: Rethinking the institutional dimensions of urban water supply

to poor households

Journal

World Development

Source

Electronic database

186

II. Study coverage

Basic service

Water

Country

Indonesia

Cities

Jakarta

III. Context and intervention

Type of settlement/slum

Informal settlement

Nature of agencies

involved in planning and

service provision

Other

Private-sector participation

Form of user

participation

Project /intervention

funding agency

National government

IV. Research design

Aim of the study

This paper examines factors that explain the persistent failure of both

public and private water-supply-system operators to achieve high rates

of individual network connections to poor households in urban areas.

Type of study

Quantitative

Research design

Observational

Methodology used for

data analysis

Quantitative

V. Data and sample

Data sources

Primary data

Secondary data

187

 Data from a household survey, archives, GIS-based mapping, and

interviews are used

Data period

2005

VI. Results and evidence

Evidence on outcomes

Adequacy: moderately negative

Summary of results

 This paper has demonstrated that Jakarta’s water-supply system

has been highly fragmented since its inception.

 Access to a household network connection has been strongly

differentiated economically (that is, poverty is correlated with

lack of access to a household connection, with the use of

alternative water sources, with low levels of water consumption,

and with spending higher proportions of household income on

water supplies) and spatially (that is, those lacking access are

concentrated in specific districts of the city, and within lower in-

come areas in neighbourhoods across the city).

 This differentiation of access has deep historical roots. The

current lack of access throughout large areas of Jakarta is due, in

part, to the legacy of segregated colonial water-supply systems,

and deliberate underinvestment in the post-colonial period, as

policymakers sought to discourage rural–urban migration, and

gave low priority to extending water-supply access to the urban

poor, focusing instead on economic development of key sectors,

or on an urban-redevelopment agenda focused on

‘‘monumental’’ infrastructure.

Brief theory of change

 In the case of Jakarta, the culture of urban governance, the

conventional water-supply utility business model adopted in

Indonesia, broader urban-planning constraints, cost-recovery

requirements, and economic incentives linked to tariff structures

were identified as some of the contributing factors to

governance failure.

 The factors preventing or precluding the capability of poor

households to connect to the network include limited ability to

pay transaction costs (rather than volumetric costs); insecure

tenure; the inability of the water-supply utility to deal with poor

households’ need for flexible payment options; and perceptions

of the relative quality, availability, and reliability of different

water sources.

R 9 / A15

I. Study Details

Authors

Bakker, K

Year

2007

188

Title

Trickle Down? Private sector participation and the pro-poor water supply debate

in Jakarta, Indonesia

Journal

Geoforum

Source

Electronic database

II. Study coverage

Basic service

Water

Country

Indonesia

Cities

Jakarta

III. Context and intervention

Type of settlement/slum

Informal settlement

Nature of agencies

involved in planning and

service provision

Private-sector participation

Form of user

participation

Project /intervention

funding agency

National government

IV. Research design

Aim of the study

This article examines the performance of the private sector in respect of

network connections for poor households in Jakarta, Indonesia

Type of study

Quantitative

Research design

Observational

Methodology used for

data analysis

Quantitative

189

V. Data and sample

Data sources

Primary data

 Data collected through a household survey of poor households

in six Jakarta neighbourhoods in 2005.

 Data provided by the two private concessionaires and the Jakarta

municipal government.

 Interviews with water-supply managers, government officials,

and NGO representatives.

Data period

2001‒05

VI. Results and evidence

Evidence on outcomes

Connectivity: Moderately negative

 Proportion of households with network water connection.

Affordability: Moderately negative

 Proportion of households spending more than 5% of their

income on water bills.

Summary of results

 There is evidence that new connections have targeted middle-

class customers, and that tariff increases have been higher for

poorer customers, without concurrent attempts to address

issues of ability to pay, income thresholds, and cross-subsidy

mechanisms.

 Tariff pricing (with lower tariff bands, below marginal costs),

decided by the municipal government in negotiation with

concessionaires, is implicitly ‘anti-poor’, providing a disincentive

to both the municipality and the private concessionaires to

connect the poor.

 The physical layout of the network, which is spatially

concentrated in wealthier areas of the city - a legacy of public-

sector management — is an additional barrier to connecting the

poor. Moreover, poor users have multiple disincentives to

connect to the network. Total costs of networked water supply

may be higher than alternative sources (such as groundwater or

vended water).

Brief theory of change

 The analysis concludes that the Jakarta PSP contract has not

been pro-poor. New connections were preferentially targeted at

middle- and upper-income households and the numbers of new

connections have been lower than the original targets.

 The paper argues that the failure to connect the poor is not

solely attributable to the private operators, and identifies

disincentives to provide individual network connections to poor

households on the part of the municipality, private

concessionaires and poor households.

 Other disincentives include insecure tenure, the need for

flexibility of payment, convenience, status, and high ‘transaction

costs’ associated with dealing with the formal water utilities.

190

‘Transaction costs’ (infrastructure costs to build storage because

networked water supply is only intermittent; line-ups and time

required to pay bills (for those without bank accounts and

regular income); fear of time required (to deal with meter

misreading and bill over-charging) are other disincentives.

R 10 / A34

I. Study Details

Authors

Bapat, M and Agarwal, I

Year

2003

Title

Our needs, our priorities: Women and men from the slums in Mumbai and Pune

talk about their needs for water and sanitation

Journal

Environment and Urbanization

Source

Electronic database

II. Study coverage

Basic service

Water and sanitation (Tap connection and toilets)

Country

India

Cities

Mumbai and Pune

III. Context and intervention

Type of settlement/slum

Both formal and informal

Nature of agencies

involved in planning and

service provision

NGO

SPARC/MAHILA MILAN)

Form of user

participation

Participation through self-mobilisation

The nature of participation and intervention can be gleaned from a few

interviews.

191

Project /intervention

funding agency

Private-NGO

Local Government-Municipal Corporation

Central-Bombay Port Trust

State-Government mental hospital

IV. Research design

Aim of the study

This paper presents extracts from interviews with slum-dwellers,

primarily women, in Mumbai and Pune, and discusses the conditions

they cope with every day with regard to water and sanitation, and the

ways these conditions have changed over time.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Interview method

V. Data and sample

Data sources

Primary data-Interviews with the slum-dwellers

Data period

Not stated

VI. Results and evidence

Evidence on outcomes

Mumbai

Connectivity: moderately positive

 NGO constructed the toilets for the community

 Municipal corporation provided stand pipes

 Bombay port trust provided public toilets (as the land belongs to

them)

 Community members collected money and secured shared

water connections, but there is no supply of water

Adequacy: moderately negative

 Municipal Corporation provided in-house connections to those

who could pay for them

 Duration of the water availability during the day

192

 Quantity of water available during the day

Affordability: moderately negative

 User charges/pay per use

Effort and time: moderately negative

 Time spent/distance travelled in accessing water

 Due to unavailability of water in stand pipes, community

members buy water from the nearby communities

Pune

Connectivity: moderately positive

 Community members lobby the Municipal Corporation to

provide water connection

 Local councillor agrees to provide water connections after

requests from the community

 NGO and self-help group jointly build community toilets

 Government mental hospital, which owns the land, has provided

shared water connections to the community

Adequacy: moderately positive

 Availability of toilets for use by community members (separate

toilets for men, women and children)

 Community members form self-help group and lobby the

Municipal Corporation to provide water connection

Effort and time: moderately positive

 NGO and self-help group jointly build community toilets in order

to reduce time spent/distance travelled in accessing water.

Summary of results

Results are not clearly stated. The interviews are reported verbatim and

there is no reporting of results, analysis, conclusions

Brief theory of change

Not clearly mentioned

R 11 / E8

I. Study Details

Authors

Baruah, B

Year

2010

Title

Energy services for the urban poor: NGO participation in slum electrification in

India

193

Journal

Environment and Planning

Source

Google Scholar

II. Study coverage

Basic service

Electricity

Country

India

Cities

Ahmedabad

III. Context and intervention

Type of settlement/slum

Informal settlement

Nature of agencies

involved in planning and

service provision

Government

 Ahmedabad Electricity Company (AEC) provides the electricity

to the Slum Electrification Pilot Project.

Form of user

participation

Participation through providing information

 The NGOs conducted a detailed needs assessment and

willingness-to-pay study among the slum-dwellers and also

involved community representatives and CBOs in implementing

the electrification programme.

Project /intervention

funding agency

NGO and ODA

 NGO's Saath, Sewa Mahila Housing Trust (MHT) and United

States Agency for International Development (USAID) pool

resources to provide funds to cover the cost of connection to

the urban poor to secure electricity under a Slum Electrification

Pilot Project.

IV. Research design

Aim of the study

 The aim of this paper is to share the experiences of two NGOs in

India, the Self-Employed Women's Association (SEWA) and

Saath, which have participated in a multiple-stakeholder pro-

poor electrification programme.

 This paper also tries to identify policy inputs that are required to

scale up and optimise NGO participation in the design and

implementation of pro-poor electrification activities, and in the

energy-reform process in general.

Type of study

Qualitative

194

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data

 The author employs a pricing survey carried out by Saath, project

reports prepared by NGOs and international aid agencies,

internal and external evaluations of the project, and interviews

with staff from the NGOs and the electricity utility, in order to

analyse the project in terms of its impacts upon access, tariffs,

quality of service, tenure security, and its role in empowering

women through the formation and maintenance of CBOs.

Secondary data

 The author use academic literature on urban infrastructure

provision and politics, project reports and evaluations.

Data period

Not clearly mentioned

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately positive

 A total of 820 households in four slums were provided with

electricity during the pilot project.

Affordability: moderately negative

 Households had to contribute a reduced connection cost (capital

cost) of Rs3,350 to obtain connections from the AEC. This was

only a part of the total cost of Rs.,7,750. USAID and AEC

contributed Rs2,200 each.

Durability: moderately positive

 The NGOs facilitated negotiations between AEC and AMC to

overcome the problem of tenure status and security. The AMC

issued a No Objection Certificate (NOC), stating that the

beneficiaries of the pilot project and the Slum Networking

Project will not be evicted by the AMC for a period of ten years.

Summary of results

 The MHT and Saath have succeeded in making a contribution to

pro-poor electrification to which few other NGOs in India can lay

claim.

 Their experience suggests that NGOs can play a very effective

role in slum electrification, as intermediaries between CBOs,

municipalities and utilities. They can assist in developing

innovative ways of addressing land-tenure issues; devising

195

equitable ways of paying for electricity; improving business

processes, including metering, billing, collections, and rate

making; dealing with non-payment and theft; and developing

information and reporting systems by providing feedback to

utilities and municipalities.

 However, it is important to understand that the NGO’s role in

slum electrification is time-consuming, labour-intensive and

expensive.

 Scaling up and optimising NGO participation in pro-poor

electrification activities requires strong state involvement in

securing financial resources and developing a policy framework

for NGOs to participate in the design and implementation of

partnership projects and in the oversight of the electricity-

reform process in general.

Brief theory of change

 MHT and Saath staff identified the absence of policy guidance

and financial resources as the biggest impediment for NGO

participation in pro-poor electrification projects.

 The profitability of slum electrification motivated the AEC

progressively to reduce connection fees for slum households

after the completion of the pilot project.

 However, the AEC completely ignored the pricing guidelines of

the survey conducted by Saath in setting the unconscionably

high connection fees in the pilot project.

 The lack of a recognised role for NGOs made it easy for the utility

to reject Saath's findings and recommendations. There were no

administrative or capacity-building funds available to the NGOs

to participate in this project.

 The conflict between the different partners in the Ujala Yojana

slum electrification project is also compounded by the absence

of a project-specific memorandum of understanding (MOU) that

defines the specific roles and responsibilities of each partner.

R 12 / D 4

I. Study Details

Authors

Barja, G and Urquiola, M

Year

2001

Title

Capitalization, regulation, and the poor: Access to basic services in Bolivia

Journal

World Institute for Development Economics Research, Report

Source

Cross reference

196

II. Study coverage

Basic service

Water, sanitation and electricity

Country

Bolivia

Cities

Cochabamba, El Alto, La Paz, Oruru, Potosí, Santa Cruz, Tarija, Trinidad

III. Context and intervention

Type of settlement/slum

Low-income

Nature of agencies involved in

planning and service provision

Private

Form of user participation

Project /intervention funding agency

Private

IV. Research design

Aim of the study

To analyse the impact of reforms on poor or lower-income households

along two dimensions: (i) access, understood as connection, and (ii)

affordability, as determined by changes in consumption and pricing

patterns.

Type of study

Mixed-methods

Research design

Observational

Methodology used for

data analysis

Statistical method

V. Data and sample

Data sources

Secondary data

 Encuesta Integrada de Hogares, 1st round 1989

 Encuesta Integrada de Hogares, 7th round 1994

 Encuesta Continua de Hogares 1999

Data period

1989, 1994, 1999

197

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity

 Outcome

Strongly positive

 Trend in percentage increase of households with access to water

supply

 Trend in percentage increase of households with access to

sewerage system

 Trend in percentage increase of households with access to

electricity

Summary of results

 Water access rates are relatively stable in the control period, but

increase between 1994 and 1999. The convergence in

connection rates is more marked: by 1999, households in all

quintiles have access rates above 90%, and the differences

between them are often not statistically significant.

 Electricity has been the sector with the smallest improvements

in access, partially reflecting relatively favourable initial

conditions. The quintiles with the lowest access levels in 1989

have been those with the greatest increases during 1989‒99, an

observation which also holds for the 1994‒99 period. While, in

1989, households in the lowest quintile had an access rate of only

86%, by 1994 all five had rates exceeding 95%. It is surprising

that, by 1999, the lowest-income group seems to have surpassed

all but the richest. In part, this may reflect sampling issues, since,

when all groups have high and similar access rates, these

differences can cease to be statistically significant.

 Surveys suggest that the sewerage situation of the lowest-

income quintile is better than that displayed by quintile 2, or

even 3. Household-survey data suggest that the

capitalisation/regulation reforms, to the extent that they caused

increases in connection rates, have not bypassed poor

households, and have, in some cases, tended to benefit poor

households disproportionately.

Brief theory of change

Bolivian privatisation/capitalisation and regulation have made a positive

impact on the access in water, sanitation and electricity for the urban low-

income poor.

R 13 / A39

I. Study Details

Authors

Birkenholtz, T

Year

2010

198

Title

‘Full-cost recovery’: Producing differentiated water collection practices and

responses to centralized water networks in Jaipur, India

Journal

Environment and Planning A

Source

Electronic database

II. Study coverage

Basic service

Water (access)

Country

India

Cities

Jaipur (Rajasthan)

III. Context and intervention

Type of settlement/slum

Both formal and informal

Nature of agencies

involved in planning and

service provision

Government: Rajasthan Urban Infrastructure Development Project

(RUIDP)

Form of user

participation

Project/intervention

funding agency

ODA: ADB, Japan Bank

IV. Research design

Aim of the study

This paper examines the political and ecological effects of the expansion

of an urban centralised water-supply network and its transformation into

a full-cost-recovery system in Jaipur, Rajasthan, India.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative case study

V. Data and sample

Data sources

Primary data

199

 Household survey of six Jaipur neighbourhoods stratified by class;

follow-up household interviews, interviews with public water-

supply managers and private water-tanker vendors.

Secondary data

Data period

2007‒09

V. Results and evidence

Evidence on outcomes

Connectivity: moderately positive

 Residents have household-level metered connections. Residents

have access to water from public shared-stand posts.

Adequacy: moderately negative

 Water supply is intermittent and inadequate. Residents have

plastic tanks (of capacity 250‒1,000l) to capture the intermittent

supply.

Affordability: moderately negative

 Residents in this slum pay more for water than elsewhere. Even

residents in affluent areas pay less than this community.

Effort and time: moderately negative

 Unreliable water supply from the shared-stand post resulting in

long queues and wait times of up to two hours daily.

Summary of results

The highly uneven flow of water from the network is critical to highlighting

the differential character of adaptive responses and effects of cost-

recovery reforms.

 First, inadequate service is leading to self-provision through the

construction of private tube wells by the affluent. This occurs in

the absence of construction regulations and is happening in the

industrial sector as well. To date, the proposed policy changes in

the PHED water supply do not address this issue, because

regulating private tube-well construction and abstraction is a

politically divisive issue the growth of private water markets is

occurring as an outcome of the uneven expansion of public

supply, yet with very divergent class and spatial practices.

 Private water markets, in general, are subsidised by the formal

sector through side-selling, which negatively impacts the

underserved informal sector by driving up operation costs of the

PHED network. The uneven service being provided through the

water-supply network will continue to encourage private-water-

tanker provision, rather than eliminating it.

 The city continues to struggle, in socially fragmented ways, with

access to water. By continuing to designate particular areas of the

city as ‘informal’ and ‘non-regularised’, access to water is not only

uneven, but the adaptations that people institutionalise and their

political and ecological effects are socially differentiated, with the

poor and disenfranchised being most negatively impacted.

200

Brief theory of change

The investigation concludes that the spatially uneven integration of

network expansion and the intermittent flow of water circulating through

it, combined with historical axes of political economic difference produces

uneven adaptive responses to maintain access to water, such as waiting on

water, private tube-well construction, and private water-tanker

operations, while transforming social-power relations.

 First, that these uneven flows and cost-recovery initiatives are

exacerbating current disparities in access to drinking water.

 Second, that the current public water-supply system has only

been partially reformed and that these policy changes have

rendered the public supplier unable to recover costs. This makes

the need for a private-sector rescue of an incapacitated and

inefficient public institution seem obvious to planners, yet the

public utility's inability to set costs or to set infrastructure

priorities draws into question the need for the private sector and

full-cost-recovery reforms.

R 14 / A 6

I. Study Details

Authors

Bravo, G, Kozulj, R and Landaveri, R

Year

2008

Title

Energy access in urban and peri-urban Buenos Aires

Journal

Energy for Sustainable Development

Source

Electronic database

II. Study coverage

Basic service

Electricity

Country

Argentina

Cities

Buenos Aires

III. Context and intervention

Type of settlement/slum

Slum and poor

201

Nature of agencies

involved in planning and

service provision

Government

Form of user

participation

Project/intervention

funding agency

Government

IV. Research design

Aim of the study

The objective of the study is the identification of unsatisfied energy

needs, and then the assessment of the most appropriate sources that

should be encouraged in order to fulfil the basic needs.

Type of study

Qualitative

Research design

Observational method

Methodology used for

data analysis

Descriptive analysis

V. Data and sample

Data sources

The case study surveyed 100 poor households in Villa Fiorito and Budge

 Questionnaire method

 In-depth interview method

Data period

November 2007

VI. Results and evidence

Evidence on outcomes

Adequacy: moderately negative

Connectivity: moderately negative

Summary of results

 Although modern energy sources (LPG and electricity) are

broadly used by poor households in Greater Buenos Aires,

LPG availability and affordability are found to be key issues.

Compounding the fuel-availability issue, another barrier to

access can be the high up-front cost of LPG cylinders.

 Often it is replaced by charcoal and kerosene by poor slum

families and these fuels are dirtier and less efficient, thereby

202

increasing energy consumption and possibly even fuel

expenditure for cooking.

 The study attempts to quantify unmet basic energy needs,

finding that cooling, lighting, and space-heating have the

smallest satisfaction levels. The study found that 54% of the

total surveyed energy expenditure is on cooking fuels.

Brief theory of change

 The study found a notable absence of appropriate and

comprehensive policies, both for providing access to clean

energy and for securing its affordability. Specifically and going

beyond energy aspects, the roots of poverty are related to two

unaddressed structural issues: land tenure and the availability of

regular employment.

R 15 / A 33

I. Study Details

Authors

Burra, S, Patel, S and Kerr, T

Year

2003

Title

Community-designed, built and managed toilet blocks in Indian cities

Journal

Environment and Urbanization

Source

Electronic database

II. Study coverage

Basic service

Sanitation (Access to toilets)

Country

India

Cities

Mumbai, Kanpur, Bangalore, Pune

III. Context and intervention

Type of settlement/slum

Slum-Informal

Nature of agencies

involved in planning and

service provision

NGO

SPARC, the National Slum Dwellers Federation and Mahila Milan.

203

Form of user

participation

Participation through partnership and contribution

Community involvement in designing, construction and maintenance of

toilet blocks.

Project/intervention

funding agency

ODA

The city of Mumbai sought funding from the World Bank to expand its

sewer system.

IV. Research design

Aim of the study

The aim of this paper is to explain the following.

 Why sanitation has been neglected, describing the inadequacies

in government-sanitation programmes, first experiments with

community sanitation and the difficult negotiations involving

many cities, including Mumbai, Kanpur and Bangalore.

 The major community-toilet programmes that developed in

Pune and Mumbai.

 The innovations that allow community toilets to work better

than previously used public toilet blocks; the reasons why CBOs

and NGOs took on these projects, the lessons learnt, and the

ways in which community toilet blocks helped address problems

faced by the urban poor, such as quality of toilet construction,

inappropriate design, limited water supply, inadequate cleaning

and maintenance, no access to drainage, etc.

Type of study

Qualitative study

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data

Secondary data, collected by NGOs

Data period

1988‒96

204

VI. Results and evidence

Evidence on outcomes

Mumbai

Connectivity: moderately positive

 Access to community toilets

Adequacy: moderately positive

 Availability of toilets for use by community members throughout

the day/night

Kanpur

Connectivity: moderately positive

 Constructed community 10 toilets. Access to those community

toilets

Adequacy: moderately positive

 Availability of toilets for use by community members throughout

the day/night

Affordability: unclear

 Cost of access — user fee operation and maintenance Effort and

time: Moderately positive

 Location of toilets near the slum

Bangalore

Connectivity: moderately positive

 Community-built toilets. Access to those toilets

Pune

Connectivity: moderately positive

 114 blocks were constructed in Pune. Access to those toilets

Adequacy: moderately positive

 Availability of toilets for use by community members throughout

the day/night

Summary of results

 In Mumbai, the alliance suggested that the city should pay for

the capital cost of toilet construction. However, the World Bank

had ideas such as slums’ getting organised and bidding against

each other to get the fund. So, the alliance did not agree to take

part.

 In Kanpur, many steps were taken by the public authorities, but

the steps taken were not successful. Then, Mahila Milan

constructed 10 toilets with seats. The pay-and-use system

generated funds for maintenance. There is an improvement in

access to toilets.

 In Bangalore, with start-up money from the Society for

Promotion of Area Resource Centres (SPARC), a group of

205

residents started building a communal toilet. The toilets were

entirely community-built.

 In Pune, the alliance (SPARC, NSDF, and MM) became one of the

principal contractors and constructed 114 toilet blocks. The

alliance designed and costed the project; the city provided the

capital costs; and the communities developed the capacity for

management and maintenance.

 In Mumbai, SPARC targeted the completion of 320 toilet blocks

by March 2003, but they could not meet the deadline. They

argued with the World Bank for an extension. The WB extended

to December 2003, but the alliance could only complete 180

blocks while a 110 toilet blocks were underway.

Brief theory of change

 The alliance promoted a system whereby each family buys a pass

for 20 rupees a month — far less costly than the 1-rupee-per-use

charge by other public toilets — thereby increasing usage and

affordability.

 The Indian government has introduced a new programme, the

Nirmal Bharat Abhiyan, -whereby a 50% subsidy for the

construction of community toilets is available to local bodies and

public authorities.

 The lacks of funds and political issues are the reason for lack of

attention to sanitation in cities such as Pune, Mumbai, etc.

 The community-toilet projects all represent, to varying degrees,

partnerships that begin to break the conventional approach to

service delivery.

 Community-maintained toilets are more successful than public

toilets, which are government-maintained.

 A large community-toilet-block-building programme gives a big

push to communities to undertake projects and to create an

environment that makes room for experimentation. Externally

supported intervention (SPARC, NSDF and MM) do not set new

standards, but alter and influence the circumstances that allow

communities to develop standards of their own.

R 16 / C 5

I. Study Details

Authors

Burra, S

Year

2001

Title

Slum sanitation in Pune: A case study

Journal

SPARC Research Report

Source

Author correspondence

206

II. Study coverage

Basic service

Sanitation

Country

India

Cities

Pune

III. Context and intervention

Type of settlement/slum

Slum-informal

Nature of agencies

involved in planning and

service provision

NGOs

Form of user

participation

Project/intervention

funding agency

NGO

IV. Research design

Aim of the study

The case study seeks to describe the way in which the programme was

implemented and draw lessons for urban governance.

Type of study

Qualitative study

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data

Data period

Not mentioned clearly

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity, Affordability and Adequacy

 Outcome

207

Moderately positive and moderately negative

 Access to toilet facilities

 Affordability of pay-to-use toilet

 Construction of new toilet blocks

Summary of results

 High cost to slum-dwellers of using the toilet – usually Rs1 per

use, per person. A family of five would have to spend Rs150 a

month to access these toilet blocks and this is not affordable for

the majority of the urban poor. This results in early deterioration

and disuse, and the pay-and-use approach, which is not

sustainable in slums on account of its high cost.

 Since 1992, only 22 pay-and-use toilet blocks had been built in

the city, annual expenditure never going beyond Rs20 or Rs25

lakhs. A decision was taken to construct 220 toilet blocks, with

about 3,500 toilet seats through NGOs in 1999‒2000. This was

to be the first phase of the programme. On completion of the

second phase (planned for another 220 blocks between

November 2000 and January 2001), more than 400 blocks or

more than 10,000 toilet with seats would be constructed at a

cost of more than Rs40 crores and benefiting more than 5 lakh

slum-dwellers, if we assume that 50 persons can use a toilet seat

on a given day. The expenditure incurred on the first phase was

Rs22.5, crores or about 100 times what was spent in any

preceding year.

 Over two phases of the programme, the alliance has constructed

114 toilet blocks, with more than 2,000 toilet seats and more

than 500 children’s seats. The programme envisaged the

collection of Rs20 per family per month to fund the appointment

of a caretaker and for cleaning materials.

Brief theory of change

After the intervention of NGOs in the Pune slum, the newly adequate

amount of basic service provision is high-impact. but the affordability of

using toilets is slightly negative

R 17 / A 40

I. Study Details

Authors

Cavill, S, Sohail, M

Year

2004

Title

Strengthening accountability for urban services

Journal

Environment and Urbanization

Source

Electronic database

208

II. Study coverage

Basic service

Basic services (household connections for water and sewerage, tarmac roads, pit

latrines and standpipes, etc.)

Country

Bangladesh, South Africa

Cities

Dhaka, Mdantsane

III. Context and intervention

Type of settlement/slum

Informal and low-income settlement

Nature of agencies

involved in planning and

service provision

Government, NGO

Seoul’s metropolitan government, Bristol city council, SITA GB Ltd,

Resource Saver (an NGO the operates the kerbside ‘black-box’ recycling

collection service under sub-contract) and Community at Heart (a

resident-led organisation established to deliver the New Deal for

Communities anti-deprivation programme in the area). Local government

and community organisation in Mdantsane. Government and NGO in

Dhaka government. Dushta Sasthya Kendra, Water Aid, the World Bank,

UNICEF and the government utility (DWASA)

Form of user

participation

Project/intervention

funding agency

Local Government

 Municipality

ODA

 Partnership between Dushta Sasthya Kendra, Water Aid, World

Bank, UNICEF and government utility (DWASA)

IV. Research design

Aim of the study

The objectives of this paper are to:

• consider contemporary innovations in the way urban services are

delivered — the context of accountability;

• define accountability using the existing literature and present current

models for accountability;

• discuss how the concept of participatory governance can be

operationalised in the context of urban services;

• present initial findings from case studies undertaken in South Africa,

Bangladesh, South Korea and the UK; these case studies are used to

illustrate different functions of accountability; and

209

• examine the potential of accountability arrangements demonstrated in

these case studies to improve the quality of local services and the

responsiveness of service providers.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data collected from field visits and semi-structured interviews,

from closed-answer questionnaires, document review, newspaper articles

and direct observation in study areas.

A random survey of about 100 respondents was conducted in deprived

(squatter settlements) and non-deprived areas of Mdantsane, Dhaka and

Seoul, and was intended to give an overall impression of user satisfaction,

rather than a statistically significant sample.

Data period

July 2002‒July 2003

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately negative

 Low-income households were provided with legal access to safe

drinking water, which had to be paid for. A majority of the people

were dissatisfied with the service

 Low-income households were provided with legal access to safe

drinking water, which had to be paid for. Majority of the people

were dissatisfied with the service

 Residents were not happy with the service provision and felt

there were no service improvements

Summary of results

The analysis suggests that improvements in accountability hadn’t

improved user satisfaction in respect of planning, delivery and

maintenance of urban services.

On the whole, respondents thought that they were only slightly better off

than they had been before reforms were introduced. The majority

reported that levels of service had remained the same or had worsened,

and user satisfaction with agency responses to requests and complaints

had not changed markedly.

Therefore, it could be concluded that there has been no substantial change

in user satisfaction during the period since practices underwent change.

However, in the long run (this might mean decades), one would expect

210

participatory accountability mechanisms to lead to improvements in

service outcomes and user satisfaction.

Brief theory of change

 The research found that approaching councillors and voting for

politicians, holding public meetings, protests and organising

petitions emerged as the most useful mechanisms for securing

accountability.

 In particular, users from deprived areas appeared to prefer more

participatory mechanisms; that is, those with an indirect

influence on service providers, as well as arrangements where

residents could sort out problems directly with frontline service

providers.

 This research suggests that, particularly in deprived areas, service

users seldom rely on a single mechanism to produce

accountability. It was observed that participation in such

attempts depends on a range of factors, including resources,

incentives and motivation to improve urban services, the kind of

benefits to be gained (personal or common), the nature and

location of the services in question, the intensity of concern with

services, and the sustainability of the accountability created.

R 18 / D 2

I. Study Details

Authors

Clarke, G and Wallsten, S

Year

2002

Title

Universal (ly Bad) Service: Providing infrastructure services to rural and poor

urban consumers

Journal

World Bank policy research working paper

Source

Cross-reference

II. Study coverage

Basic service

Water, sanitation and electricity

Country

Multiple

Cities

Multiple

211

III. Context and intervention

Type of settlement/slum

Low-income

Nature of agencies

involved in planning and

service provision

Government

Form of user

participation

Project / intervention

funding agency

Government

IV. Research design

Aim of the study

 Discuss the rationale for universal-access laws and review the

different ways in which subsidies can be financed and allocated,

along with the implications of those various methods.

 To evaluate the historical effectiveness of monopoly enterprises

in providing service to the poor and how privatisation has

affected coverage.

Type of study

Mixed-methods

Research design

Observational

Methodology used for

data analysis

Simple percentage analysis

V. Data and sample

Data sources

Primary

 MEASURE DHS+ Demographic Health Survey

Data period

MEASURE DHS+ Demographic Health Survey

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity

 Outcome

Moderately negative

212

 Access to water

 Access to flushable toilet

 Access to electricity

Summary of results

 In low-income countries in Africa, about 80% of urban

households headed by an individual with a secondary education

had access to electricity; 63% had access to piped water, either

in their house or yard; and 38% had a flushable toilet.

 In comparison, only 32% of urban households headed by

individuals with no education had electricity; 27% had piped

water; and only 10% had a flushable toilet.

 Although coverage was higher in low-income countries in Latin

America, the basic pattern was similar. The differences in

coverage were not due to differences in only a few countries. For

electricity, piped-water coverage was lower — and, in most

cases, much lower — for houses headed by individuals with no

education than it was for households headed by individuals with

a secondary education or higher, in all low-income countries in

Africa and Latin America.

 In middle-income countries in Latin America, similar patterns

were observed for electricity and flushable toilets, although, on

average, urban households headed by individuals with no

education were slightly more likely to have access to piped water

than urban households headed by individuals with a secondary

education or higher. Europe and Central Asia appear to be

different, with higher overall coverage in most sectors and less

noticeable differences between households the heads of which

have different education levels.

Brief theory of change

The massive failure of state-monopoly enterprises in providing service to

the poor, except Eastern Europe. Cross-subsidies have often been poorly

directed and have typically failed to reach poor consumers.

R 19 / D 8

I. Study Details

Authors

Chowdhury, F and Nurul Amin, A

Year

2006

Title

Environmental assessment in slum-improvement programmes: Some evidence

from a study on infrastructure projects in two Dhaka slums

Journal

Environmental Impact Assessment Review

Source

Cross-reference

213

II. Study coverage

Basic service

Sanitation

Country

Bangladesh

Cities

Dhaka (Bank-Maath and City-Polly)

III. Context and intervention

Type of settlement/slum

Slum ‒ formal

Nature of agencies

involved in planning and

service provision

Government and NGO

Form of user

participation

Project/intervention

funding agency

Government and NGO

IV. Research design

Aim of the study

To address the deteriorated socio-economic and physical environmental

conditions of the slums, the Government of Bangladesh, with the support

of different donor agencies, has initiated different SIPs.

Type of study

Mixed-methods

Research design

Experimental

Methodology used for

data analysis

Statistical method

V. Data and sample

Data sources

Primary survey

 on-site observations, questionnaire survey, in-depth discussions

with the project stakeholders, conducting interviews with the

experts and professionals

214

Data period

April 2003

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity

 Outcome

Strongly positive, strongly negative

 Households’ responses to non-existence of drainage problems

Summary of results

 Before the implementation of the Supporting Household

Activities for Health, Assets and Revenue project (SHAHAR) and

SIP, the drainage situation was very poor in both slums. After

implementation, drainage has improved in both slums, but the

situation seems to have improved greatly in the Bank-Maath

slum. Responses of residents of this slum suggest near non-

existence of the drainage problem after implementation of this

project. The situation, however, did not improve as much in the

City-Polly. Indeed, 74% of the respondents from this slum noted

the persistence of this problem, even after the implementation

of the project. In the Bank-Maath slum, this problem had been

solved through a complete and well-designed drainage network.

In Chi-2 test results (p value=0.000 and a=0.01) confirms that the

number of experiencing this problem in the City-Polly are

significantly higher than those in the Bank-Maath slum.

 Survey results reveal that the drainage intervention did not

improve the wastewater overflow problem in City-Polly. Most of

the respondents (83.9%) noted the continuation of the problem

after the implementation of the drainage system.

 The provision of the drainage system in the Bank-Maath slum has

largely solved the wastewater-overflow problem. About 90% of

respondents confirm non-persistence of this problem.

Consultation with the slum-dwellers in this slum facilitated

proper identification of wastewater sources and its drainage.

Chi-2 test result (p value=0.000 and a=0.01) on the wastewater-

overflow-problem responses in two slums confirms that the

problem in the City-Polly is significantly higher than that in the

Bank-Maath.

 Significant improvement took place in the Bank-Maath slum

after the implementation. However, the situation did not

improve in City-Polly. In the latter, 81% of respondents reported

continuation of the problem. Unsanitary hanging latrines existed

in this slum, even after the project’s implementation. It was

observed that community latrine pits were located adjacent to

the kitchen, some of which were broken, with the consequent

possibility of transmission of germs to the food. It was evident

from the survey that excreta were overflowing from the filled up

pits. This problem has been exacerbated overflow of wastewater

and lack of drainage. Chi-2 test result (p value=0.000 and a =0.01)

215

confirms this problem in City-Polly is significantly greater than

that in the Bank-Maath slum.

Brief theory of change

The Bangladesh slums (Bank-Maath and City-Polly) have seen enormous

changes in the sanitation sector after the intervention of different donors,

such as SHAHAR and USAID.

R 20 / E 7

I. Study Details

Authors

Chandrasekhar, S

Year

2005

Title

Growth of slums, availability of infrastructure and demographic outcomes in

slums: Evidence from India

Journal

Urbanization in Developing Countries at The Population Association of America,

Conference Research Report

Source

Google Scholar

II. Study coverage

Basic service

Water, sanitation and electricity

Country

India

Cities

All major Indian cities

III. Context and intervention

Type of settlement/slum

Slum — formal and informal

Nature of agencies involved in

planning and service provision

Government

Form of user participation

Project/intervention funding agency

Government

216

IV. Research design

Aim of the study

This study aims to analyse the services available in the slums and to

examine the improvements in slum conditions over the last five years

using NSSO data 2002.

Type of study

Mixed-methods

Research design

Observational

Methodology used for

data analysis

Simple percentage analysis

V. Data and sample

Data sources

NSSO Data 2002

Data period

July‒December 2002

VI. Results and evidence

Evidence on outcomes

 Outcome

Connectivity

 Evidence

Moderately positive, moderately negative

 Provision of improved water supply

 Provision of improved electricity service

 Provision of improved latrine facilities

 Provision of improved drainage facilities

 Provision of improved sewerage facilities

Summary of results

 Nearly 50% of slums reported improvements in latrines, 47% in

drainage facilities and 24% in sewerage.

 In the context of improvements in respect of drainage and

sewerage, the residents were responsible for improvements in

nearly 21% and 27%, respectively, of the non-notified slums.

 In 84% (71) of the notified (non-notified) slums, the main water

source is the tap. However, these numbers mask differences

across the states of India. In the state of Bihar, none of the slums

gets water via the tap. In Chhattisgarh, Gujarat and Uttar

Pradesh, less than 35% of slums receive tap water.

Brief theory of change

This study does not propose a theory of change; rather, it discusses the

monopoly of the conventional service provider: that is, the government.

217

R 21 / E12

I. Study Details

Authors

Chung, M and Hill, D

Year

2002

Title

Urban informal settlements in Vanuatu: Challenge for equitable development

Journal

Pacific Islands Forum Secretariat and UN Economic and Social Commission for

Asia and the Pacific, Pacific Operation Centre, Research Report

Source

Google Scholar

II. Study coverage

Basic service

Sanitation

Country

Vanuatu

Cities

Port Vila and Luganville

III. Context and intervention

Type of settlement/slum

Slum — informal

Nature of agencies

involved in planning and

service provision

Government

Form of user

participation

Project/intervention

funding agency

Government

IV. Research design

Aim of the study

The study aims to assess the extent and nature of informal settlements

in Vanuatu and identify a way to address social, planning and land

issues affecting these settlements.

218

Type of study

Mixed-methods

Research design

Observational method

Methodology used for

data analysis

Simple descriptive analysis

V. Data and sample

Data sources

Household-questionnaire-survey method

Data period

1999

VI. Results and evidence

Evidence on outcomes

 Outcome

Connectivity

 Evidence

Moderately negative

 Improved sanitary and drainage access

Summary of results

 Informal settlements depend on pit toilets.

 Responsibility for sanitation lies with individual property owners,

and there is no urban service provider for sanitation, with the

exception of septic tank pump-out services. Most of the urban

area relies upon site-based disposal via septic tanks.

Brief theory of change

There is no valid theory of change employed in this study.

R 22 / A41

I. Study Details

Authors

Chauhan, U and Lal, N

Year

1999

Title

Public-Private Partnerships for Urban Poor in Ahmedabad: A Slum Project

Journal

Economic and Political Weekly

219

Source

Electronic database

II. Study coverage

Basic service

Water, sanitation and electricity

Country

India

Cities

Ahmadabad

III. Context and intervention

Type of settlement/slum

Informal settlements

Nature of agencies

involved in planning and

service provision

Government-Ahmadabad Municipal Corporation (AMC)

NGO-SAATH

Corporate Sector-Arvind Mills

Form of user

participation

Participation through contribution

Project/intervention

funding agency

SEWA Bank (loan)

IV. Research design

Aim of the study

There are three objectives of this paper.

 To establish the factors that impeade PPPs.

 To examine the reasons behind the tardy progress of the central

and state governments in providing housing and employment to

the urban poor.

 To establish an argument for the corporate sector’s working

with government organisations and NGOs to delelop services for

the urban poor.

Type of study

Qualitative

Research design

Observational

220

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data-survey method

Data period

Not clearly mentioned

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately positive

 Individual water-supply lines as well as community-level water

supply lines were provided to approximately 200 households

 All the houses were provided with an in-house toilet

 Sewerage and storm-water drains were provided to the

community

 Residents obtain individual power connections

Adequacy: moderately positive

 70% of water needs are met between 6am and 8am; water

pressure in the mains is well maintained and individual

connections ensure the volume of water supplied is adequate.

No complaints were received about the quantity of water

supplied.

 Previously, there were only three toilet blocks, which were

shared by the entire community. After this project, every house

had an individual toilet.

Durability: moderately positive

 Choice of materials and engineering techniques considerably

reduced the cost of the infrastructure. A local resident-welfare

association was formed to look after the maintenance of the

infrastructure created. Once the infrastructure was in operation,

it withstood a monsoon, during which there was no waterlogging

or blockage of sewerage mains within the community.

Effort and time: moderately positive

 Household time spent on water collection is less than an hour,

far less than prior to the slum-networking project, where there

were only three public stand-posts for the entire community.

 Previously, there were only three toilet blocks, which were

shared by the entire community. After this project, every house

had an individual toilet.

Summary of results

Successes of the project

221

 An adequate quantity of water was supplied to each household.

Seventy percent of the water was supplied in the morning. Water

pressure was equal in each household during the supply time.

 With no compromise in terms of quality or performance, the

choice of materials and engineering techniques employed in

slum networking brings down the cost of infrastructure

considerably, in comparison to conventional materials and

techniques used by most government/quasi-government bodies.

 The project stayed within the budget estimate for on-site

infrastructure.

Failure of the project

 Despite these efforts, there were three major failures of the

project. The first was a delay in completing the pilot project.

 The second is that very little was achieved in terms of community

development.

 The third failure is the organisations' inability to seek industry's

participation in the citywide slum-networking project.

Brief theory of change

 The unique strength of the government is its mandate from civil

society and the large infrastructure already in place. In such

projects, the government should play the role of ‘facilitator’. This

means, besides co-financing the project, giving all necessary

approvals, information and other support to the lead agency.

 The unique strength of NGOs is their ability to communicate

effectively with the poor. Their role should be to work with the

community to facilitate the physical-upgrading work, as well as

manage the community-based health and education

components.

 An alliance is meaningless unless each functionary understands

his/her respective role in the alliance. Frequently, the leadership

conceives and negotiates alliances and delegates their day-to-

day management to lower-level supervisors — ‘the troops in the

trenches’. It is these troops in the trenches that are usually

responsible for the failure of alliances.

 Lack of shared values in the organisation is the root cause of the

problems.

 The NGO was, from the very beginning, wary of the alliance with

the corporate partner, fearing ‘big-brother’ syndrome.

 The slum-networking project at Sanjay Nagar is a small step

towards mobilising this ‘pull factor’ among low-income

communities in Ahmadabad.

222

R 23 / A 36

I. Study Details

Authors

Connors, G

Year

2005

Title

When utilities muddle through: Pro-poor governance in Bangalore's public water

sector

Journal

Environment and Urbanization

Source

Electronic database

II. Study coverage

Basic service

Water and sanitation (water connection)

Country

India

Cities

Bangalore

III. Context and intervention

Type of settlement/slum

Both formal and informal

Nature of agencies

involved in planning and

service provision

Government: Bangalore Water Supply and Sewerage Board (BWSSB)

AusAID: In 2000, the Australian aid agency began a large project to

provide the BWSSB with a comprehensive master-plan for the city’s

future water and sewerage network

Form of user

participation

Project/intervention

funding agency

Government: Bangalore Water Supply and Sewerage Board (BWSSB)

AusAID

223

IV. Research design

Aim of the study

The aim of this paper is:

 To show how messy and slow paths to reform can have useful

lessons for public-sector water utilities in developing countries,

most of which continue to operate by ‘muddling through’.

 This paper also analyses the shifts in policy and operations

behind the BWSSB’s innovative work to connect the city’s slum-

dwellers to the piped-water supply, using the case of the

BWSSB.

 Rather than routinely criticise public utilities for their failure to

reach the poor, this paper argues that local successes that start

small and are slow to diffuse should be recognised and

disseminated across organisations.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative-analysis case study

V. Data and sample

Data sources

Secondary data: Census data (2001), AusAID survey (2000), Karnataka

slum-clearance board (1999), local NGO survey

Data period

1991,1999, 2000, 2001 (Data period is not in the order)

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately positive

 Access to individual and shared meter connections

 Access to communal toilets and drainage

 Access to sewerage network and drains

Affordability: moderately positive

 Connection fees were significantly reduced for slum connections

with street-level infrastructure cost borne by AusAID.

Community members had to bear only minor plumbing charges

and cost for connecting to the street-level mains. Community

members pay a monthly user-charge of Rs115 for individual

connections and Rs. 20‒30 for shared connections.

Durability: Moderately positive

224

A local water and sanitation committee is established to oversee the

maintenance of the infrastructure created.

Summary of results

Since 2000 there has been a change in the BWSSB’s approach to slums.

 First, three excellent pilot projects, funded by a large donor

programme, demonstrated that water could be piped to slums

legally, that residents were willing to pay for household

connections and water supply, that the traditional stumbling

block of insecure tenure status could be managed, and that

systems could be designed to meet the needs of specific

typologies of tenure and density.

 Second, a decision made by the BMP to end funding for public

taps forced acceptance at the BWSSB that it would, over time,

have to shut down all public taps, a politically impossible

solution.

 Third, the legislative and executive branches of the BMP agreed

to pay, as a lump-sum contract, for the complete extension of

the BWSSB’s piped network to the city’s new and partially added

wards, in view of its responsibility to fund basic infrastructure

within municipal boundaries. Slums previously on the periphery

of municipal awareness would suddenly have the opportunity to

connect to the network, and the BWSSB could expect either a

surge in illegal connections or the possibility of more revenue.

Brief theory of change

 For the first time, slums are being serviced as a distinct category

by the water utility, and new working relationships are being

forged between the utility, NGOs and residents, as they learn to

cooperate with each other.

 Although Bangalore’s new water-governance patterns are not

altogether ‘good’, in the sense of being inclusive, accountable,

transparent and predictable, they are moving in the right

direction.

R 24 / B 19

I. Study Details

Authors

Das, A

Year

2012

Title

End of project evaluation of Madhya Pradesh urban services for the poor

programme (MPUSP)

Journal

DFID Report

Source

Website search

225

II. Study coverage

Basic service

Water, sanitation and electricity

Country

India

Cities

Bhopal, Indore, Jabalpur, Indore

III. Context and intervention

Type of settlement/slum

Slum — informal

Nature of agencies

involved in planning and

service provision

Others

(DFID)

Form of user

participation

Contribution

Project/intervention

funding agency

DFID

IV. Research design

Aim of the study

To evaluate the eventual programme goal for MPUSP of achieving

sustainable poverty reduction and economic growth in urban areas in

Madhya Pradesh.

Type of study

Quantitative

Research design

Quasi-experimental

Methodology used for

data analysis

V. Data and sample

Data sources

Primary and secondary data

 Household survey, FGDs

 Municipalities’ annual review reports

Data period

2006

226

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity and effort and time

 Outcome

Moderately positive and inconclusive

 Proportion of households with piped-water supply

 Proportion of households assessing community taps for water

 Proportion of households with <1 hour of water supply

 Proportion of households with electricity connection

 Proportion of households with access to private toilet facility

 Proportion of households with access to community toilet facility

 Proportion of households with access to drainage facility

Summary of results

 Study found that the treatment slums are 29% more likely to

have toilets than the control households.

 Households in an MPUSP slum are about 32% more likely to have

piped-water supply than a household in the control slums.

 Study did not find a significant impact of the intervention on the

access to improved sewerage and drainage systems (that is,

having access to concrete and covered drains/sewers).

 The sources of drinking water at the disposal of a slum are better

if the slum is an MPUSP slum. The combined number of

community taps and household taps were our metric of

improved source of drinking water. This brings down the impact

of MPUSP to 6%, from the 32% for the piped-water supply, but

it is still significant, statistically.

 To determine the quality of access (in terms of water

connections) provided to MPUSP slums, we checked the daily

hours of water supply. A key observation made is that it is no

better than the non-MPUSP slums. A similar concern was also

observed: that there are about 3% households in our MPUSP

slum sample, which reported no water supply to date, in spite of

having piped-water connections.

 Measured in terms of use of toilets — household and common

— the practice of improved sanitation is greater for MPUSP

slums than that of the control slums. It was found that the

treatment slums are 7% more likely to use an improved mode of

sanitation than the control slums. But, no evidence was found of

households resorting to open defecation in either control or

treatment.

 Most of the MPUSP slums reported improvement in the

electricity situation, in comparison to a pre-MPUSP scenario. In

some slums, the supply was already there; hence, they did not

require intervention under Project Utthan. Almost all the MPUSP

slums reported increase in the number of electric poles in the

area.

Brief theory of change

 The intervention of MPUSP drastically changes basic services,

especially water, sanitation and electricity access.

227

R 25 / B 18

I. Study Details

Authors

Das, M

Year

2011

Title

End-term impact assessment of the Kolkata urban services for the poor

programme

Journal

DFID Report

Source

Website search

II. Study coverage

Basic service

Water and sanitation

Country

India

Cities

Kolkata

III. Context and intervention

Type of settlement/slum

Slum — informal

Nature of agencies

involved in planning and

service provision

NGO

Form of user

participation

Partnership

Project/intervention

funding agency

NGO

IV. Research design

Aim of the study

 Evaluate the intended and unintended impacts of key Kampala

Urban Sanitation Project (KUSP) Programme components and

assess whether they have reached targeted beneficiaries

 Assess the sustainability of reforms initiated under the KUSP

Programme

228

 Determine cost effectiveness (and value for money, VfM) of the

programmatic approach taken under the KUSP Programme

 Provide lessons learned and recommendations for other

ongoing or planned DFID urban programmes

Type of study

Quantitative

Research design

Observational

Methodology used for

data analysis

Simple percentage analysis

V. Data and sample

Data sources

Primary and secondary data

Data period

2005

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity

 Outcome

Moderately positive and moderately negative

 Proportion of households with individual piped-water

connection

 Proportion of households with access to public taps

 Proportion of households with individual toilet facility

 Proportion of households with access to community toilet facility

Summary of results

 Significant improvement has been reported in access to physical

infrastructure from KUSP slums. The same slums suggest an

improvement in water supply to the tune of 30%, in sanitation

around 13%, in drainage around 72%, and in access to road

around 57%. Also, these improvements have been 3‒6

percentage points greater than the non-KUSP-programme

slums. Consequently, about 95% of the respondents from KUSP

slums report access to water supply through individual pipe

connections or street taps, compared to 86% in non-KUSP slums.

Similarly, the case has been with sanitation (with increase in

community toilets), drainage with more respondents having

access to Pucca drains.

 About 73% of the respondents from KUSP slums are satisfied

with the current mechanism of meeting the D&M cost for basic

services. When individual services, such as water supply,

sanitation and drainage, are taken into account separately, the

proportion of KUSP-slum respondents who perceive an

229

improvement in D&M and service quality ranges from 82% to

93%. However, the current D&M mechanism, as reported by the

respondents in KUSP-programme slums for water supply,

sanitation and drainage suggests a large proportion are

dependent upon urban local bodies (ULB), with 67% in the case

of water supply, 25% in the case of sanitation and 99%in the case

of drainage. D&M mechanisms adopted in non-KUSP slums are

very similar to that used in KUSP slums.

Brief theory of change

After the KUSP-programme intervention, there is a high level of

improvement in community tap water and community toilet facilities.

Individual water-tap connections and individual toilet facilities are not

increasing at the same rate as the community facilities.

R 26 / E 13

I. Study Details

Authors

Das, K

Year

2009

Title

Agency and Access under Decentralized Governance: Water Supply and

Sanitation in Kolkata City

Journal

Gujarat Institute of Development Research

Source

Google Scholar

II. Study coverage

Basic service

Water and sanitation

Country

India

Cities

Kolkata

III. Context and intervention

Type of settlement/slum

Low-income

Nature of agencies

involved in planning and

service provision

Government

 Kolkata Municipal Corporation

230

Form of user

participation

Project/intervention

funding agency

ODA

 ADB assisted Kolkata Environment Improvement Programme

(KIEP)

IV. Research design

Aim of the study

This paper discusses the issues for agencies in providing access to basic

services, such as drinking water and sanitation in the bustling eastern

Indian city of Kolkata.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data

Secondary data

 This paper discusses the issues for agencies in providing access

of basic services in the Kolkata Municipal Corporation (KMC),

drawing upon both secondary sources and a primary survey in

four wards in the city.

Data period

Not clearly mentioned

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately negative

 15‒20% of residents in slum areas did not have tap connections

in their homes, whereas almost all residents living in upper-

middle-class households had in-house connections.

 While most residents had some form of in-house toilet, about

10% of slum-residents resorted to open defecation. The situation

of sewerage was also deplorable, with drain pipes overflowing,

especially during monsoons. However, the high-income-area

residents had in-house toilets. and the drains in these areas were

covered and cleaned once every two months.

231

Adequacy: moderately negative

 Water was available only twice a day, for about three hours in the

morning and evening, whereas affluent areas received

continuous supply for 8‒10 hours a day. Public stand pipes in low-

income slum areas were not in good condition and water supply

was very erratic.

Summary of results

 The residents, notwithstanding lapses in services and

inadequate/ unsatisfactory responses from the elected

representatives and KMC functionaries, did value the system of

democratic decentralisation.

 This, in any case, provided ample space for popular participation

in the process of governance through expressing their opinions

publicly regarding basic service provisioning/maintenance.

Brief theory of change

Two specific observations are made :

 First, while residents from poorer (or, relatively disadvantaged in

terms of services) localities insisted on a more

accountable/attentive/(even ‘punishable’!) agency, those from

well-off areas looked forward to a ‘modernised’ and ‘friendly’

governance structure.

 Second, there was only a fragile case for privatising services. In a

substantive sense, these observations from the field defy the

much-hyped neo-liberal prescription of ensuring good

governance of cities through privatising basic services. In a

substantive sense, these observations from the field indicate that

there are deeper structural issues of legal status and

opportunities to improve the livelihood of the urban poor.

 Those are the persisting problems that require a different kind of

intervention, preferably mediated through a democratically

accepted governance system.

R 27 / A 7

I. Study Details

Authors

Daniere, A and Takahashi, L

Year

1999

Title

Poverty and access: Differences and commonalities across slum communities in

Bangkok

Journal

Habitat International

Source

Electronic database

II. Study coverage

Basic service

Water

232

Country

Thailand

Cities

Bangkok

III. Context and intervention

Type of settlement/slum

Slum

Nature of agencies

involved in planning and

service provision

Government

Form of user

participation

Project/intervention

funding agency

Government

IV. Research design

Aim of the study

 To work towards a classification of the notion of access,

particularly as it relates to basic services among the urban

poor.

 To illustrate how this framework can be used to assess access in

large cities in developing countries, such as Bangkok.

Type of study

Quantitative

Research design

Quasi-experimental

Methodology used for

data analysis

Statistical method

 Chi-square test

V. Data and sample

Data sources

Primary data

 Surveyed 540 households in slum or squatter settlements

located within Bangkok Metropolitan Region. In 25

slums/squatter settlements selected for survey in three

municipal zones, inner (224), middle (246) and outer (50) sample

data were collected.

 Questionnaire survey method

Data period

February and March 1994

233

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately positive

Summary of results

 24.6% of inner-city household use bottled water for drinking,

which is high, especially compared to residents in the outer

areas. The outer zone’s recently settled area and this zone’s

communities, which have much lower community access to

piped municipal water, rely primarily on local wells for water and

are much less likely to buy bottled drinking water (only 12.8%),

and much more likely to drink untreated water.

 Access to piped water is 66.7% in the lowest income grouping,

which is a higher connection rate than in any other income

group. The lowest reported access to piped-water connections is

found in communities of middle-income groups, which are slum

communities with much higher incomes, followed by the highest

income-group community, with a piped-water connection rate

of 48.7%.

 High-income-group households spend less than 2% of their total

household income on water, while the poorest group spends

4.33% of their income on water.

 The study found that slums in the middle zone have better access

to individual piped-water connections than do slums in the outer

suburbs of the city. Access to piped water is limited in the outer

zone, because the residents rely on water from privately

developed wells, resulting in lower water prices.

Brief theory of change

 The somewhat unexpected policy implications gleaned from the

analysis illustrate the importance of a comprehensive

understanding of access issues prior to the development of

policy.

 This is important, not only because it allows one to distinguish

between actual policy-choice instruments (such as increasing or

lowering the price of services) and induced behaviour (such as

buying of bottled water for drinking purposes), but also because

it permits a better understanding of the relationship between

different policies and how they might be used to reinforce or

support one another.

 From a larger planning perspective, the challenge of providing

adequate and appropriate levels of basic services, from either

private or public sources, revolves around fundamental issues of

supply and demand, and their interaction. Demand among users

and potential users, in particular, seems particularly poorly

understood in terms of its importance to the actual design and

implementation of basic services, suggesting that this is an area

of research deserving of more extensive analysis.

234

R 28 / A56

I. Study Details

Authors

Devas, N and Korboe, D

Year

2000

Title

City governance and poverty: The case of Kumasi

Journal

Environment and Urbanization

Source

Electronic database

II. Study coverage

Basic service

Water and sanitation

Country

Ghana

Cities

Kumasi

III. Context and intervention

Type of settlement/slum

Informal settlement

Nature of agencies

involved in planning and

service provision

Government

 Ghana Water and Sewerage Corporation provide the service.

The Kumasi Metropolitan Assembly (KMA), the local

government, provided counterpart contribution to the donor

fund.

Form of user

participation

Project/intervention

funding agency

ODA

 DFID-funded project to improve access to water for low-

income settlements.

 CIDA, UNDP and World Bank have funded improvements in

urban sanitation.

235

IV. Research design

Aim of the study

This article seeks to examine:

 The ways in which the poor in Kumasi may or may not be

benefiting from the current economic situation.

 How the present arrangements for the provision of services

impact on the poor.

 Whether and how the poor have been able to influence the

agenda of the institutions of city governance.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Secondary data

Ghana Living Standards Survey

Data period

Not clearly mentioned

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately positive

 Improvements in the capacity of the water-supply system, as

funded by DFID, have been seen, especially with regard to access

to water for low-income settlements.

 Construction of private and public latrines and the provision of

sewage-treatment facilities are part of the donor-funded project

towards improvements in sanitation for low-income areas.

These projects, albeit at a nascent stage, have shown some

impact.

Summary of results

Most improvements in infrastructure and services have come about

through donor intervention. Donor-funded projects have included:

 Improvements to electricity supplies essential for businesses,

both formal and informal.

 Improvements in urban sanitation funded by the CIDA, UNDP

and the World Bank, with the construction of private and public

latrines, the provision of sewage-treatment facilities, and the

carrying out of health-education programmes, etc.

236

 Increases in the capacity of the water-supply system, funded

by DFID.

 The current programme to improve access to water for low-

income settlements.

Brief theory of change

 Despite some improvement in the national economy, the

position of the poor has not really been improved and may have

worsened in recent years. In this, Kumasi’s city government,

KMA, must share part of the blame.

 The process of decentralisation in Ghana, begun a decade ago,

remains incomplete. Central ministries have been reluctant to

decentralise sectorial programmes and many of the services on

which the poor depend are outside the control of local

government. Cost-recovery policies for some of these services

have made access for the poor more difficult.

 Those essential services for which KMA is responsible —

sanitation, waste disposal, drainage, environmental health —

remain woefully inadequate. In terms of accountability to the

consumers of the services, and particularly to the urban poor,

who are often not served at all, the lines of political

accountability are weak.

R 29 / A 20

I. Study Details

Authors

Aguilar, M and De Fuentes, A

Year

2007

Title

Barriers to achieving the water and sanitation-related Millennium Development

Goals in Cancún, Mexico, at the beginning of the twenty-first century

Journal

Environment and Urbanization

Source

Electronic database

II. Study coverage

Basic service

Water and sanitation

Country

Mexico

Cities

Cancún

237

III. Context and intervention

Type of settlement/slum

Informal settlement

Nature of agencies

involved in planning and

service provision

Water

 Provision of access to piped water

 Sanitation-Others/User involvement

 Provision of sewerage connection

 Construction of septic tank

Form of user

participation

Sanitation

 User involvement: participation through self-mobilisation

Project/intervention

funding agency

Private sector

 Private company

IV. Research design

Aim of the study

 This paper discusses some of the barriers faced by the city of

Cancún, Mexico, to making progress towards MDG targets on

extending safe water and basic sanitation.

 It analyses the socio-economic, political, demographic,

environmental and land-use dimensions of problems of access

to safe drinking water and improved sanitation services in the

city.

Type of study

Mixed-methods

Research design

Observational

Methodology used for

data analysis

Qualitative and quantitative

V. Data and sample

Data sources

Primary data

 Qualitative and quantitative data collected included both

historical and recent information on urban development and the

use and management of drinking-water supply.

Data period

The dates of the recent data used vary between 2000 and 2003

238

VI. Results and evidence

Evidence on outcomes

Water: connectivity: inconclusive

 Access to piped-water connection

Sanitation: connectivity: moderately negative

 Access to sewerage system

 Access to self-constructed septic tank

Summary of results

 In 2003 Cancún had a public sewerage network that potentially

could serve 77%of its population, yet only 44%of its inhabitants

had effective connections to the system.

 More importantly, only the residents of the hotel zone and the

majority of those living in the city centre had access to the

system, and only the hotel zone had what this paper defines as

an ‘improved sanitation service’.

 When comparing the level of access to sewerage in Cancún (44

%) with the average for urban areas in Mexico for 2000 (75%),

the extent of provision in the city is clearly very poor.

 However, if the coverage of infrastructure is considered instead

(77%), then Cancún comes slightly above the national average.

These potentially misleading statistics have impeded the

municipal government’s recognition of the true extent of

deficiencies in sewerage provision in the city.

 The coverage of piped water in the city as a whole is good (97%)

(29) and is above the average for urban areas in Mexico in 2000

(93%). However, the capacity of the water-supply infrastructure

is inadequate and water services throughout the city are

intermittent, with the exception of the hotel zone.

Brief theory of change

The following barriers to sustainable development in Cancun that relate

to safe water and improved sanitation services continue to have a

negative impact on social and economic development in the city and its

region:

 The socio-economic disparity and inequity produced by market

forces, which is reinforced by government policies. In this way,

the tourists and the richest areas of the city are provided with

subsidised services and have free access to resources, while the

poorest have either inadequate, improvised or

disproportionately expensive basic services, or no access to

services whatsoever.

 The failure, for political and economic reasons, to enforce the

State Drinking Water and Sanitation Law.

 The lack of concern shown by social actors to aquifer

contamination. However, there are some NGOs that strive for

natural-resources conservation in the city, despite the low level

of social organisation that is characteristic of most parts of

Mexico.

239

R 30 / A30

I. Study Details

Authors

Dube, I

Year

2003

Title

Impact of energy subsidies on energy consumption and supply in

Zimbabwe. Do the urban poor really benefit?

Journal

Energy Policy

Source

Electronic database

II. Study coverage

Basic service

Electricity

Country

Zimbabwe

Cities

Three cities

III. Context and intervention

Type of settlement/slum

Low-income

Nature of agencies

involved in planning and

service provision

Government

 Provision of electricity services

Form of user

participation

Project/intervention

funding agency

State government

IV. Research design

Aim of the study

 The objective of this paper is to ascertain the extent to which

the poor urban households could afford the cost of electricity,

with or without subsidies. This gives an indication of whether,

contrary to current thinking, subsidies are decisive for the

affordability of electricity by urban households.

240

 The paper also examines the distribution of the subsidies across

the different urban-household income categories and other

economic sectors.

Type of study

Quantitative

Research design

Observational

Methodology used for

data analysis

Quantitative

V. Data and sample

Data sources

Primary data

 The survey sample was across all income groups and households

deriving their incomes from different sources; for example,

salary, informal sector, etc. The survey also took into

consideration the gender aspect of energy use by targeting both

male- and female-headed households. In total, 128 households

were covered by the survey in the three cities.

Secondary data

 Based on the poverty datum lines provided by the Central

Statistics Office, the households were classified in different

poverty categories, namely, non-poor and poor households. The

urban-poor households were further divided into moderately

poor and extremely poor households.

Data period

Not clearly mentioned

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately positive

 Proportion of households with access to electricity connection

Affordability: inconclusive

 The amount of money paid for electricity cost without subsidy

Summary of results

 It can then be concluded that there is a differential ability to pay

for electricity by different household-income categories.

 Available evidence from the study indicates that a larger

proportion of urban-poor income is devoted to energy

expenditure than that of non-poor urban households.

 In addition, the energy costs incurred by the poor on non-

electrical energy sources could cover the current subsidised

electricity costs.

 Urban households are currently paying much more for kerosene

than the stipulated subsidised price. This means that subsidies

241

are not decisive for the affordability of energy to kerosene users.

The impact of the removal of subsidies on the current pricing

could not be ascertained, since there is a possibility that the

middleman benefiting from the subsidy could increase their

prices to compensate for the reduction in profit margins due to

subsidies.

 The existence of electricity subsidies is also not decisive for the

affordability of electricity to the urban household, but the

removal of such subsidies will impact more negatively on the

most vulnerable groups than the affluent groups.

Brief theory of change

 This finding shows that the poor spend more of their incomes on

electricity than the non-poor. However, the energy cost of

electricity, compared to the income of the moderately poor, is

comparable to that of the non-poor. This means that, even

among the poor urban households there is a differential ability

to pay for energy.

 Twenty percent of Zimbabwe’s urban poor households are still

to be connected to the grid. The majority of these households

are poor. There are several reasons why the Zimbabwe urban

poor are still not connected to the grid, the most important

being the low level of household incomes and the cost of

different sources of energy. In order to facilitate wider usage of

electricity by the poor, policymakers have introduced a subsidy

policy.

R 31 / A18

I. Study Details

Authors

Edelman, B and Mitra, A

Year

2006

Title

Slum-dwellers’ access to basic amenities: The role of political contact, its

determinants and adverse effects

Journal

RURDS

Source

Electronic database

II. Study coverage

Basic service

Water and sanitation

Country

India

Cities

New Delhi

242

III. Context and intervention

Type of settlement/slum

Formal settlement

Nature of agencies

involved in planning and

service provision

Government

 Provision of water service

 Provision of sanitation facility

 Provision of toilet facility

Form of user

participation

Project/intervention

funding agency

State government

IV. Research design

Aim of the study

This paper analyses slum-dwellers’ access to basic amenities and the

ways in which they gain access. Associations between Indian states’

share of slums, proportions of notified slums, and prevailing conditions

in terms of basic amenities, present political contact as a key factor.

Type of study

Quantitative

Research design

Observational

Methodology used for

data analysis

Quantitative

V. Data and sample

Data sources

Secondary data

 Government data

Data period

2004‒05

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately positive

 Proportion of households having access to drinking water

 Proportion of households having access to sanitation

 Proportion of households having access to toilets/defecation

243

Summary of results

 Positive correlations between states’ shares in aggregate slums

and slum conditions imply that states with more slums have

better slum conditions, perhaps because larger slum populations

draw the attention of more interested politicians.

 Correlations between states’ proportions of notified slums to

total slums, a proxy for slum-dwellers’ political contact, and the

prevailing conditions in slums confirm a positive relationship

between political contact and access to amenities.

Brief theory of change

 The survey data also position direct evidence in favour of this.

However, other households, although limited in number,

demonstrate a gain in access to these facilities, even without any

political contact.

 Relating to the question of what determines the slum-dwellers’

decision to participate in the political process, estimates of the

binomial-logit model elicit some interesting results.

 With a rise in the duration of migration, the degree of reliance

on political support increases, the probability being the highest

among the natives and political contact confers short-term

benefits upon slum-dwellers in terms of access to basic

amenities, although without genuine concern for their upward

mobility. The other important determinants of increased

political contact include level of education (higher), sex (male) of

head of household and the lack of social contact with colleagues

or employers and relatives.

R 32 / B1

I. Study Details

Authors

Field, E

Year

2005

Title

Property rights and investment in urban slums

Journal

Journal of the European Economic Association

Source

Website search

II. Study coverage

Basic service

Electricity

Country

Peru

Cities

Not mentioned

244

III. Context and intervention

Type of settlement/slum

Low-income

Nature of agencies

involved in planning and

service provision

Government

Form of user

participation

Project/intervention

funding agency

Government

IV. Research design

Aim of the study

To examine the impact of a nation-wide titling program in Peru, in

which 1.2m property titles were distributed to urban squatters on

public land.

Type of study

Quantitative method

Research design

Experimental method

Methodology used for

data analysis

Simple percentage analysis and regression analysis

V. Data and sample

Data sources

Primary data

Data period

May 2000

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity

 Outcome

Moderately positive

 Households receive electricity connection

Summary of results

 A comparison between households in early and late

neighbourhoods reveals few differences in observable

household characteristics unrelated to housing. Meanwhile, the

245

fraction of households undertaking home improvements over

the past two years is 50% higher in titled neighbourhoods. The

comparison between programme beneficiaries and non-

beneficiaries suggests that the difference in investment does not

reflect neighbourhood-level variation. While there are notable

differences in household characteristics between comparisons

between treatment households and both control groups indicate

approximately the same difference in post-programme

investment.

 In the household characteristics, access to electricity

beneficiaries in programme neighbourhoods rises from 93% to

96%.

Brief theory of change

Intervention of nationwide titling programme in Peru, in which

1.2mproperty titles were distributed to urban squatters on public land;

household characteristics show access to electricity beneficiaries in

programme neighbourhoods receive a high level of positive impact.

R 33 / B 2

I. Study Details

Authors

Field, E

Year

2004

Title

Property rights, community public goods, and household time allocation

in urban squatter communities: Evidence from Peru

Journal

William & Mary Law Review

Source

Website search

II. Study coverage

Basic service

Water and electricity

Country

Peru

Cities

Lima

III. Context and intervention

Type of settlement/slum

Slum — informal

246

Nature of agencies

involved in planning and

service provision

Government and NGOs

Form of user

participation

Project/intervention

funding agency

Government and NGOs

IV. Research design

Aim of the study

This study examines whether improvements in tenure security that result

from giving property titles to urban squatters in Peru influence on the

households access the valuable property of basic services, such as

electricity and water connection.

Type of study

Mixed-methods

Research design

Observation

Methodology used for

data analysis

V. Data and sample

Data sources

Primary data

Data period

March 2000

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity

 Outcome

Moderately positive

 Average households with municipal water supply

 Average households with electricity supply

Summary of results

 Study indicates that there is variation in some demographic

characteristics across programme and non-programme regions.

Sample households in programme areas, on average, have

smaller dwellings (fewer rooms), are more likely to have

electricity, and have higher nativity rates (percentage of

247

members born in the province). Although statistically significant

differences exist across programme and non-programme areas,

no statistically significant differences in difference (DID) is

observed between squatters and non-squatters in programme

and non-programme areas. This finding supports the use of non-

squatters as a comparison group.

 Land and property governance — including reallocation of land,

neighbourhood security and (informal) titling — and projects

related to public utilities and infrastructure provision. A dramatic

difference in the presence of titling and land-allocation-related

organisations, as well as significantly fewer infrastructure-

related neighbourhood groups. These data provide evidence

that land formalisation indeed shifts key institutional

responsibilities away from local communities, as well as local

households.

 Household participation hours in neighbourhood groups. More

striking is the fact that early- and late-programme

neighbourhoods report approximately near- identical frequency

of neighbourhood organisations before the programme is

implemented, as evidenced by a comparison. This pattern

strengthens support for a causal interpretation of land titling and

neighbourhood public-goods provision.

Brief theory of change

The Peruvian government and the NGO embarked on an innovative

property-titling project intervention that has a high impact on water

supply and electricity connection for the slum-dwellers.

R 34 / D 7

I. Study Details

Authors

Foster, V and Araujo, M

Year

2004

Title

Does infrastructure reform work for the poor? A case study from Guatemala

Journal

Word Bank Policy Research working paper

Source

Cross-reference

II. Study coverage

Basic service

Water, sanitation and electricity

Country

Guatemala

Cities

Guatemala

248

III. Context and intervention

Type of settlement/slum

Slum — informal

Nature of agencies

involved in planning and

service provision

Government

Form of user

participation

Project/intervention

funding agency

Government

IV. Research design

Aim of the study

This paper explores how the important policy changes experienced in

the utilities sector in Guatemala since the Peace Accords have affected

the lives of poor households.

Type of study

Quantitative

Research design

Observational

Methodology used for

data analysis

Simple percentage analysis

V. Data and sample

Data sources

Secondary data

Data period

2000

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity, affordability, adequacy and effort and time

 Outcome

Moderately positive, moderately negative

 Proportion of households with access to electricity

 Proportion of households with access to piped-water supply

249

 Proportion of households with basic sanitation facility

 Proportion of households with sewerage facility

 Proportion of households that can afford to pay for piped-

water supply

 Proportion of households with adequate consumption of

electricity

 Average expenditure on piped-water consumption

 Average time taken to collect water

 Average distance taken to reach community tap

Summary of results

 An important benefit of the electricity-sector reform has been

the rapid increase in coverage, from 53% in 1996 to 70% in

1999. As reported in the ENCOVI survey, while 73% of the

households report to be connected to the electricity network

(95% in the urban and 56% in the rural areas), only 62% have

an electricity meter (78% in the urban and 50% in the rural

areas). The lack of a meter suggests that these households are

illegally connected, or at best, that the amounts they pay for

the service are not proportional to their monthly consumption.

 According to the ENCOVI survey, 69% of households have piped

water and 87% of the households have some form of

sanitation, although only 38% are connected to the sewerage

network.

 The results show that one in six Guatemalan households has no

access to any modern network services electricity, piped water

or sewerage.

 The statistics show that, in about 60% of cases, the only service

available in the household is electricity, and, in the other 40%

of cases, water. The greater prevalence of electricity services

holds good for almost every sub-category of the population,

except for the poorest. Where only two services are available,

they are invariably water and electricity, while households with

only three services most typically have electricity, water and

sewerage.

 Historical trends show that the rate of increase of coverage

accelerated after the major policy changes introduced in 1996.

For all three services (electricity, water and sanitation),

coverage improved by close to 15 percentage points over the

subsequent four years (1997‒2000) compared with just over

10 percentage points over the previous four years (1993‒96).

Clearly, it is difficult to attribute this acceleration to the Peace

Accords and to the structural reforms introduced at that time.

 The subsidy reaches 100% of poor households with electricity

connections, but only 40% of poor households enjoy these

connections and benefit from the subsidy as a consequence.

 A recent survey of water tariffs found that, in the larger cities

Guatemala City and Quetzaltenango, the flat rate charge of

US$1 to US$2 per month entitled households to consume

between 15 and 25 cubic meters per month, while further

consumption was charged at a rising rate of between 10 and 30

US cents per cu metre.

 In the ENCOVI survey, households who collect water on a

regular basis report that, on average, they travel for around

nine minutes to reach their nearest water source.

250

Brief theory of change

The Guatemala urban infrastructure policy makes a wide range of

changes in provision of basic services. After the policy changes, the

water and sanitation sector has a positive impact, as opposed to

electricity, which has a negative impact.

R 35 / B 3

I. Study Details

Authors

Galiani, S, Gertler P, Cooper, R, Martinez, S, Ross, A and Undurraga, R

Year

2013

Title

Shelter from the storm: Upgrading housing infrastructure in Latin

American slums

Journal

3ie Grantee final report

Source

Website search

II. Study coverage

Basic service

Water, sanitation and electricity

Country

El Salvador, Uruguay, Mexico

Cities

Not mentioned

III. Context and intervention

Type of settlement/slum

Slum — informal

Nature of agencies

involved in planning and

service provision

Private

Form of user

participation

Self-mobilisation

Project/intervention

funding agency

TECHHO — NGO

251

IV. Research design

Aim of the study

 This paper provides some of the first pieces of rigorous empirical

evidence regarding the causal effects that upgrading dwellings

can have on the living conditions of extremely poor persons in

the slums of three Latin American countries: El Salvador, Mexico

and Uruguay.

 To examine the impact of the extremely inexpensive, but sturdy,

houses constructed by TECHO, a youth-led NGO that provides

basic, pre-fabricated houses to extremely poor population

groups in Latin America

Type of study

Quantitative method

Research design

Experimental method

Methodology used for

data analysis

 Simple percentage analysis

 Regression analysis

V. Data and sample

Data sources

Primary data

Data period

The fieldwork program was rolled out in two phases. In El Salvador, Phase

I took place between August and December 2007, while Phase II was

carried out between March and August 2008. In Mexico, Phase I took

place between April and June 2010, while Phase II was conducted

between September and December 2010. In Uruguay, Phase I was held

between October and December 2007, while Phase II took place between

July and September 2008.

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity

 Outcome

 Households access onsite water connection

 Households build own toilets

 Households get electricity connection

Summary of results

 Study highlights a set of 11 baseline housing characteristics in all

of the countries and tests the null hypothesis of no difference

between the mean values of each variable by country. Baseline

housing was, as is to be expected, substantially better in Mexico

and Uruguay than in El Salvador. In Uruguay and Mexico, a large

percentage of households had electricity (95.9% and 83.8%,

respectively) and some form of water connection (91.3% and

51.0%), respectively, while, in El Salvador, only 39.1% of

252

households had electricity and 21.5% had some sort of water

connection on the property. The service conditions tended to be

much better in Uruguay than in Mexico, which is consistent with

the fact that the settlements in Uruguay are located in the

richest urban centres of the country.

 The first salient aspect of the comparison is that it demonstrates

that, in all three countries, slum-dwellers are, in general, even

worse off in terms of assets than other poor populations. Rates

for water connections, access to toilets and sewerage systems,

are all significantly higher for the average poor household of El

Salvador and Mexico than for slum-dwellers in the same country.

In Uruguay, the differences are smaller in part because the

average rates are much higher among this urban-focused

population.

 Study found that the TECHO programme has had the expected

positive effect on the quality of housing and its assets of basic

infrastructure facilities, but no more than that. No further

housing improvements have been undertaken by the treated

households. This may well be due to the transitional nature of

the houses provided by the programme.

Brief theory of change

TECHHO programme intervention has a positive impact on water and

sanitation improvement in treatment group of slum-dwellers, but not in

access to electricity.

R 36 / B 11

I. Study Details

Authors

Gadir, A, Njiru, C and Smith, M

Year

2006

Title

Small water enterprises in Africa, Sudan: A study of small water enterprises in

Khartoum

Journal

Water, Engineering and Development Centre Report

Source

Website search

II. Study coverage

Basic service

Water

Country

Sudan

Cities

Dar AI Salam

253

III. Context and intervention

Type of settlement/slum

Low-income

Nature of agencies

involved in planning and

service provision

Private

Form of user

participation

Project/intervention

funding agency

Private

IV. Research design

Aim of the study

 The goal of this research is to improve the well-being of the

poor in informal urban settlements through cost-effective,

improved water-supply service.

 To identify and test constraints, opportunities and strategies

for enabling small-scale independent providers to deliver

acceptable water services to poor urban consumer.

Type of study

Mixed-methods

Research design

Observational

Methodology used for

data analysis

Simple percentage analysis

V. Data and sample

Data sources

Primary data

Data period

Not mentioned clearly

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity, affordability and effort and time

 Outcome

Moderately positive and moderately negative

254

 Private provision of water supply

 Cost of access in piped-water supply

 Distance to access the water in water yard

Summary of results

 95‒98% of the households in Dar Al Salam get their water from

vendors.

 Households pay a maximum of SD6,000, which is about six

times the price paid by those with piped water in the third- or

poor-class residential areas.

 Poorer households that are a reasonable walking distance from

a water-yard obtain water delivery from source.

Brief theory of change

Dar AI Salam city aims to provide better access to water in informal

urban settlements, by supporting small water-providing enterprises,;

this programme was financed by the UK Department of International

Development (DFID) and Engineering Knowledge Research Programme

(EngKAR). The Small Water Enterprises (SWE), with the assistance of

NGOs, improve access for informal dwellers.

R 37 / A54

I. Study Details

Authors

Gerlach, E and Franceys, R

Year

2010

Title

Regulating Water Services for All in Developing Economies

Journal

World Development

Source

Electronic database

II. Study coverage

Basic service

Water

Country

Bolivia, Chile, Philippines, Indonesia, Ghana, Kenya, Zambia, Jordan, India and

Uganda

Cities

La Paz-El Alto, Santiago de Chile, Manila, Jakarta, Accra, Nairobi, Lusaka, Amman,

Jaipur and Kampala

III. Context and intervention

Type of settlement/slum

Low-income

255

Nature of agencies

involved in planning and

service provision

Public-sector and private-sector

 Service providers included both private and public agencies.

Form of user

participation

Project/intervention

funding agency

Private-sector

 At different points in time, water provision has been privatised

in all of these countries, and a regulatory authority has been

set up. Service providers are either private companies or public

departments who continue to function as primary water

providers.

IV. Research design

Aim of the study

This paper aims to analyse the regulatory experience in 11 metropolitan

areas, with respect to the challenge of reaching all urban consumers,

particularly the poor.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data

 Initial fieldwork, consisting of semi-structured interviews with

representatives of regulatory agencies, national and local

government, water-service providers, civil-society groups and

development partners, substantiated by extensive document

reviews, was undertaken by a team of local and international

researchers.

Secondary data

 World Bank, UNICEF, WHO, etc.

Data period

2004 and 2005

V. Results and evidence

Evidence on outcomes

La Paz-El Alto, Santiago de Chile, Nairobi, Lusaka and Jaipur

256

Connectivity: moderately negative

In five countries —Bolivia, Chile, Kenya, Zambia and India — number of

urban water-supply (household) connections decreased between 2002

and 2006. (refer to comments for more details).

Manila, Jakarta, Accra, Amman, and Kampala

Connectivity: Moderately positive

In four countries — Philippines, Indonesia, Jordan and Uganda — the

number of connections has increased.

Summary of results

 The case-study research found that regulators are not legally

required to facilitate and monitor the early achievement of

universal service.

 Neither are they enabled to do so, their allocated powers and

responsibilities often falling short of the complementary, if not

prerequisite, regulatory duty of ensuring that reasonably

efficient providers may achieve an adequate return on capital

employed to enable them to meet any such service obligation.

 Despite these weaknesses in the formal regulatory framework,

some of the regulators studies have been able to respond to the

universal-service challenge.

Brief theory of change

 Lack of legal clarity in respect of mandates, which subsequently

failed to specify regulatory powers and responsibilities in respect

of economic and social matters.

 An incomplete separation of operator (and/or asset-holding

agency), regulator and policymaking functions was a common

observation in the case studies.

 The research found that, in most cases, regulators did not have

sufficient information as to the location, extent and present

service access of the poorest, most needy (in public-health

terms) consumers.

 The findings highlighted a lack of information as to the full cost

of water services to the various user groups, which is a significant

input variable for regulators’ price determinations.

 No pro-poor strategy in place.

 Oversight mechanisms for alternative providers’ (AP) operations

were generally found to be limited in extent and enforcement

was lacking, most notably in respect of resale-pricing

regulations.

R 38 / A12

I. Study Details

Authors

Garlic, E and Frances, R

Year

2009

Title

Regulating water services for the poor: The case of Amman

257

Journal

Geoforum

Source

Electronic database

II. Study coverage

Basic service

Water supply

Country

Jordan

Cities

Amman

III. Context and intervention

Type of settlement/slum

Both formal and informal

Nature of agencies

involved in planning and

service provision

Government: Program Management Unit (PMU)

Private: Joint venture of Lyonnaise des Eaux (Suez Environment,

France), Montgomery Watson (US) and Arabtech Jardaneh (Jordan),

trading under the name LEMA, under a management contract.

Form of user

participation

Project/intervention

funding agency

ODA: A World Bank loan was secured to cover the fixed management

fee (JD1.6m/year, US$2.2m/year) and an incentive bonus equal to 5%

of incremental cash flow. Additional funding for capital investment was

provided by foreign donors through a mixture of soft loans and grants.

The Program Management Unit (PMU) is funded through a number of

grants and loans from American and European development partners,

and receives counterpart contributions from the Water Authority of

Jordan (WAJ).

IV. Research design

Aim of the study

This paper investigates the status of the water-supply service and

regulatory arrangements in respect of poor and vulnerable consumers.

Type of study

Qualitative

Research design

Observational

258

Methodology used for

data analysis

Interview and case-study method

V. Data and sample

Data sources

 The analysis of fieldwork carried out in Amman. Semi-structured

interviews with key stakeholders in the water sector,

representing various levels of government, the then private

operator LEMA, international development agencies and civil

society, were complemented by a survey of households in

selected poor neighbourhoods and small-scale surveying of

private water-tanker operations.

 The household survey was intended to capture a variety of low-

income settings within the boundaries of the Greater Amman

service area.

Data period

Between summer 2004 and summer 2005.

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately positive

 Of the respondent households, only 60% had access to their own

water connection, with nearly one-fifth sharing a connection

between three or more households.

 In response to the persistent insufficiencies in water supplied via

the municipal network, an increasing number of households turn

to the open private market. Water is typically purchased from

private tankers, but so called ‘water-stores’ selling treated

drinking water have also become increasingly popular in recent

years. According to WAJ figures, 1,267 private tankers were

registered in the Amman Governorate.

 The water-services policy and practice implicitly and explicitly

impact on low-income customers, both positively and negatively,

through the application of tariff structures, subsidies and supply

hours.

Affordability: moderately positive

 Affordability is a key consideration of Jordanian water-pricing

policy. Despite high water-production costs and the WAJ’s

approaching insolvency, tariffs have historically been kept very

low, not even allowing the recovery of operating and

maintenance costs.

 Interviews confirmed unanimous agreement among government

institutions that low-income households are being supported

through the tariff structure, which includes a lifeline block of 20

cu metres per quarter, at a fixed price of JD3.472 (US$4.90).

 But, the lifeline allowance covers the water requirements of only

a minor proportion of respondents (3%), while the majority

(46%) pay up to three times the minimum charge and 14%

regularly pay more than ten times the cost of the lifeline (Fig. 6).

259

The average amount billed to a poor household was JD17.4

(US$24.5)/quarter.

Adequacy: moderately positive

 19% of the surveyed households received water only once per

week. Storage capacity emerges as the limiting factor in

household water consumption for low-income families.

Summary of results

 This study shows that achieving service coverage, the goal of the

international community, and a first approximation to economic

regulation is not enough.

 Above-average household size and least-favoured hours of

supply, whereby the rich are given the continuous water supply

rather than the poor, cost lower-income households a

disproportionate amount through too-quickly-increasing tariff

blocks allied with storage and small-scale-tanker purchase-

coping costs.

 Having invested in a high-cost pipe network, society would do

better to ensure delivery of sufficient quantities of this lower-

cost water to the lower-income households, in order to allow

their lower economic wealth to be invested in more productive

uses than paying for a duplicate supply through tankers.

Economic regulators who tend to focus primarily on the finance-

ability of overall services need to recognise an equal duty to

ensure lowest-cost services to the poor.

Brief theory of change

 The quasi-regulatory agency, PMU, seeks to safeguard consumer

interests, but at a practical level is mostly concerned with

technical issues surrounding the improvement of service

provision.

 LEMA has made significant progress towards achieving

contractual targets and turning Amman water services into a

profitable and customer-focused business, with recent

improvements in service levels cited as positive by a PMU source.

However, company sources explained that the short-term

contract often does not justify the employment of specialist staff

to tackle known problem areas, as an adequate return on this

investment cannot be guaranteed.

 A lack of joined-up thinking within the sector is a serious cause

for concern for an operator who is under strong pressure to

improve service levels from a government that fails to associate

service standards with capital-investment requirements.

R 39 / A35

I. Study Details

Authors

Gessler, M, Brighu, U and Franceys, R

Year

2008

Title

The challenge of economic regulation of water and sanitation in urban India

260

Journal

Habitat International

Source

Electronic database

II. Study coverage

Basic service

Water, sanitation, electricity (piped-water supply, drainage system, electricity —

illegal connection)

Country

India

Cities

Jaipur (Rajasthan)

III. Context and intervention

Type of settlement/slum

Slums — formal and informal

Nature of agencies

involved in planning and

service provision

Government

The Public Health and Engineering Department (PHED), a department of

the state government, overseen by Rajasthan Water Supply and

Sewerage Management Board (RWSSMB)

Form of user

participation

Project/intervention

funding agency

State government

Public Health and Engineering Department (PHED) for water and

sewerage.

Rajasthan Electricity Regulatory Commission (RERC) for electricity

IV. Research design

Aim of the study

This paper considers the present state of water supply in Jaipur,

Rajasthan, particularly the extent to which the poor are served and, in

readiness for the proposed water regulator, the authors contrast the

261

management of water with the state of the newly reorganised and

economically regulated electricity sector.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data: Survey in four slums and FGD

Secondary data: Government records

Data period

Not mentioned

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately positive

 Of the four different slums that were investigated, the

regularised slum was in the best condition.

 Standpost water supply (abstracting from a borehole to

overhead distribution tank).

 Proper roads and functioning drainage.

 In the poorest slum the direct provider has provided a surface-

level pipe network.

 The electricity services were reported to be satisfactory in all

survey areas.

 Some slums, which are not regularised, as they are in the low-

lying areas and so are planned to be rehabilitated, have no

sanitary facilities.

Summary of results

 In the case of Jaipur water utility, there are inefficiencies, a lack

of customer involvement and representation, a haphazard pro-

poor water policy and, consequently, a strong need for reforms.

 Although the water and sanitation service may not be

considered ‘good’, it may well be considered ‘good enough’

under the circumstances, and be of a much higher standard than

many other Indian cities.

 In contrast to water, the electricity services were reported to be

satisfactory in all survey areas, including the slums. Connection

rates are high, billing procedures clear and efficient.

Brief theory of change

 Division of roles, recovery of production cost through proper

tariff structure, better services to the poor, reduction in the

number of illegal connections and theft of electricity, have all

been achieved.

262

 Jaipur water utility shows inefficiencies, lack of customer

involvement and representation, a haphazard pro-poor water

policy and, consequently, a strong need for reforms.

R 40 / A42

I. Study Details

Authors

Ghafur, S

Year

2000

Title

Entitlement to Patronage: Social construction of household claims on

Slum Improvement Project, Bangladesh

Journal

Habitat International

Source

Electronic database

II. Study coverage

Basic service

Water and sanitation

Country

Bangladesh

Cities

Faridpur, Comilla, Mymensingh

III. Context and intervention

Type of settlement/slum

Both legal and illegal settlements

Nature of agencies

involved in planning and

service provision

Government: SIP

NGOs

Community organisers (Cos)

Form of user

participation

Project/intervention

funding agency

ODA

UNICEF

263

IV. Research design

Aim of the study

The objective of this paper is to explore the role of social factors in

establishing household claims on urban local intervention in Bangladesh.

This paper argues that, due to key institutional constraints in local

government, (that is, lack of finance and an unrealistic set of functions),

poor households maintain a dependent relationship with local

government in their claims on urban services.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data

Informal interviews conducted during the survey with people in the

community, ‘field workers’, and official and elected members.

Secondary data

UNICEF Bangladesh

Data period

Not clearly mentioned

VI. Results and evidence

Evidence on outcomes

 Water connectivity: moderately positive

- Improvement in living conditions in 200 project sites in

25 municipal towns.

 Sanitation connectivity: moderately positive

- Improvement in living conditions in 200 project sites in

25 municipal towns.

Summary of results

 The SIP, with donor assistance, has provided basic urban services

and socio-economic facilities in low-income settlements in cities

and towns of different sizes.

 But, in investigating the factors that condition household ability

to claim benefits of SIP, the relationship between the

intervention and beneficiary households are seen as passive; that

is, the latter simply takes what is given.

264

 Urban-poor households' claims to SIP in three intermediate-sized

cities in Bangladesh do not take place in a value-neutral setting.

 SIP beneficiaries develop a dependent relationship with the local

government. This relationship has been rooted in the social

construction of de facto entitlements, which finds expression in,

and is mediated by, the existing social situation in Bangladesh.

 This finding has important implications for future urban local

interventions in Bangladesh. It suggests a need to reorient our

focus away from availability of services (by provision) and

towards the household ability to claim them.

Brief theory of change

 Due to key institutional constraints in local government (that is,

lack of finance and an unrealistic set of functions), poor

households maintain a dependent relationship with local

government in their claims on urban services.

R 41 / B 12

I. Study Details

Authors

Gold, J and Namupolo, M

Year

2013

Title

Sanitation issues in Namibia.

Journal

Namibia housing action group CLIP. Team Research Report

Source

Website search

II. Study coverage

Basic service

Sanitation

Country

Namibia

Cities

Not mentioned

III. Context and intervention

Type of settlement/slum

Slum — informal

Nature of agencies

involved in planning and

service provision

Government and self-mobilisation

265

Form of user

participation

Project/intervention

funding agency

Government and self-mobilisation

IV. Research design

Aim of the study

 To evaluate a consortium of research and knowledge agencies

seeking to improve access to sanitation and hygiene.

 This study seeks to direct attention to the inequality of access to

improved and adequate sanitation for many Namibians, an issue

that has garnered new interest at national level over the last few

years.

Type of study

Mixed-methods

Research design

Observational

Methodology used for

data analysis

Simple percentage analysis

V. Data and sample

Data sources

Primary and secondary data

 Case-study method

 CLIP Survey 2011

Data period

April 2011

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity

 Outcome

Moderately positive and moderately negative

 Proportion of households accessing public toilet

 Proportion of households having private toilet facility

Summary of results

 According to the findings, the majority of residents (57%) used

public toilets, while 39% practised open defecation, which is

slightly more than the one-third indicated in the CLIP profile

document of 2009. Only 2% of the households actually have

access to private toilets.

 In 2008, some households qualified for low-income house and

services loans from the government’s Build Together housing

scheme, and brick houses with internal toilets were built. To

266

date, six female- and one male-headed household have a private

toilet inside their house. Six households built toilets in their yards

by using available pipes to extend the infrastructure. Any

additional materials that were required, they bought

themselves. Two families are still using the communal toilet.

Brief theory of change

Joint interventions of the government and Namibia Housing Action Group

CLIP team provided sanitation services to the informal slums-dwellers;

this had a positive impact on sanitation access at community level and in

respect of individual toilets.

R 42 / A 26

I. Study Details

Authors

Goli, S, Arokiasamy, P and Chattopadhayay, A

Year

2011

Title

Living and health conditions of selected cities in India: Setting priorities

for the National Urban Health Mission

Journal

Cities

Source

Electronic database

II. Study coverage

Basic service

Water, sanitation and electricity

Country

India

Cities

Delhi, Meerut, Kolkata, Indore, Mumbai, Nagpur, Hyderabad, Chennai

III. Context and intervention

Type of settlement/slum

Formal settlement

Nature of agencies

involved in planning and

service provision

Water: government

 Provision of water service

Sanitation: user involvement

 Self-construction of toilets

Electricity: government

267

 Provide electricity facility

Form of user

participation

Sanitation: participation through self-mobilisation

 Construction of toilets at home

Project/intervention

funding agency

Water: state government

Sanitation: private (self-funding)

Electricity: state government

IV. Research design

Aim of the study

This paper aims to assist policy-makers by providing critical insights into

the health and living conditions in selected major cities in India, with

special emphasis on slums.

Type of study

Quantitative

Research design

Observational

Methodology used for

data analysis

Quantitative

V. Data and sample

Data sources

Secondary data

Census data

Data period

2001

VI. Results and evidence

Evidence on outcomes

Water: connectivity: moderately positive

Sanitation: connectivity (Indore, Nagpur, Hyderabad): Moderately

positive

Sanitation: connectivity (Delhi, Meerut, Kolkata, Mumbai, Chennai):

Moderately negative

Electricity: connectivity: Moderately positive

Summary of results

 The analysis reveals that all eight cities are lagging in respect of

India’s goal of full coverage of these basic services.

268

 Within the slums of five out of the eight cities, less than 50% of

those populations have access to improved sanitation facilities,

and three out of the four mega-cities examined have less than

50% coverage of cooking-gas connections.

 Mumbai, New Delhi, and Meerut are also facing the problem of

extreme over-crowding. The lack of safe drinking water in

Chennai and the scarcity of sanitation facilities in Mumbai

require special attention.

Brief theory of change

 This study reveals the heterogeneity of socio-economic and

health problems across Indian cities.

 It is critical to note, that despite socio-economic progress, cities

such as New Delhi and Nagpur are weak in respect of basic health

indicators.

 Based on this detailed analysis, the study suggests that Indian

cities need to prioritise challenges and identify effective health

interventions in the context of their respective socio-economic

and health conditions.

 The analysis also informs guidelines for the implementation of

action necessary to achieve healthy cities through India’s

National Urban Health Mission.

R 43 / E 10

I. Study Details

Authors

Global Network on Energy for Sustainable Development (GNESD)

Year

2008

Title

Energy access in urban slums: A case of Khon Kaen, Thailand

Journal

Global Network on Energy for Sustainable Development (GNESD), Research

Report

Source

Google Scholar

II. Study coverage

Basic service

Electricity

Country

Thailand

Cities

Khon Kaen, Bangkok

269

III. Context and intervention

Type of settlement/slum

Slum — informal

Nature of agencies

involved in planning and

service provision

Government

Form of user

participation

Project/intervention

funding agency

Government

IV. Research design

Aim of the study

The aim of this study, focusing on urban and peri-urban areas of Thailand,

is primarily to assess the current levels of access to modern forms of

energy, energy-consumption patterns and total energy-related

expenditures in poor urban and peri-urban areas.

Type of study

Mix method

Research design

Observational

Methodology used for

data analysis

Simple percentage method

V. Data and sample

Data sources

 Primary

Household survey

 Secondary data

National Statistical Office (NSO), National Economic and Social

Development Board (NESDB), Statistical Yearbook, Census,

Household Socio-Economic Survey, Household Energy

Consumption Survey, Metropolitan Electricity Authority (MEA),

Provincial Electricity Authority (PEA), Community Organizations

Development Institute (CODI)

Data period

January‒February 2007 and October 2007

270

VI. Results and evidence

Evidence on outcomes

 Outcome

Connectivity, affordability and adequacy

 Evidence

Moderately positive and moderately negative

 Proportion of households with access to electricity

 Average monthly electricity expenditure of households

 Average reliable electricity supply

Summary of results

 61% of the households feel that the electricity price is too high

and 85% of them feel that the tariff is increasing. Ninety-six

percent of the households say that the electricity supply is

reliable in the Khon Kaen Slum area.

 Households in Khon Kaen feel the electricity price to high

compared with Bangkok. In Bangkok, 77% of the households

have portrayed the electricity bill as expensive, compared to the

61% in Khon Kaen.

 It is important to highlight the fact that several households in

slums in Bangkok report difficulty in paying for their monthly

electricity bill. In Khon Kaen, average monthly household

electricity expenditure in slum areas is found to be Bt697, while

the poor households below the poverty line spend Bt362 per

month. These figures are lower than the average monthly

electricity expenditure in slum areas in Bangkok, where the

corresponding figure is Bt856 and Bt728 per household,

respectively.

Brief theory of change

Study has not mentioned the theory of change

R 44 / A10

I. Study Details

Authors

Gulyani, S, Talukdar, D and Mukami, K

Year

2005

Title

Universal (Non) service? Water markets, household demand and the poor in urban

Kenya

Journal

Urban Studies

Source

Electronic database

271

II. Study coverage

Basic service

Water

Country

Kenya

Cities

Nairobi, Mombasa and Kakamega

III. Context and intervention

Type of settlement/slum

Urban poor

Nature of agencies

involved in planning and

service provision

Government/self-mobilisation

Form of user

participation

Self-mobilisation: households mobilised their own community water

supply

Project/intervention

funding agency

Government/self-mobilisation

IV. Research design

Aim of the study

 This paper examines current water use and unit costs in three

Kenyan towns and also tests the willingness of the

unconnected to pay for piped water or improved kiosk service.

 By examining the water-use behaviour of poor and non-poor

households, this study brings into question a long-standing

notion in the literature: namely, that only the poor are

underserved, use little water and pay a lot for it. It also

indicates that the standard prescription to ‘price water and

create water markets’ is, in itself, insufficient to improve

service delivery and that kiosks are not always a good solution

for serving the poor.

Type of study

Quantitative

Research design

Quasi-experimental

Methodology used for

data analysis

Descriptive analysis

272

V. Data and sample

Data sources

Surveyed 674 households randomly selected for Nairobi (300), Mombasa

(199) and Kakamega (175)

 Questionnaire survey

Data period

November 2000

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately negative

 Number of poor households with access to in-house piped

connection

Affordability: moderately positive

 Unit price of water borne by households to private supply after

using government ( US$ per cu meter)

Adequacy: moderately negative

 Average water use per capita (lcd)

Effort and time: moderately negative

 Average time spent in collecting water (minutes per day)

Summary of results

 This study finds that the current water-supply situation in

Nairobi, Mombasa and Kakamega is dismal. Although about half

of the sampled households have access to private piped-water

connections, only 5% of those connected are poor.

 The poor households are consequently overwhelmingly

dependent on alternative water sources, and end up spending

an average of 42 minutes per day in collecting water (compared

with 15 minutes spent by non-poor households).

 Stories of underserved poor households are legion in the

literature, which shows that the urban poor are not likely to have

a private water connection, are likely to be paying high unit

prices for water, and are likely to spend a significant amount of

time in collecting water.

 In contrast to the supply-side penchant for pushing kiosks as

affordable and desirable strategy for serving the poor, we find

kiosks are the least-preferred ‘improvement’ option among

unconnected urban households in Kenya.

Brief theory of change

 The study indicates that there is broad constituency for reform

in the water sector in urban Kenya — a constituency that

includes, perhaps unlike in many Asian and Latin American cities,

both poor and non-poor consumers.

 The low levels of water use have at least one positive implication:

the size of the systems and investments required to meet

demand and the MDGs is smaller.

 Despite low water use, the existing water budget of the

population is large, indicating that households’ willingness to pay

273

for improvements is backed by an ability to pay. In other words,

this is a situation where user support for, and the financial and

economic viability of, an improvement programme are high.

 There are no major supply constraints either; water production

and water-treatment capacity exist, but they need to be

complemented by improvements and expansions in the

transmission and distribution networks

R 45 / A 14

I. Study Details

Authors

Hailu, D, Osorio, R and Tsukada, R

Year

2012

Title

Privatization and renationalization: What went wrong in Bolivia’s water

sector?

Journal

World Development

Source

Electronic database

II. Study coverage

Basic service

Water

Country

Bolivia

Cities

La Paz, El Alto, Cochabamaba, Santa Cruz

III. Context and intervention

Type of settlement/slum

Low-income

Nature of agencies

involved in planning and

service provision

Others

 Private provision of concession for water

Form of user

participation

Project/intervention

funding agency

Private-sector

 Lyonnais Des Eaux

274

IV. Research design

Aim of the study

This paper investigates the impact of water-service privatisation in

Bolivia. It compares the performance of cities in which the service was

privatised (La Paz and El Alto), with a city in which it is managed as a

cooperative (Santa Cruz de la Sierra), and one where the service is

publicly provided (Cochabamba).

Type of study

Quantitative

Research design

Observational

Methodology used for

data analysis

Quantitative

V. Data and sample

Data sources

Primary data

Secondary data

 Household survey

Data period

1992, 1996, 2001, 2005

VI. Results and evidence

Evidence on outcomes

La Paz

 Connectivity: moderately positive

 Affordability: moderately positive

El Alto

 Connectivity: moderately positive

 Affordability: moderately positive

Cochabamba

 Connectivity: moderately negative

 Affordability: moderately positive

Santa Cruz

 Connectivity: moderately positive

 Affordability: moderately positive

Summary of results

 The analyses of water provision in Bolivia have shown that the

post-privatisation period is associated with expanded access to

water in the cities where privatisation took place, especially

among low-income households.

275

 The distribution analysis found that targeting the poor clearly

helped create a more equitable society in terms of access to

water. The results of the affordability analysis, however, were

mixed.

 Trends in spending during 2001–05 show both an increase and a

decline in the number of people who could not afford water in

the two groups (privatised and non-privatised cities).

 No conclusive inference can be drawn about the effect of water

prices on each city’s affordability, given the shortage of data.

What is evident from the expenditure data is that non-

affordability is also a common problem among households in

cities where the utility was not privatised.

Brief theory of change

 In the cities where provision was privatised (La Paz and El Alto),

there was expansion of access to piped water for all quintiles.

The low-income households benefited more than the high-

income households, especially the lowest quintiles of El Alto.

 In the cities where water provision was not privatised, overall

access to water remained constant. In Cochabamba, in fact,

access to water deteriorated sharply.

 The concentration indices declined in both La Paz and El Alto,

moving toward equitable water access.

 While the average share of income spent by the poor on water

has declined for all, it did not for El Alto (where privatisation took

place). This is to do with expansion in metered connections,

improvements in bill collection and new charges for water, which

was previously freely available.

 Expenditure on water has been persistently higher over time in

Santa Cruz and Cochabamba, among both the richest and

poorest households. These cities have the highest incidence of

non-affordability. However, there is a significant improvement in

affordability for the poorest quintile, Cochabamba. This is

related to falls in water tariffs after 2000, following the

termination of the privatisation contract.

R 46 / A8

I. Study Details

Authors

Hanchett, S, Akhter, S, Khan, M, Mezulianik, S and Blagbrough, V

Year

2003

Title

Water, sanitation and hygiene in Bangladeshi slums: An evaluation of the

WaterAid — Bangladesh urban programme

Journal

Environment and Urbanization

Source

Electronic database

276

II. Study coverage

Basic service

Water and sanitation

Country

Bangladesh

Cities

Dhaka and Chittagong

III. Context and intervention

Type of settlement/slum

Slum

Nature of agencies

involved in planning and

service provision

NGO/Grant agencies (WaterAid)

Form of user

participation

Contribution

Grant agency (WaterAid) funded the water and sanitation

programmes, where implemented and operated by NGO

Project/intervention

funding agency

WaterAid

IV. Research design

Aim of the study

To evaluate the WaterAid programme in order to deliver water and

sanitation effectively to the urban poor, including benefits and non-

benefits to the poorest slums of Dhaka and Chittagong.

Type of study

Mixed-methods

Research design

Observational

Methodology used for

data analysis

Statistical method

 Descriptive analysis

V. Data and sample

Data sources

Primary data

 In total, 1,130 households surveyed for Dhaka and Chittagong

areas, of which 491 households were WaterAid programme

beneficiaries, and the remaining 639 were non-beneficiaries,

selected using random sampling techniques.

277

 Questionnaire-survey method

 Observation method

 Group discussion

 Interview method

Data period

November 2001

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately positive

 Stand-pipe and tube-well water connections inside slums

 Communal latrines

Summary of results

 More than 98% of beneficiary have access to water supply from

metropolitan authority or tube wells within their slums,

compared to just 77% of non-beneficiaries; that is a 27% overall

improvement in access.

 The effect of this intervention was to improve the different

socio-economic groups’ access. The proportion of very poor

beneficiary households with convenient access to safe water is

38% greater than the proportion of 72% of very poor non-

beneficiary households with convenient access.

 Most of the households used hanging latrines, open spaces,

slabs over drains or water bodies. Thirty-seven percent of very

poor households in the beneficiary group and 54% of very poor

non-beneficiary households practice high-risk defecation

behaviour.

Brief theory of change

 Because of this programme, all slum-dwellers in Dhaka and

Chittagong now have a chance of improved basic water and

sanitation facilities, and of the health advantages that these

offer.

 The programme has improved the living environment of many

poor people, but large numbers still cannot gain full access to

programme facilities, because they do not have enough money

to use the facilities for all their water and sanitation needs.

 The study has found virtually unanimous agreement among the

staff and managers of partner NGOs that the programme, as

organised at present, cannot do much for the poorest of the

poor. While cost-recovery is manageable for many poor

households, it is not for the very poorest. Indeed, some partners

mentioned selecting for enhanced services only areas where

people would be able to pay.

278

R 47 / A 44

I. Study Details

Authors

Hasan, A

Year

2006

Title

Orangi Pilot Project: The expansion of work beyond Orangi and the mapping of

informal settlements and infrastructure

Journal

Environment and Urbanization

Source

Electronic database

II. Study coverage

Basic service

Sanitation (Connection)

Country

Pakistan

Cities

Karachi

III. Context and intervention

Type of settlement/slum

Informal settlements

Nature of agencies

involved in planning and

service provision

 Local government of Karachi

 NGO-Orangi Pilot Project — Research and Training Institute

(OPP–RTI)

 CBOs

Form of user

participation

Participation through partnership and contribution

 The institute does not collect money from communities — the

local people collect and use it themselves.

Project/intervention

funding agency

ODA: UNDP

 Through the UNDP-supported Karachi Master Plan 1975–85,

proper land-use plans for the cities were developed through

aerial surveys. For the UNDP-supported Karachi Development

Plan 2000, an operational digital-mapping system (using

remote sensing) was developed within the now-defunct

Karachi Development Authority (KDA) to replace the old

analogue-mapping system.

Community

 Orangi Pilot Project (OPP) is a Pakistan NGO that has provided

managerial support for improving sanitation in the informal

settlement of Orangi. Community members built and financed

sewers within the community.

279

IV. Research design

Aim of the study

 This paper aims to describe the work of the Pakistan NGO,

Orangi Pilot Project–Research and Training Institute (OPP–RTI),

in supporting improved provision for sanitation and other

services in Orangi and other informal settlements in Karachi,

and in other cities and smaller urban centres in Pakistan.

 It also describes an OPP–RTI programme to map and survey

informal settlements in Karachi, and the youth-training

programme that supported this, and also the support for OPP–

RTI partners in mapping in other urban centres.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data

 Interviews with the Deputy Director of Planning (Shahid Saleem)

of the Water and Sewage Department of the district

government, and Deputy District Officer (Javaid Sultan) of the

Master Plan Group of Offices of the city government. This is a

method of surveying widely used in topographical surveys.

Secondary data

 Author’s own calculations, based on figures from the

Government of Pakistan.

 Data acquired from the Karachi Building Control Authority and

the Sindh Katchi Abadi Authority (SKAA), 2001. Information

provided by the Urban Resource Centre, Karachi, which monitors

evictions in Karachi.

 OPP–RTI (2004), Quarterly Reports.

Data period

Not clearly mentioned

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately positive

 Internal development consists of sanitary latrines inside homes,

underground sewers in lanes, and neighbourhood collector

sewers. External development consists of trunk sewers and

treatment plants.

 By 2004, 97.1% of lanes were connected to sewer lines and

98.9% of the houses have access to sanitary latrines.

280

Affordability: moderately positive

 Community volunteers collect money and use it themselves for

maintenance.

 98.9% of the population had in-house sanitary latrines, which

gave them adequate access to sanitation facilities.

Durability: moderately positive

 Since OPP provides training to community members on

construction of latrines and sewage lines, and, since almost all

the community members had in-house sanitary latrines, which

were connected to the sewerage mains, the repairs and

maintenance (durability) level of the infrastructure increased.

Summary of results

 As a result of the OPP–RTI’s involvement with the KMC’s

upgrading work in Orangi, the cost of the ADB-funded project

decreased from Rs1.3bn (US$21.6m) to Rs36.2m (US$600,000).

With technical and managerial support from the OPP–RTI, local

people have built and financed sewers in 1,093 lanes, with

21,866 houses, and have supervised external development work.

An ADB report describes this project as the only successful

sanitation project it has funded in Karachi in the KUDP.

 As a result of the project, excellent relations were built with

local-government engineers and administrators. Because of this,

the OPP–RTI has been able to lobby successfully to convert the

Orangi natural drains into box trunks.

 The OPP–RTI had also become a consultant to the SKAA, a

government institution in charge of regularising and improving

katchi abadis in the province of Sindh, where Karachi is located.

 SKAA decided to follow the OPP–RTI proposed methodology for

upgrading katchi abadis.

 The results of the documentation of the katchi abadis by the YTP

clearly showed that the OPP–RTI concept of ‘internal’ sanitation

being built by communities, and ‘external’ sanitation being built

by the government, was valid and workable.

 OPP-RTI decided to prepare union-council plan books for the

Nazims (governors) of each UC.

 OPP–RTI partner CBOs and NGOs outside Karachi have also

developed expertise in mapping. This expertise is the result of

the OPP–RTI strategy of supporting NGOs and CBOs wishing to

replicate its programmes.

Brief theory of change

 Documenting katchi abadis showed people’s involvement and

investment in development in clear terms. As a result, planning

agencies and local government have realised the need to

support this work, rather than duplicate it or simply go out and

build schools (often without teachers), clinics (often without

paramedics) and water and sanitation systems that are not

properly designed, maintained and operated.

 Community members were trained in skills and knowledge that

communities require in order to establish a more equitable

relationship with government agencies, improve their

settlements, and build local institutions.

 The documentation laid the basis for questioning government

and IFI planning policies and development projects, and for

281

promoting viable alternatives that were based on a sound

knowledge of on-the-ground realities that government agencies

and their foreign consultants do not have, and do not possess

the skills to develop.

 As a result of the documentation, the OPP–RTI’s concepts were

reinforced by statistics and maps for all Karachi, not just Orangi.

This has increased the OPP–RTI’s standing and credibility, to the

extent that its advice is now sought at the national, provincial

and city levels in all matters related to sewage and katchi-abadi

upgrading.

R 48 /A 43

I. Study Details

Authors

Hardoy, A and Schusterman, R

Year

2000

Title

New models for the privatization of water and sanitation for the urban poor

Journal

Environment and Urbanization

Source

Electronic database

II. Study coverage

Basic service

Water and sanitation

Country

Argentina

Cities

Buenos Aires

III. Context and intervention

Type of settlement/slum

Informal settlement

Nature of agencies

involved in planning and

service provision

Local government

Local NGO

Private sector: Aguas Argentinas

Form of user

participation

Participation through contribution

 The users are increasingly engaging themselves in the

formulation of proposals and participating in solutions; in many

282

cases, they are also bearing a proportion of the costs of

neighbourhood improvement and maintenance.

Project/intervention

funding agency

Private

 Aguas Argentinas was awarded a 30-year contract by the

National Executive Authority to provide water and sanitation

services to the Federal districts.

IV. Research design

Aim of the study

This paper analyses the difficulties and possible solutions for the urban

poor in obtaining access to water and sanitation services under private

operation.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data

 Interviewed by the authors

Secondary data

 Action Plan for the Regularisation of Low-income Settlements,

Buenos Aires.

Data period

November 1997

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately positive

Summary of results

 Access to water supply and sanitation services constitutes a

change of attitude on the part of the private operator, the

regulatory body, government and politicians, communities and

other civil-society organisations. This will allow a differentiated

level of service to be introduced, in accordance with the different

realities of the groups to be served, together with participation

and coordination between the different actors’ interests and

resources.

 The failure to extend services to the poor is due to the lack of

economic incentives offered to the private operator to invest in

283

low-income neighbourhoods, to the absence of appropriate

social policies, and to the lack of experience and the lack of

proven models.

 Subsidies were mentioned as one of the appropriate

mechanisms for the provision of water and sewerage services to

low-income groups. However, it was indicated that different

levels of subsidy are required for different income levels among

those living in poverty.

 On the one hand, private sector participation in the provision of

piped water and sewers has monopolistic characteristics,

thereby making it unlikely that the operator will decide to serve

low-income urban residents of its own accord. On the other

hand, it is impossible to extend services to low-income

settlements without the participation and political will of the

local government.

Brief theory of change

The factors are identified as influential in the above outcomes.

 Local governments and regulatory bodies are usually at a

disadvantage in negotiations with private operators, due to the

operator’s higher level of resources and information compared

to those of the government and regulator.

 The lack of a regulatory tradition.

 The politicised appointment of regulators.

 Influence being exerted on the regulator by the operator or

politicians.

 The excessive costs of regulation.

R 49 / A 46

I. Study Details

Authors

Hossain, S

Year

2012

Title

The production of space in the negotiation of water and electricity supply

in a bosti of Dhaka

Journal

Habitat International

Source

Electronic database

II. Study coverage

Basic service

Water and electricity

Country

Bangladesh

Cities

Dhaka

284

III. Context and intervention

Type of settlement/slum

Informal settlement

Nature of agencies

involved in planning and

service provision

Bazaar somiti (members are shop owners, etc.)

Committee members (not registered with the government)

Awami League (one of the two largest political parties in Bangladesh)

Form of user

participation

Project/intervention

funding agency

Not mentioned

IV. Research design

Aim of the study

The paper presents the process of regulation of water and electricity

supply by the local association.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data: field investigation

 Overnight stays at a rented house in the bosti and informal

discussions with local inhabitants helped develop relationships

with the inhabitants and the local leaders and, consequently,

understanding of their everyday lives.

 A case-study approach has been taken to the empirical

investigation of the project. The ‘grounded theory’ (Glaser and

Strauss 1968) provides the framework for the selection of the

cases and analysis for the project, while a multidimensional

methodological approach provides the necessary empirical tools

for field investigation.

Data period

2008 and 2010

285

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately negative

Affordability: moderately negative

Durability: moderately negative

Summary of results

 The case study illustrates the involvement of ruling political

leaders in the production of space. Like the influential local

leaders who protect their ‘invented space’ through creating

fragmentation in the bosti, the ruling political leaders (including

Members of Parliament and Ministers) exercise fragmentation

to produce and establish an unequal, informal relationship with

influential local leaders of the bosti, in such a way that inequality

acts for the ruling political party as a political instrument for

maintenance of social order and control.

 Reciprocal relationships between the ruling political party and

local leaders are based on the exchangeability of their

individually produced space. This reciprocity includes, but is not

limited to, guaranteed privileges for the local leaders in return

for their electoral support of political leaders, and organisation

of political party meetings in the bosti.

 Rather more importantly for the ruling political party, it aims to

selectively employ local leaders, creating a hierarchy among

them, and thereby developing a dependency relationship in the

community and a controlled social order that minimises the

chance of a local-level movement against the government in

power in this highly politicised society.

Brief theory of change

 No doubt, the informal practice of access to water and electricity

is an outcome of the state’s reluctance to recognise the bosti

bashis, who compose more than one-third of the city population

of Dhaka, as its legitimate citizens.

 It leads to the emergence of numerous ways in which these

population groups negotiate with political party leaders and

government administrations for access to governmental-welfare

provisions, including utilities.

 The politics of such an arrangement are very much linked to the

notion of governmentality that defines the administrative logic

of government authorities and that creates ‘an entirely new field

of competitive mobilisation by political parties and leaders’.

R 50 / A 45

I. Study Details

Authors

Hobson, J

Year

2000

Title

Sustainable sanitation: Experiences in Pune with a municipal-NGO-

community partnership

286

Journal

Environment and Urbanization

Source

Electronic database

II. Study coverage

Basic service

Sanitation (communal toilets)

Country

India

Cities

Pune

III. Context and intervention

Type of settlement/slum

Informal settlements

Nature of agencies

involved in planning and

service provision

Government: Pune Municipal corporation

NGO: Shelter Associates

 As an NGO, Shelter Associates’ objective is to work on building

capacities among the poor as a basis for sustainable,

community-led projects.

 The current project is led and controlled by the municipal

corporation, which has taken a positive step in initiating and

funding the project and by establishing a new institutional

partnership in Pune by bringing in NGOs.

Form of user

participation

Participation through contribution

Project/intervention

funding agency

State government — Municipal Corporation

IV. Research design

Aim of the study

The objective of this paper is to give an account of the project (communal

toilet-construction programme) in the city of Pune (India), undertaken

through a partnership between the municipal corporation and eight

NGOs. It focuses on the 13 toilet blocks that are the responsibility of one

of these NGOs, Shelter Associates, and includes details of how they have

been working with local residents with regard to design, construction,

provision for maintenance and incorporation of space for community

287

activities. It highlights the positive aspects, especially the municipal

corporation’s willingness to try a new approach, while also describing the

difficulties that NGOs face in having to meet official implementation

schedules and cope with bureaucratic delays while delivering for, and

remaining accountable to, low-income groups.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data: conducted interviews

Secondary data: Shelter Associates’ own database of 400 informal

settlements in Pune, compiled in 1998‒99.

Data period

1998‒99

VI. Results and evidence

Evidence on outcomes

Connectivity: Moderately positive

 Shelter Associates undertook responsibility for the construction

and maintenance of 13 community toilet blocks.

 The corporation’s role in the project is to provide the funds and

coordinate the project. It also agreed to provide electricity and

water supplies to each site, free of cost, for the construction

period and future use.

Affordability: Moderately positive

 The caretaker is responsible for collecting the monthly payment

of Rs20 per household and can prevent people from using the

toilets if they have not paid.

Adequacy: Moderately positive

 The number of toilets is adequate, so there have been no

queuing problems with respect to the toilets that are already in

operation.

Durability: Moderately positive

 The caretaker is motivated by the salary, but also by the use of

the caretaker’s room for the local boys.

 A community room that is attached to a toilet block helps ensure

that the toilets also become a community focus and the room

288

becomes an extra motivation for ensuring that the toilets and

surrounding area are kept clean.

Summary of results

 This project represents a positive new departure in urban

development, which focuses on the poor in Pune.

 The combination of the municipality’s funds and powers, and the

commitment of NGOs, is enabling the implementation of a large-

scale and long-term project that is beginning to tackle the severe

sanitation problems affecting thousands of poor women and

men.

 The overall project has harnessed the resources of two actors,

allowing both sides to gain experience in working together

constructively.

 While the project is corporation-led and NGO-centred, Shelter

Associates’ priority has been to support the programme and take

advantage of the opportunity it has presented, simultaneously

ensuring that community involvement is placed on the agenda

and encouraging it, in practice, in the settlements where they are

building.

Brief theory of change

 By working on a corporation-initiated project, Shelter Associates

has placed itself in a position where it is caught between the

demands and everyday workings of the corporation, which sets

the terms, and the interests and priorities of local women and

men whose community toilets are the purpose of the project.

 Certain aspects, most notably meeting the corporation’s

requirement for fast implementation, have made community-

building more difficult at these early stages. However, the

experience so far indicates that the project has provided a

significant and tangible focus for working with women and men

in informal settlements.

 In initiating this project, the corporation has demonstrated a

new willingness to tackle its responsibility towards providing

basic amenities for the urban poor. For Shelter Associates,

working with the municipality on its own project has been an

intense learning process, combining the practicalities of a

municipal project with the ideology that underlies their work as

an NGO.

R 51 / A47

I. Study Details

Authors

Ioris, A

Year

2012

Title

The geography of multiple scarcities: Urban development and water problems in

Lima, Peru

Journal

Geoforum

Source

Electronic database

289

III. Study coverage

Basic service

Water

Country

Peru

Cities

Lima

III. Context and intervention

Type of settlement/slum

Urban poor

Nature of agencies

involved in planning and

service provision

Government: Drinking Water and Sanitation Service of Lima (SEDAPAL)

NGOs

Form of user

participation

Project/intervention

funding agency

State government, ODA, private sector

 Public-sector surplus, foreign loans and private-sector

investments

IV. Research design

Aim of the study

The aim of this paper is to describe the contradictory evolution of water

services and the politicised nature of water scarcity in Lima, the capital

of Peru.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data

 Fieldwork carried out, which included policy analysis, archival

research and 54 in-depth interviews with local residents,

regulators, policymakers and parliamentarians, NGO activists,

290

workers and managers of the water utility, and representatives

of multilateral agencies.

Secondary data

 SEDAPAL data

Data period

2009

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately positive

 Total numbers of users is progressively increasing. However,

public services are still lagging behind. 157,000 families still lack

access to water.

Adequacy: moderately negative

 Half of the houses receive treated water for only a few hours

every day.

Summary of results

 Rather than privileging physical and administrative factors, the

analytical approach provided an examination inside the multi-

dimensional nature of water scarcity and an examination of the

intricate barriers that prevent its resolution. Water scarcity

cannot be understood as an isolated phenomenon, but as a

process constantly reinserted in the totality of multiple urban

scarcities of Lima.

 Instead of a purely material phenomenon, the condition of water

scarcity reflects the long-term development of the capital city in

relation to the rest of the country and the internal inequalities

within the metropolitan area.

 While the old barriadas (as the slums of Lima are often called)

remain areas partially integrated into the life of the city, the new

barriadas propagate the same hierarchical organisation of space

that presupposes renewed forms of scarcity.

 Despite the higher sums of capital that now circulate in the city

due to the adoption of neo-liberal economic policies in the last

two decades, city expansion and economic growth have, in

effect, accelerated the social presupposition of scarcity, as is

made evident by the spread of unemployment and job

informality, the foundation of new neighbourhoods at significant

distances from the city centre, and the unresponsiveness to

grass-roots demands for water and public services.

Brief theory of change

 The geography of water scarcity in Lima offers a representative

example of the complex interlinkages that constitute the

contemporary megacity.

 The constant reinforcement of multiple scarcities — due to a

combination of top-down strategies and the manipulation of

investments and infrastructure — has become the most basic

experience in the daily struggle for survival in the periphery of

such vast urban areas.

 In the case of the Peruvian capital, both city regeneration and

water management have operated within the hegemonic

291

asymmetries that dominate the political scene and, crucially,

have reinforced disparities inherited from the previous historical

periods.

 The dialectical interplay between scarcity and abundance has

been systematically used as a political device to handle

expectations in the deprived areas of the capital.

 The deficiencies of the public water services are less the result of

state failure than the convergence of powerful private interests

in the organisation of urban water systems.

R 52 / B 14

I. Study Details

Authors

Islam, S and Khan, U

Year

2013

Title

Access to urban basic services and determinants of satisfaction: A

comparison by non-slum and slum-dwellers in Dhaka City.

Journal

Institute of Governance Studies, BARC University, working paper

Source

Website search

II. Study coverage

Basic service

Water, sanitation and electricity

Country

Bangladesh

Cities

Dhaka

III. Context and intervention

Type of settlement/slum

Slum — informal

Nature of agencies involved in

planning and service provision

Government

Form of user participation

Self-mobilisation

Project/intervention funding

agency

Government

292

IV. Research design

Aim of the study

This study examines both the level of satisfaction of three key urban

services — water and sanitation, waste management and electricity —

as well as the factors that determine the satisfaction level of those utility

services in Dhaka city.

Type of study

Quantitative method

Research design

Observational

Methodology used for

data analysis

Statistical method

V. Data and sample

Data sources

Primary data

Data period

August 2011

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity, adequacy, affordability and effort and time

 Outcome

Strongly positive, strongly negative, moderately positive

and moderately negative

 Proportion of households with access to piped water

 Proportion of households with access to tube well

 Proportions of households with adequate water pressure

 Proportion of households satisfied with distance to the facility

 Proportion of households satisfied with time taken to fetch

water

 Proportion of households satisfied with regularity of water

supply

 Proportion of households with attached toilets

 Proportion of households accessing public toilets

 Proportion of households with simple latrine facility

 Proportion of households with electricity meter installed

 Proportion of households satisfied with reliable electricity supply

 Proportion of households satisfied with affordable billing

Summary of results

 Respondents of non-slums were less satisfied (either partially or

completely) about the behaviour of the staff and quality of

maintenance and complaint-redress system vis-à-vis slums. The

293

pattern of satisfaction, as far as water availability and water

pressure are concerned, was significantly different among

people living in non-slum and those living in slum areas.

 The study hypothesises that satisfaction with water services is

positively related to the predictability of water-supply timing,

water colour (clear), absence of foul scent in water and income

level of households. In contrast, satisfaction level is adversely

affected by factors including whether the respondents are house

owners, large household size, lack of adequate pressure in water

and consumers’ drinking of pipe water. Moreover, the

satisfaction level of water services is negative if households live

in non-slum areas.

 In Dhaka city, households in slums mostly use common toilets

(82.5%). However, in non-slum areas, attached toilets (77.5%)

dominate. Moreover, very few respondents from the non-slum

areas (5%) had experience of using common toilets. It was found

that, in slum areas, for those who have to use common toilets,

the provision of water was irregular and the cleanliness of toilets

was rarely maintained. Besides, more people in slum areas had

to wait in a queue to avail themselves of sanitation facilities.

About 47% of people in slums, either partially or completely

dissatisfied over the location of a common toilet. Cleanliness of

common toilets is the major source of dissatisfaction, both in

slum and non-slum areas. The survey strongly suggests that the

number/availability of common toilets is inadequate, particularly

in slums.

 In 76% of cases households in non-slum areas have electric

meters installed. Most of them responded positively to the

meter reading. However, a large number of households are

unaware about the current tariff structure of electricity. In non-

slum areas, the survey shows that meter reading was done in

74% cases, and half of the respondents were aware of the

current tariff structure of electricity. However, in slum areas,

only 7.6% of households had electricity meters installed, as the

service is generally provided by house-owners who buy

electricity services from the DESCO and DPDC.

 The study hypothesises that satisfaction over electricity services

is positively related if the connection is provided by the

government agencies, meter reading is done every month, and

households’ annual income is more than 2 lac taka. In contrast,

the satisfaction level is adversely affected if the household size is

large, the respondent is a house owner, the respondent is aware

of the tariff structure, there is a meter installed in the house, or

the household needs to queue to pay bills. The results suggest

that consumers’ awareness about electricity tariffs adversely

affect their satisfaction level. This is also true for the households

that have a greater number of family members. However,

earning more than two lac taka annually positively affects

households’ satisfaction levels in respect of electricity services.

Brief theory of change

This study does not mentioned the theory of change

294

R 53 / A 3

I. Study Details

Authors

Issaka, K

Year

2007

Title

Environmental concerns of poor households in low-income cities: The

case of the Tamale Metropolis, Ghana

Journal

Geo Journal

Source

Electronic database

II. Study coverage

Basic service

Water and sanitation

Country

Ghana

Cities

Tamale

III. Context and intervention

Type of settlement/slum

Low-income

Nature of agencies

involved in planning and

service provision

Government/User involvement

Form of user

participation

 Self-mobilisation

Households self-mobilised their own community toilets

Project/intervention

funding agency

Government/User involvement

IV. Research design

Aim of the study

To study the environmental concerns on sanitation access in poor

households in Tamale Metropolitan area, Ghana

Type of study

Mixed-methods

295

Research design

Observational method

Methodology used for

data analysis

Statistical method

 Descriptive analysis

V. Data and sample

Data sources

Questionnaire survey among 300 households, using representative

sample of residential areas and interviews with randomly selected

households in the selected residential categories

 Questionnaire-survey method

 FGDs

Data period

January 2005 to February 2006

VI. Results and evidence

Evidence on outcomes

Sanitation

 Private intervention: Connectivity: Moderately negative

 State intervention: Connectivity: Moderate positive

 State intervention: Electricity: Inconclusive

Water

 Private intervention: Connectivity: Moderately positive

 State intervention: Connectivity: Moderately negative

 State intervention: Electricity: Moderately negative

Summary of results

 Access to private toilet facilities is highly wealth-dependent; the

poor rarely have private toilets inside their homes, but usually in

the yard. The high-wealth households had 75.4% of flush toilets,

compared with 17.5% for the medium-wealth households and

only 7% for the low-wealth households. The only facility for the

poor is the KVIP/pit/pan latrine, but it is described as sub-

standard and undesirable for human use.

 Households with exclusive water supplies spend less than five

minutes and, in case of the households sharing water sources,

spend at least 25 minutes to get a bucket of water.

 The role of the private sector is less evident in sanitation

provision to the urban poor, rather benefitting high-income

households.

 A number of household environmental problems have been

identified in this paper. Water supply appears to be the

environmental service area that most households are concerned

with, followed by solid waste-management and sanitation. Most

of the affected households belong to the lowest wealth group,

who have little or no capacity to improve the situation.

 Moreover, the economic cost of environmental services is

regressive, with a much greater impact on the poor, either

296

because they lie outside the formal system of service provision

or because they depend on services from shared sources.

Brief theory of change

 People might lack environmental services because they are poor,

or they might be poor because they lack environmental services.

However, it is difficult to avoid the conclusion that there is an

interaction. In many instances, the observed inequality in access

to environmental services reflects the wider inequalities in life

chances that have eroded the basic principles of equal

opportunities.

 Households did not generally view housing, indoor air pollution

and insects as major problems. This reflects both a misplaced lack

of concern for poor housing, indoor air pollution and

insects/vectors infestation, and the fact that, unlike most

environmental problems, none of these is a public problem —

the burden falls on the affected individuals/households.

 However, many exposed people are probably unaware of the

risks, and their ignorance of the danger posed by these hazards

make them unconcerned. This is a clear indication that peoples’

concerns and priorities are not based directly on health

considerations. Rather, they are influenced by the lack of access

to environmental services to satisfy basic living conditions.

R 54 / D 5

I. Study Details

Authors

Israel, D

Year

2007

Title

Impact of increased access and price on household water use in urban Bolivia

Journal

The Journal of Environment Development

Source

Cross-reference

II. Study coverage

Basic service

Water

Country

Bolivia

Cities

Cochabamba, El Alto, La Paz, Oruru, Potosí, Santa Cruz, Tarija, Trinidad

III. Context and intervention

Type of settlement/slum

Low-income

297

Nature of agencies

involved in planning and

service provision

Private

Form of user

participation

Passive

Project/intervention

funding agency

Private

IV. Research design

Aim of the study

 This article examines the equity implications of urban water

reform, using data on household water expenditures and water

sources from the 1994 Bolivian Integrated Household Survey.

 It examines the distribution of both the impact of price increases

on households with access to piped-water pre-reform and the

potential impact of expanded coverage on households without

access to piped-water pre-reform.

Type of study

Quantitative

Research design

Observational

Methodology used for

data analysis

Simple percentage analysis

V. Data and sample

Data sources

Secondary

Data period

July to December 1994

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity and affordability

 Outcome

Moderately positive, moderately negative and inconclusive

 Households connected to piped in-house water connection

 Households connected to water supply outside the house

 Households pay more to access water from private water

vendors than yard taps

 Households expenditure on water per month in bolivianos

 Households expenditure on water per capita in bolivianos

298

Summary of results

 The majority, 55%, have piped water in their buildings or yards,

but not inside their homes, whereas 26% of households have

piped water inside their homes. Approximately 10% have access

to piped water from a tap located outside of their buildings or

yards. About 5% of households obtain water directly from

various groundwater and surface-water sources, whereas

another 5% of households purchase water from private water

vendors.

 Overall, 84% of households have spending on water. Of the 16%

of households (total households=992) with zero water

expenditure, 251 households obtain water from free water

sources, such as wells and surface water.

 On average, households purchasing from private water vendors

have lower monthly water spending than those obtaining piped

water within their homes, but higher monthly water spending

than those with piped water outside their homes, but within

their buildings or yards.

 Those purchasing from private water vendors spend Bs18.22 per

month, which is Bs5.50 per month more than the Bs12.72 spent

by those with piped water outside their homes, but within their

buildings or yards. Assuming that households purchasing from

vendors use a similar amount or less water, this observed

difference in water spending is consistent with higher prices for

private vended water than for piped water.

Brief theory of change

The Bolivian urban water-supply sector reform has had a positive impact,

except on in-house connection and private connections.

R 55 / B 15

I. Study Details

Authors

Joshi, D, Morgan, J and Fawcett, B

Year

2005

Title

Sanitation for the urban poor: Whose choice, theirs or ours?

Journal

DFID

Source

Website search

II. Study coverage

Basic service

Sanitation

Country

India, Kenya

Cities

Hyderabad, Kiambiu-Nairobi, Kibera slum

299

III. Context and intervention

Type of settlement/slum

Both formal and informal

Nature of agencies

involved in planning and

service provision

India: Government

 Municipality provides the sanitation service by constructing

toilets

Kenya: NGO and others

 Maji na Ufanisi, a local NGO, constructs public toilets

Form of user

participation

Participation through contribution

 Beneficiary households have contributed 10% of the

construction cost and the remaining 90% was in the form of

subsidy and no-interest loan.

Participation through contribution

 The users have formed themselves into a community group

that pays for use either through monthly payments or per use.

Project/intervention

funding agency

India: ODA

 DFID funded Andhra Pradesh Urban Services for the Poor

(APUSP) programme, which complements the Integrated Low-

Cost Sanitation (ILCS) Programme.

Kenya: Private

 Intermediate Technology Development Group (ITDG), now

called Practical Action, UK.

IV. Research design

Aim of the study

The purpose of this report is to establish broad guidelines as a foundation

for effective interventions in sanitation improvements for those living in

urban poverty.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data

 This includes additional and approximated information on a

number of respondents, based on a number of visits per

300

respondent or group, a number of discussions with individuals,

as well as number of FGDs for each particular research question

in specific countries. The information in this report is, therefore,

primarily qualitative and includes observing and talking to a

select number of residents in a select number of urban settings,

over a period of time.

Data period

June 2003 to April 2004

VI. Results and evidence

Evidence on outcomes

India

Connectivity: moderately negative

 Only notified slums were selected as beneficiaries, thereby

leaving out a large proportion of slum populations who resided

in non-notified slums, as well as pavement dwellers. Even in the

notified slums, toilets have been left incomplete. There are only

four walls and no pans or pits in which to defecate. Water

connections have also not been provided.

Kenya

Connectivity: moderately positive

 Community members use the toilets, showers and water kiosks

for their sanitary, bathing and drinking needs.

 This toilet block serves a population of about 71,000 people.

Adequacy: moderately negative

 At the time of data collection, the toilets were closed due to

overflowing of a septic tank, which was not cleaned by a private

company. There was no electricity or water.

Affordability: moderately negative

 Casual visitors pay Ksh3 for one use and Ksh4 for A shower and

community members pay a subscription fee of Ksh150 per

month. Many residents preferred to pay per use, rather than pay

the monthly fee, which ate into their disposable income.

Summary of results

 The case studies from India and Kenya reveal that water supply

and sanitation in ‘illegal’ slums is often provided as a result of

active leaders, mastaans and/or NGOs, all of whom will have

their own interests and motivations.

 The government in India provides individual pit latrines in most

‘formal’ settlements, but these latrines rarely address the

sanitation needs of women, the elderly, the disabled or children,

and may not even be appropriate for men.

Brief theory of change

 Poorer tenants in Bangladesh had to move out when NGOs

provided interest-free loans to landlords in some slums to

construct latrines and obtain water points. The landlords, in turn,

raised their rents, which were no longer affordable for the

poorest tenants.

301

 Despite higher subsidies, the poorest households were unable to

demand and secure individual latrines under India’s ILCS

programme. Public latrines in India and Kenya are not used by

many women, often as a result of cost, inconvenience or fears

for safety.

 Projects often fail to take into account the social and economic

dimensions of inter- and intra-household poverty, which

determines not only who lives where, but also the level of access

to services.

 The designs and modes of delivery of sanitation services are

planned and decided in a top-down manner and not according

to user needs and situations.

R 56 / C 4

I. Study Details

Authors

Kayaga, S and Franceys, R

Year

2008

Title

Water services regulation for the urban poor: Zambia

Journal

Water management

Source

Author correspondence

II. Study coverage

Basic service

Water

Country

Zambia

Cities

Lusaka

III. Context and intervention

Type of settlement/slum

Low-income

Nature of agencies

involved in planning and

service provision

Others

 Lusaka Water and Sewerage Company, wholly owned by

Lusaka City Council

302

Form of user

participation

Project/intervention

funding agency

Others

 The Water Supply and Sanitation Act of 1997 requires

regulators to ensure improved service provision to the poor. A

Devolution Trust Fund (DTF) was set up. DTF receives funding

from the government, as well as external support agencies.

IV. Research design

Aim of the study

This paper reports on research carried out in developing countries on

systems and structures put in place effectively to regulate water-service

providers for the benefit of all consumers, particularly the poor.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data

 Interviews and FGDs were conducted.

Data period

2005

VI. Results and evidence

Evidence on outcomes

Connectivity: Moderately positive

 The Devolution Trust Fund (DTF) has improved the livelihoods of

over 120,000 people living in low-income settlements.

Summary of results

 The operating environment was conducive to the regulator’s

making independent decisions, with minimal interference from

the state. The regulator has exploited this environment and

made remarkable progress in fulfilling ‘good attributes’ of

regulation.

 The DTF has improved the livelihoods of over 120 000 people

living in low-income settlements.

303

 There is no doubt that water watchdog groups have increased

consumer representation in the regulator’s decision-making

processes.

Brief theory of change

 The sensitisation campaigns by water watchdog groups have led

to increased awareness of roles, responsibilities and obligations

for both the utilities and the consumers. Furthermore, the

transformation of water watchdog groups into consumer watch

groups, to cater for the three utility services of water, sanitation

and electricity, is highly commended.

R 57 / A13

I. Study Details

Authors

Kayaga, S and Franceys, R

Year

2007

Title

Costs of urban utility water connections: Excessive burden to the poor

Journal

Utilities Policy

Source

Electronic database

II. Study coverage

Basic service

Low income

Country

Uganda

Cities

Jinja and Kampala

III. Context and intervention

Type of settlement/slum

Low-income

Nature of agencies

involved in planning and

service provision

Government

Form of user

participation

Project/intervention

funding agency

Central

 National Water and Sewerage Corporation

304

IV. Research design

Aim of the study

Drawing from the Uganda case study, this paper will contribute to the

understanding of the enormity of the barriers of the connection process

and costs levelled against the urban poor, and the importance of

programmes and pricing structures for enabling access to the water-

supply systems.

Type of study

Quantitative

Research design

Quasi-experimental

Methodology used for

data analysis

Econometric method

 Ordinary Last Square (OLS) method

V. Data and sample

Data sources

Primary data

 Sample selected for four public and private water utilities n

Cambodia, for four towns and one city, in randomly selected 428

connected and 354 non-connected households.

 Questionnaire survey

Data period

January 2004

VI. Results and evidence

Evidence on outcomes

Connectivity: Inconclusive

Adequacy: Inconclusive

Summary of results

 The results of the Uganda research demonstrate the substantial

and unpredictable nature of the costs involved in obtaining a

new water connection, costs which are often too risky, as well as

unaffordable.

 The poor, almost by definition, are unable to build up such

capital. A mean of US$500 with a median of US$197 for a ‘two-

dollar-a-day’ household is too high.

 Many more water utilities need to adjust their new connection

policies, reducing charges and including costs in the type of ‘all-

in’ approach now being developed by NWSC, with distribution

costs depreciated over several years.

Brief theory of change

 Extending services to the low-income settlements in urban areas

is a critical success factor for increasing access of the urban poor

to water services. Given the intense capital costs associated with

conventional services, utilities might need to adopt interim

measures to reduce the huge service gap, and provide lower

service levels that utilise appropriate technologies.

305

 Such measures will ensure that the urban poor receive improved

drinking-water services, for which they are able and willing to

pay, and avoid the exploitative alternative service providers.

 Additionally, water utilities need to learn from the cable-

television and mobile-phone operators, who seem to have

perfected the art of segmenting their customer base and

differentiating their services to cater for all types of customers.

 Furthermore, utilities need to revisit their cross-subsidy policies,

and develop mechanisms to detect and stamp out corruption,

tendencies exhibited by some sections of their staff. These issues

have deliberately been addressed by the NWSC’s change-

management programme, which has already started paying

dividends.

R 58 / C 3

I. Study Details

Authors

Kayaga, S and Kadimba-Mwanamwambwa, C

Year

2006

Title

Bridging Zambia’s water service gap: NGO/community partnerships.

Journal

Water Management

Source

Author correspondence

II. Study coverage

Basic service

Water

Country

Zambia

Cities

Kanyama, Lusaka

III. Context and intervention

Type of settlement/slum

Low-income

Nature of agencies

involved in planning and

service provision

NGO

 Care International raises funds for this programme from DFID

306

Form of user

participation

Participation through consultation

 Through a series of zone-level meetings, community members

identified water supply as the most critical issue. Further into

the project, the communities were demarcated into 30 zones

and each zone had a Zone Development Committee (ZDC) to

enhance participation throughout the project life cycle.

Project/intervention

funding agency

ODA:

 DFID funds the Programme of Support for Poverty Elimination

and Community Transformation (PROSPECT)

IV. Research design

Aim of the study

The aim of this paper is to explore CARE’s experience with the

establishment of the Water Trust in the Kanyama Settlement, an

unplanned low-income settlement of approximately 145,500 people.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data (fieldwork)

Data period

July/August 2004

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately positive

 101 stand-pipe connections and 120 yard-tap connections were

provided.

Affordability: moderately negative

 51% of the residents surveyed felt that the water service

provided by the Water Trust was more expensive than that

before the advent of the project. Although there is a flexible bill-

payment system and a pay-as-you-fetch model, residents felt it

was more expensive.

Adequacy: moderately negative

307

 18% of the residents surveyed (N=801), felt the number of tap

stands was inadequate.

Effort and time: moderately positive

 The distance travelled and the time spent in collecting water was

more favourable in the per-urban areas served by the Water

Trust than with the service offered by traditional water-utility

providers.

Summary of results

 Water Trusts, set up by CARE International through the

PROSPECT project, have plugged the water-service gap in the

cities of Lusaka and Livingstone in Zambia. Over a five-year

project period, PROSPECT, in partnership with Lusaka City

Council and LWSC, developed the organisational capacity of

communities in 13 peri-urban settlements, with an estimated

population of 600,000 people, and facilitated the formation of

Water Trusts, which are currently providing water services to

residents in these low-income settlements.

 Evaluation of the community-managed Water Trusts, carried out

in mid-2004, showed that the majority of service recipients were

satisfied with the level of service in terms of reliability,

continuity, customer relations, price and flexibility of payment

methods. However, at the time of the study, there was no

evidence of direct contact between the Water Trust and the

Regulator.

 Therefore, there is a need to explore the optimum institutional

arrangement to ensure that communities served by the Water

Trust fully benefit from the water-services regulatory systems.

Brief theory of change

 What this case study demonstrates is that partnerships between

NGOs, communities and water-utility providers are capable of

adequately bridging the service gap, to the extent of even

providing better service levels than conventional water-utility

providers, at least in the short-to-medium term.

 This mode of service delivery is qualitatively better than the

diversified small-scale intermediate service providers that are a

common feature of many low-income cities, and who present

more challenges for service-quality regulation.

R 59 / A 31

I. Study Details

Authors

Kebede, B, Bekele, A and Kedir, E

Year

2002

Title

Can the urban poor afford modern energy? The case of Ethiopia

Journal

Energy Policy

Source

Electronic database

308

II. Study coverage

Basic service

Electricity

Country

Ethiopia

Cities

CSA data, Mekelle, Bahir Dar, Gondar, Dessie, Jimma, Nazret, Debre Zeit, Harar,

Addis Ababa, Dire Dawa, others cities in Ethiopia

III. Context and intervention

Type of settlement/slum

Low-income

Nature of agencies

involved in planning and

service provision

Government

 Provision of electricity services

Form of user

participation

Project/intervention

funding agency

State government

IV. Research design

Aim of the study

Comparing rough measures of the costs of using modern fuels and

purchasing power of the urban poor in Ethiopia, this study shows that,

whether or not the kerosene is relatively cheap even for the very poor,

electricity is extremely expensive for everyone. The upper stratum of the

poor may have the purchasing power to access butane gas. In addition,

the article examines the relevance of the ‘energy-ladder’ hypothesis.

Type of study

Quantitative

Research design

Observational

Methodology used for

data analysis

Quantitative

V. Data and sample

Data sources

Secondary data

309

 This study used the data from the Household, Income,

Consumption and Expenditure Survey conducted by the Central

Statistical Authority (CSA).

Data period

1995‒96

VI. Results and evidence

Evidence on outcomes

Affordability: moderately negative

 The amount of money paid for electricity (in Birr)

Summary of results

 All fuels considered here, including traditional fuels, have

positive income elasticity. This is true whether the parameters

are computed for all households, or for only the poor or the non-

poor. Even non-poor households increase their demand for

traditional fuels when their income increases. These results

show that Ethiopian urban households are at a very low level in

respect of a transition to an energy system dominated by

modern fuels.

 Finally, the income elasticity for poor and non-poor households

indicates that pro-poor growth probably increases the demand

for firewood, while growth benefiting mainly higher-income

groups will boost the consumption of electricity.

Brief theory of change

 Results show that the prices of electricity and butane gas are too

high relative to the income of the urban population, particularly

the poor. In the case of electricity, the Ethiopian Electric and

Power Company (EEPCO), a government-owned autonomous

enterprise, is the sole supplier and the initiatives can be

attempted within its jurisdiction.

 No legal complications can arise, since the government has

defined the objectives of the Ethiopian Electricity Power

Corporation, (EEPCO) in1997.

 In the case of electricity, the EEPCO, a Government-owned

autonomous enterprise, is the sole supplier and the initiatives

can be attempted within its jurisdiction.

 In the future, private electricity suppliers (if they emerge) can be

encouraged to apply initiatives by using tax and other incentives.

The latter is also applicable for butane gas distributed by oil

companies.

 The demand on human resources and technical capacity does

not seem to be large; the initiatives mainly require reorienting

the priority of electric suppliers and the changing modes of their

operation. The experiences of utilities in other African countries,

such as Zimbabwe, can help assess both human and technical

requirements.

310

R 60 / D 6

I. Study Details

Authors

Khandaker, H and Badrunnessa, G

Year

2006

Title

The Value of Environmental Sanitation — Case studies, Bangladesh — CBO

management of slum neighbourhood sanitation services: the Aynal’s Bastee Case,

Dhaka, Bangladesh

Journal

IRC

Source

Cross-reference

II. Study coverage

Basic service

Access to toilets

Country

Bangladesh

Cities

Dhaka

III. Context and intervention

Type of settlement/slum

Informal settlement

Nature of agencies

involved in planning and

service provision

CBO

 The Population Services and Training Center (PSTC) initiated

the WatSan programme by following a community-based

approach. Community members were formed into a

Community Management Committee (CMC), which took the

lead in construction and management of the sanitation blocks.

The CMC negotiated with the government to secure land for

construction of sanitation block, as well as water connections

within toilets.

Form of user

participation

Participation through partnership

 CMC appoints Sanitation Block Management Committees

(SBMCs), which took care of the day-to-day operations and

management of the sanitation blocks. The CMC negotiates with

the government to secure land for construction of sanitation

blocks. SBMCs appoint caretakers and maintain the toilets and

also collect the maintenance fee from the community

members.

311

Project/intervention

funding agency

Private-sector

 PSTC provided interest-free loans to CMCs, to build sanitation

blocks. PSTC is funded by WaterAid Bangladesh.

IV. Research design

Aim of the study

This case study, discussing some fundamental issues regarding aspects of

environmental sanitation and, more specifically, ecological sanitation.

This occasional paper hopes to have provided information towards the

larger debate regarding development work and the critical role that

sanitation plays in this area.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data

 Field observation

Secondary data

 Referred to many reports

Data period

Not clearly mentioned

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately positive

 A total of 1,800 people from 300 slums households have been

using these two sanitation blocks. 100% of the residents have

been reached by this project.

Affordability: moderately negative

 Each home owner pays Tk150 per month towards repaying the

WatSan loan to the PSTC and all households pay Tk10 every

month to maintain sanitation blocks and pay the caretaker's

salary.

Adequacy: moderately positive

 Sanitation blocks are open from 5am to 12midnight.

312

Durability: moderately positive

 Two caretakers for each sanitation block, take care of the

maintenance of the toilets. Their role is to regularly clean and

maintain the toilets, for which they are paid Tk300 per month

from the SBMC

Summary of results

 All the residents of the Aynal’s Bastee use sanitary latrines.

 Residents are more aware of their health status and practice

hygiene behaviour.

 From SBMC reports and field staff observations, it is evident that

residents wear sandals when going to the latrines and wash their

hands with soap or ashes after using them.

 Latrines are maintained and used in a hygienic manner and

children now use sanitary latrines.

 Where people, in particular newly arrived residents, are found

not to be practising hygienic behaviour, efforts are made to

address this problem.

Brief theory of change

 SBMCs meet regularly to discuss issues and resolve them in a

democratic way.

 They collect monthly contributions from users, and are repaying

the loan to PSTC through monthly instalments.

 They also discuss how to improve their management skills.

 They realise that, although they have to make payments, once

the capital loan is repaid, they will own the sanitation blocks and

will not have to make loan repayments any longer.

 A monthly contribution will be required only to pay the

caretakers’ salary, for the purchase of cleaning materials, and to

cover the cost of minor repairs.

 Residents and users have also enhanced their information,

knowledge and skills base through participating in training

provided by PSTC. They regularly contact the local-government

bodies and representatives at their own initiative and raise other

issues, such as sewerage, with a view to gaining a greater

understanding about potential solutions.

 PSTC hopes gradually to transfer responsibilities to the SBMC

and respective neighbourhood people. These responsibilities

include approaching and negotiating with DCC, the agency that

helped neighbourhood people to establish their right to

sanitation services.

313

R 61 / E 5

I. Study Details

Authors

Kifanyi, G, Shayo, B and Ndambuki, J

Year

2013

Title

Performance of community-based organisations in managing

sustainable urban water supply and sanitation projects

Journal

International Journal of Physical Science

Source

Google Scholar

II. Study coverage

Basic service

Water

Country

Africa

Cities

Tanzania

III. Context and intervention

Type of settlement/slum

Slum ‒ informal

Nature of agencies

involved in planning and

service provision

CBO

Form of user

participation

Passive

Project/intervention

funding agency

CBO

IV. Research design

Aim of the study

This study aims to address the effectiveness of community

participation, appropriate technologies and institutional arrangements

for the overall CBOs’ performance in Tanzania.

Type of study

Quantitative

314

Research design

Observational

Methodology used for

data analysis

Simple percentage analysis

V. Data and sample

Data sources

Primary and secondary data

 Questionnaires and semi-structure interviews

 1994 and 1998 baseline-survey data

Data period

1994 and 1998 baseline survey

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity, adequacy

 Outcome

Moderately positive and moderately negative

 Proportion of households with access to in-house water supply

 Proportion of households consuming water below 100l

Summary of results

 The Hanna Nassif water supply depends on the water main pipe

through the settlement to the Kinondoni area. The situation of

water supply at the Hanna Nassif settlement area is better

compared to the situation before the commencement of the

project: out of 96 heads of household interviewed, 85 (88.5%)

agreed that the project has reduced water shortages and

improved the drainage system. The same pattern of results was

gleaned from the interviews conducted with water users who

were found fetching water at water-collection points: out of 270

respondents, 246 (91.1%) respondents said that water shortages

had been reduced. Furthermore, a housing-registration survey,

which was carried out in May 1998, revealed that, out of 1,897

houses, 20% (373) had private water connections, 8% (149)

houses had plot connections, and the remaining 72% (1,375) had

no water connection. People living in houses with no water

connection were buying water within settlement areas.

 There was relatively small change in water consumption

compared to the patterns revealed in the 1994 and 1998

baseline studies. The study showed that about 27% of the 396

total respondents interviewed were using less than five buckets

per day or below 100l per day; 46.2% 101‒200l per day; 18.3%

201‒250l per day; and the remaining 8.5% were using above 250l

per day. Findings from the 1994 and 1998 baseline studies

portrayed almost the same trend of water consumption. The

315

1994 survey study revealed that 47.9% of the sample population

used below 100l per day; 40.5% used 101‒200l per day; 7.2%

used 201‒250l per day; and 4.5% used above 250l per day. The

1998 water-consumption pattern indicated that 34% of the

sample population was using below 100l per day; 43% were

using 101‒200l per day; 15% were using 201‒250l per day; and

the remaining 8% were using above 250l per day.

Brief theory of change

CBO intervention slightly increased the adequate amount of water supply

to the slum-dwellers.

R 62 / E 1

I. Study Details

Authors

Kolkata Metropolitan Area (KMA)

Year

2012

Title

Basic services for the urban poor (BSUP): An impact-evaluation study of

BSUP programme intervention in Kolkata Metropolitan Area (KMA)

Journal

Socio-Economic Planning Unit, KMDA, Research Report

Source

Google Search

II. Study coverage

Basic service

Water and sanitation

Country

India

Cities

Kolkata

III. Context and intervention

Type of

settlement/slum

Slum — informal

Nature of agencies

involved in planning

and service provision

Others

Jawaharlal Nehru National Urban Renewal Mission (JNNURM)

316

Form of user

participation

Project/intervention

funding agency

JNNURM

IV. Research design

Aim of the study

Type of study

Mixed-methods

Research design

Observational

Methodology used for

data analysis

Simple percentage analysis, Service Deprivation Index (SDI) and Basic

Amenities Deprivation Index (BADI)

V. Data and sample

Data sources

Primary

Data period

July 2008

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity, effort and time

 Outcome

Moderately positive

 Deprivation index following provision of in-house water

connection

 Deprivation index following time taken to collect water from

outside

 Deprivation index following provision of yard-tap connection

 Deprivation index following construction of bricked drainage

facility

Summary of results

 Some level of improvement due to BSUP intervention in

municipal water supply by house connections and roadside taps.

Having access to water taps, however, does not guarantee

regular and reliable supply of water with adequate pressure. It

shows that the provision of piped-water supply in the region has

improved, but not considerably across the slum’s population.

317

 The accessibility to safe drinking water was quite low in

Gayespur and in the Uttarpara Kotrung Municipality. In KMA,

over 83% of the population had access to safe drinking water.

 A composite water-deprivation index that shows an overall

improvement (more than 20%) after intervention. In the data, all

municipalities show a decline in the deprivation level that

signifies a positive impact.

 There are significant inter-municipality variations in access to

toilet facilities. Among the municipalities in KMA, at one end is

Kalyani, where 82% of the households had access to toilet

facilities and. at the other end it was less than 15%in the case of

Uluberia. There were a few common toilets with septic tanks in

some slums and for the balance no sewerage system was

available. It was proposed to provide two pit latrines, as per

PWD, norms, to individual houses. Regarding changes in the

deprivation level, all municipalities showed a significant

improvement, especially the Rishra and Bally municipality. The

Rishra and Bally municipality showed a 100% change: before

intervention, the households had no toilets of their own and

mostly used community toilets. The overall deprivation index

(KMA) for proper latrines after intervention reduced from 0.437

to 0.004, showing a 99% improvement in impact.

 Some parts of the slums fall in low-lying areas and proper

drainage is necessary to drain out water to the nearby outfall

through connecting drains. These drains were to be of

constructed of brick with plaster lining. Bally and Rishra slums

indicated a 100% improvement after intervention. The drainage

facilities have improved considerably, and this has been

reflected by an overall reduction in the deprivation index, from

0.765 to 0.394, leading to an improvement of 48%.

Brief theory of change

After the JNNURM intervention, slum-dwellers accessed a tremendous

level of basic services for water and sanitation in the KMA.

R 63 / E 3

I. Study Details

Authors

Karanthi, N and Rao, K

Year

2009

Title

Security of tenure and its link to the urban basic services in slums: A case of

Hyderabad

Journal

The IUP Journal of Infrastructure

Source

Google Scholar

318

II. Study coverage

Basic service

Water, sanitation and electricity

Country

India

Cities

Hyderabad

III. Context and intervention

Type of settlement/slum

Slums — formal and informal

Nature of agencies

involved in planning and

service provision

Government

Form of user

participation

Passive

Project/intervention

funding agency

Government

IV. Research design

Aim of the study

 This paper attempts to understand the link between tenure

security and access to basic urban services in slums, for which a

field investigation was carried out in three slums of Hyderabad.

 The paper particularly focuses on the different types of tenure

system — formal, informal, etc., and examines whether a

correlation exists between secure tenure and access to urban

basic services.

Type of study

Quantitative

Research design

Observational

Methodology used for

data analysis

Simple percentage analysis

V. Data and sample

Data sources

Secondary data

Data period

2003

319

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity

 Outcome

Moderately positive and moderately negative

 Proportion of households with individual piped-water

connection

 Proportion of households with underground drainage facility

 Proportion of households with electricity connection

Summary of results

 It was found that the average percentage of households having

access to basic services increased, with a concomitant increase

in the degree of tenure security. An average of 37.1% of

households have access to basic services in Vinayak Veedhi (with

threat of eviction/already evicted). The access increased to

40.5% in Suleman Nagar (with informal tenure) and in Pukat

Nagar (with formal tenure), the access to basic services by the

households further increased to 67.9%.

 It was found that more than 57% of the sample households felt

that the provision of legal tenure or patta would increase their

access to basic services, connection to the source in particular.

 In addition to this, nearly 67% of them had to invest in the

drainage maintenance. Nearly one-fourth of the households

have access to individual toilets and underground drainage.

 Only one-third of the sample households are connected with

individual water taps, hence there is still a shortfall of water

supply. On average, the residents pay Rs147 as the monthly

water bill. The households have frequent electrical-wiring

problems owing to the poor condition of electricity lines and

street-lights.

Brief theory of change

Formal and informal slum-dwellers access to the basic service of water,

sanitation and electricity has improved vastly from the service received

from the monopoly government provider.

320

R 64 / A 48

I. Study Details

Authors

Laurie, N and Crespo, C

Year

2007

Title

Deconstructing the best case scenario: Lessons from water politics in La

Paz–El Alto, Bolivia

Journal

Geoforum

Source

Electronic database

II. Study coverage

Basic service

Water and sanitation

Country

Bolivia

Cities

El Alto, La Paz

III. Context and intervention

Type of settlement/slum

Low-income-poor

Nature of agencies

involved in planning and

service provision

Private concession

 Aguas del Illumani, a French-led consortium, part of the Suez

group

Form of user

participation

Participation through contribution

 The terms of the concession agreement did not involve

community participation in any form. The terms were finalised

between the private companies and the Bolivian government,

with supervision of the World Bank. However, one of the pro-

poor technological innovations of this project was the

contribution of labour by the community members, in the form

of laying smaller tubing along pavements. This contribution

was equated to the savings to the project as a result of

adopting this technological improvement.

Project/intervention

funding agency

ODA

 International Development Association (IDA) funded Major

Cities Water and Sewerage Rehabilitation Project (1990‒97)

 World bank

321

IV. Research design

Aim of the study

The historical analysis of the privatisation of pro-poor credentials of the

concession in the pro-poor story of the La Paz–El Alto case.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data

Fieldwork with poor users

Data period

2006

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately positive

 New connections were provided, although the number of

connections was lower in low-income communities than for new

connections in high-income areas.

Affordability: moderately negative

 The tariff structures were discriminating against poor

households. Several poor households did not cross the

minimum-consumption level, but were required to pay for it.

Although the private company was required to install meters,

the majority of households did not have meters and were paying

much more for their water use. The community contribution

interims of labour, materials and maintenance, added together

as connection cost, were higher than the conventional

connection cost.

Durability: moderately negative

 The shallow tubing installed in the community as a result of pro-

poor technology did not withstand the weight of the Lorries

passing through and often broke down. Maintenance of the

infrastructure was the responsibility of the community members

and this exposed them to hazardous conditions, especially while

clearing blocked sewage. The slope in El Alto resulted in blocking

of sewerage lines and low pressure in water connections.

322

Summary of results

 There was no guarantee that the poorest areas would be those

targeted for new connections. Generally, the poorest areas are

those on the margins of cities, farthest away from the formal

network and, therefore, requiring extensive pipe-work to

connect them. Rather than emphasising new connections to

these distant places, however, in the Aguas del Illimani case ‘new

connections’, especially for drinking water, mainly comprised the

densification of the existing network in areas already serviced.

 In other words, new in-house connections and secondary piping

were provided to homes in zones where the main network

infrastructure of deep pipes was already present. Such zones are

usually in established neighbourhoods, where large plots of land

have been sub-divided over time and new dwellings built.

 Water management in El Alto implied a number of hidden costs

for poor users, one of which was the lack of a widespread

metering system. Poor users without meters continue to

‘overpay’ for their water, because they are charged at the

average rate established by the company. These increased costs

are very real for those living on the margins, near the poverty

line.

Brief theory of change

 The situation was complicated by the fact that the Aguas del

Illimani contract was unclear about whether the mandate to

extend targets referred to the full area of the concession (which

includes poor outlying communities not yet connected to the

network), or only to the existing service and coverage area.

 Tariff systems in La Paz–El Alto, established in the contract,

generally follow pro-poor criteria by focusing on pricing

structures based on consumption. These consumption charges

are also linked to a commitment in the contract to install water

meters, to ensure that the poor only pay for the amount of water

they consume. At first glance, therefore, the La Paz–El Alto

concession appears to operate a pro-poor pricing structure.

 Despite the fact that the pricing systems for Aguas del Illimani

adopt pro-poor structures based on consumption rates and,

when introduced, were an improvement upon systems

operating in other Bolivian cities, the model still contains crucial

elements that work against benefiting the poor. Rather than

being driven by social-equity goals, which focus on the payment

capacity of the population, the concession reflects what Bakker

(2001) terms ‘economic equity criteria’ (the principle of

economic benefit for the company based on full-costs recovery).

Consequently, pro-poor claims about the tariff structures in the

Aguas del Illimani contract seem somewhat overblown.

R 65 / A 22

I. Study Details

Authors

Massoud, M,Maroun, R, Abdelnabi, H, Jamali, I and El-Fadel, M

Year

2013

323

Title

Public perception and economic implications of bottled water consumption in

underprivileged urban areas

Journal

Environ Monit Assess

Source

Electronic database

II. Study coverage

Basic service

Water

Country

Jordon, Lebanon

Cities

Irbid, Tripoli

III. Context and intervention

Type of settlement/slum

Low-income

Nature of agencies

involved in planning and

service provision

Government

 Provision of in-house piped-water connection

Form of user

participation

Project/intervention

funding agency

Jordan

 State government

Lebanon

 State government

IV. Research design

Aim of the study

 This paper presents a comparative assessment of the public

perception of drinking-water quality in two underprivileged

urban areas in Lebanon and Jordan, with similar cultural and

demographic characteristics.

 It compares the quality of bottled water to the quality of

drinking water supplied through the public network and

examines the economic implications of bottled-water

consumption in the two study areas.

Type of study

Quantitative

324

Research design

Observational

Methodology used for

data analysis

Quantitative methodology

 Descriptive statistics

 Chi-square

V. Data and sample

Data sources

Primary data

 Primary data were acquired using a standardised, closed-ended,

structured and coded questionnaire, which was pre-tested to

ensure that the questions were understandable and clear to

respondents, and that the exact meaning of the questions was

captured in the English-to-Arabic translation.

Data period

Not clearly mentioned

VI. Results and evidence

Evidence on outcomes

Jordan

Connectivity: moderately positive

 Percentage of households connected to the drinking-water

network

Adequacy: moderately negative

 Average water consumption rate (L/capita/day)

Affordability: inconclusive

Water consumption costs (US$/cu metre/day)

Lebanon

Connectivity: moderately positive

 Percentage of households connected to the drinking-water

network

Adequacy: moderately positive

 Average water consumption rate (L/capita/day)

Affordability: inconclusive

 Water consumption costs (US$/cu metre/day)

Summary of results

 In both study areas, bottled water was perceived to be of better

quality than drinking water supplied through the public network.

This perception affects drinking-water preferences and

consumption patterns.

325

 Yet, the water-quality assessment revealed that public water

provided through the network system is generally of comparable

quality to bottled water, and sometimes better. Moreover, in

one area, the bottled-water industry is not adequately regulated

to ensure purity and safety.

Brief theory of change

 This study highlights the evidence that fear of contamination in

the public water network compels the community to purchase

bottled water at a considerable financial burden, particularly for

low-income families.

 More importantly, the bottled water has often similar or lower

quality than the public water supply, further underscoring the

burden of environmental degradation that impedes poverty

alleviation.

R 66 / B 5

I. Study Details

Authors

Manzetti, l and Rufin, C

Year

2006

Title

Private Utility Supply in a Hostile Environment

The Experience of Water, Sanitation and Electricity Distribution Utilities in

Northern Colombia, the Dominican Republic and Ecuador

Journal

Inter-American Development Bank, Sustainable Development Department

Source

Website search

II. Study coverage

Basic service

Water and sanitation

Country

Colombia, Ecuador

Cities

Barranquilla, Guayaquil

III. Context and intervention

Type of settlement/slum

Low-income

Nature of agencies

involved in planning and

service provision

Other

 Sociedad de Aceueducto, Alcantarillado y Aseo de Barranquilla

S.A. (AAA) provides the services in place of the local

326

municipality, which was doing a very poor job of service

delivery.

 Interagua is a SPV established to operate the concession

contract for provision of water and waste-management

services in Guayaquil.

Form of user

participation

Barranquilla: participation through consultation

 The company developed a social-responsibility programme to

show customers that they could rely on a much-improved

quality of service by identifying community leaders who served

as intermediaries. These leaders not only provided information

to the community, but also helped the company focus on the

areas for service improvement.

Project/intervention

funding agency

Private-sector

 Sociedad de Aceueducto, Alcantarillado y Aseo de Barranquilla

S.A. (AAA) is a mixed company. A Spanish operator owns 60%,

the municipality owns 35% and the remaining 5% is owned by

a small private domestic investor.

 Interagua is a SPV established to operate the concession

contract for provision of water and waste management

services in Guayaquil.

IV. Research design

Aim of the study

The aim of this paper is to analyse the innovative experiments of two

Colombian providers of electricity and water and sanitation services.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Secondary data

Data period

Not clearly mentioned

327

VI. Results and evidence

Evidence on outcomes

Barranquilla

Connectivity: Moderately positive

 The company made major investments to substantially upgrade

the quality of water supplied, as well as increase the coverage

area. Increased coverage has resulted in increased revenue for

the company, as well as higher levels of customer satisfaction.

Respondents to a National Bureau of Standards survey,

consistently rated AAA over 4.0 on a scale of 0‒5.

Guayaquil

Connectivity: moderately positive

 In the first three years of service, Interagua expanded installation

with 20,000 new connections, to cover more than 100,000

people by installing new meters. Their monthly collections

jumped from US$3.3m to US$5.3m in two years.

Affordability: moderately positive

 Once Interagua provided water, shantytown dwellers paid an

average of 26 US cents per cu meter, as opposed to US$3.50 per

cu meter for water supplied by water trucks.

Summary of results

 The installation of new meters allowed the company to improve

billing and base it upon actual, rather than estimated

consumption. In other words, as monitoring improved, people

began to consume less and pay more.

 Once Interagua started to provide service, water supply became

continuous and prices fell.

 Notwithstanding the progress made, Interagua still faces

daunting problems. From a financial standpoint, the long-

standing tariff dispute with Ecapag has made it difficult for the

company to raise money domestically and internationally, which

has had a negative impact on its investment plans.

Brief theory of change

 Interagua’s management emphasised that the keys to success in

dealing with customers rested on a substantial improvement in

service quality, good communications skills, and a transparent,

straightforward management style.

328

R 67 / B 9

I. Study Details

Authors

Mahadevia, D

Year

2010

Title

Shelter security and urban social protection: Findings and policy implications in

India

Journal

Chronic Poverty Report

Source

Website search

II. Study coverage

Basic service

Water and Sanitation

Country

India

Cities

Ahmedabad and Surat

III. Context and intervention

Type of settlement/slum

Slum — informal

Nature of agencies

involved in planning and

service provision

NGOs

Form of user

participation

Passive

Project/intervention

funding agency

NGOs

IV. Research design

Aim of the study

This study aims to provide empirical evidence of the link between shelter

security and social protection in Ahmedabad and Surat, Gujarat.

Type of study

Mixed-methods

Research design

Observational

329

Methodology used for

data analysis

Simple percentage analysis

V. Data and sample

Data sources

Primary data

Data period

Not mentioned

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity

 Outcome

Moderately positive, moderately negative

 Proportion of households with individual water supply

 Proportion of households depending on public water supply

 Proportion of households with individual toilet facility

 Proportion of households accessing community toilet

Summary of results

Land ownership did not influence water-supply provision by the AMC, and

nearly 89% of households in this ward received water supply at individual

level from the local government. However, the proportion of households

depending on public water-supply taps was somewhat higher (5.9%) in

slums on public land than in slums on private land (1%). The toilet-access

situation toilets, however, is better in slums on private lands than on

public lands; in the case of the former, 92% had an individual household

toilet whereas, in the case of the former, this figure was 83.5%.

Consequently, use of community-level toilets was greater in slums on

private land than on public land.

Brief theory of change

The intervention of NGOs in Ahmedabad’s and Surat’s slums, together

with tenure security, had a positive impact on individual water

connections and toilet facilities.

R 68 / A 49

I. Study Details

Authors

McFarlane, C

Year

2008

330

Title

Sanitation in Mumbai's informal settlements: State, 'slum' and

infrastructure

Journal

Environment and Planning A

Source

Electronic database

II. Study coverage

Basic service

Sanitation

Country

India

Cities

Mumbai

III. Context and intervention

Type of settlement/slum

Informal settlements

Nature of agencies

involved in planning and

service provision

NGO

 NGOs and engineering firms are contractors in this Slum

Sanitation Project and are responsible for the construction of

toilet blocks.

Form of user

participation

Participation through contribution

 Community members are consulted on the design and location

of the toilet blocks, and are also involved in the actual

construction by contributing labour. However, the author

concludes that community involvement has been very low and

the main NGO has taken most of the decisions.

Project/intervention

funding agency

State government

ODA

 The Brihanmumbai Municipal Corporation (BMC) uses World

Bank credit, matching funds from the state government of

Maharashtra to pay for water, sewer and electricity

connections and provide land under the SSP.

IV. Research design

Aim of the study

 The aim of this paper is to examine an ongoing intervention in

sanitation in informal settlements in Mumbai, India. The SSP is

premised upon partnership, participation and cost-recovery in

the delivery of large toilet blocks, as a practical solution to the

inadequacy of sanitation, and offers an opportunity to examine

331

and test a growing consensus on sanitation provision among

mainstream development agencies.

 This paper argues for a more flexible approach to policy

infrastructure, technical infrastructure, and cost recovery in

urban sanitation interventions.

 This paper also considers whether the SSP, as the largest city

project of its nature in Indian history, marks a shift in the

relationship between the state and the slums in Mumbai.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data

 The paper is based on fieldwork conducted in Mumbai.

Secondary data

 In addition to fieldwork, the tentative reflections on sanitation

and the SSP programme presented in the paper draw on the

work of researchers based at Mumbai’s Tata Institute for Social

Sciences.

Data period

Between November 2005 and April 2006

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately positive

 300,000 people were connected to a water and sanitation

network. Out of 86% of total work orders completed, 75% had

water connections and 70% had an electricity connection.

Affordability: moderately negative

 Community members are charged Rs10‒20 per household per

month for the use of toilets.

Durability: moderately negative

 91% of SPARC- (NGO) built toilets lacked water connections and

93% of the toilets lacked electricity connections. A few blocks

had not been opened due to unsound construction. Overall, 25%

of the new blocks lacked water connections and 81% lacked

electricity connections. Furthermore, a majority of the toilet

blocks are not connected to the sewerage system and instead

use septic tanks. This results in blocking or over-flowing, which

when not cleared, leads to disuse of the toilet blocks.

332

Maintenance of blocks is indicated as a problem due to the high

ratio of use (1:250), even though a separate caretaker is

appointed by the local CBO for maintenance.

Adequacy: moderately positive

 Toilets are open and available for use throughout the day and

night, and are well maintained by the local caretaker.

Summary of results

 First, the discussion of partnership and participation indicates

that greater flexibility could allow a more plural policy

infrastructure. The SSP could usefully make its tendering process

more flexible to enable smaller NGOs to bid for smaller

contracts, rather than simply favouring large contracts and

NGOs. This could make space for smaller organisations that have

a greater familiarity with particular settlements, and that are not

divisively associated with particular groups, to use their local

expertise to extend participation and maximise the sanitation

needs of these settlements.

 Second, the discussion, of technical infrastructure production

indicates that the programme could usefully be more driven by

the needs, constitution and geography of specific settlements.

This could result in more effective results over the long term,

including individual, twin and shared toilets, rather than simply

large common blocks.

 Third, the discussion of cost recovery suggests a need for

caution. In particular, there may be a requirement for full

subsidies in areas that clearly cannot afford to spare money (as

in the case of Rafi Nagar), if sanitation delivery is to reach poorer

groups. In addition, it is worth considering more effective

monitoring of how contributions are being used locally, as well

as more general monitoring of user and non-user views on

sanitation.

Brief theory of change

 The SSP distinguishes itself from the previous ad hoc model of

sanitation provision.

 It is a citywide, long-term project to improve informal

settlements. The SSP is, in part, an attempt to foster a particular

kind of civic consciousness of community responsibility deemed

lacking among those living in informal settlements.

 To this extent, it is an attempt to instil a particular sense of urban

modernity, which echoes nationalist discourses in the early years

of independence.

 The subaltern is condemned as lacking a sense of civic

consciousness and is viewed as integral to the making of a

modern city. The view peddled in the media and among many

neighbourhood-improvement groups is often that it is their fault

that sanitation is the way it is, and, if things don’t improve, then

it is they who are to blame. For example, some BMC officials

complained that one of the reasons for health problems among

the poor is a lack of discipline, or the wrong mentality. These

perceptions often act as an explanation for emerging

shortcomings in community maintenance.

 In this act of condemnation, the slum remains fixed to the terrain

of population, without any inherent moral claim on the state.

Slums remain populations outside of the sphere of citizenship,

outside of discourses of rights, and remain, in the view of these

333

officials and many others in the city, a necessary scourge on

visions of the modern, clean and ordered city.

R 69 / B 13

I. Study Details

Authors

MdAdbul, B, MdMustak, A and Tofail Md Alamgir, A

Year

2012

Title

Health status and its implications for the livelihoods of slum-dwellers in Dhaka city

Journal

External Poverty Research Group, Shiree Working paper

Source

Website search

II. Study coverage

Basic service

Water and sanitation

Country

Bangladesh

Cities

Dhaka

III. Context and intervention

Type of settlement/slum

Slum — informal

Nature of agencies

involved in planning and

service provision

NGOs

Form of user

participation

Passive

Project/intervention

funding agency

NGOs

IV. Research design

Aim of the study

To investigate the impact illness has had on livelihoods, and what coping

strategies have been employed in terms of getting access to health

services and basic infrastructure.

334

To evaluate the effectiveness of existing health services and basic-

infrastructure access, including those provided by DSK.

Type of study

Quantitative method

Research design

Observational

Methodology used for

data analysis

Simple percentage analysis

V. Data and sample

Data sources

Primary data

Data period

2011

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity, adequacy

 Outcome

Moderately positive and moderately negative

 Proportion of households with in-house piped-water connection

 Proportion of households with access to yard tap outside

 Proportion of households with individual toilet facility

 Regular supply of water

 Adequate water supply

 Hours of water supply

 Proportion of households with access to yard tap outside

Summary of results

 From the quantitative survey, it was found that 74% of slum-

dwellers were using drinking water from a pipe or supply water.

As government policy prevents a legal water supply, most of this

water came from illegal sources and the pipes had been set up

through drains and sewerage channels. The supply system was

also irregular and usually only ran twice per day, for an hour at a

time. The remaining 26% of respondents were using deep hand

tube wells. Non-beneficiary households, in particular, used hand

tube wells as more of them were from newly developed areas

where no supply water is available.

 The quantitative survey showed that 37% of non-beneficiary

households used hanging latrines, 30% used sanitary latrines,

and 30% used ring-slab latrines. Forty-four percent of

beneficiary households had access to sanitary latrines, 34% used

ring slabs, 13% used pit latrines, 8%used hanging latrines, and

1%used other types.

 Only 54% (n=78) of beneficiary and 43% (n=30) of non-

beneficiary households were using latrines with functioning,

335

water-sealed facilities. Thirty-eight percent (2 to 200 persons) of

beneficiary and 46% (7 to 150 persons) of non-beneficiary

households were sharing latrines among households. Each of

these cluster latrines had 1‒3 chambers, but varied from house

to house. The DSK-Shiree project established 62 community

latrines during the last three years of the project.

Brief theory of change

Bangladesh Water Supply and Sewerage Authority (WASA) policy changes

have a positive impact on in-house water connection and individual toilet

facilities. Other than the yard-tap or community-tap water supply, there

is negative impact on house water supply and an adequate amount of

water supply.

R 70 / A 28

I. Study Details

Authors

Mimmi, L and Ecer, S

Year

2010

Title

An econometric study of illegal electricity connections in the urban

favelas of Belo Horizonte, Brazil

Journal

Energy Policy

Source

Electronic database

II. Study coverage

Basic service

Electricity

Country

Brazil

Cities

Belo Horizonte

III. Context and intervention

Type of settlement/slum

Low-income

Nature of agencies

involved in planning and

service provision

Government

 Provision of electricity services

Form of user

participation

336

Project/intervention

funding agency

State government

IV. Research design

Aim of the study

This paper studies the incidence and determinants of illegality in the

context of low-income urban favelas. The probability of engaging in

illegal behaviour is explained not just by low income, but by a

combination of concurring factors: sub-standard energy provision and

equipment, inefficient/incorrect use of domestic electric appliances, and

running an informal in-house business.

Type of study

Quantitative

Research design

Observational

Methodology used for

data analysis

Quantitative

V. Data and sample

Data sources

Primary data

 We use data from the baseline survey conducted by the Conviver

Agents in 12 Belo Horizonte communities.

Data period

October 2006 to October 2007

VI. Results and evidence

Evidence on outcomes

Adequacy: moderately positive

Affordability: inconclusive

Summary of results

 Illegal connections and energy thefts are mostly explained as the

urban slum-dwellers’ response to non-affordable prices of

electricity.

 The findings from the analysis of the Conviver-programme data

(carefully controlling for endogeneity of certain variables) verify

this intuitive explanation that low incomes lead to illegality, but,

importantly, also prove how income is not the only relevant

factor.

 In obtaining these results, we assess the determinants of

illegality in a comprehensive way, taking into account also the

socio-economic texture of these communities.

Brief theory of change

 A robust outcome of the present study is that, when energy is

supplied via poor-quality equipment and the supply is

337

consequently of a low, the probability of illegal behaviour

consistently increases.

 This is not a purely technical issue, but one that has social and

cultural implications for the urban favela residents, as well. In

fact, poor-quality equipment and unreliable and unsafe delivery

(together with disproportionate costs) aggravate the perception

of exclusion and abandonment among low-income customers,

thereby creating a further incentive to illegality.

 This finding validates the emphasis that many recent slum-

electrification programmes put on tangible improvements in

energy equipment and service for low-income customers, as a

way to overcome hostility and the sense of disparity that is at the

root of illegality. In general, once the service improves in a

noticeable way, the non-payment culture that generates non-

technical losses slowly starts to change.

R 71 / B 10

I. Study Details

Authors

Moulik, T, Singh, N, Mallick, M and Datta, S

Year

1999

Title

Energy provision for the urban poor

Journal

Environmental Resources Management India, Report

Source

Website search

II. Study coverage

Basic service

Electricity

Country

India

Cities

New Delhi

III. Context and intervention

Type of settlement/slum

Slum — formal and informal

Nature of agencies

involved in planning and

service provision

Government

338

Form of user

participation

Passive

Project/intervention

funding agency

Government

IV. Research design

Aim of the study

This study focuses on the urban poor and their specific problems related

to access to energy, and the impacts on them of current government

policies on energy provisions.

Type of study

Mixed-methods

Research design

Observational

Methodology used for

data analysis

Simple percentage analysis

V. Data and sample

Data sources

Primary and secondary data

 Household survey

 Case studies

 NSSO data 1997

Data period

NSSO data 1997, (primary household survey data-collection period not

mentioned)

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity and affordability

 Outcome

Moderately positive and moderately negative

 Households’ monthly per capita consumption of electricity as

proportion of overall spending

 Proportion of households with legal electricity connection

Summary of results

 Although electricity was available in all the clusters, households

did not have legal connections, and were using street lighting

connections. This is a common practice in areas where

households do not have a legal electricity supply. Households

buy their own wires, make a loop or hook at the end, and attach

339

that hook to the low-tension wires running over their houses for

street lighting. Electricity is accessed in this way, and is

connected to switchboards in the houses and used for various

purposes. Meters had not been installed in any of the houses. All

the households possessed at least two electrical gadgets, mainly

for lighting (bulbs and tube lights) and cooling (fans and coolers)

purposes.

 As none of the houses had meters provided by the government,

no-one received any bills for the use of electricity. However, in

places, informal systems had been set up within clusters, with

one or two people taking responsibility for installing wires on to

the electric cables (hooking) and of maintaining and repairing

whenever necessary. Each household paid between Rs25‒50 per

month as maintenance costs to these middlemen. In other

places, families had set up their own wires, and only paid a paltry

Rs5‒10 for maintenance to local electricians.

Brief theory of change

Under the government provision, there is a positive impact on cost and

consumption of electricity in the formal slums, while there is a negative

impact on electricity connections in the informal slums.

R 72 / A 9

I. Study Details

Authors

Mustafa, D and Reeder, P

Year

2009

Title

People is all that is left to Privatize: Water supply privatization, globalization and

social justice in Belize City, Belize

Journal

International Journal of Urban and Regional Research

Source

Electronic database

II. Study coverage

Basic service

Water

Country

Belize (Central America)

Cities

Belize

III. Context and intervention

Type of settlement/slum

Informal settlements

340

Nature of agencies

involved in planning and

service provision

Private

Form of user

participation

Contribution

Private provider to provide the urban water supply to the informal

settlements

Project/intervention

funding agency

Private

IV. Research design

Aim of the study

To study the perception of water-supply privatisation in Belize City’s

informal settlements

Type of study

Mixed-methods

Research design

Observational

Methodology used for

data analysis

Statistical method

 Descriptive analysis

V. Data and sample

Data sources

A total of 225 questionnaires distributed across Belize City, including

informal settlements, and a convenience sampling method was adopted.

 Questionnaire-survey method

 Focus group discussions

Data period

2005 (Pre- and post-privatisation)

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately positive

 Access to piped-water connection by indoor plumbing

Affordability: moderately positive

 Cost of accessing water services pre- and post-privatisation

Adequacy: moderately positive

 Proportion of households with reliable and quality water supply,

post-privatisation

341

Summary of results

 Belize City survey indicated 82% households having s proper

water connection; the remaining 18% from the poorest part of

the city were associated with sources of domestic water

including public faucets, neighbours, street pipes and, most

commonly, stored of rainwater, in addition to bottled water for

drinking.

 The study revealed that 31% of households felt that access to

water was better pre-privatisation, while 42% and 27% of the

households, respectively, felt that it was either the same or

much worse.

 Affordability of water supply: 84% of households reported that

it was less affordable than before privatisation, while only 5% of

the households reported that it was more affordable and 11%

that it was just as affordable as pre-privatization.

Brief theory of change

 The experience of water-supply privatisation was largely

negative. Residents complained bitterly about an increase in

water tariffs and excessive disconnection rates by the privatised

Belize Water Supply Limited (BWSL).

 Many policymakers also accused BWSL of front-loading

investments and not making strategic investments in

infrastructure. But the symbolic significance of water

privatisation for the residents of a small Caribbean country such

as Belize exceeded its practical implications.

 We argue that the major themes to emerge from the

ethnographic data collected for the study can be synthesised

into three ‘popular privatization narratives’ (PPNs). The first is

based on the perception that poor governance led to

privatisation; the second is based on a preference for national

over global-scale politics, so that objections to privatisation were

based on nationalism; the third on angst about losing control to

the systemic compulsions of neo-liberal globalization.

R 73 / A 32

I. Study Details

Authors

Obrist, B, Cisse, G, Koné, B, Dongo, K, Granado, S and Tanner, M

Year

2006

Title

Interconnected Slums: Water, Sanitation and Health in Abidjan, Côte D’Ivoire

Journal

The European Journal of Development Research

Source

Electronic database

342

II. Study coverage

Basic service

Water and sanitation

Country

Côte d’Ivoire

Cities

Abidjan, Dokoure and Yao-sehi

III. Context and intervention

Type of settlement/slum

Both formal and informal settlements

Nature of agencies

involved in planning and

service provision

Abidjan: water: private (SODECI)

 Private provision of water supply

Abidjan: sanitation: local government

 Provision of sewerage service

Dokoure: water: local government

 Installed water pumps

Yao-sehi: water: private: PAMS & NGO

 Construction of communal taps

Form of user

participation

Yao-sehi

 Participation through providing information (community

request for water service)

Project intervention

funding agency

Abidjan: water: private (SODECI)

Abidjan: sanitation: local government

Dokoure: water: local government

Yao-sehi: water: private: PAMS & NGO

IV. Research design

Aim of the study

 This paper questions whether a focus exclusively on slums is

useful for the examination of the provision of water, sanitation

and health in African cities and suggests a complementary

perspective, emphasising urban interconnectedness.

 Using a comparative-case-study approach, it examines

responses to environmental conditions in urban, as well as rural

contexts along drainage channels in Abidjan, West Africa.

 The paper traces linkages on various and partly interrelated

analytical levels: spatial, material, social, political, local, national

and international. Such an analysis of multi-level dynamics

343

between stakeholders contributes to a better understanding of

slums as a phenomenon of urbanisation.

Type of study

Mixed-methods

Research design

Observational

Methodology used for

data analysis

Quantitative

V. Data and sample

Data sources

Primary data

 Conducted household survey, in-depth interviews. The study

was carried out in Abidjan, the commercial centre in Côte

D’Ivoire.

Secondary data

Data period

2003 to 2005

VI. Results and evidence

Evidence on outcomes

Abidjan

Water: connectivity: moderately negative

 Households with water in-house connection

 Households receive water from public tap

Water: adequacy: moderately negative

 Households get water supply at a low pressure

Water: effort and time: moderately negative

 Households walk long distances to fetch water

Sanitation: connectivity: moderately negative

 Households connected to sewerage service

Dokoure: connectivity: inconclusive

 Households get water supply through water pumps

Yao-sehi: connectivity: inconclusive

 Households get water supply from community taps

Summary of results

 The new, illegal and ethnically heterogeneous inner-city ‘slums’

are becoming better connected to the municipality and official

service providers than the old, legal Ebrié villages. These findings

indicate that connectedness has a dynamic dimension and may

344

change in intensity: links do not just exist, they are strengthened

and maintained, but they can also be weakened and given up.

 This means that individuals, households and communities are

not only social actors, but stakeholders who push their interests

forward, whether this means building illegal water connections

or mobilising community members to form neighbourhood

committees. For example, in the case of illegal water

connections, collective action has forced the SODECI company

and the government into action to license water resellers. The

formation of local neighbourhood organisations enables

representatives to create political connections, both in

horizontal (with similar committees in other neighbourhoods),

and vertical (with municipal, city and national governments)

directions.

Brief theory of change

 The findings of this study suggest that a rigid division between

the development of ‘slums’ and the rest of the city does not

reflect the reality of African cities. A focus on

interconnectedness, rather than differentiation, is needed for a

better understanding of slums as a structural phenomenon of

urbanisation. This is particularly true for approaches to the study

of environmental health in densely populated urban areas. The

three closely interrelated issues of fluid- and solid-waste

removal, water provision and healthcare call for a broader and

more integrated perspective. Waste produced in one area may

cause pollution in another area, and the provision of services to

a large number of households necessitates concerted action.

 Not only the material flow, but, more importantly, the

management of waste water connects various settlements

(horizontal connections), as well as individuals, social groups and

institutions (vertical connections). Networks of sewage channels

and water pipes are concrete manifestations of connections

between service providers and households. Policies, regulations

and contracts are less visible, but also create connections

between government bodies, private companies and customers.

R 74 / A 19

I. Study Details

Authors

Omole, K

Year

2010

Title

An assessment of housing conditions and socioeconomic life styles of

slum dwellers in Akure, Nigeria

Journal

Federal University of Technology

Source

Electronic database

345

II. Study coverage

Basic service

Water, sanitation and electricity

Country

Nigeria

Cities

Akure

III. Context and intervention

Type of settlement/slum

Informal settlement

Nature of agencies

involved in planning and

service provision

Government

 Provide piped in-house water connection

User involvement

 Construction of toilets at home

Form of user

participation

User involvement

 Participation through self-mobilisation

Project/intervention

funding agency

Central government

IV. Research design

Aim of the study

 The study seeks to assess the condition of housing and the socio-

economic life style of slum-dwellers in Akure’s urban centre.

 To effectively carry out this assessment, the various

components of the buildings need to be examined in terms of

materials used for construction, age of building, structural

condition of building, the level of household facilities and

infrastructure available within the neighbourhood.

 Also, the literacy level, occupation and income-distribution

pattern of respondents, the effects of slum condition of the

residents were equally investigated.

Type of study

Quantitative

Research design

Observational

Methodology used for

data analysis

Quantitative

346

V. Data and sample

Data sources

Primary data

Secondary data

 The data for this study was collected through primary and

secondary sources. Questionnaire administration constitutes the

major instrument used in information collection.

 Information from related ministries and government

departments, in particular, the state Ministry of Environment,

Town Planning Office and Akure South Local Government

Secretariat were also used.

Data period

2006

VI. Results and evidence

Evidence on outcomes

Water: connectivity: moderately positive

 Proportion of households with piped-water connection

Sanitation: connectivity: moderately negative

 Proportion of households with toilets

Electricity: connectivity: moderately positive

 Proportion of households with electricity connection

Electricity: adequacy: moderately positive

 Reliability of electricity supply

Summary of results

 The main source of water supply is largely through underground

well water, some of which has shallow depth. This poses some

problems because the water is not treated before use. Only a

small proportion of the population, about 14.3%, enjoys tap

water, supply of which is not regular. From this situation, the

existing water supply does not guarantee a good-quality water

supply in the area, hence the people are at greater risk of

contracting acute water-borne diseases. The state of waste

disposal in the area is generally absurd, in spite of government

efforts to curb indiscriminate disposal.

 Over 30% dispose of their refuse indiscriminately, some in open

spaces (21.3%); some through burning within a residential

environment, thereby causing air pollution (11.7%); and 1.7%

leaves theirs at roadsides and drainages, where nobody disposes

of it.

 The main source of electricity supply to the area is through the

Power Holding Company of Nigeria (PHCN), which accounts for

over 90% of the sampled buildings. About 1.7% use generating

plants as supplements, while 17.4% depends solely on hurricane

lamps. This is quite impressive, except for the erratic nature of

the electricity supply from the PHCN.

347

Brief theory of change

 Findings from the study reveal that the area chosen for the study

exhibits slum conditions that have an undeniable impact on the

socio-economic lifestyles and the health of the residents, as well

as the general outlook for the environment.

 Recommendations were proffered to guide policymakers

towards enhancing the lives of the residents of the area. Some

of these include an upgrading programme through the provision

of urban basic services and improved sanitation strategies for

sustainable management of the area. A public-enlightenment

campaign is also recommended, so that the residents know the

importance of good living conditions to their health and

recognise the dangers of abusing their environment.

R 75 / E 2

I. Study Details

Authors

Owusu, G and Afutu-Kotey, L

Year

2010

Title

Poor urban communities and municipal interface in Ghana: A case study

of Accra and Sekondi-Takoradi metropolis.

Journal

Centre for African Studies

Source

Google Search

II. Study coverage

Basic service

Sanitation

Country

Ghana

Cities

Accra and Sekondi-Takoradi

III. Context and intervention

Type of settlement/slum

Informal settlement

Nature of agencies

involved in planning and

service provision

CBO

 After devolution, the Metropolitan Assemblies attempted to

provide poor urban communities with toilets and solid-waste

348

collection by sub-contracting public services to micro-

enterprises and individuals.

Form of user

participation

Project/intervention

funding agency

Others

 Decentralisation programme was initiated by the government.

Metropolitan Assemblies sub-contract public services and

communities pay for the use of toilets and solid-waste services.

IV. Research design

Aim of the study

 The aim of this article is to explore slums and municipal

interfaces in Ghana, based on a study carried out in selected

poor communities in two metropolitan areas of Ghana, namely,

Accra and Sekondi-Takoradi.

 It also explores the effectiveness of Metropolitan Assemblies

(municipal governments) in Accra and Sekondi-Takoradi in

engaging poor communities, as well as addressing the needs of

these communities.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data

 The primary data generated from interviews, FGDs, and transect

walks included oral histories of settlements, community

infrastructure/services and opportunities, social structures, and

local-government activities in the communities.

Secondary data

 The secondary data sources generated information on the

general Ghanaian urban environment: governance structure of

Ghanaian cities; key stakeholders and their influence on urban

development; and city-level poverty levels.

Data period

June‒July 2008

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately negative

349

Although users pay for the service, the quality has remained very poor. In

fact, some respondents claimed the service had worsened after

decentralisation and sub-contracting.

Summary of results

 Poor urban communities in Accra and Sekondi-Takoradi are

confronted by weak infrastructure and services provision. Most

critical to these poor urban communities is the poor state of

waste and sanitation facilities.

 To address this situation, Accra Metropolitan Assembly (AMA)

and the Sekondi-Takoradi Metropolitan Assembly (STMA) have

adopted two approaches: namely, privatisation and community-

based participation in waste collection and management of

public toilets.

 These approaches have, however, run into difficulties, due to

weak local institutional structures (especially local-government

sub-structures) to monitor the activities of private operators, as

well as public agitation regarding payment for poor services.

 In addition, the franchising of waste collection and sanitation has

enhanced the city government’s political patronage, as contract

awards have become a means of rewarding political loyalists.

This has further weakened the Metropolitan Assemblies’

capacity to regulate private operators and ensure improved

service delivery.

Brief theory of change

 In large metropolitan areas such as Accra and Sekondi-Takoradi,

changes are occurring within the context of the decentralisation

programme introduced in 1988. A widely shared view is that

poor city infrastructure and neighbourhoods are the result of

poor city governance.

 In this direction, decentralisation has been strongly advocated as

a solution to the emergence of urban slums and other challenges

of rapid urban growth in many parts of the developing world.

 However, the Ghanaian case, as explored in this study, indicates

that decentralisation is unlikely to have meaningful impact on

poor urban communities if it is based on mere rhetoric.

R 76 / A 27

I. Study Details

Authors

Parikh, P, Chaturvedi, S and George, G

Year

2012

Title

Empowering change: The effects of energy provision on individual aspirations in

slum communities

Journal

Energy Policy

Source

Electronic database

350

II. Study coverage

Basic service

Water

Country

India

Cities

Ahmadabad, Baroda

III. Context and intervention

Type of settlement/slum

Formal settlement

Nature of agencies

involved in planning and

service provision

User involvement

 Self-construction of services

Form of user

participation

Participation through partnership

 Partnership with the government to access their needs

Project/intervention

funding agency

Community residents

IV. Research design

Aim of the study

 This paper discusses the role of energy provision in influencing

the social aspirations of people living in slums.

 This paper examines the factor that influences the shift in

aspirations in five slum settlements.

Type of study

Mixed-methods

Research design

Observational

Methodology used for

data analysis

Quantitative

V. Data and sample

Data sources

Primary data

 We examine factors that influence the shift in aspirations in

five slum settlements, using data from 500 interviews

conducted in serviced and non-serviced slums from the state

of Gujarat in India.

Data period

1996 and 2006

351

VI. Results and evidence

Evidence on outcomes

Connectivity: inconclusive

Summary of results

 The non-serviced slums did not have access to basic services

such as water, sanitation, energy, roads, solid waste and

rainwater management.

 It was found that, when basic infrastructure provisions are met,

slum-dwellers shift their focus from lower-order aspirations to

higher-order aspirations, such as healthcare, education, housing

and land ownership.

 The study argues that energy provision enhances productivity

and enables slum-dwellers to shift their aspirations upwards.

 Furthermore, the study test the effect of work-days lost due to

illness on the relationship between higher-order aspirations and

aspirations for energy provision. When provision of energy is

low, greater work-day losses dampen higher-order aspirations.

 For policymakers, this study highlights the critical link between

the infrastructure services preferred by slum-dwellers and their

social aspirations for growth.

Brief theory of change

 In India, issues surrounding access to basic services such as

electricity, piped water, and cooking fuels provoke extensive

policy debates about the role and level of intervention and

investment on the part of the state.

 From a policy perspective, the prioritisation of services that

match social norms and individual aspirations in slums implies

that initial government investment can be more effectively

targeted towards lower-order services.

 In order to trigger co-investment and community investments in

creating housing stock, for example, the provision of basic

services such as water, sanitation and energy, can be used as a

powerful incentive.

 Such targeted government interventions could empower slum-

dwellers to shift from inferior living conditions to a clean

environment with reasonable housing, healthcare and

educational facilities.

R 77 / A 50

I. Study Details

Authors

Rana Md, M

Year

2011

Title

Urbanization and sustainability: Challenges and strategies for sustainable urban

development in Bangladesh

Journal

Environment Development Sustainability

352

Source

Electronic database

II. Study coverage

Basic service

Water

Country

Bangladesh

Cities

Dhaka

III. Context and intervention

Type of settlement/slum

Informal settlements

Nature of agencies

involved in planning and

service provision

Government and NGO

In Bangladesh, the WSS services are provided by the public authorities

named Water Supply and Sewerage Authority (WASA), Department of

Public Health and Engineering (DPHE) and Local Government and

Engineering Department (LGED). There are some NGOs that are working

for water and sanitation, besides government.

Form of user

participation

Project / intervention

funding agency

State government

IV. Research design

Aim of the study

 This paper attempts to examine this situation, drawing upon

examples of developing cities in general and Dhaka in

Bangladesh, in particular.

 The paper indicates that the inadequacy of infrastructural

services, basic amenities and environmental goods,

environmental degradation, traffic jams and accidents, violence

and socio-economic insecurity are the major challenges for

the city.

 To analyse these challenges, the paper provides an overview of

urbanisation of the world and tries to introduce Dhaka as one of

the fastest-growing megacities in developing countries, which

suffers from inadequacy of water supply.

Type of study

Qualitative

353

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Secondary data

 The paper is based on secondary data that were collected from

different published and unpublished documents.

Data period

Not clearly mentioned

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately negative

 Only 7 1% of the demand for water is met.

Affordability: moderately negative

 Since water ‘lords’ supply water to the communities illegally,

they often charge much more than the normal water charge in

the city. People pay due to their dependence on these water

lords and also because of their need for clean drinking water.

Effort and time: moderately negative

 45.8% of slum clusters shared one tap connection between 6‒10

households.

Adequacy: moderately negative

 Slum-dwellers have to pay Tk400/month for water supplied for

one hour per day.

Summary of results

 DWASA is capable of supplying only 184m l of water (71% of the

demand) per day for the population of about 10m, while the

demand of the consumers is 256m l per day.

 Therefore, small segments of the city population are receiving an

adequate supply of piped water, and the rest of the population

are experiencing inadequate supply of water, while the situation

in low-income communities is unpleasant. The price and pricing

mechanism of water varies from settlement to settlement,

depending upon ownership patterns. Community leaders decide

how much each family will pay.

 The case study of water supply in Dhaka demonstrates that a

large proportion of people in the city do not have access to water

connections or a formal water-revenue system. It also

emphasises the issue of ‘system hijacking’ in the name of system

losses by the water lords and corrupt DWASA officials.

Brief theory of change

The real problems of water and sanitation provisions are:

354

 Incomplete customer base.

 Unmetered connections.

 Illegal and illegally reconnected service connections.

 Inaccurate and tempered meters, and

 Incorrect meter reading as part of corrupt practice of the

revenue collectors.

 Technical losses, which include leaking piped water because of

poor management, and illegal motors used in pipelines.

R 78 / A 29

I. Study Details

Authors

Reddy, B , Balachandra, P and Nathan, H

Year

2009

Title

Universalization of access to modern energy services in Indian households:

Economic and policy analysis

Journal

Energy Policy

Source

Electronic database

II. Study coverage

Basic service

Electricity

Country

India

Cities

NSSO — 64th round

III. Context and intervention

Type of settlement/slum

Low-income

Nature of agencies

involved in planning and

service provision

Government

 Provision of electricity services

Form of user

participation

Project/intervention

funding agency

State government

355

IV. Research design

Aim of the study

The individual goals of this paper are to (i) study existing energy-use

patterns in the household sector; (ii) estimate the number of needy

households; (iii) estimate the economics of providing modern energy

services to all; (iv) estimate the environmental cost of such

universalisation; (v) develop a PPP business model in this regard; and (vi)

suggest an enabling policy framework for implementation.

Type of study

Quantitative

Research design

Observational

Methodology used for

data analysis

Quantitative

V. Data and sample

Data sources

Secondary data

This study uses the National Sample Survey (NSS) data, 61st round, on

consumer expenditure.

Data period

2004‒05

VI. Results and evidence

Evidence on outcomes

Adequacy: moderately negative

 Quantity of electricity used per month, per household (kWh)

Affordability: inconclusive

 Income spent on electricity by households (Rs/unit)

Summary of results

 A targeted programme based access creation is proposed, which

envisages multi-stakeholder responsibility and cost sharing. A

desirable scenario is developed with base year 2010–11 and

2030–31 as the final target year for universal provision of modern

energy services; the interim period is divided into four five-year

plans. The cost estimates of energy empowerment are calculated

separately for rural and urban areas, where the former is higher

than the later due to greater deprivation.

 The annual investments for the four plan periods are estimated

to be Rs93bn, Rs93bn, Rs102 and Rs87bn,. respectively. The

annual CO2 emission-reduction potential is quite substantial at

94m tons (mt) at the end of 2016, which reaches a peak of 458

mt by the end of 2031, when all the households are projected to

have provision of modern energy services. The cumulative CO2-

356

emission reduction in the entire plan period is approximately

2300 mt.

 At the outset, it appears that the combination of benefits

accruing through energy access, improved living standards of the

poor, livelihood opportunities and climate-change mitigation

more than justifies the expected investments.

Brief theory of change

The following are some of the driving forces of, and barriers to,

improvement.

 Political will

 Centralisation/decentralisation

 Initial cost

 Fuel inferiority

 Social advocacy

 Academic activism

R 79 / A 51

I. Study Details

Authors

Roma, E and Jeffrey, P

Year

2011

Title

Using a diagnostic tool to evaluate the longevity of urban community

sanitation systems: A case study from Indonesia

Journal

Environment Development and Sustainability

Source

Electronic database

II. Study coverage

Basic service

Sanitation

Country

Indonesia

Cities

Java and Bali

III. Context and intervention

Type of

settlement/slum

Informal settlements

357

Nature of agencies

involved in planning

and service provision

Government and NGOs

 Local government and NGOs implement the SANIMAS approach

to Decentralized wastewater treatment systems (DEWATS).

Bremen Overseas Research and Development Agency (BORDA)

offers technical support.

Form of user

participation

Participation through consultation

 SANIMAS is a community-developed programme where

community members participate in the implementation and

management of the DEWATS infrastructure.

Project/intervention

funding agency

Central government

 Government of Indonesia introduced the SANIMAS programme

as a pilot case study.

IV. Research design

Aim of the study

 The aim of the study is to compare the intended performance

and benefits of DEWATS technologies with early post-

implementation user experiences.

 The timing of such an evaluation is significant, as sufficient

opportunity is still available to diagnose potential challenges

and develop sound solutions. The article contributes to the

continuing discourse on MDG achievement by exploring those

aspects that may compromise sustained and beneficial use of

sanitation technologies.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data

 Survey and qualitative interviews

Data period

Between 2003 and 2008

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately positive

 78% of communities surveyed used the communal sanitation

centres (CSD) and 100% used the simplified sewerage system

(SSS) of DEWATS.

358

Adequacy: moderately negative

 Users reported difficulties such as poor or intermittent water

supply, clogged waste-water pipes and poor maintenance.

Durability: moderately negative

 Users’ inability to fix the technical problems represents a

challenge in maintaining the technology. The social and

managerial aspects. such as maintenance and queuing outside

facilities. are disincentives for people to use the DEWATS facility.

Summary of results

 This study investigated the intended performance and

experience of DEWATS by means of interviews with key

stakeholders and users.

 The analysis of results shows that SANIMAS is a financially,

socially and environmentally effective programme, well suited to

improving progress towards the attainment of MDG Target 10.

 Users believe SANIMAS to be an affordable approach and

recognise the health benefits gained from the use of appropriate

sanitation.

 The high degree of community satisfaction with DEWATS and

users’ proactive attitudes towards problem-solving, generated

by the use of participatory approaches in the planning and

implementation stages, is equally rooted in the country’s

tradition of community-development programmes and well

established village committees.

 Compared to other community-managed approaches

implemented in developing countries, the SANIMAS

participatory programme has proven to be successful to DEWATS

implementation.

 The balance between technical soundness and knowledge

management, coupled with the country’s tradition of community

activism, contributes to a high level of ownership for the

implemented technologies.

 Notwithstanding the positive engagement of communities, in

fact, two main discrepancies between technology’s intended

performance and users’ experiences have emerged from the

RECAP assessment. A first challenge relates to a lack of

mechanisms to monitor and assess problems within

communities.

 Each community presents a specific set of problems perceived as

challenges to sustained system use. A high number of

communities are preoccupied with challenges posed by technical

problems with DEWATS.

Brief theory of change

 Within the Indonesian government, a lack of organised

strategies, coupled with shortage of trained and skilled staff,

undermines the ability to sustain successful and accepted

sanitation, in a legal environment featuring no specific

regulations to allocate responsibilities and enforce practices for

maintenance and monitoring.

 The lack of institutional agendas for system maintenance

corroborates the argument increasingly maintained by scholars,

which warns of a limitation of community- (and demand-) driven

approaches, which may lead to a process of disenfranchisement

359

by local governments from playing a supportive role to WatSan

technology users.

R 80 / A 11

I. Study Details

Authors

Russ, L and Takahashi, L

Year

2012

Title

Exploring the influence of participation on programme satisfaction:

Lessons from the Ahmedabad slum-networking project

Journal

Urban studies

Source

Electronic database

II. Study coverage

Basic service

Water and sanitation

Country

India

Cities

Ahmedabad

III. Context and intervention

Type of settlement/slum

Formal settlement

Nature of agencies

involved in planning and

service provision

NGO

Gujarat Mahila Housing SEWA Trust (MHT), SAATH and World Vision.

Form of user

participation

Participation through contribution

 Residents who continue to participate in the project (via

maintenance and community-development activities)

Project/intervention

funding agency

CBO

IV. Research design

Aim of the study

 This paper examines the importance of continued project

involvement and participation for long-term resident

satisfaction in terms of programme results, after services have

360

been provided and municipal funding for community

involvement withdrawn.

 In so doing, the authors seek to clarify project satisfaction, given

what other scholars have argued, namely, that professed

programme satisfaction may be a less accurate reflection of the

quality of services provided, and is more likely to reflect other

factors, such as individual preferences, socio-economic status,

strength of social networks and neighbourhood location.

Type of study

Quantitative

Research design

Observational

Methodology used for

data analysis

Quantitative

V. Data and sample

Data sources

Primary data

 A survey of 300 CBO leaders and members, representing 38

separate neighbourhood organisations in Ahmedabad, was

conducted.

Data period

January and June 2009

VI. Results and evidence

Evidence on outcomes

Adequacy: moderately positive

 Satisfaction in respect of quality and quantity of water service.

 Satisfaction in respect of quality and quantity of sewerage

service.

Summary of results

 All four models of respondent satisfaction suggest that

continued involvement and participation in the project (as

measured by meeting attendance), access to and pursuit of

redress (frequency of service requests on behalf of the

community), and an on-going partnering relationship with a

sponsoring NGO are associated with respondents’ expressing

greater satisfaction with project outcomes.

 Nevertheless, the results of the logistic regression models used

to explain the variation in negative comments about specific

service types have greater explanatory value than a general

measure of overall satisfaction with programme quality.

 The models also suggest that different characteristics are

significant in explaining the variation in negative comments and

how CBO and NGO organisational factors might matter in the

variation of negative comments made by respondents.

Brief theory of change

 For overall SNP satisfaction, participation in the CBO (measured

by attendance at meetings of the CBO) was positively associated

with overall SNP satisfaction.

361

 For water services, however, negative comments were

associated with not having a strong partnering relationship with

the sponsoring NGO, and with not communicating with the NGO

or with the municipality to request service assistance.

 Negative comments about sewerage services were associated

with being a member of the ethnic/linguistic majority, lower

density of projects per city region, and not contacting the

sponsoring NGO to request service assistance.

 Finally, negative comments for street-lighting services were

associated with being a member of a not-highly active CBO and

contacting the municipality (in contrast to the other service

types, in which contacting the municipality was associated with

less likelihood of negative comments).

 These results suggest that satisfaction with service types differs

substantially in terms of the importance of CBO activity, contact

with NGOs and municipalities, as well as project characteristics

(density of projects in city region) and community characteristics

(neighbourhoods’ relative wealth).

R 81 / E 9

I. Study Details

Authors

Sankar, S

Year

2005

Title

Study of the World Bank-financed slum-sanitation project in Mumbai

Journal

Water and Sanitation Programme (WSP) and The World Bank Research Report

Source

Google Scholar

II. Study coverage

Basic service

Water and sanitation

Country

India

Cities

Mumbai

III. Context and intervention

Type of settlement/slum

Slum — informal

362

Nature of agencies

involved in planning and

service provision

Government

Form of user

participation

Passive

Project/intervention

funding agency

Government

IV. Research design

Aim of the study

 Suggesting an appropriate demand-responsive participatory

approach to scaling up sustainable environmental-sanitation

services in Mumbai, which enable improvement in the quality of

life of slum-dwellers, recognising the constraints of land

availability, complex land-ownership issues and the existence of

several supply-driven sanitation programmes being

implemented by various agencies.

 Recommending an appropriate and effective strategy and

operational plan that will enable the implementation of a cost-

effective, sustainable, replicable, socially and environmentally

acceptable slum-sanitation programme. This plan is expected to

give due consideration to bundling of environmental sanitation

services via coordinated implementation efforts of various

actors involved after defining key risks, and possible mitigation

measures.

Type of study

Quantitative

Research design

Observational

Methodology used for

data analysis

Simple percentage analysis

V. Data and sample

Data sources

 Primary survey

MCBM Slum Survey

Data period

2001

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity, adequacy

363

 Outcome

Moderately positive, moderately negative

 Proportion of households with individual water connections

 Proportion of households accessing public tap water

 Proportion of households receiving water for less than one hour

per day

 Proportion of households satisfied with the adequate amount of

water supplied

 Proportion of households with access to community-toilet

facility

Summary of results

 The survey indicated that water to nearly half (49%) of the

settlements is supplied through shared connections. Individual

household connections are available in 5% of the slums, while

12% of the slums are only provided with stand posts. The study

further indicates that there are no water-supply arrangements

in 17 slums, with an estimated total population of 100,000.

 More than half of the surveyed households reported that they

receive a sufficient quantity of water; however, almost 43%

mentioned that the quantity of water received is insufficient.

 The duration of water supply was reported to be less than an

hour per day in 3% of the study slums. In 23% of the study slums,

it was reported to be between one and three hours a day,

whereas, in 40% of slums, it was reported to be 3–5 hours. The

remaining 34% of slums reported the duration to be more than

five hours. In the Chikhalwadi slum in Govandi, there is no piped-

water supply. The residents in this slum fetch water from long

distances, as observed.

 A majority of study households (84%) expressed satisfaction over

the quality of water supplied. Nevertheless, nearly 16% of

households complained that the water was contaminated.

 The Slum survey indicated that populations in nearly three-

quarters of the slums had access to public toilets, with 17% of

the population of the Mumbai slums having access to individual

toilets. Fewer than 5% of the slum population had access to

other facilities, including mixed provisioning, pay-and-use toilets

(less than 1% each), and one slum has mobile-toilet facilities.

Residents in more than 5% of slums exclusively practise open

defecation, due to absence of sanitation facilities. These are

clearly primary areas for MCBM interventions, irrespective of

tenure or other constraints.

Brief theory of change

MCBM interventions are enhancing the provision of basic services to the

slum-dwellers but with inadequate proportion.

364

R 82 / B 20

I. Study Details

Authors

Sekhar, S, Nair, M and Reddy, V

Year

2005

Title

Are they being served? Citizen report card on public services for the

poor in peri-urban areas of Bangalore

Journal

Association for Promoting Social Action (APSA) and Public Affairs

Centre (PAC) Report

Source

Website search

II. Study coverage

Basic service

Water and sanitation

Country

India

Cities

Bangalore

III. Context and intervention

Type of settlement/slum

Slum — informal

Nature of agencies

involved in planning and

service provision

Government

Form of user

participation

Passive

Project/intervention

funding agency

Government

IV. Research design

Aim of the study

 Understand the priorities of the community in terms of

development.

 Prepare a Citizen Report Card on the quality and reach of

services provided to the urban poor.

 Disseminate the findings to the respective service providers to

highlight the reality on the ground.

365

 Use the findings to implement a pilot project involving

community mobilisation, and empowering the people of four

slums in two CMCs to seek and access better-quality basic

amenities from the local government, in particular with regard

to water and sanitation.

Type of study

Mixed-methods

Research design

Observational

Methodology used for

data analysis

Simple percentage analysis

V. Data and sample

Data sources

Primary data

 Household Survey and Focus Group Discussion (FGD)

Data period

Not mentioned

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity, adequacy, affordability and effort and time

 Outcome

Moderately positive and moderately negative

 Proportion of households with access to piped-water connection

 Proportion of households with access to public tap

 Proportion of households with access to public water throughout

the year

 Proportion of households with once-a-week frequency of water

supply

 Proportion of households accessing public tap at less than 50m

distance

 Proportion of households with adequacy of water supply

 Proportion of households spending about Rs20 every month on

piped-water supply

 Proportion of households with private-toilet facility

 Proportion of households with access to community-toilet

facility

 Proportion of households with sewerage-system connection

 Proportion of households with drainage facility outside

 Proportion of households that can afford to pay to access

community-toilet facility

Summary of results

 Access to piped water is very limited, with only about 9% of the

population having access. The major sources is public taps or

mini-water supply taps (95%). Other sources available include

hand pumps, community wells and water supplied by cart. Only

366

about 30% of users have said water is available throughout the

year from public taps. This availability is much higher in KR

Puram (44%) than in Mahadevapura (20%).

 On average, people travel a distance of 48.7 metres to access

water. While Mahadevapura slum-dwellers have a public tap just

13 metres from their residences, residents of KR Puram have to

travel 102 meters to access the tap.

 Less than one-quarter of the slum citizens (23%) find the water

to be adequate for their needs. In KR Puram, 40% find the

quantity adequate and 11.9% of residents of Mahadevapura

complain that the water is inadequate. Only 22% of the residents

of the two CMCs find their timing convenient.

 Water is available throughout the year for 66.7% of the residents

(68% in KR Puram and 60% in Mahadevapura).

 On average, households spend about Rs20 every month on piped

water. While, in KR Puram, the average amount paid is Rs16.67,

it is Rs50 In Mahadevapura. The frequency of supply was found

to be insufficient by 56.7% of the slum residents. While 68% of

KR Puram slum-dwellers said they did not find the frequency

sufficient, all five households in Mahadevapura who have access

to piped water found it to be insufficient.

 Out of the 51 respondents using the public toilet in KR Puram

CMC, 76% say that they pay for the use of the toilets.

Brief theory of change

The introduction of citizen report card (CRC) has provided information to

the government about quality and reach of services to the urban poor. It

is observed that the performance of water and sanitation services needs

improvement on many fronts.

R 83 / A 52

I. Study Details

Authors

Scott, P, Cotton, A and Sohail, K

Year

2013

Title

Tenure security and household investment decisions for urban sanitation: The case

of Dakar, Senegal

Journal

Habitat International

Source

Electronic database

II. Study coverage

Basic service

Sanitation

367

Country

Senegal

Cities

Dakar

III. Context and intervention

Type of settlement/slum

Informal settlements

Nature of agencies

involved in planning and

service provision

User involvement

 Users in low-income communities construct their own toilets,

as the government is significantly absent from provision of

sanitation services. Low-income informal settlements are not

serviced adequately due to the irregular city layout and narrow

streets.

Form of user

participation

Participation through self-mobilisation

 This paper examines the correlation between tenure security

and investments made in sanitation. Since the state does not

provide sanitation services, households often provide for

themselves.

Project/intervention

funding agency

Private sector

 Communities build/upgrade their own toilets, which may be

private in-house connections or toilets shared among a few

households.

IV. Research design

Aim of the study

 The aim of this paper is to address how tenure security affects

household-investment decisions for urban sanitation. This is

achieved through a review of the relevant literature on

sanitation for the urban poor and urban land tenure, including

peer-reviewed and grey literature, which is not case-specific to

Dakar. Significant gaps in knowledge are identified and explored

through field studies in Dakar.

 The paper seeks to answer what the relationships are between

tenure issues and sanitation, and to what extent they affect

investment in on-site sanitation systems (that is, systems in

which the disposal of excreta takes place on or near the housing

plot, in the absence of networked sewerage; pit latrines and

septic tanks fall into this category).

 Throughout the paper, an important distinction is drawn

between: capital-investment costs that are incurred through

constructing a new latrine or otherwise improving the quality of

a sanitation asset by upgrading; and operating costs, which are

paid to service the facility, for emptying the pit or tank and

subsequent transport and disposal of the contents.

Type of study

Qualitative

368

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data

 Field studies in Dakar, Senegal.

 Primary data were collected in relation to tenure status,

available sanitation services, and the expenditure by users on

different aspects of sanitation services.

Data period

Not clearly mentioned

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately positive

 62.8% of residents in informal settlements had access to

sanitation.

 72% and 64.7% of residents in regularised and planned

settlements, respectively, had access to sanitation.

Affordability: moderately negative

 Regardless of ownership of toilets (by landlord or tenant), users

pay the latrine-pit-emptying charges.

Summary of results

 The study has found that de facto tenure security is a sufficient,

but necessary, precondition for household capital investment in

sanitation.

 Equally important is the finding that tenants and those lacking

tenure security, while they are unlikely to be willing to invest in

the capital cost of latrines, do pay substantial fees to service

providers for operational sanitation services, such as the

emptying of full pits and tanks, and the removal and disposal of

their contents.

 These operational investments are not accounted for in formal-

policy settings. Tenure status is associated with a much greater

disparity in the levels of service for sanitation than it is for either

water supply or electricity.

Brief theory of change

 This research has shown that low-income residents can, and do,

progressively invest in the capital cost of their own sanitation

infrastructure; however, this was only found to be the case with

owners who enjoyed relatively good tenure security.

 Tenant households, or those with lower levels of tenure security,

were less likely to invest. This confirms that residents have the

tendency progressively to improve their own infrastructure and

do so based upon tenure security, thereby implying a parallel

development between housing and infrastructure.

369

 The study also suggests that, where sanitation is an on-plot,

independently managed infrastructure, it is de facto, rather than

de jure tenure security that is a necessary, but sufficient

precursor to household investment in sanitation. This argument

is underpinned by two essential facts: firstly, in the developing-

world context, tenure security and legal tenure are not

necessarily the same, and secondly, non-networked sanitation

(for example, a pit latrine or septic tank) constitutes improved

sanitation.

R 84 / B 16

I. Study Details

Authors

Scott, N, McKemey, K and Batchelor, S

Year

2005

Title

Energy in low-income urban communities: Barriers to access to modern energy in

slums

Journal

DFID Report

Source

Website search

II. Study coverage

Basic service

Electricity

Country

India, Philippines and South Africa

Cities

Delhi, Rodriguez, Payatas, Davao, Khayelitsha, Makhaya, Monwabisi, Site C, Kuyas

III. Context and intervention

Type of settlement/slum

Low-income

Nature of agencies

involved in planning and

service provision

Others

Form of user

participation

Passive

Project/intervention

funding agency

Others

370

IV. Research design

Aim of the study

To identify barriers preventing low-income urban households from

accessing electricity, and, in particular, preventing them from making

formal connections.

Type of study

Mixed-methods.

Research design

Observation

Methodology used for

data analysis

 Simple percentage analysis

 Non-parametric statistical test

V. Data and sample

Data sources

Primary data

 Household questionnaire survey, Interviews and FGDs

Data period

Not mentioned clearly

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity, adequacy

 Outcome

Moderately positive and moderately negative

 Metered electricity connection in resettlement area

 Metered electricity connection in unauthorised area

 Metered electricity connection in Rodriguez community

 Metered electricity connection in Payatas community

 Metered electricity connection in Davao community

 Metered electricity connection

 Electricity consumption

Summary of results

 The New Delhi sample is characterised by a high proportion

(approaching 50%) of households with illegal connections

(stealing). Their main concern is related to power cuts, which

affect the activities for which they use electricity, and there is

also a regular experience of electrical shocks. Contrary to what

might be expected, the economic status of slum-dwellers was

highest here, and respondents in unauthorised communities had

the lowest reported levels of expenditure. The mean proportion

of household expenditure on energy is 14%.

 In the Philippines sample, the mean proportion of income spent

on energy is 11%, but this increases among the poorer

households. Almost all have electricity, so physical access is not

a barrier, and all households have an electricity connection, used

371

for lighting and cooling (fans); there is also a high penetration of

entertainments.

 In the case of South Africa, the price structure on the ground has

been successful in extending the benefits of electrification to the

poor. Most households use electricity for cooking and water

heating, but paraffin remains more commonly used than

electricity for space heating.

 The fact that two-thirds of households with a metered electricity

supply indicate that they mainly use electricity for cooking, is

considered one of the most important findings of the survey.

 The proportion of household income spent on energy is

moderate (mean for whole sample = 9%), although the

proportion is higher among poorer households.

 17% of the sample has no electricity; 16% have extension cords,

and 67% have metered connections. All of those households

without metered electricity are unserved shacks located in

Monwabisi Park in South Africa, and the low-income households

using extension cords do not benefit from Free Basic Electricity.

Brief theory of change

Not mentioned

R 85 / A 5

I. Study Details

Authors

Shrestha, R, Kumar, S, Martin, S and Dhakal, A

Year

2008

Title

Modern energy use by the urban poor in Thailand: A study of slum households in

two cities

Journal

Energy for Sustainable Development

Source

Electronic database

II. Study coverage

Basic service

Electricity

Country

Thailand

Cities

Bangkok and Khon Kaen

372

III. Context and intervention

Type of settlement/slum

Slum

Nature of agencies

involved in planning and

service provision

Government

Form of user

participation

Government has been independently providing the infrastructure to

urban-slum households

Project/intervention

funding agency

Government

IV. Research design

Aim of the study

To assess the current level of access to modern forms of electricity in

the slums of two cities in Thailand

Type of study

Qualitative

Research design

Observational method

Methodology used for

data analysis

Statistical method

 Descriptive analysis

V. Data and sample

Data sources

Primary data

 Questionnaire survey

Secondary data

 National Statistical Office (NSO) • National Economic and Social

Development Board (NESDB) • Statistical Yearbook • Census

data • Household Socio-Economic Survey • Household Energy

Consumption Survey • Metropolitan Electricity Authority

(MEA) • Provincial Electricity Authority (PEA) • Community

Organizations • Community Organization Development

Institute (CODI)

Data period

January‒February 2007

373

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately negative

Affordability: moderately negative

Summary of results

 This study finds that, even in the slums of Bangkok and Khon

Kaen, almost 100% of the households have electricity

connections. In Greater Bangkok, over 67% of households use

LPG and about 13% use electricity for cooking. Interestingly,

about 16% of the households in Greater Bangkok do not cook at

home and so do not use energy for cooking. This study finds that

a very high percentage of slum-dwellers (about 87% in Bangkok

and 86% in Khon Kaen) use LPG for cooking.

 The limited survey under this study of slum-dwellers shows that

they spend about 16% of their monthly income on energy (that

is, LPG and other cooking fuels, electricity and gasoline) in

Bangkok, while the corresponding figure is about 2 % in Khon

Kaen. It also shows that the poor (households below the poverty

line) spend a higher percentage of their income on energy; for

example, in Bangkok slums, the poor were found to spend 18.5%

of their monthly income, compared to 16.5% in the case of

average households.

Brief theory of change

 Household registration: Although more and more households

are believed to be getting access to a legal electricity connection,

with the introduction of quasi-Ids. Some households still do not

have a quasi-household ID and, therefore, have to rely on

neighbours to provide them with access to electricity.

 Connection fees: Initial connection fees can pose a barrier to

enhancing electricity access. The lowest price to get a legal

connection is Bt2,380. In the course of the limited survey under

this study, it was reported that the cost of getting an electricity

connection from the neighbours was about t1,700 (that is.,

nearly 29% less than the legal connection fee). Consequently,

the latter option might seem more attractive to some

households (especially the poor) although the price charged by

neighbours (Bt5‒6 per kWh) can be more than twice the price

charged by the utility.

 LPG cost: Although, at present, the retail LPG price is subsidised,

the poor households, which cannot afford to buy LPG in a

standard (15-kg) cylinder, may have to buy it in small (4-kg)

cylinders, which may require paying a substantially higher price

(up to Bt 24) per kg than the average retail price of LPG (Bt16.81

per kg). This puts the poorest households at a disadvantage.

Policies and measures to reduce the price of LPG, especially that

in small cylinders, would, therefore, increase its affordability for

and the welfare of the poor households.

374

R86 / A4

I. Study Details

Authors

Smith, L and Hanson, S

Year

2003

Title

Access to water for the urban poor in Cape Town: Where equity meets

cost recovery

Journal

Urban studies

Source

Electronic database

II. Study coverage

Basic service

Water

Country

Africa

Cities

Tygerberg and Cape Town

III. Context and intervention

Type of settlement/slum

Low-income

Nature of agencies

involved in planning and

service provision

Government

Form of user

participation

Government

 Government has independently provided the infrastructure to

the urban low-income informal settlements.

Project/intervention

funding agency

Government

IV. Research design

Aim of the study

To investigate the effect of corporatisation on equity in access to water

in the post-apartheid period in Cape Town, South Africa, between 1997

and 2001.

Type of study

Mixed-methods

375

Research design

Observational method

Methodology used for

data analysis

Descriptive analysis

V. Data and sample

Data sources

Primary data

 120 households randomly selected for the Tygerberg and Cape

Town areas, interviews were designed to assess territorial

differences in households’ access to water according to race and

class in the post-apartheid period. In addition, three

neighbourhoods were selected for each township according to

the standard South African typology of urban service levels.

 Personal-interview method

 Semi-structured interviews

Data period

2001

VI. Results and evidence

Evidence on outcomes

Adequacy: moderately negative

Affordability: moderately positive

Summary of results

 Households with standpipe access living in informal settlement

areas have extremely low consumption levels and have arrived

more recently to the township areas.

 Households in the informal settlements consume an average of

17l per person per day, an amount that is well below the 25l-a-

day South African standard.

 Local authorities are not even meeting the very low basic-needs

mandate in delivering water to residents living in these

settlements. Households with an income of R800 per month or

more would get access to in-house waterborne sanitation;

people with lower incomes would have to get water from

communal taps and use chemical toilets as a form of sanitation.

Brief theory of change

 The essential point is that taking the technocratic route through

cost recovery, at the expense of democratising the delivery of

essential services that shape individual, household and

community development undermines both the equity and the

efficiency objectives of local authorities.

 It has been shown that the cost-recovery methods associated

with local-government efforts to improve water provision to

poor households and improve distributional equity have been

undermined by the lack of attention to procedural equity.

 Local governments, especially those in Cape Town, lack the

institutional wisdom to understand how low-income households

prioritise expenditure.

376

 South African local authorities do, however, lack the ability to

translate existing legislation into practice and the mechanisms to

transform skewed distribution systems. These limitations have

created bottlenecks in implementation.

R 87 / A 23

I. Study Details

Authors

Snyder, R, Jaimes, G, Riley, L, Faerstein, E and Corburn, J

Year

2013

Title

A Comparison of Social and Spatial Determinants of Health Between Formal and

Informal Settlements in a Large Metropolitan Setting in Brazil

Journal

Urban Health

Source

Electronic database

II. Study coverage

Basic service

Water, sanitation and electricity

Country

Brazil

Cities

Rio de Janeiro

III. Context and intervention

Type of settlement/slum

Informal

Nature of agencies

involved in planning and

service provision

Government

 Provision of service

Form of user

participation

Project/intervention

funding agency

State government

377

IV. Research design

Aim of the study

 This paper examines the key socio-demographic and

infrastructure characteristics that are associated with health

outcomes in Rio de Janeiro with the census tract as the unit of

analysis.

 The author tries to describe some aspects of Rio de Janeiro's

informal settlements by disaggregating census data to identify

distinct differences among and between these communities.

Type of study

Quantitative

Research design

Observational

Methodology used for

data analysis

Quantitative

V. Data and sample

Data sources

Secondary data

 Brazilian Census data through the official open-access IBGE 2010

Census website

Data period

2010

VI. Results and evidence

Evidence on outcomes

Water: connectivity: moderately negative

 Proportion of households with access to water services

Sanitation: connectivity: moderately negative

 Proportion of households with access to sanitation services

Electricity: connectivity: moderately negative

 Proportion of households with access to electricity services

Summary of results

 The analysis explored spatial heterogeneity of services access

between AGSN and non-AGSN census tracts within three areas

of the municipality: Centro, Copacabana, and Complexo do

Alemão.

 In all areas, access to sanitation and electricity had a distinctive

spatial pattern, in which AGSN areas were less well served.

 Fewer than 70% of AGSN households had adequate sanitation in

Complexo do Alemão and Centro. Contrastingly, more than 90%

of the households outside of AGSNs in Copacabana and

Complexo do Alemão had adequate electricity, but less than 80%

378

of households within AGSNs in these areas had adequate

electricity.

 Census tracts in the oldest area of the city, Centro, had fewer

households with adequate electricity than in Copacabana and

Complexo do Alemão.

Brief theory of change

 The 2010 Brazilian Census indicated that there is heterogeneity

of demographic and infrastructure characteristics between and

within AGSNs in the municipality of Rio de Janeiro.

 In general, AGSN residents in Rio de Janeiro were poorer, less

literate, younger, and had less access to basic services than

residents of non-AGSN census tracts. These variables are

important determinants of health outcomes. Further,

inequalities between these determinants are frequently cited as

drivers of disease disparity.

 It also highlighted spatial variation in the distribution of poverty

and services between different AGSN census tracts in different

regions of the city. Relative inequality and service needs in Rio's

different districts suggest that policy and planning might pay

special attention to the most impoverished areas.

 For instance, the AGSN census tracts in the western district of

Rio were more vulnerable in terms of poverty and lack of services

than the older southern and central AGSN census tracts of the

city (APs 1, 2, 3).

R 88 / C 1

I. Study Details

Authors

Subbaraman, R, Shitole, S, Shitole, T, Sawant, K, Brien, O, Bloom, E, Patil-

Deshmukh, A

Year

2013

Title

The social ecology of water in a Mumbai slum: Failures in water quality, quantity,

and reliability

Journal

BMC Public Health

Source

Author correspondence

II. Study coverage

Basic service

Water

Country

India

Cities

Mumbai

379

III. Context and intervention

Type of settlement/slum

Slum — informal

Nature of agencies

involved in planning and

service provision

Government and private

Form of user

participation

Passive

Project/intervention

funding agency

Government and private

IV. Research design

Aim of the study

To evaluate an informal water-distribution system in Kaula Bandar (KB),

a non-notified slum in Mumbai, using the following commonly accepted

social-equity indicators: cost of water, quantity of water consumed at

household level, and residents’ opinions of hardships associated with

water access.

Type of study

Mixed-methods

Research design

Observational

Methodology used for

data analysis

Simple percentage analysis

V. Data and sample

Data sources

Primary

Data period

2008 and 2011

380

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity, affordability and effort and time

 Outcome

Moderately positive, moderately negative

 Community access to water supply

 Communities cost of access water

 Access to water from outside their lanes

 Time spent to reach water connection from outside their lanes

Summary of results

 Most of the KB residents roll large storage drums at least 1km,

and as far as 2km, to access taps in the closest community, while

others get water from private tankers.

 A majority of households pay a monthly base fee to water

vendors of R150‒400 per month (US$2.73‒7.27) for water

during all study periods.

 KB residents spend 52 to 206 times more than residents of slums

with legal water access, depending on the season.

 The mean total cost of water spent by a household over an entire

year Is R6,479 (US$117.80).

 In the BNA, 952 households (99.3%) report having to regularly

purchase water. The majority, 529 (55.2%), are only able to

access water every three or more days. Most households, 817

(85.2%), have water delivered via water vendors’ hoses, while

125 (13.1%) must fetch water from outside of their lanes. Due to

queues at hoses or time involved in fetching water, 370 (38.5%)

spend more than 30 minutes per day on obtaining water.

Brief theory of change

Private water vendors have improved access to water services; however,

costs of these services have adversely affected the urban poor. The state

monopoly did not meet the demand of slum-dwellers in this non-notified

slum.

R 89 / A 25

I. Study Details

Authors

Subbaraman, R, Brien, O, Shitole, T, Shitole, S, Sawant, K, Bloom, D and Patil-

Deshmukh, A

Year

2012

381

Title

Off the map: The health and social implications of being a non-notified slum in

India

Journal

Environ Urban

Source

Electronic database

II. Study coverage

Basic service

Water, sanitation and electricity

Country

India

Cities

Mumbai

III. Context and intervention

Type of settlement/slum

Informal

Nature of agencies

involved in planning and

service provision

Water/electricity: government

sanitation: user involvement

Form of user

participation

Water/electricity:

Sanitation: participation through self-mobilisation and partnership

 Self-construction of toilets in homes

 Community and local leaders construct toilets for community

to use

Project/intervention

funding agency

Water: state government

Sanitation: self-financed (private/community)

Electricity: local government

382

IV. Research design

Aim of the study

This paper highlights the problem of inter-slum health disparities in

Mumbai, India, using the findings of a four-year series of studies of KB.

Type of study

Mixed-methods

Research design

Observational

Methodology used for

data analysis

Quantitative and qualitative

V. Data and sample

Data sources

Primary data

Secondary data

 Datasets on KB from the PUKARHSPH-NYU collaboration and

datasets from India’s NFHS-3. The Anthropometrics survey

collected health and social information (for example., literacy,

immunisation history), as well as anthropometric measurements

(height, weight, etc.).

Data period

March 2010 to January 2011

VI. Results and evidence

Evidence on outcomes

Water: connectivity: moderately negative

 Proportion of households with piped drinking water

Sanitation (self-mobilisation): connectivity: moderately negative

 Proportion of households using private toilet facility

Sanitation (partnership): connectivity: moderately positive

 Proportion of households accessing community toilets

Electricity: adequacy: inconclusive

 Reliable electricity supply

383

Summary of results

 The result shows a significant gap in access to basic services.

Access to piped water (through community or home water taps)

is almost universal in the NFHS slums, while virtually no KB

households have access to piped water.

 KB residents have a lower rate of access to a non-shared toilet

and a higher rate of open defecation among adults.

 A higher proportion of KB households use biomass fuels for

cooking, which is associated with an increased risk of lung

disease.

Brief theory of change

 KB’s non-notified status is a major contributing factor to its

relatively poor health and social indicators.

 Based on four years of community-based research, this paper

shows the health consequences of widespread failures of basic

entitlements that occur due to a legal vacuum.

 Social and legal exclusion become embodied in poor health

outcomes; indeed, this structural violence takes its toll on the

very lives and bodies of the urban poor.

R 90 / C 2

I. Study Details

Authors

Sohail, M and Cavill, S

Year

2009

Title

Public-private partnerships in the water and sanitation sector

Journal

Water Management

Source

Author correspondence

II. Study coverage

Basic service

Water and sanitation

Country

South Africa

Cities

Queenstown and the Dolphin Coast

384

III. Context and intervention

Type of settlement/slum

Low-income

Nature of agencies

involved in planning and

service provision

Government and private-sector

 Water and sanitation service in Africa (WSSA) meets all the

operational costs, the prescribed standards and performance

to provide/repair/replace the water and sewer network,

including new connections and civic structures.

 Siza Water Company (SWC) is responsible for the provision of

water and sanitation services to the Dolphin Coast since 1999.

The three levels of water and sanitation provided by SWC are:

Level 1 is a water dispenser; that is, community standpipe pre-

payment meter. Level 2 is a 200l tank and a septic tank for each

household. Level 3 is a full water connection with a flushable

toilet for each household.

Form of user

participation

Project/intervention

funding agency

Government and private-sector

 Queenstown municipality enters into a concession contract

with the WSSA, a joint venture with Group Five, for a period of

25 years.

 Borough of Dolphin Coast signed a 30-year contract with

Umgeni Water and SWC worth R4m. SWC buys water from

Umgeni and distributes it to retail consumers in the area.

IV. Research design

Aim of the study

The key objective of this research was to fill in some of the gaps that exist

in evidence-based reporting of the facts and issues around the impacts

of PPP on poor consumers. The case studies undertaken in South Africa

reveal factors that determine the effectiveness of PPPs, and thereby lead

to a better understanding of the conditions under which such

arrangements work best.

Type of study

Qualitative

Research design

Observational

385

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data

 Interviews were conducted.

 In-depth household questionnaires were conducted in

Queenstown.

 In the Dolphin Coast area, FGDs were conducted with

consumers.

Data period

Not clearly mentioned

VI. Results and evidence

Evidence on outcomes

Queenstown

Connectivity: moderately positive

 Almost all residents were connected to the water-supply service.

Interviews with households indicated that water quality is good.

Affordability: moderately negative

 Although bills are received regularly, non-payment is high, as

residents felt it was unaffordable. Households were not willing

to take on the responsibility for leaks on private property.

 Tariffs for waterborne sewerage are beyond the majority of

households’ ability and willingness to pay.

Dolphin Coast

Connectivity: moderately negative

 Some people who had household connections were reverting

back to using standpipes because they could not afford their

bills.

Affordability: moderately negative

 Some people who had household connections were reverting

back to using standpipes because they could not afford their

bills. Communities did not fully understand the implications of

full water and sewerage connections before occupying the

houses. Due to the block tariffs, even those residents who

386

consumed much less than the first block of 10,000l had to pay

the basic tariff of R24.20, which was a heavy burden for some

families. However, with the introduction of 6,000l of free water,

several households gained access. Despite this scheme, several

households could not pay their bills due to unemployment and

poverty.

Summary of results

 There was a visible acceleration of privatisation in service

delivery in South Africa. While PPPs can work well,

implementation of a concession poses a number of risks to all.

 There are clear advantages in spelling out these risks at an early

stage of such an arrangement, so that the various stakeholders

are aware of the pressures that exist and are, therefore, more

likely to approach negotiations more realistically.

Brief theory of change

 In Queenstown, ward councillors have become involved in credit

control and in arranging the reconnection of customers who

have been disconnected.

 On the Dolphin Coast it was reported that some people who

have household connections are reverting back to using

standpipes because they cannot afford their bills.

 The main danger to the poor under PPP water and sanitation

provision is that tariffs and/or connection charges become

unaffordable, meaning that this group does not gain access to

better water and sanitation services.

 Sanitation is a particularly difficult service to provide under a

PPP. Respondents in both case studies were dissatisfied with the

increased sewerage costs that resulted from the PPP.

 The Queenstown PPP case study indicated that, while the quality

of supply had improved significantly on a broad scale, the

improvements had accrued largely to the municipality (improved

maintenance and reduction in aged pipes) and had not been felt

by poor households, who are unhappy with tariff issues and the

way leaks on private property are dealt with.

R 91 / B 17

I. Study Details

Authors

Sohail, M

Year

2007

Title

Accountability arrangements to combat corruption in the delivery of infrastructure

service in Bangladesh

Journal

Institute for Developmental Policy Analysis and Advocacy (IDPAA) Report

Source

Website search

387

II. Study coverage

Basic service

Water, sanitation and electricity

Country

Bangladesh

Cities

Dhaka

III. Context and intervention

Type of settlement/slum

Slum —informal

Nature of agencies

involved in planning and

service provision

Government, CSOs and NGOs

Form of user

participation

Project/intervention

funding agency

Government, CBOs and NGOs

IV. Research design

Aim of the study

The purpose of the study is to improve governance through appropriate

accountability arrangements for combating corruption in the delivery of

infrastructure services such as water supply, sanitation, electricity and

drainage in Dhaka, leading to an improvement of the livelihoods of the

poor.

Type of study

Mixed-methods.

Research design

Observational

Methodology used for

data analysis

Simple percentage analysis

V. Data and sample

Data sources

Primary data

 Structured interview, semi-structured interview, FGD and

transact-walk interview

Data period

Not mentioned

388

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity

 Outcome

Moderately positive and moderately negative

 Access to water

 Access to sanitary latrine facilities

 Access to electricity service

 Access to drainage service

Summary of results

 Currently, the majority of people have access to water supply,

but very few of them are satisfied with the service. Only 12%

expressed their satisfaction with the quantity and quality of the

water supply.

 Almost all CSOs working with the community have a sanitation

programme. Only 26.7% respondents expressed their

satisfaction with the sanitary latrine facilities. So, the access of

poor people to sanitary latrines is relatively better in

communities.

 There are some unstructured water-passing facilities in the

community and only 12.4% have expressed their satisfaction

with these.

Brief theory of change

Service delivery with a top-down approach mechanism leads to

corruption in the provision of public utilities; therefore, slum-dwellers

lack access to basic services.

I. Study Details

Authors

Sohail, M and Surjadi, C

Year

2003

Title

Public Private Partnerships and the poor drinking water concessions: A study for

better understanding of public-private partnerships and water provision in low-

income settlements.

Journal

WEDC, Loughborough University, UK

Source

Cross-reference

389

II. Study coverage

Basic service

Water

Country

Indonesia

Cities

Jakarta

III. Context and intervention

Type of settlement/slum

Low-income

Nature of agencies

involved in planning and

service provision

Others

 Private companies: Thames and Lyonnaise supply water to

consumers directly through piped connections and water

vendors.

Form of user

participation

Project/intervention

funding agency

Others

 A consortium of international and domestic investors, including

Thames Water Company, Lyonnaise, PAM, the government

water company, and a private-government water company,

manage the potable water supply in terms of product and

service delivery to consumers.

IV. Research design

Aim of the study

 The purpose of this report is to determine workable processes

whereby the needs of the poor are promoted in strategies,

which encourage PPPs in the provision of water supply and

sanitation services.

 One of the key objectives is to fill in some of the gaps, which

exist in evidence-based reporting of the facts and issues around

the impacts of PPP on poor consumers.

 This series of reports present the interim findings and case

studies of an analysis of both the pre-contract and operational

phases of a number of PPP contracts.

 Central to this study will be a comparison of the experiences,

perceptions and priorities of different stakeholders.

 By comparing and contrasting these different experiences, the

study is expected to gain an understanding of how PPPs can

better serve the poor.

Type of study

Qualitative

Research design

Observational

390

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data

 In-depth interviews

Secondary data

 Collect policy documents and agreements between public and

private actors, and review PPPs and their operations in Jakarta.

Data period

Not clearly mentioned

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately positive

 Under both the categories of poor households and poor/simple

households, coverage by Palyja and Thames PJ had improved to

56.8% and 60.9%, respectively.

Affordability: no impact

 A majority (61%) of households thought that the price paid for

drinking water was the same as before privatisation.

Adequacy: moderately negative

 Several respondents also felt that the quality of water had not

improved after privatisation and the flow of water (that is, water

pressure) was also very poor.

Summary of results

 These data indicate that expectation of the improvement of flow

of the drinking water and quality of the water is still high, but has

yet to be fulfilled.

 On the issues of the cost of drinking water, half of the

respondents perceive the cost to be the same as before

privatisation. The percentage of the respondents who perceive

the cost of drinking water to be the same is 55%, whereas 44%

believe it to be higher.

 From the review, it seems as though the water company has

performed well in terms of the amount of water sold, but has

performed poorly in respect of consumer services and increasing

the number of customers.

 Another issue is the transfer of skills and technology from the

private company to the government, although it is not clear how

this will be achieved.

Brief theory of change

 The study indicated that there is concern regarding the fairness

of the agreement in representing the interests of the

government and the public.

391

 In relation to the welfare of the urban poor, the study found that

there is no specific statement in the PPP agreements.

 Study review indicates that the water company has performed

well in terms of the amount of water sold, but more is needed in

respect of consumer services and increasing the numbers of new

customers, especially the poor.

 This indicates that there is lack of improvements in control and

regulatory mechanisms and in collaboration among

stakeholders.

R 93 / E11

I. Study Details

Authors

Stanwix, B

Year

2009

Title

Urban slums in Gujarat and Rajasthan: Study of basic infrastructure in

seven cities

Journal

Mahila Milan SEWA Trust Research Report

Source

Google Scholar

II. Study coverage

Basic service

Water, sanitation and electricity

Country

India

Cities

Ahmedabad, Nadiad, Godhra, Ankleshwar, Jaipur, Bikaner, Jodhpur

III. Context and intervention

Type of settlement/slum

Slum — informal

Nature of agencies

involved in planning and

service provision

NGO

Form of user

participation

Passive

Project/intervention

funding agency

NGO

392

IV. Research design

Aim of the study

 To provide a basic picture of the conditions facing the average

household in these slums by presenting and examining data on

household characteristics.

 To investigate some underlying relationships in the data that

would help to tell the story of these households more

accurately.

Type of study

Quantitative method

Research design

Observational

Methodology used for

data analysis

Simple percentage and regression analysis

V. Data and sample

Data sources

Secondary data

Data period

Not mentioned

VI. Results and evidence

Evidence on outcomes

 Outcome

Connectivity

 Evidence

Moderately positive, moderately negative, strongly negative

 Proportion of households connected to in-house tap facility

 Proportion of households with access to public tap

 Proportion of households with access to public toilet facility

 Proportion of households with access to sewerage system

 Proportion of households with access to metered electricity

Summary of results

Ahmedabad slum

 The majority of households in these slums had an in-house tap

(66%), but there were still a large number of households who

had to fetch water.

 Fifty-eight percent of households spent more than 30 minutes

per trip to collect water, and 27% of the families had to travel

more than 1km to obtain water. In addition, for those who used

public taps installed by the municipality, water supply was

available on average for only 2.5 hours per day.

 The majority of the slum families had in-house toilets (74%), but

there was still a large number of families who had to defecate in

the open (14% or 1,827 households). Of those who did not have

their own toilet facility, 2,700 households stated that they

urgently required a toilet in their house, and, of these families,

393

80% showed willingness to pay to acquire a toilet. The average

payment offered was Rs338.

 It was found that 17% of households did not have any storm-

water drainage, and only 10% had no gutter for sewerage. Of

those that did have some kind of drainage, 20% reported

problems of water clogging. One-third of all households had to

pay for repairs on their houses in the rainy season because of

lack of a drainage system or due to dysfunction of drains.

 Ninety-two percent of the households in these areas had

electricity in their homes. Of these, a vast majority had an in-

house meter. On average, each household paid Rs235 per month

for electricity.

Nadiad slum

 Seventy-one percent of households had access to some kind of

water facility, while the rest stated that they had no regular

access to water.

 Out of the total slum population, only 43% families had adequate

toilet facilities. Of the families without access to proper toilet

facilities, 58% used open areas to defecate, and only a small

percentage made use of public toilets.

 It was found that 70% of houses had electricity meters, and their

average monthly bill was Rs306.

 Around 90% of houses had no storm-water drainage.

Godhra slum

 For households who relied on conventional water sources,

approximately 81% stated that they had running water for only

1‒2hrs per day, and half of the residents said that the water

pressure was inadequate to meet their needs during that time.

 About 44% of households had bathroom facilities in their house,

around 26% of the population used public bathrooms to wash

and bathe, and 30% used other facilities.

 Only 7% of the residents had drainage in their homes and the

rest had no drainage facility.

 Around 71% of the families had electricity, and all of them used

an in-house meter.

Ankleshwar slum

 65% of the families had individual water connections, and the

remaining 35% did not have access to private connection.

 On average, a household had spent Rs1,010 to install a water

connection in their house and the families that did not have

water connections were willing to pay Rs420 to get a connection.

It was predominantly the households with lower earnings that

did not have access to individual water connections: 41% of

those who did not have water connections were from the

poorest quintile.

394

 Around 24% did not have their own toilets. Those who had their

own toilet had paid an average of Rs3,526 for the facility, and

those who did not have were willing to pay, on average,

approximately Rs600 each (the maximum offer was Rs2,000).

 Eighty-nine percent of houses did not have adequate drainage

facility to deal with rain water. Around 80% complained that they

faced waterlogging when it rained.

 The survey showed that 64% of the houses had an electricity

meter and, on average, each family spent Rs1,227 per month on

electricity. Those who did not have a meter were willing to spend

Rs954 to get one.

Jaipur slum

 The residents used a variety of water sources; 26% households

availed themselves of the municipal water supply, 37% used the

public supply, 17% obtained water from neighbours, 8% fetched

water from the river, and 2% used a hand pump.

 Approximately 40% of households had their own toilets, and

almost half of the population in these slums used open areas for

their ablutions.

 Around 60% of households did not have either gutter or

sewerage tanks.

 Only 82% households had electricity. Around 55% of houses

reported that there were no street lights near their houses.

Bikaner slum

 Only 66% households had a piped-water supply and, on average,

water was available for 1.5 hours per day. Those who did not

have piped water used either public stand posts, hand pumps, or

water tankers.

 Many of the residents in this community did not have adequate

access to toilet facilities. Only 43% of residents had their own

toilets and the rest used open areas for their toilet needs. The

survey also showed that around 56% of households had indoor

bathrooms.

 Around 65% of households in these slums had electricity meters.

On average, households were paying Rs465/ month for

electricity, and more than half of the residents stated that their

usage of electricity was legal.

Jodhpur slum

 It was found that 42% of households had municipal water

connections, and, while 6% used public stand-post

 75% of respondents had toilet facilities; unfortunately. it was not

clear from the data what type of toilet facilities they had or what

the other 25% of households used.

395

 A large percentage (68%) of residents had no sewerage facility in

their homes, while 83% said that they had no storm-water

drainage for their homes.

 The survey revealed that around 68% of households had

electricity, and, on average, households paid Rs910 per month

for it.

Brief theory of change

The NGOs actively participated in the provision of basic infrastructure

service to the informal-slum-dwellers.

R 94 / B 8

I. Study Details

Authors

Takeuchi, A, Cropper, M and Bento, A

Year

2006

Title

The welfare effects of slum improvement programs: The case of Mumbai

Journal

World Bank policy research working paper

Source

Website search

II. Study coverage

Basic service

Water and sanitation

Country

India

Cities

Mumbai

III. Context and intervention

Type of settlement/slum

Slum ― informal

Nature of agencies

involved in planning and

service provision

Government

Form of user

participation

Self-mobilisation

Project/intervention

funding agency

Government

396

IV. Research design

Aim of the study

The goal of this paper is to evaluate the welfare effects of such

programmes (policies to improve the welfare of slum-dwellers include

upgrading slum housing in situ ― for example, by providing piped-water

and sewage connections-and relocating slum-dwellers to better quality,

low-cost housing.) using data for Mumbai ( formerly Bombay), India.

Type of study

Mixed-methods

Research design

Observational

Methodology used for

data analysis

Simple percentage analysis

V. Data and sample

Data sources

Primary data

Data period

2003 and 2004

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity

 Outcome

Moderately negative

 Proportion of households with access to in-house piped-water

supply

 Proportion of households with access to in-house piped-water

supply based on zone (proximity affects access)

 Proportion of households with private toilet facility

Summary of results

 Chawls, which house approximately 35% of sample households,

are usually low-rise apartments with community toilets that, on

average, have better amenities than slums. The remaining 25%

of households live in either cooperative housing, which includes

modern, high-rise apartments; in bungalows; or in employer-

provided housing.

 The quality of slum housing varies considerably by zone: whereas

61% of slum households in zone 2 have piped water, only 19% of

slum households in zone 4have piped water.

 Slum dwellings are, on average, smaller than either chawls or

cooperative housing, and less likely to have piped-water

connections inside the dwelling.

397

Brief theory of change

The Prime Minister’s Grant Project (PMGP) and Valmiki Ambedkar Awas

Yojana (VAMBAY): both projects provided loans to the poor for

improvement in the welfare of slum-dwellers, which includes upgrading

slum housing in situ by providing piped-water and sewage connections,

and relocating slum-dwellers to better quality, low-cost housing.

However, the above interventions have not brought much positive impact

on the provision of water supply, and there is a negative impact on

sanitation services.

R 95 / A1

I. Study Details

Authors

Tukahirwa, J, Mol A and Oosterveer, P

Year

2011

Title

Access of urban poor to NGO/CBO-supplied sanitation and solid waste

services in Uganda: The role of social proximity

Journal

Habitat International

Source

Electronic database

II. Study coverage

Basic service

Sanitation

Country

Uganda

Cities

Kampala

III. Context and intervention

Type of settlement/slum

Informal settlement

Nature of agencies

involved in planning and

service provision

NGOs and CBOs

Form of user

participation

Contribution

NGOs/CBOs contributed to sanitation service in the informal

settlements

398

Project/intervention

funding agency

NGOs and CBOs

IV. Research design

Aim of the study

To investigate whether social proximity influences access to sanitation

for provided the urban poor by NGOs and CBOs.

Type of study

Quantitative

Research design

Observational method

Methodology used for

data analysis

Statistical method

 Simple descriptive analysis

 Non-parametric techniques

 Logit model

V. Data and sample

Data sources

Primary data

 Kampala survey was conducted from May 2008 to July 2009,

purposively selecting 12 poor neighbourhood slums (in

Kawempe, Makindye and Central). In each neighbourhood slum,

35 households were selected for random sampling method and

377 questionnaires were collected.

 Questionnaire-survey method.

 Interview method.

Data period

May 2008 to July 2009

VI. Results and evidence

Evidence on outcomes

Affordability: moderately negative

Effort and time (NGO): strongly positive

Effort and time (CBO): moderately positive

Summary of results

 65% of the households accessed sanitation services. Of those

that accessed sanitation, about 28% received it from NGOs and

only 6% from CBOs.

 A large number of households (54%) indicated that NGOs/CBOs

were not offering effective service provision to the poor. Study

results indicate that 40% of households felt that high levels of

recognition for organisations enhanced access to sanitation

services provided by NGOs and CBOs.

399

 A large number of poor households did not access the NGO/CBO

sanitation service due to the income and service costs.

 NGOs and CBOs play a major role in the provision of sanitation

to urban slum-dwellers in Kampala. Slum-dwellers benefited

from the CBO/NGOs sanitation service, in the form of

connectivity and affordability.

Brief theory of change

 This study investigated the urban poor’s access to sanitation and

solid-waste services provided by NGOs/CBOs, and estimated the

determinants of access to these services.

 The results reveal that, indeed, some of the poor households in

Uganda’s capital, Kampala, have access to sanitation and solid-

waste services as a result of active intervention from NGOs and

CBOs.

 Although the contribution from NGOs and CBOs to servicing the

poor may not be as great as that from government authorities,

it is comparable to that from the private sector.

 Without the involvement of NGOs and CBOs, more urban poor

would suffer from inadequate sanitation and solid-waste

services and the related health impacts.

R 96 / B 6

I. Study Details

Authors

USAID

Year

2004

Title

Innovative approaches to slum electrification

Journal

USAID

Source

Website search

II. Study coverage

Basic service

Electricity

Country

Philippines, South Africa, Brazil

Cities

Manila, Cape Town, Rio de Janeiro, Salvador, Bahia

III. Context and intervention

Type of settlement/slum

Informal

400

Nature of agencies

involved in planning and

service provision

Others

Philippines

 Manila Electric Company (MERALCO) supplies the electricity to

the urban slums and leaves the distribution and policing of

electricity lines to community members.

South Africa

 PN Energy, a community-based distribution, was created to

electrify the Khayelitsha slum.

Brazil

 RIO LIGHT's Program for Normalization of Informal Areas

(PRONAI)

 COELBA ― a private company.

Form of user

participation

Project/intervention

funding agency

ODA and private sector

Philippines: ODA

 Japan Bank for International Construction (JBIC) provides

assistance to the Philippines Government (PCUP), the National

Electrification Agency (NEA) and MERALCO to implement a

Depressed Areas Electrification Programme (DAEP) to expand

electricity connections to low-income urban settlements

throughout Manila.

South Africa: private sector

 ESKOM, Électricité de France (EDF) and East Midlands

Electricity of the UK jointly created PN Energy, a community-

based distribution company to electrify the Khayelistsha slum.

Brazil: ODA and private sector

 Self-financing commercial loan guaranteed by MIGA and IDB.

 COELBA ― a private company.

IV. Research design

Aim of the study

 A few electricity companies have forged new approaches, in

partnership with national and local governments, donors, NGOs,

and the communities themselves, to show that there are

effective ways to achieve legal and safe electrification with

generally low costs and improved service.

 As a first step toward finding effective solutions to the problems

of providing electricity to the urban poor, USAID launched a

study in May 2003 of innovative approaches to slum

electrification.

401

 In this report, out of 12 potential cases, five programmes were

selected that represented creative and distinct approaches to

promoting legal access and addressing theft of electricity in

urban slums.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data

 Site visits were conducted to each community

 Formal meetings were held with the governmental agencies and

private entities, as well as a number of NGOs and other

programme.

Secondary data

 Annual report, E-paper etc.

Data period

2003

VI. Results and evidence

Evidence on outcomes

Philippines: connectivity: moderately positive

 More than 300,000 households were connected to electricity for

the first time.

South Africa: connectivity: moderately positive

 Between 1994 and 2003, PN Energy added 60,000 new

connections.

Brazil: connectivity: moderately positive

 Over 250,000 households were provided access to electricity for

the first time.

 181,000 customers were newly added to COELBA's customer

base, 150,000 legal customers with inadequate connections

were upgraded, and 100,000 illegal connections were

regularised.

Summary of results

Manila, Philippines

 Households: Became eligible for individual lifeline tariff that was

substantially below illegal-service-provider charges; connection

fee subsidised and house-wiring loans offered.

402

 Community: Formed neighbourhood organisations to manage

payment for extension of distribution line and meter wall; took

responsibility for system within the slums.

Cape Town, South Africa

 Households: Families have the means to keep within-budget

through pre-payment meters; no-interest financing for

subsidised connection fee; low-tech, low-cost standardised

internal wiring (ready board) and prepayment package.

 Community: Better electric service, leading to noticeable

upgrading of homes and economic improvements. Project

officers put a value on electrification of improving people’s lives

by 15‒20%.

Rio de Janeiro, Salvador, Bahia, Brazil

 Households: Lower connection fee, amnesty for prior debts from

non-payment, education of energy efficient use, replacement of

inefficient and unsafe internal wiring, and free energy saving

lights.

 Community: Better service, safer, better appearance, economic

improvements; community events.

Brief theory of change

Manila, Philippines:

 Electricity company: Achieved cost and theft reduction by

placing meters in highly visible locations at perimeter of slum;

informal distribution system managed and policed by the

residents.

 Government: Set goal to upgrade and regularise slums; resolved

land-tenure issues; urban-poor commission assisted in selecting

and preparing communities for DAEP.

Cape Town, South Africa:

 Electric company: Theft and supply cost-reduction via hard-to-

reach service drop and pre-payment meters.

 Government: The programme helped it to achieve an ambitious

goal to electrify all poor households; provides part of subsidy for

connection.

Rio de Janeiro, Salvador, Bahia, Brazil

 Electric company: Theft and supply cost-reduction through

theft-proof meter boxes.

 Government: Programme is a concrete means by which to

achieve electrification and poverty-alleviation goals.

403

R 97 / B 7

I. Study Details

Authors

UN-HABITAT

Year

2006

Title

UN-HABITAT report on poverty mapping: A situation analysis of poverty

zones in Jabalpur

Journal

Water Aid India Report

Source

Website search

II. Study coverage

Basic service

Water and Sanitation

Country

India

Cities

Jabalpur

III. Context and intervention

Type of settlement/slum

Slum ― informal

Nature of agencies

involved in planning and

service provision

NGO

Form of user

participation

Project/intervention

funding agency

ODA Fund

UN-HABITAT and NGOs

IV. Research design

Aim of the study

 In consultation with the Jabalpur Municipal Corporation (JMC)

select Poverty Pockets (PPs), covering 5,000 households that

were poorly placed on the MDG 7 target 10 (that is, double, by

2015, the percentage of households with access to improved

water source and percentage of households with access to

improved sanitation).

404

 To collate the data on all PPs on availability of environmental

deficiency parameters for kick starting the MAPP process by the

Municipal Corporation.

Type of study

Mixed-methods

Research design

Observations

Methodology used for

data analysis

Simple percentage analysis

V. Data and sample

Data sources

Primary

Data period

April 2006

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity, adequacy and affordability

 Outcome

Moderately positive and moderately negative

 Proportion of households with water supply from stand posts

 Proportion of households with piped-water connection

 Proportion of households accessing water for up to two hours

per day

 Proportion of households accessing public toilets

 Proportion of households pay for accessing public toilets

 Proportion of households connected to drainage facility

 Proportion of households with individual toilet facility

Summary of results

 The availability of public stand posts in Jabalpur is relatively high,

with only 25 of the 324 PPs reporting no availability of stand

posts. This seems to be indicative of the water supply’s being at

a relatively acceptable level in the surveyed PPs, especially if

these data are combined with findings of the drinking-water

supply scenario.

 In the surveyed PPs, a large proportion of households depend on

public stand posts, boreholes, wells, springs, etc., for drinking

water (62%), which have been designated as a safe source of

drinking water. Overall, an overwhelming 66% of the households

do not have access to a piped-water supply. But, of the 37,668

households that do have access to piped water, more than 64%

are in areas where water supply is only available for up to two

hours a day and at extremely low pressure, representing again

the limited usability of available infrastructure.

 In the surveyed PPs an overwhelmingly large proportion of

households depend on public stand posts, boreholes, wells,

springs etc, for drinking water (61%) which have been designated

405

as a safe source of drinking water. Only 34% of the households

have access to piped water. Only 3% rely on relatively unsafe

sources of water, such as tankers and vendors, or unprotected

wells and springs.

 The average amount of water availability per household is 15‒20

buckets per day, which varies in summer, because of the reduced

water supply from existing water sources.

 The supply of water from sources of water, such as tube wells

and municipal taps, is comparatively good, and supplies water

for 2‒3 hours at each time (twice in a day), but, in the summer,

this becomes a problem, where water is available for around 1.5

hours only once a day, despite increased consumption during the

season.

 The average time spent on fetching water is not uniform; it varies

from slum to slum. People spend on average 30 minutes to 2

hours a day on fetching water, sources as close as 100m to some

as far as 2km.

Brief theory of change

The UN-HABITAT and NGO interventions in JMC have had a positive

impact on access to water-supply services, however; other service

measures, such as affordability, and effort and time, require considerable

improvements.

R 98 / E 6

I. Study Details

Authors

Wagah, G, Onyango, M and Kibwage, K

Year

2010

Title

Accessibility of water services in Kisumu municipality, Kenya

Journal

Journal of Geography and Regional Planning

Source

Google Scholar

II. Study coverage

Basic service

Water

Country

Kenya

Cities

Kisumu

406

III. Context and intervention

Type of settlement/slum

Slum ― formal informal

Nature of agencies

involved in planning and

service provision

Government

Form of user

participation

Passive

Project/intervention

funding agency

Government

IV. Research design

Aim of the study

 This paper aims to demonstrate that the stated policy of

increasing the proportion of people with access to safe water

through privatisation of water services is likely to be

unattainable with the current small and ageing distribution

network.

 The paper assesses the accessibility to water services, by income

category, of the residential estates.

 The study examines households’ accessibility in four residential

estates in Kisumu: Milimani (high-income), Migosi (middle-

income); Arina (low-income, planned); and Nyalenda (low-

income, unplanned).

Type of study

Mixed-methods

Research design

Observation

Methodology used for

data analysis

Simple percentage analysis

V. Data and sample

Data sources

 Primary and secondary data

 Primary data

Household survey (stratified random sampling)

 Secondary data

libraries, Internet, KIWASCO, Lake Victoria South Water Service

Board, Water Resources Management Authority, Municipal

Council of Kisumu and NEMA, among others.

Data period

Not mentioned

407

VI. Results and evidence

Evidence on outcomes

 Outcome

Connectivity, adequacy, effort and time

 Evidence

Moderately positive and moderately negative

 Average per capita water use by households

 Average hours of water service per day

 Average distance of access to water service

 Households access to piped or community tap

Summary of results

 The study, therefore, found that 77.1% of the households access

water within a distance of 200m or less. The study further found

that the unplanned low-income Nyalenda estate enjoys shorter

distances to the nearest water source than the low-income,

planned, Arina and middle-income Migosi estates. This is

because of the existence of many water kiosks on the unplanned

low-income Nyalenda estate.

 The kiosks have been established at closer intervals, reducing

the distance travelled by households to the nearest water

points. Only 17.3% of the households in Nyalenda travel a

distance of over 200m to reach the nearest water point,

compared to Migosi and Arina Estate,38.6 and 32.4%,

respectively, travel the same distance.

 Private in-house piped connections are of primary important, yet

only 19.8% of the sampled households use them as their primary

source. An additional 18.6% of the households use yard taps as

their primary source. In other words, 38.4% of the households in

the four estates have access to a piped-water supply, either in

their houses or in their yard. The study found out that 35.7% of

the sampled households use the vendors as their primary

source, while 21% rely on the kiosks. Therefore, 56.7% of the

households in the four estates surveyed depend on either

vendors or kiosks. Kiosk operators sell their water to both the

vendors and household customers, who, therefore, have to

transport the water over varying distances.

Brief theory of change

Government has provided the piped water connections, while the private

vendor has fixed the water points nearby to the unplanned settlement

areas.

408

R 99 / B 21

I. Study Details

Authors

WaterAid India

Year

2008

Title

Tiruchirappalli shows the way: Community-Municipal Corporation-NGO

Partnership for City-wide Pro-poor Slums Infrastructure Improvement

Journal

WaterAid Report

Source

Website search

II. Study coverage

Basic service

Water and sanitation

Country

India

Cities

Tiruchirappalli

III. Context and intervention

Type of settlement/slum

Slum ― informal

Nature of agencies

involved in planning and

service provision

Government and NGOs

Form of user

participation

Passive

Project/intervention

funding agency

ODA (WaterAid)

IV. Research design

Aim of the study

 This study, undertaken by Gramalaya and WaterAid, with the

support of Tiruchirappalli City Corporation in July 2006, sought

to understand the benefits of community manageg toilets and

the challenges facing this model after six years of

experimentation.

409

 This study is an attempt to take stock of the achievement in

Trichy over the last six years and draw out lessons for building

on this success.

Type of study

Mixed-methods

Research design

Observation

Methodology used for

data analysis

Simple percentage analysis

V. Data and sample

Data sources

Primary

 Structured questionnaire survey, interviews and group

discussions

Data period

July 2006

VI. Results and evidence

Evidence on outcomes

 Evidence

Connectivity, affordability

 Outcome

Moderately positive and moderately negative

 Proportion of households with access to community toilets

 Proportion of households access to piped or community water

tap

 Proportion of households who can afford t to pay for and receive

a water connection

 Proportion of households who can afford to pay for and receive

a sanitation facility

Summary of results

 Seventy eight percent of the total population and 92% of the 211

approved slums are reported to have access to TCC water supply,

either through household connections or stand-posts. There are

around 70,500 household connections, of which 6,050 (9%) are

metered.

 Sanitation coverage is reported at 70% in the city. In slum

communities where there are no sanitation facilities, people

defecate in open areas and along the banks of the Cauvery.

There are 359 toilet units, with 3,146 seats, including 1,653 seats

for women. Twenty of these are pay-and-use public toilets

managed by TCC, located in commercial areas, and used by

passers-by and people working nearby. The remaining toilet

units have been constructed mainly for use by communities,

mostly by TCC, and a few by Gramalaya. In recent years, TCC has

constructed these toilets under the Tamil Nadu Urban

Development Programme (TNUDP).

410

 In Tiruchirappalli, there are 20 pay-and-use toilets, located

primarily in commercial areas, are spread across the four zones.

Out of these, 12 are leased to the private sector and the rest are

managed by TCC.

 The water-connection charge in Trichy is Rs3,000 and the

sewage-connection charge Rs6,000. Households wanting a

water connection must also pay for a sewage connection. These

charges apply in all city corporations in the state. The water tariff

for domestic use is R8 per 1,000l and Rs 25 for commercial use.

However, many meters do not function and TCC levies a flat rate

of Rs85 per household per month for domestic water supply and

Rs30 for sewage. The poor find these connection fees and tariffs

unaffordable and rely upon shared stand-posts, household

toilets with septic tanks, community toilets or open defecation.

 The slum has 107 households, six of which had individual latrines

in 2005; this figure had increased to 18 in 2007.

 It has an Integrated sanitary programmewith 10 seats (five each

for men and women), two bathing units and three child-friendly

toilet (CFT) seats constructed in 2005.

Brief theory of change

The involvement of Gramalaya and WAVE (NGOs), and WaterAid have

resulted in a positive impact on the provision of community sanitation

and water connection in Tiruchirapalli.

R 100 / D 3

I. Study Details

Authors

Weitz, A and Franceys, R

Year

2002

Title

Beyond boundaries: Extending services to the urban poor

Journal

Asian Development Bank

Source

Cross-reference

II. Study coverage

Basic service

Water and sanitation

Country

Bangladesh: Informal settlement

Nepal, Pakistan, India, Vietnam, Philippines: low-income

Cities

Kathmandu, Dhaka, Karachi, Hyderabad and Vijayawada, Phan Rang-Thap Cham,

Olongapo

411

III. Context and intervention

Type of settlement/slum

Nepal, Bangladesh, Pakistan, India, Vietnam, Philippines

Nature of agencies

involved in planning and

service provision

Kathmandu, Nepal: government

 Nepal Water Supply Corporation

Dhaka, Bangladesh: government

 Dhaka Water Supply and Sewerage Authority (DWASA)

Karachi, Pakistan: user involvement

 Communities lay their own sewerage lines to connect their

toilets to the street laterals, and then onto the sewer pipes and

storm-water drains.

Hyderabad and Vijayawada, India: NGO

 Sulabh International

Phan Rang-Thap Cham, Vietnam: Others

 Dong My Hai Water Supply Enterprise invested US$230,000 of

its own resources raised from high-interest loans from the state

and private sources to establish a private-water-supply project.

Olongapo, Philippines: Others

 Subic Water and Sewerage Company Inc.

Form of user

participation

Karachi, Pakistan: participation through contribution

 Community members often construct their own lines and

provide for the internal infrastructure costs.

Phan Rang-Thap Cham, Vietnam: participation through contribution

 The company collected advance payment from households that

would use the water-supply system and after three months of

operation, return the advance to the households. Water meters

were to be fitted at the expense of the households, but, due to

the presence of poor-quality meters, the company decided to

install their own.

Project /intervention

funding agency

Kathmandu, Nepal: private sector

 Lumanti, an NGO that offers a credit programme for the poor,

helps to negotiate with municipal wards to secure metered

community taps.

Dhaka, Bangladesh: private sector

 Dusthya Shasthya Kendra (DSK) is an NGO that works primarily

in the field of public health, but has assisted the communalities

to secure water connections from DWASA by negotiation with

the city corporation for road cutting, bearing capital costs and

paying bills regularly.

412

Karachi, Pakistan: ODA

 Bank of Credit and Commerce International ― UNDP-funded

project to connect 500 households to a large, communal

septic tank.

Hyderabad and Vijayawada, India: local government

 Municipal government provides land, utilities and capital

finance to Sulabh International, to construct pay-and-use

community toilets in slums.

Phan Rang-Thap Cham, Vietnam: private-sector

 Dong My Hai Water Supply Enterprise invested US$230,000 of

its own resources, raised from high-interest loans from the

state and private sources, to establish a private-water-supply

project.

Olongapo, Philippines: others

 Subicwater is a joint venture of Biwater International (UK), local

construction firm, D.M. Consunji, Subic Metropolitan Area

(SBMA) and Olongapo City Water District (OCWD).

IV. Research design

Aim of the study

The case studies represent three service sectors — water supply,

sanitation, and solid-waste management — and show how the urban

poor are being served and what roles the various stakeholders play.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data

Secondary data

Data period

Jan 2001‒June 2002

VI. Results and evidence

Evidence on outcomes

Kathmandu, Nepal

413

 Connectivity: moderately positive

Dhaka, Bangladesh

 Connectivity: moderately positive

 Affordability: moderately negative

 Effort and time: moderately positive

 Durability: moderately positive

Karachi, Pakistan

 Connectivity: moderately negative

Hyderabad and Vijayawada, India

 Connectivity: moderately positive

 Affordability: moderately positive

 Durability: moderately positive

Phan Rang-Thap Cham, Vietnam

 Connectivity: moderately positive

 Affordability: moderately negative

Olongapo, Philippines

 Connectivity: moderately positive

 Affordability: moderately negative

Summary of results

Kathmandu, Nepal

 13 community connections, benefiting 168 households in five

communities were provided by Nepal Water Supply Corporation.

 After the launch of the community-sanitation programme, 59

toilets were constructed within a month in the community.

Dhaka, Bangladesh

 93 water points had been installed, providing water to an

estimated 8,000 squatter households.

 The rates are fixed by the community, with guidelines agreed

upon by DSK to cover water bills, instalment of capital costs, and

caretakers’ salaries.

 Before installation of water points, residents had to wait until

1am to collect water. However, after the installation, the wait

has been reduced and water is easily accessible.

 DSK has involved the community by forming them into a

Community Water Management Committee, which collectively

manages the infrastructure, including payments, etc. DSK

monitors the activities of the committee, but hands over the

bank accounts to the committee after one year, during which

time, the capital costs are recovered by the NGO.

Karachi, Pakistan

 Over 500 households were connected to the communal septic

tank, but, after a few years, the tank ceased to function due to

lack of regular dislodging. Some neighbourhoods have

disconnected their lines and have resumed discharge into the

natural storm-water drains. Government is also implementing a

414

Greater Karachi Sewerage Plan, which superimposes a new

system over the existing one and does not take into account the

numerous community-built sewerage systems.

Hyderabad and Vijayawada, India

 Sulabh has constructed and maintained 58 community-toilet

complexes in Hyderabad and 50 free-of-charge complexes in 29

slums. Over 75% of users expressed satisfaction with access to

toilets with water and soap.

 Poor people are allowed to use the services free of charge.

 Sulabh International has adopted innovative construction-

management practices and materials, which have reduced long-

term maintenance costs. Sulabh appoints caretakers to maintain

the toilets and staff members regularly visit the complexes to

check for cleanliness and collection of user charges.

Phan Rang-Thap Cham, Vietnam

 The company was supplying water to around 6,000 families and,

in the seven years of operations, customer groups expressed

satisfaction with the quantity and quality of water supplied.

 Cost of water was high compared to household-income levels.

Olongapo, Philippines

 Disadvantaged groups, such as river squatters, now have reliable

and good-quality water due to installation of piped connections.

Tariffs increased from 12 to 20 US cents per cu.

Brief theory of change

 The environmental health sector is in need of reform. The public-

health needs in urban areas are being served by a mixture of

public agencies, resourced to provide only the bare minimum

water supply, sanitation, and solid-waste services; and by small-

scale private enterprises.

 High-income households rely upon a mixture of self-provision

through ‘coping strategies’ and public supply. Low-income

households cope by queuing for a long time for inadequate

water, overpaying small private enterprises, and disposing of

waste unhygienically.

 Efficient NGOs working with communities make a difference, but

usually only for a limited time and in a restricted area. Public-

health provision is a government responsibility because of the

scale of the task and because of the benefits to the whole of

society. However, in many countries, the public sector has

largely failed to deliver, and it has not proved possible to reform

government agencies sufficiently to provide public health

services directly.

R 101 / A 53

I. Study Details

Authors

Winayanti, L and Lang, H

415

Year

2004

Title

Provision of urban services in an informal settlement: A case study of Kampung

Penas Tanggul, Jakarta

Journal

Habitat International

Source

Electronic database

II. Study coverage

Basic service

Water and sanitation

Country

Indonesia

Cities

Jakarta

III. Context and intervention

Type of settlement/slum

Informal settlements

Nature of agencies

involved in planning and

service provision

Government

 Government provided electricity connections to those houses

that were legal.

NGO

 World Vision International (WVI), with funds from USAID,

provided the community with communal toilets with a septic

tank.

 SJ provides the community with resources to undertake

infrastructure improvements. ISJ was also instrumental in

securing the tenure of this community by organising a protest

against proposed eviction. It is after the security of tenure that

all infrastructures were created in the community with the help

of NGOs.

Form of user

participation

Participation through contribution

Project/intervention

funding agency

ODA

 USAID funds provision of basic services to the selected slum

through World Vision International, an NGO working in the

community.

Private

416

 Institute Social Jakarta (ISJ), an NGO working in the community

provided some funds to upgrade pathways, build communal

bathing and toilet facilities, and water pumps.

 After the slum was granted legal status, community members

undertook housing improvements using their own resources,

as they were sure they would not be evicted.

IV. Research design

Aim of the study

 The objective of this paper is to understand how poor

communities gain access to urban services in informal

settlements, and how NGOs and governments engage in this

process.

 It investigates the tensions between NGOs and governments on

informal settlements and what the implications are for

improvement in the quality of the housing and its environment.

Type of study

Qualitative

Research design

Observational

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data

 The research is based on field observations, in-depth interviews

with 21 households in the kampong, and interviews with the

head of the NGO, who had assisted the community since 1986.

Data period

April‒July 2011

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately positive

 New community toilet blocks with septic tanks were added 10

meters away from the river bank.

 Five communal bath, washing facilities and toilets (MCK) with

hand pumps were constructed for the first time in the

community.

 Ten households had installed their own electricity meters after

the slum was granted legal status.

Affordability: no impact

 The toilets were managed collectively without routine expenses

or user charges for maintenance or cleaning. Residents took

turns to clean, repair or replace worn-out parts.

417

Summary of results

 Provision in urban services in informal settlements has been

mostly conducted through self-help mode. The case study in

Kampung Penas Tanggul shows that mobilising the community’s

resources outside the market and the government domain, with

the assistance of the NGO, was successful.

Brief theory of change

 The perception of security of tenure and community

participation in the provision of urban services is crucial if

kampong residents are to have better lives, and also if their

settlements are to be of a better quality, environmentally and

health-wise.

 The perception of secure tenure in this case study shows that it

did not depend on legal title, but on the recognition of the

settlement as a formal Rukun Tetangga or neighbourhood

association, which, in turn, allowed the residents to become

legal citizens that could fully participate in the city.

 The participation of the residents in the provision of urban

services also built up the cohesiveness of the community, which

became an important asset of community organisation. This is

an important step for people that have always been considered

as illegal residents in Jakarta.

 The relationship between the NGO and the local community had

also become a learning process for the community in organising

themselves, mobilising their resources, and understanding their

rights and obligations in the neighbourhood.

 The problem is complicated by the lack of coordination between

central and local government, among the various local-

government agencies, and a lack of understanding of the roles of

government institutions in policy implementation on land,

housing, and other urban services in informal settlements.

 The intervention of the central government in the allocation of

land and recognition of informal kampong settlements, as formal

RT shows that land for housing the urban poor is still a political

issue.

R 102 / E 14

I. Study Details

Authors

Xabendlini, M

Year

2010

Title

An examination of policy implementation of water and sanitation services

in the city of Cape Town: A case study of the informal settlements in the

Khayelitsha area

Journal

University of Western Cape

Source

Google Scholar

418

II. Study coverage

Basic service

Sanitation

Country

South Africa

Cities

Cape town

III. Context and intervention

Type of settlement/slum

Informal settlement

Nature of agencies

involved in planning and

service provision

Government

 The Integrated Development Plan (IDP) is the mechanism for

attaining integration between players at local level, as well as

between municipalities and their provincial and national

counterparts. The local municipality has the responsibility for

implementing the IDP and providing the services.

Form of user

participation

Project/intervention

funding agency

National government

 The IDP recognised the inadequacy of the sanitation services

for the informal slums and aimed to increase universal access

to basic services, such as water and sanitation, by replacing old

and damaged infrastructure, as well as maintaining existing

passable infrastructure.

IV. Research design

Aim of the study

 The primary objective of this research is to identify the problems

and challenges confronting the implementation of policies

relating to water and sanitation at local-government level.

 To review specific legislation and policies in the water and

sanitation sector that apply to informal settlements.

 To provide an overview of the role played by national, provincial

and local government and other stakeholders in policy

implementation and evaluation in this sector.

 To assess the current status of implementation on the bucket-

eradication project in the Khayelitsha area.

 To make recommendations to policymakers for improving

service delivery, particularly in the informal Khayelitsha

settlement.

Type of study

Qualitative

Research design

Observational

419

Methodology used for

data analysis

Narrative analysis

V. Data and sample

Data sources

Primary data

Secondary data

 Numerical statistics, such as the number of different sanitation

facilities available in the targeted informal settlements, including

containerised toilets, flushable toilets and pit toilets. In addition,

questionnaires will be utilised to collect data from the informal-

settlements-dwellers. However, the documentary and content

analyses will be used to collect data from policy documents, legal

instruments and documented material.

Data period

Not clearly mentioned

VI. Results and evidence

Evidence on outcomes

Connectivity: moderately negative

 Even though the bucket system of toilets has been replaced by

the container type of toilets in all informal slums, the sanitation

facility does not function properly, due to lack of water. Users

are unable to wash their hands due to lack of water, posing

health risks.

Adequacy: moderately negative

 Maintaining the condition of these toilets is a challenge in itself.

One toilet is often shared by five households. Facilities are often

leaking or blocked every week.

Durability: moderately negative

 Communal toilets are dysfunctional, since no-one takes the

responsibility of maintenance.

Summary of results

 The majority of the communities in the informal settlements of

Khayelitsha have access to clean water and sanitation. However,

the challenge is the management and maintenance of the

facilities in place.

 The major informal settlements of Khayelitsha, such as Site B,

Site C and Nkanini are utilising containerised toilets and a few

flushable toilets.

 The containerised sanitation system is a container type of toilets,

which is similar to the bucket system. The difference between

the containerised and bucket system is the size of the bucket and

the facilities itself.

 The challenge is that the communal taps in the informal

settlements are located far from the sanitation facilities.

420

 The lack of provision of basic services, such as water and

sanitation, has a negative impact on the livelihood of the

communities. This relate to the health of the community and the

protection of the environment from contamination, particularly

in the informal settlements. This also links to the management

and collection of solid waste in the informal settlements. In fact,

environment, health, and socio-economic conditions are directly

linked to the provision of water and sanitation.

Brief theory of change

 The three identified issues include infrastructure development,

solid waste and access to water and sanitation for the informal

settlements dwellers.

 This study also analyses the causes of the challenges confronting

government on the implementation of water and services

policies.

 It has alluded to the South Africa’s political history, the effects of

political differences, and lack of communication and

consultation with communities.

 One of the critical aspects highlighted in this chapter is the role

of projects and programmes in the implementation of public

policies.

 The provision of basic services, such as water and sanitation,

cannot be completely separated from the economic and

environmental issues.

 This includes the protection of the environment, in the process

of implementing projects and programmes meant to bring

services to the people.

 It is also important to mention that the contaminated

environment has a negative impact on the lives of the

community. In essence, the provision of water and sanitation is

linked to the socio-economic conditions, environment and

health.

R 103 / A 2

I. Study Details

Authors

Zaki, S and Nurul, A

Year

2009

Title

Does the basic service privatization benefit the urban poor? Some evidence from

water supply privatization in Thailand

Journal

Urban studies

Source

Electronic database

II. Study coverage

Basic service

Water

421

Country

Thailand

Cities

Pathumthani

III. Context and intervention

Type of settlement/slum

Slums or formal and informal settlements (urban poor)

Nature of agencies

involved in planning and

service provision

Private-sector

Form of user

participation

Contribution

Privatisation to contribute water-service delivery to the urban slums or

informal settlements

Project/intervention

funding agency

Private-sector

IV. Research design

Aim of the study

To evaluate the effect of water-supply privatisation on the urban poor

Type of study

Quantitative method

Research design

Quasi-experimental

Methodology used for

data analysis

Statistical methods

 Descriptive analysis

 Chi-squared test

V. Data and sample

Data sources

A total of 212 household samples were surveyed in slum or informal

settlements in the Pathumthani province of Thailand, and were used for

the systematic sampling method adopted for survey.

 Questionnaire survey

Data period

1998‒2003 pre- and post-privatisation

422

VI. Results and evidence

Evidence on outcomes

Connectivity: strongly positive

Affordability: strongly positive

Sustainability: moderately positive

Summary of results

 After the privatisation, access to the poor living in small informal

settlements has improved. The effect of privatisation increased

the poor communities’ access to the water supply: the access

level of 11.8% in 1998 had increased to 85.3%, a positive change

of 73.5%, by 2003.

 Privatisation has effected moderate changes in affordability in

terms of connection cost to the poor residents in informal

communities. The connection cost pre-privatisation was 95.5%

in 1998, which was reduced to 74% in 2003 post-privatisation.

 This study found that reliability of service and response to

complaints and hours of water supply did not change between

the pre- and post-privatisation periods.

Brief theory of change

 This study contributes to the on-going discourse of improving

access of the urban poor to sanitation and solid-waste services.

 An important insight is the influence of social proximity on

access, in addition to conventional spatial proximity, socio-

economic and perception factors.

 Social proximity was shown to be one of the major factors

dictating level of access of the poor to NGO- and CBO-provided

sanitation and solid-waste services.

 Cooperation between households and these organisations is

important in providing solid-waste services, and trust is an

essential factor dictating access to sanitation.

 One way to ensure access of the urban poor to both sanitation

and solid-waste services provided by NGO/CBO service providers

is to ensure the functioning of social networks and to build trust

for those organisations and their services.

 It is also in that area that non-accessing households have to be

convinced through offering reliable, timely and high-quality

services.

R 104/ A 24

I. Study Details

Authors

Zanuzdana, A, Khan, M and Kraemer, A

Year

2013

Title

Housing satisfaction related to health and importance of services in

urban slums: Evidence from Dhaka, Bangladesh

423

Journal

Social Indicators Research

Source

Electronic database

II. Study coverage

Basic service

Water

Country

Bangladesh

Cities

Dhaka

III. Context and intervention

Type of settlement/slum

Slum ― informal

Nature of agencies

involved in planning and

service provision

Government

 Provision of in-house piped-water connection

 Provision of piped-water connection outside home

Form of user

participation

Project/intervention

funding agency

State government

IV. Research design

Aim of the study

The aim of our study is to identify the multiple sources of the satisfaction

with housing in urban-slum populations and rural areas in Dhaka,

Bangladesh.

Type of study

Quantitative

Research design

Observational

Methodology used for

data analysis

Quantitative

 Ordinal regression, logistic regression

V. Data and sample

Data sources

Primary data

424

 The data used in this study were generated through baseline

surveys

Data period

March‒April 2008; March‒April 2009

VI. Results and evidence

Evidence on outcomes

Connectivity (Inside home): moderately negative

 Proportion of households with piped-water connection inside

home

Connectivity (outside home): moderately positive

 Proportion of households with piped-water connection outside

home

Summary of results

 This study uncovered a strong link between in-house access to a

water supply and overall satisfaction with the housing

 In general, access to drinking water in Dhaka for slum-dwellers

can be very expensive, time-consuming and physically

demanding.

 Other results of this study showed positive associations between

unhygienic toilet facilities and overall dissatisfaction with

housing. Therefore, access to clean water and sanitation, as well

as waste disposal, remains a traditional challenge for the urban

poor population, significantly affecting the quality of their

housing and life.

 At the same time, from the point of view of urban planners, this

challenge can be addressed by targeted housing programmes

and reaching positive results within assessable periods of time.

Brief theory of change

 The findings of this study clearly demonstrate the complexity of

the concept of housing satisfaction and its socio-economic

predictors, as well as the importance of including several sets of

explanatory variables in analysis.

 The existing link between health and housing satisfaction was

made obvious and should be the focus of further research in

urban housing and urban-planning policy. The study brings

evidence for urban planners and municipal governors about

which issues should be prioritised to provide urban residents

with satisfactory and safe housing, taking into account growing

urbanisation and migration in the megacities such as Dhaka.

Beyond efforts to reduce poverty, action is required to improve

sub-standard housing conditions in the long term.

425

APPENDIX 3: IDENTIFYING AND DESCRIBING STUDIES

Table A3.1: List of countries covered in the evidence base and the study count for

each country

S. No.

Countries

No. of studies

Percentage

India

35%

Bangladesh

13%

Indonesia

South Africa

Bolivia

Ghana

Philippines

Thailand

Argentina

Brazil

Jordan

Pakistan

Peru

Uganda

Zambia

Kenya

Mexico

Vanuatu

Nigeria

Belize

Côte d’Ivoire

El Salvador

Ethiopia

Guatemala

426

S. No.

Countries

No. of studies

Percentage

Malaysia

Lebanon

Namibia

North Colombia

Senegal

Sudan

Tanzania

Uruguay

Zimbabwe

Nepal

Total

104

427

Table A3.2: List of cities covered in the evidence base and the study count for each

city

S. No.

Cities

No. of studies

Percentage

Dhaka

13%

Mumbai

Ahmedabad

Jakarta

Delhi

Kolkata

Bangalore

Buenos Aires

Cape Town

El Alto

Hyderabad

Karachi

La Paz

Manila

Pune

Jaipur

Accra

Bangkok

Cochabamba

Indore

Jabalpur

Kampala

Khon Kaen

Lusaka

Nairobi

Port Vila

428

S. No.

Cities

No. of studies

Percentage

Rio de Janeiro

Rajasthan*

Santa Cruz

Akura

Abidjan

Addis Ababa

Ankleshwar

Asawase

Baroda

Bahir Dar

Belize City

Belo Horizonte

Bali

Bikaner

Bhopal

Cancún

Central Katatura

Chennai

Chittagong

Dakar

Davao

Dire Dawa

Dessie

Debre Zeit

Dokoure

Eastern Cape

Greenwell Matongo C

Greater Amman

429

S. No.

Cities

No. of studies

Percentage

Gondar

Godhra

Gwalior

Gujarat*

Hanna Nassif

Harar

Irbid

Inderpuri

Java

Jinja

Jimma

Jodhpur

Kathmandu

Kakamega

Kanpur

Karnataka*

Khartoum

Khayelitsha

Kota Kinabalu

Kisumu

Kumasi

Holumbi Kalan

Luganville

Lima

Mekele

Meerut

Mombasa

Nagpur

430

S. No.

Cities

No. of studies

Percentage

Nadiad

Nazret

Oruro

Pathumthani

PotosÍ

Phnom Penh

Payatas

Phan Rang

Rosario

Salvador

Sekondi-Takoradi

Sucre

Surat

Tarija

Tamale

Trinidad*

Tiruchirappalli

100

Vishakapatnam

101

Vikas Nagar

102

Yao-sehi

103

Windhoek

Total studies

104

(* Specific name of the city not given in the study. Only the state or country has been mentioned)

431

APPENDIX 4: META-ANALYSIS RESULTS

Figure A4.1: Forest plots for government provision of connectivity services to the

slum (by type of facility)

Egger’s test: p = 0.163

Begg-Mazumdar test: z=0.46 p=0.643

NOTE: Weights are from random effects analysis

Overall (I-squared = 97.1%, p = 0.000)

Kranthi,N.,Rao,D.K.(2009)

Subtotal (I-squared = 94.9%, p = 0.000)

Sanitation - Sewerage

Shrestha,R.M.et al(2008)

Snyder,R.E.et al(2013)

Field,E.(2005)

Ahmad,S.,Choi,M.J.,Ko,J.(2013)

Gulyani,S.,Talukdar,D.,Mukami,K. R.(2005)

Ahmad,S.,Choi,M.J.,Ko,J.(2013)

Snyder,R.E.et al(2013)

Ahmad,S.,Choi,M.J.,Ko,J.(2013)

Evidence

Subtotal (I-squared = 92.4%, p = 0.000)

Sankar, S.(2005)

Electricity

Sanitation - Community Toilet

Water - Community Tap

Islam,S.M.,Khan,U.N.M.(2013)

Subbaraman,R.et al(2012)

Sankar, S.(2005)

Subtotal (I-squared = 92.2%, p = 0.000)

Sankar, S.(2005)

Ahmad,S.,Choi,M.J.,Ko,J.(2013)

Daniere,A.G.,Takahashi,L.M.(1999)

Kranthi,N.,Rao,D.K.(2009)

Issaka,K.O.(2007)

Snyder,R.E.et al(2013)

Issaka,K.O.(2007)

Islam,S.M.,Khan,U.N.M.(2013)

Subtotal (I-squared = 87.5%, p = 0.000)

Subtotal (I-squared = 54.9%, p = 0.137)

Water - Individual Tap

Kranthi,N.,Rao,D.K.(2009)

0.63 (0.58, 0.69)

0.06 (0.00, 1.07)

0.71 (0.39, 1.31)

0.53 (0.33, 0.85)

0.48 (0.48, 0.48)

0.78 (0.48, 1.26)

0.37 (0.25, 0.57)

0.16 (0.08, 0.33)

0.63 (0.48, 0.84)

0.54 (0.54, 0.55)

0.76 (0.51, 1.15)

0.14 (0.09, 0.22)

ES (95% CI)

0.71 (0.40, 1.29)

1.09 (0.69, 1.71)

0.20 (0.15, 0.28)

33.76 (10.75, 105.99)

0.78 (0.53, 1.14)

1.13 (0.61, 2.11)

1.42 (0.78, 2.56)

0.78 (0.52, 1.18)

0.22 (0.12, 0.39)

1.38 (0.58, 3.26)

10.12 (3.45, 29.68)

0.36 (0.05, 2.81)

0.54 (0.53, 0.55)

0.11 (0.01, 1.80)

2.75 (2.12, 3.56)

1.74 (1.36, 2.21)

0.17 (0.12, 0.25)

0.42 (0.26, 0.67)

1.12 (0.28, 4.43)

10.12 (3.45, 29.68)

0.63 (0.58, 0.69)

0.06 (0.00, 1.07)

0.71 (0.39, 1.31)

0.53 (0.33, 0.85)

0.48 (0.48, 0.48)

0.78 (0.48, 1.26)

0.37 (0.25, 0.57)

0.16 (0.08, 0.33)

0.63 (0.48, 0.84)

0.54 (0.54, 0.55)

0.76 (0.51, 1.15)

0.14 (0.09, 0.22)

ES (95% CI)

0.71 (0.40, 1.29)

1.09 (0.69, 1.71)

0.20 (0.15, 0.28)

33.76 (10.75, 105.99)

0.78 (0.53, 1.14)

1.13 (0.61, 2.11)

1.42 (0.78, 2.56)

0.78 (0.52, 1.18)

0.22 (0.12, 0.39)

1.38 (0.58, 3.26)

10.12 (3.45, 29.68)

0.36 (0.05, 2.81)

0.54 (0.53, 0.55)

0.11 (0.01, 1.80)

2.75 (2.12, 3.56)

1.74 (1.36, 2.21)

0.17 (0.12, 0.25)

0.42 (0.26, 0.67)

1.12 (0.28, 4.43)

10.12 (3.45, 29.68)

1.00382 1 262

Ratio favours Intervention

432

Figure A4.2: Forest plots for government provision of connectivity services to slums

(by region, for different facilities)

NOTE: Weights are from random effects analysis

Overall (I-squared = 97.1%, p = 0.000)

Ahmad,S.,Choi,M.J.,Ko,J.(2013)

Subtotal (I-squared = 74.0%, p = 0.050)

Sanitation - Sewerage - South America

Subtotal (I-squared = .%, p = .)

Ahmad,S.,Choi,M.J.,Ko,J.(2013)

Subtotal (I-squared = 83.0%, p = 0.003)

Subtotal (I-squared = 94.8%, p = 0.000)

Islam,S.M.,Khan,U.N.M.(2013)

Subtotal (I-squared = 0.0%, p = 0.805)

Snyder,R.E.et al(2013)

Electricity - South America

Sanitation - Sewerage - Asia

Water - Community Tap - Asia

Snyder,R.E.et al(2013)

Islam,S.M.,Khan,U.N.M.(2013)

Subtotal (I-squared = .%, p = .)

Islam,S.M.,Khan,U.N.M.(2013)

Electricity - Asia

Evidence

Ahmad,S.,Choi,M.J.,Ko,J.(2013)

Kranthi,N.,Rao,D.K.(2009)

Gulyani,S.,Talukdar,D.,Mukami,K. R.(2005)

Subbaraman,R.et al(2012)

Issaka,K.O.(2007)

Kranthi,N.,Rao,D.K.(2009)

Ahmad,S.,Choi,M.J.,Ko,J.(2013)

Subtotal (I-squared = .%, p = .)

Kranthi,N.,Rao,D.K.(2009)

Subtotal (I-squared = .%, p = .)

Ahmad,S.,Choi,M.J.,Ko,J.(2013)

Islam,S.M.,Khan,U.N.M.(2013)

Sankar, S.(2005)

Snyder,R.E.et al(2013)

Subtotal (I-squared = 96.2%, p = 0.000)

Subtotal (I-squared = 92.2%, p = 0.000)

Water - Individual Tap - Asia

Sankar, S.(2005)

Sanitation - Community Toilet - Asia

Field,E.(2005)

Ahmad,S.,Choi,M.J.,Ko,J.(2013)

Daniere,A.G.,Takahashi,L.M.(1999)

Sanitation - Community Toilet - Africa

Water - Individual Tap - South America

Issaka,K.O.(2007)

Shrestha,R.M.et al(2008)

Water - Individual Tap - Africa

Sankar, S.(2005)

0.63 (0.58, 0.69)

0.22 (0.12, 0.39)

0.57 (0.36, 0.90)

0.54 (0.54, 0.55)

0.14 (0.09, 0.22)

0.28 (0.12, 0.69)

1.01 (0.24, 4.34)

1.74 (1.36, 2.21)

0.15 (0.08, 0.32)

0.54 (0.54, 0.55)

0.48 (0.48, 0.48)

0.20 (0.15, 0.28)

0.36 (0.05, 2.81)

0.17 (0.12, 0.25)

ES (95% CI)

0.76 (0.51, 1.15)

0.06 (0.00, 1.07)

0.16 (0.08, 0.33)

33.76 (10.75, 105.99)

0.36 (0.05, 2.81)

10.12 (3.45, 29.68)

0.63 (0.48, 0.84)

0.54 (0.53, 0.55)

10.12 (3.45, 29.68)

1.74 (1.36, 2.21)

0.78 (0.52, 1.18)

2.75 (2.12, 3.56)

1.42 (0.78, 2.56)

0.54 (0.53, 0.55)

1.13 (0.38, 3.29)

1.13 (0.61, 2.11)

1.09 (0.69, 1.71)

0.78 (0.48, 1.26)

0.37 (0.25, 0.57)

1.38 (0.58, 3.26)

0.11 (0.01, 1.80)

0.53 (0.33, 0.85)

0.78 (0.53, 1.14)

0.63 (0.58, 0.69)

0.22 (0.12, 0.39)

0.57 (0.36, 0.90)

0.54 (0.54, 0.55)

0.14 (0.09, 0.22)

0.28 (0.12, 0.69)

1.01 (0.24, 4.34)

1.74 (1.36, 2.21)

0.15 (0.08, 0.32)

0.54 (0.54, 0.55)

0.48 (0.48, 0.48)

0.20 (0.15, 0.28)

0.36 (0.05, 2.81)

0.17 (0.12, 0.25)

ES (95% CI)

0.76 (0.51, 1.15)

0.06 (0.00, 1.07)

0.16 (0.08, 0.33)

33.76 (10.75, 105.99)

0.36 (0.05, 2.81)

10.12 (3.45, 29.68)

0.63 (0.48, 0.84)

0.54 (0.53, 0.55)

10.12 (3.45, 29.68)

1.74 (1.36, 2.21)

0.78 (0.52, 1.18)

2.75 (2.12, 3.56)

1.42 (0.78, 2.56)

0.54 (0.53, 0.55)

1.13 (0.38, 3.29)

1.13 (0.61, 2.11)

1.09 (0.69, 1.71)

0.78 (0.48, 1.26)

0.37 (0.25, 0.57)

1.38 (0.58, 3.26)

0.11 (0.01, 1.80)

0.53 (0.33, 0.85)

0.78 (0.53, 1.14)

1.00382 1 262

Ratio favours Intervention

433

Figure A4.3: Forest plots for provision of connectivity to slums by alternative

service providers (by type of facility)

Egger’s test: p = 0.097

Begg-Mazumdar test: z=1.60 p=0.109

NOTE: Weights are from random effects analysis

Overall (I-squared = 100.0%, p = 0.000)

Das, A.K (2012)

Zaki,S.,Nurul,A.A.T.M.(2009)

Das, M(2011)

Das, A.K (2012)

Subtotal (I-squared = 54.8%, p = 0.065)

Electricity

Water - Community Tap

Das, M(2011)

Subtotal (I-squared = 98.8%, p = 0.000)

Subbaraman,R.et al(2012)

Das, A.K (2012)

Subtotal (I-squared = 98.4%, p = 0.000)

Mustafa,D.,Reeder,P.(2009)

Subbaraman,R.et al(2012)

Stanwix, B.(2009)

Hanchett,S.et al(2003)

Sanitation - Community Toilet

Galiani,S et al(2013)

Foster,V.,Araujo,C.M.(2004)

Das, A.K (2012)

MdAdbul,B.,et al(2013)

Hailu,D.,Osorio,R.G.,Tsukada,R.(2012)

Galiani,S et al(2013)

Issaka,K.O.(2007)

Hanchett,S.et al(2003)

Galiani,S et al(2013)

Kranthi,N.,Rao,D.K.(2009)

Ahmad,S.,Choi,M.J.,Ko,J.(2013)

Subtotal (I-squared = 97.0%, p = 0.000)

Das, A.K (2012)

Subtotal (I-squared = 99.7%, p = 0.000)

Das, M(2011)

Sanitation - Sewerage

Water - Individual Tap

Galiani,S et al(2013)

Foster,V.,Araujo,C.M.(2004)

Hailu,D.,Osorio,R.G.,Tsukada,R.(2012)

Das, M(2011)

Sanitation - Individual Toilet

Kifanyi,G.E.,et al(2013)

Galiani,S et al(2013)

Stanwix, B.(2009)

Das, A.K (2012)

Das, M(2011)

Foster,V.,Araujo,C.M.(2004)

Kayaga,S.,Kadimba-Mwanamwambwa,C.(2006)

Das, A.K (2012)

Galiani,S et al(2013)

Zaki,S.,Nurul,A.A.T.M.(2009)

MdAdbul,B.,et al(2013)

Hanchett,S.et al(2003)

Hailu,D.,Osorio,R.G.,Tsukada,R.(2012)

Islam,S.M.,Khan,U.N.M.(2013)

Evidence

Hailu,D.,Osorio,R.G.,Tsukada,R.(2012)

Foster,V.,Araujo,C.M.(2004)

Subtotal (I-squared = .%, p = .)

1.05 (0.73, 1.52)

1.36 (0.84, 2.20)

0.41 (0.19, 0.91)

3.63 (1.68, 7.83)

0.88 (0.69, 1.12)

1.18 (0.96, 1.45)

0.94 (0.76, 1.17)

0.96 (0.53, 1.75)

1.15 (0.86, 1.54)

0.99 (0.61, 1.59)

2.53 (2.22, 2.87)

0.56 (0.35, 0.90)

0.85 (0.70, 1.03)

0.75 (0.64, 0.87)

1.33 (1.01, 1.74)

1.11 (0.68, 1.80)

0.31 (0.30, 0.31)

1.93 (1.40, 2.65)

0.41 (0.15, 1.06)

1.11 (0.19, 6.43)

2.43 (2.31, 2.56)

1.11 (0.41, 3.04)

1.42 (1.12, 1.81)

0.97 (0.54, 1.75)

2.56 (2.45, 2.68)

2.40 (2.28, 2.53)

0.00 (0.00, 0.00)

9.54 (8.14, 11.18)

1.19 (0.48, 2.96)

0.89 (0.61, 1.30)

2.89 (2.76, 3.02)

1.15 (1.00, 1.34)

0.30 (0.05, 1.71)

0.66 (0.50, 0.87)

1.11 (0.59, 2.08)

2.12 (2.12, 2.13)

0.55 (0.21, 1.44)

2.32 (2.21, 2.44)

1.03 (0.88, 1.21)

5.28 (4.00, 6.97)

0.79 (0.31, 2.00)

1.04 (0.71, 1.52)

1.24 (1.01, 1.52)

0.23 (0.22, 0.23)

3.01 (0.95, 9.57)

1.09 (0.94, 1.26)

1.76 (1.33, 2.33)

0.33 (0.15, 0.68)

3.46 (2.19, 5.48)

2.46 (0.94, 6.45)

1.02 (0.81, 1.30)

2.07 (0.47, 9.18)

1.73 (1.57, 1.91)

ES (95% CI)

0.91 (0.23, 3.60)

0.34 (0.34, 0.34)

1.15 (1.00, 1.34)

1.05 (0.73, 1.52)

1.36 (0.84, 2.20)

0.41 (0.19, 0.91)

3.63 (1.68, 7.83)

0.88 (0.69, 1.12)

1.18 (0.96, 1.45)

0.94 (0.76, 1.17)

0.96 (0.53, 1.75)

1.15 (0.86, 1.54)

0.99 (0.61, 1.59)

2.53 (2.22, 2.87)

0.56 (0.35, 0.90)

0.85 (0.70, 1.03)

0.75 (0.64, 0.87)

1.33 (1.01, 1.74)

1.11 (0.68, 1.80)

0.31 (0.30, 0.31)

1.93 (1.40, 2.65)

0.41 (0.15, 1.06)

1.11 (0.19, 6.43)

2.43 (2.31, 2.56)

1.11 (0.41, 3.04)

1.42 (1.12, 1.81)

0.97 (0.54, 1.75)

2.56 (2.45, 2.68)

2.40 (2.28, 2.53)

0.00 (0.00, 0.00)

9.54 (8.14, 11.18)

1.19 (0.48, 2.96)

0.89 (0.61, 1.30)

2.89 (2.76, 3.02)

1.15 (1.00, 1.34)

0.30 (0.05, 1.71)

0.66 (0.50, 0.87)

1.11 (0.59, 2.08)

2.12 (2.12, 2.13)

0.55 (0.21, 1.44)

2.32 (2.21, 2.44)

1.03 (0.88, 1.21)

5.28 (4.00, 6.97)

0.79 (0.31, 2.00)

1.04 (0.71, 1.52)

1.24 (1.01, 1.52)

0.23 (0.22, 0.23)

3.01 (0.95, 9.57)

1.09 (0.94, 1.26)

1.76 (1.33, 2.33)

0.33 (0.15, 0.68)

3.46 (2.19, 5.48)

2.46 (0.94, 6.45)

1.02 (0.81, 1.30)

2.07 (0.47, 9.18)

1.73 (1.57, 1.91)

ES (95% CI)

0.91 (0.23, 3.60)

0.34 (0.34, 0.34)

1.15 (1.00, 1.34)

1.00081 1 1232

Ratio favours Intervention

434

Figure A4.4: Forest plots for provision of connectivity to the slums by alternative

service providers (by region and type of facility)

NOTE: Weights are from random effects analysis

Overall (I-squared = 100.0%, p = 0.000)

Subtotal (I-squared = .%, p = .)

Issaka,K.O.(2007)

Subtotal (I-squared = .%, p = .)

Foster,V.,Araujo,C.M.(2004)

Mustafa,D.,Reeder,P.(2009)

Galiani,S et al(2013)

Sanitation - Sewerage - Asia

Das, M(2011)

Hailu,D.,Osorio,R.G.,Tsukada,R.(2012)

Subtotal (I-squared = 52.7%, p = 0.120)

Hailu,D.,Osorio,R.G.,Tsukada,R.(2012)

Electricity - South America

Galiani,S et al(2013)

Foster,V.,Araujo,C.M.(2004)

Water - Individual Tap - Central and North America

Galiani,S et al(2013)

Sanitation - Individual Toilet - Central and North America

Kifanyi,G.E.,et al(2013)

Ahmad,S.,Choi,M.J.,Ko,J.(2013)

Das, A.K (2012)

Das, M(2011)

Sanitation - Individual Toilet - Asia

Subtotal (I-squared = 98.5%, p = 0.000)

Stanwix, B.(2009)

Subtotal (I-squared = 78.3%, p = 0.000)

Zaki,S.,Nurul,A.A.T.M.(2009)

Stanwix, B.(2009)

Das, M(2011)

Hailu,D.,Osorio,R.G.,Tsukada,R.(2012)

Galiani,S et al(2013)

Kayaga,S.,Kadimba-Mwanamwambwa,C.(2006)

Water - Individual Tap - Africa

Sanitation - Individual Toilet - Africa

Galiani,S et al(2013)

Das, M(2011)

Das, A.K (2012)

Subbaraman,R.et al(2012)

Subtotal (I-squared = .%, p = .)

Galiani,S et al(2013)

Subtotal (I-squared = 54.8%, p = 0.065)

Subtotal (I-squared = .%, p = .)

Electricity - Asia

Kranthi,N.,Rao,D.K.(2009)

Zaki,S.,Nurul,A.A.T.M.(2009)

MdAdbul,B.,et al(2013)

Das, A.K (2012)

Electricity - Central and North America

Das, A.K (2012)

Hanchett,S.et al(2003)

Water - Community Tap - Asia

Water - Individual Tap - Asia

Subtotal (I-squared = .%, p = .)

Subtotal (I-squared = 3.7%, p = 0.402)

Islam,S.M.,Khan,U.N.M.(2013)

Das, M(2011)

Evidence

Sanitation - Community Toilet - Central and North America

Das, A.K (2012)

Foster,V.,Araujo,C.M.(2004)

Subtotal (I-squared = 68.9%, p = 0.073)

Water - Individual Tap - South America

Hailu,D.,Osorio,R.G.,Tsukada,R.(2012)

Subbaraman,R.et al(2012)

Foster,V.,Araujo,C.M.(2004)

Galiani,S et al(2013)

Subtotal (I-squared = 99.8%, p = 0.000)

MdAdbul,B.,et al(2013)

Sanitation - Individual Toilet - South America

Das, A.K (2012)

Galiani,S et al(2013)

Sanitation - Community Toilet - Asia

Hanchett,S.et al(2003)

Das, A.K (2012)

MdAdbul,B.,et al(2013)

Subtotal (I-squared = 86.0%, p = 0.000)

1.05 (0.73, 1.52)

1.15 (1.00, 1.34)

0.23 (0.22, 0.23)

1.11 (0.41, 3.04)

0.31 (0.30, 0.31)

2.12 (2.12, 2.13)

0.56 (0.35, 0.90)

0.00 (0.00, 0.00)

5.28 (4.00, 6.97)

0.94 (0.76, 1.17)

2.07 (0.47, 9.18)

2.47 (2.37, 2.57)

0.55 (0.21, 1.44)

2.43 (2.31, 2.56)

0.31 (0.30, 0.31)

2.40 (2.28, 2.53)

1.03 (0.88, 1.21)

1.19 (0.48, 2.96)

0.99 (0.61, 1.59)

0.66 (0.50, 0.87)

2.61 (1.91, 3.57)

0.75 (0.64, 0.87)

1.05 (0.83, 1.32)

0.33 (0.15, 0.68)

0.79 (0.31, 2.00)

2.32 (2.21, 2.44)

1.11 (0.19, 6.43)

2.56 (2.45, 2.68)

3.01 (0.95, 9.57)

1.76 (1.33, 2.33)

3.63 (1.68, 7.83)

2.89 (2.76, 3.02)

1.15 (0.86, 1.54)

2.12 (2.12, 2.13)

0.88 (0.69, 1.12)

1.11 (0.59, 2.08)

1.18 (0.96, 1.45)

1.11 (0.41, 3.04)

9.54 (8.14, 11.18)

0.41 (0.19, 0.91)

3.46 (2.19, 5.48)

1.36 (0.84, 2.20)

1.09 (0.94, 1.26)

1.42 (1.12, 1.81)

1.02 (0.81, 1.30)

0.34 (0.34, 0.34)

0.87 (0.67, 1.12)

1.73 (1.57, 1.91)

1.24 (1.01, 1.52)

ES (95% CI)

1.15 (1.00, 1.34)

0.88 (0.69, 1.12)

0.23 (0.22, 0.23)

1.50 (0.55, 4.08)

0.91 (0.23, 3.60)

0.85 (0.70, 1.03)

0.34 (0.34, 0.34)

0.97 (0.54, 1.75)

0.22 (0.00, 19.48)

0.41 (0.15, 1.06)

1.04 (0.71, 1.52)

1.11 (0.68, 1.80)

1.33 (1.01, 1.74)

1.93 (1.40, 2.65)

2.46 (0.94, 6.45)

0.88 (0.60, 1.31)

1.05 (0.73, 1.52)

1.15 (1.00, 1.34)

0.23 (0.22, 0.23)

1.11 (0.41, 3.04)

0.31 (0.30, 0.31)

2.12 (2.12, 2.13)

0.56 (0.35, 0.90)

0.00 (0.00, 0.00)

5.28 (4.00, 6.97)

0.94 (0.76, 1.17)

2.07 (0.47, 9.18)

2.47 (2.37, 2.57)

0.55 (0.21, 1.44)

2.43 (2.31, 2.56)

0.31 (0.30, 0.31)

2.40 (2.28, 2.53)

1.03 (0.88, 1.21)

1.19 (0.48, 2.96)

0.99 (0.61, 1.59)

0.66 (0.50, 0.87)

2.61 (1.91, 3.57)

0.75 (0.64, 0.87)

1.05 (0.83, 1.32)

0.33 (0.15, 0.68)

0.79 (0.31, 2.00)

2.32 (2.21, 2.44)

1.11 (0.19, 6.43)

2.56 (2.45, 2.68)

3.01 (0.95, 9.57)

1.76 (1.33, 2.33)

3.63 (1.68, 7.83)

2.89 (2.76, 3.02)

1.15 (0.86, 1.54)

2.12 (2.12, 2.13)

0.88 (0.69, 1.12)

1.11 (0.59, 2.08)

1.18 (0.96, 1.45)

1.11 (0.41, 3.04)

9.54 (8.14, 11.18)

0.41 (0.19, 0.91)

3.46 (2.19, 5.48)

1.36 (0.84, 2.20)

1.09 (0.94, 1.26)

1.42 (1.12, 1.81)

1.02 (0.81, 1.30)

0.34 (0.34, 0.34)

0.87 (0.67, 1.12)

1.73 (1.57, 1.91)

1.24 (1.01, 1.52)

ES (95% CI)

1.15 (1.00, 1.34)

0.88 (0.69, 1.12)

0.23 (0.22, 0.23)

1.50 (0.55, 4.08)

0.91 (0.23, 3.60)

0.85 (0.70, 1.03)

0.34 (0.34, 0.34)

0.97 (0.54, 1.75)

0.22 (0.00, 19.48)

0.41 (0.15, 1.06)

1.04 (0.71, 1.52)

1.11 (0.68, 1.80)

1.33 (1.01, 1.74)

1.93 (1.40, 2.65)

2.46 (0.94, 6.45)

0.88 (0.60, 1.31)

1.00081 1 1232

Ratio favours Intervention

435

Figure A4.5: Forest plots for proportion of households who find it affordable to pay

the cost incurred for accessing basic services provided by alternative providers

Egger’s test: p = 0.320

Begg-Mazumdar test: z=1.43 p=0.152

NOTE: Weights are from random effects analysis

Overall (I-squared = 73.1%, p = 0.000)

Mustafa,D.,Reeder,P.(2009)

Kayaga,S.,Kadimba-Mwanamwambwa,C.(2006)

Water - Community Tap - Affordability

Water - Individual Tap - Affordability

Hailu,D.,Osorio,R.G.,Tsukada,R.(2012)

Zaki,S.,Nurul,A.A.T.M.(2009)

Subtotal (I-squared = 81.1%, p = 0.000)

Hailu,D.,Osorio,R.G.,Tsukada,R.(2012)

Subtotal (I-squared = 0.0%, p = 0.668)

Hailu,D.,Osorio,R.G.,Tsukada,R.(2012)

Zaki,S.,Nurul,A.A.T.M.(2009)

Hailu,D.,Osorio,R.G.,Tsukada,R.(2012)

Evidence

1.11 (0.67, 1.83)

0.20 (0.10, 0.38)

1.28 (0.74, 2.24)

0.87 (0.43, 1.79)

2.66 (0.76, 9.28)

0.97 (0.44, 2.10)

0.82 (0.33, 2.06)

2.11 (0.78, 5.68)

1.42 (1.02, 1.97)

1.28 (0.27, 6.08)

1.75 (0.70, 4.38)

1.60 (0.84, 3.06)

1.11 (0.45, 2.72)

ES (95% CI)

1.11 (0.67, 1.83)

0.20 (0.10, 0.38)

1.28 (0.74, 2.24)

0.87 (0.43, 1.79)

2.66 (0.76, 9.28)

0.97 (0.44, 2.10)

0.82 (0.33, 2.06)

2.11 (0.78, 5.68)

1.42 (1.02, 1.97)

1.28 (0.27, 6.08)

1.75 (0.70, 4.38)

1.60 (0.84, 3.06)

1.11 (0.45, 2.72)

ES (95% CI)

1.105 1 9.53

Ratio favours Intervention

436

Figure A4.6: Forest plots for mean amount spent on water consumption in

US$/month for government and alternative provision of service

Egger’s test: p = 0.796

Begg-Mazumdar test: z=0.24 p=0.806

NOTE: Weights are from random effects analysis

Top-down / Service by public agencies

Gulyani et al (2005)

Subtotal (I-squared = .%, p = .)

Bottom - Up/ service by alternate agencies

Israel (2007)

Tukahirwa et al (2011)

Israel (2007)

Subtotal (I-squared = 83.4%, p = 0.000)

Evidence

0.83 (0.53, 1.29)

1.00 (0.16, 6.41)

0.22 (0.13, 0.38)

0.15 (0.06, 0.40)

1.00 (0.54, 1.84)

0.39 (0.14, 1.08)

ES (95% CI)

0.83 (0.53, 1.29)

1.00 (0.16, 6.41)

0.22 (0.13, 0.38)

0.15 (0.06, 0.40)

1.00 (0.54, 1.84)

0.39 (0.14, 1.08)

ES (95% CI)

1.0585 1 17.1

Ratio favours Intervention

437

Figure A4.7: Forest plots for households who have reported that the availability of

basic services was adequate for government and alternative provision of basic

services

Egger’s test: p = 0.332

Begg-Mazumdar test: z=-0.34 p=1.00

NOTE: Weights are from random effects analysis

Top-down / Service by public agencies

Gulyani et al (2005)

Subtotal (I-squared = .%, p = .)

Bottom - Up/ service by alternate agencies

Israel (2007)

Tukahirwa et al (2011)

Israel (2007)

Subtotal (I-squared = 83.4%, p = 0.000)

Evidence

0.83 (0.53, 1.29)

1.00 (0.16, 6.41)

0.22 (0.13, 0.38)

0.15 (0.06, 0.40)

1.00 (0.54, 1.84)

0.39 (0.14, 1.08)

ES (95% CI)

0.83 (0.53, 1.29)

1.00 (0.16, 6.41)

0.22 (0.13, 0.38)

0.15 (0.06, 0.40)

1.00 (0.54, 1.84)

0.39 (0.14, 1.08)

ES (95% CI)

1.0585 1 17.1

Ratio favours Intervention

438

Figure A4.8: Forest plots for consumption of electricity (in kwh) and water (in litres)

indicating adequacy levels under government service provision

Begg-Mazumdar test: z=0.00 p=1.00

NOTE: Weights are from random effects analysis

Overall (I-squared = 98.0%, p = 0.000)

Evidence

Subtotal (I-squared = .%, p = .)

Electricity - Adequacy

Mimmi and Ecer (2010)

Smith and Hanson (2003)

Water - Individual Tap - Adequacy

Subtotal (I-squared = .%, p = .)

0.09 (0.00, 7.73)

ES (95% CI)

0.01 (0.00, 0.03)

0.84 (0.78, 0.90)

0.01 (0.00, 0.03)

0.84 (0.78, 0.90)

0.09 (0.00, 7.73)

ES (95% CI)

0.01 (0.00, 0.03)

0.84 (0.78, 0.90)

0.01 (0.00, 0.03)

0.84 (0.78, 0.90)

1.00106 1 946

Ratio favours Intervention

439

Figure A4.9: Forest plots for proportion of households that have reported less

effort to access the basic services under alternative service provision

Begg-Mazumdar test: z=0.00 p=1.00

NOTE: Weights are from random effects analysis

Bottom-up/ Service provided by alternate services - Effort

Kayaga,S.,Kadimba-Mwanamwambwa,C.(2006)

Subtotal (I-squared = 0.0%, p = 0.617)

Evidence

1.15 (0.73, 1.84)

0.98 (0.62, 1.54)

1.06 (0.77, 1.47)

ES (95% CI)

1.15 (0.73, 1.84)

0.98 (0.62, 1.54)

1.06 (0.77, 1.47)

ES (95% CI)

1.544 1 1.84

Ratio favours Intervention

440

Figure A4.10: Forest plots for distance travelled (in meters) to access the basic

service under alternative service provision

Begg-Mazumdar test: z=0.00 p=1.00

NOTE: Weights are from random effects analysis

Bottom-up / Service provider by alternate service - Effort (Distance)

Tukahirwa,J.T.et al(2011)

Subtotal (I-squared = 0.0%, p = 0.402)

Evidence

1.00 (0.38, 2.65)

0.62 (0.35, 1.08)

0.70 (0.43, 1.13)

ES (95% CI)

1.00 (0.38, 2.65)

0.62 (0.35, 1.08)

0.70 (0.43, 1.13)

ES (95% CI)

1.351 1 2.85

Ratio favours Intervention

441

Figure A4.11: Forest plots for level of community participation (on connectivity)

under alternative service provision

NOTE: Weights are from random effects analysis

Overall (I-squared = 100.0%, p = 0.000)

Das, A.K (2012)

Foster,V.,Araujo,C.M.(2004)

Galiani,S et al(2013)

MdAdbul,B.,et al(2013)

Subtotal (I-squared = 100.0%, p = 0.000)

Subbaraman,R.et al(2012)

Das, M(2011)

Kayaga,S.,Kadimba-Mwanamwambwa,C.(2006)

Zaki,S.,Nurul,A.A.T.M.(2009)

Das, M(2011)

Das, A.K (2012)

Subbaraman,R.et al(2012)

Hailu,D.,Osorio,R.G.,Tsukada,R.(2012)

Galiani,S et al(2013)

Das, A.K (2012)

Galiani,S et al(2013)

Stanwix, B.(2009)

Mustafa,D.,Reeder,P.(2009)

Das, M(2011)

Issaka,K.O.(2007)

Das, A.K (2012)

MdAdbul,B.,et al(2013)

Stanwix, B.(2009)

Hailu,D.,Osorio,R.G.,Tsukada,R.(2012)

Foster,V.,Araujo,C.M.(2004)

Galiani,S et al(2013)

Das, A.K (2012)

Galiani,S et al(2013)

Das, A.K (2012)

Hailu,D.,Osorio,R.G.,Tsukada,R.(2012)

Zaki,S.,Nurul,A.A.T.M.(2009)

Active community participation

Hanchett,S.et al(2003)

Kranthi,N.,Rao,D.K.(2009)

Foster,V.,Araujo,C.M.(2004)

Subtotal (I-squared = 98.0%, p = 0.000)

Das, M(2011)

Galiani,S et al(2013)

Das, A.K (2012)

Ahmad,S.,Choi,M.J.,Ko,J.(2013)

Galiani,S et al(2013)

Das, M(2011)

Foster,V.,Araujo,C.M.(2004)

Hanchett,S.et al(2003)

Kifanyi,G.E.,et al(2013)

Limited or No Participation

Islam,S.M.,Khan,U.N.M.(2013)

MdAdbul,B.,et al(2013)

Hanchett,S.et al(2003)

Hailu,D.,Osorio,R.G.,Tsukada,R.(2012)

Galiani,S et al(2013)

Evidence

1.05 (0.73, 1.52)

1.09 (0.94, 1.26)

2.12 (2.12, 2.13)

0.97 (0.54, 1.75)

2.46 (0.94, 6.45)

0.79 (0.48, 1.29)

0.85 (0.70, 1.03)

0.66 (0.50, 0.87)

3.01 (0.95, 9.57)

0.33 (0.15, 0.68)

0.94 (0.76, 1.17)

1.36 (0.84, 2.20)

1.15 (1.00, 1.34)

1.15 (0.86, 1.54)

0.55 (0.21, 1.44)

2.43 (2.31, 2.56)

2.89 (2.76, 3.02)

1.76 (1.33, 2.33)

0.79 (0.31, 2.00)

0.56 (0.35, 0.90)

3.63 (1.68, 7.83)

1.11 (0.41, 3.04)

1.04 (0.71, 1.52)

3.46 (2.19, 5.48)

0.75 (0.64, 0.87)

2.07 (0.47, 9.18)

0.34 (0.34, 0.34)

0.00 (0.00, 0.00)

0.99 (0.61, 1.59)

2.56 (2.45, 2.68)

1.93 (1.40, 2.65)

1.11 (0.19, 6.43)

0.41 (0.19, 0.91)

1.42 (1.12, 1.81)

9.54 (8.14, 11.18)

0.31 (0.30, 0.31)

1.92 (1.62, 2.27)

2.32 (2.21, 2.44)

1.11 (0.59, 2.08)

0.88 (0.69, 1.12)

1.19 (0.48, 2.96)

5.28 (4.00, 6.97)

1.11 (0.68, 1.80)

1.24 (1.01, 1.52)

0.23 (0.22, 0.23)

1.02 (0.81, 1.30)

1.03 (0.88, 1.21)

1.73 (1.57, 1.91)

0.41 (0.15, 1.06)

1.33 (1.01, 1.74)

0.91 (0.23, 3.60)

2.40 (2.28, 2.53)

ES (95% CI)

1.05 (0.73, 1.52)

1.09 (0.94, 1.26)

2.12 (2.12, 2.13)

0.97 (0.54, 1.75)

2.46 (0.94, 6.45)

0.79 (0.48, 1.29)

0.85 (0.70, 1.03)

0.66 (0.50, 0.87)

3.01 (0.95, 9.57)

0.33 (0.15, 0.68)

0.94 (0.76, 1.17)

1.36 (0.84, 2.20)

1.15 (1.00, 1.34)

1.15 (0.86, 1.54)

0.55 (0.21, 1.44)

2.43 (2.31, 2.56)

2.89 (2.76, 3.02)

1.76 (1.33, 2.33)

0.79 (0.31, 2.00)

0.56 (0.35, 0.90)

3.63 (1.68, 7.83)

1.11 (0.41, 3.04)

1.04 (0.71, 1.52)

3.46 (2.19, 5.48)

0.75 (0.64, 0.87)

2.07 (0.47, 9.18)

0.34 (0.34, 0.34)

0.00 (0.00, 0.00)

0.99 (0.61, 1.59)

2.56 (2.45, 2.68)

1.93 (1.40, 2.65)

1.11 (0.19, 6.43)

0.41 (0.19, 0.91)

1.42 (1.12, 1.81)

9.54 (8.14, 11.18)

0.31 (0.30, 0.31)

1.92 (1.62, 2.27)

2.32 (2.21, 2.44)

1.11 (0.59, 2.08)

0.88 (0.69, 1.12)

1.19 (0.48, 2.96)

5.28 (4.00, 6.97)

1.11 (0.68, 1.80)

1.24 (1.01, 1.52)

0.23 (0.22, 0.23)

1.02 (0.81, 1.30)

1.03 (0.88, 1.21)

1.73 (1.57, 1.91)

0.41 (0.15, 1.06)

1.33 (1.01, 1.74)

0.91 (0.23, 3.60)

2.40 (2.28, 2.53)

ES (95% CI)

1.00081 1 1232

Ratio favours Intervention

442

Figure A4.12: Forest plots for connectivity by type of slum under government

service provision

NOTE: Weights are from random effects analysis

Overall (I-squared = 97.1%, p = 0.000)

Slum - informal

Islam,S.M.,Khan,U.N.M.(2013)

Ahmad,S.,Choi,M.J.,Ko,J.(2013)

Subtotal (I-squared = .%, p = .)

Low income househld

Slum - formal

Islam,S.M.,Khan,U.N.M.(2013)

Ahmad,S.,Choi,M.J.,Ko,J.(2013)

Sankar, S.(2005)

Subbaraman,R.et al(2012)

Snyder,R.E.et al(2013)

Ahmad,S.,Choi,M.J.,Ko,J.(2013)

Subtotal (I-squared = 96.8%, p = 0.000)

Islam,S.M.,Khan,U.N.M.(2013)

Daniere,A.G.,Takahashi,L.M.(1999)

Kranthi,N.,Rao,D.K.(2009)

Evidence

Snyder,R.E.et al(2013)

Ahmad,S.,Choi,M.J.,Ko,J.(2013)

Issaka,K.O.(2007)

Kranthi,N.,Rao,D.K.(2009)

Subtotal (I-squared = 97.5%, p = 0.000)

Field,E.(2005)

Shrestha,R.M.et al(2008)

Issaka,K.O.(2007)

Sankar, S.(2005)

Ahmad,S.,Choi,M.J.,Ko,J.(2013)

Gulyani,S.,Talukdar,D.,Mukami,K. R.(2005)

Ahmad,S.,Choi,M.J.,Ko,J.(2013)

Snyder,R.E.et al(2013)

Kranthi,N.,Rao,D.K.(2009)

0.63 (0.58, 0.69)

2.75 (2.12, 3.56)

1.74 (1.36, 2.21)

0.76 (0.51, 1.15)

0.78 (0.48, 1.26)

0.20 (0.15, 0.28)

0.63 (0.48, 0.84)

0.78 (0.53, 1.14)

1.09 (0.69, 1.71)

33.76 (10.75, 105.99)

0.54 (0.54, 0.55)

0.78 (0.52, 1.18)

0.55 (0.50, 0.60)

0.17 (0.12, 0.25)

1.38 (0.58, 3.26)

10.12 (3.45, 29.68)

ES (95% CI)

0.48 (0.48, 0.48)

0.22 (0.12, 0.39)

0.11 (0.01, 1.80)

0.06 (0.00, 1.07)

0.94 (0.36, 2.47)

0.78 (0.48, 1.26)

0.53 (0.33, 0.85)

0.36 (0.05, 2.81)

1.42 (0.78, 2.56)

0.37 (0.25, 0.57)

0.16 (0.08, 0.33)

0.14 (0.09, 0.22)

0.54 (0.53, 0.55)

10.12 (3.45, 29.68)

0.63 (0.58, 0.69)

2.75 (2.12, 3.56)

1.74 (1.36, 2.21)

0.76 (0.51, 1.15)

0.78 (0.48, 1.26)

0.20 (0.15, 0.28)

0.63 (0.48, 0.84)

0.78 (0.53, 1.14)

1.09 (0.69, 1.71)

33.76 (10.75, 105.99)

0.54 (0.54, 0.55)

0.78 (0.52, 1.18)

0.55 (0.50, 0.60)

0.17 (0.12, 0.25)

1.38 (0.58, 3.26)

10.12 (3.45, 29.68)

ES (95% CI)

0.48 (0.48, 0.48)

0.22 (0.12, 0.39)

0.11 (0.01, 1.80)

0.06 (0.00, 1.07)

0.94 (0.36, 2.47)

0.78 (0.48, 1.26)

0.53 (0.33, 0.85)

0.36 (0.05, 2.81)

1.42 (0.78, 2.56)

0.37 (0.25, 0.57)

0.16 (0.08, 0.33)

0.14 (0.09, 0.22)

0.54 (0.53, 0.55)

10.12 (3.45, 29.68)

1.00382 1 262

Ratio favours Intervention

443

Figure A4.13: Forest plots for connectivity by type of slum when service was

delivered by alternative providers

NOTE: Weights are from random effects analysis

Overall (I-squared = 100.0%, p = 0.000)

Das, A.K (2012)

Das, M(2011)

Das, A.K (2012)

Das, M(2011)

Hailu,D.,Osorio,R.G.,Tsukada,R.(2012)

Das, A.K (2012)

MdAdbul,B.,et al(2013)

Hanchett,S.et al(2003)

Zaki,S.,Nurul,A.A.T.M.(2009)

Das, A.K (2012)

Das, M(2011)

Kifanyi,G.E.,et al(2013)

Galiani,S et al(2013)

Hailu,D.,Osorio,R.G.,Tsukada,R.(2012)

MdAdbul,B.,et al(2013)

Subbaraman,R.et al(2012)

Hailu,D.,Osorio,R.G.,Tsukada,R.(2012)

Galiani,S et al(2013)

Hanchett,S.et al(2003)

Foster,V.,Araujo,C.M.(2004)

Das, M(2011)

Foster,V.,Araujo,C.M.(2004)

Kranthi,N.,Rao,D.K.(2009)

Galiani,S et al(2013)

Hanchett,S.et al(2003)

Zaki,S.,Nurul,A.A.T.M.(2009)

Galiani,S et al(2013)

Issaka,K.O.(2007)

Das, A.K (2012)

Mustafa,D.,Reeder,P.(2009)

Stanwix, B.(2009)

Evidence

Stanwix, B.(2009)

Das, A.K (2012)

Subbaraman,R.et al(2012)

Foster,V.,Araujo,C.M.(2004)

Galiani,S et al(2013)

Ahmad,S.,Choi,M.J.,Ko,J.(2013)

Galiani,S et al(2013)

Islam,S.M.,Khan,U.N.M.(2013)

Das, M(2011)

Das, A.K (2012)

Foster,V.,Araujo,C.M.(2004)

Das, A.K (2012)

MdAdbul,B.,et al(2013)

Kayaga,S.,Kadimba-Mwanamwambwa,C.(2006)

1.05 (0.73, 1.52)

1.36 (0.84, 2.20)

0.66 (0.50, 0.87)

0.99 (0.61, 1.59)

2.32 (2.21, 2.44)

0.55 (0.21, 1.44)

1.04 (0.71, 1.52)

3.46 (2.19, 5.48)

1.02 (0.81, 1.30)

0.33 (0.15, 0.68)

1.93 (1.40, 2.65)

1.24 (1.01, 1.52)

1.03 (0.88, 1.21)

5.28 (4.00, 6.97)

2.07 (0.47, 9.18)

0.91 (0.23, 3.60)

2.46 (0.94, 6.45)

0.85 (0.70, 1.03)

1.11 (0.19, 6.43)

1.11 (0.59, 2.08)

1.76 (1.33, 2.33)

0.00 (0.00, 0.00)

2.40 (2.28, 2.53)

1.42 (1.12, 1.81)

2.12 (2.12, 2.13)

3.63 (1.68, 7.83)

0.31 (0.30, 0.31)

9.54 (8.14, 11.18)

2.56 (2.45, 2.68)

1.33 (1.01, 1.74)

0.41 (0.19, 0.91)

1.11 (0.68, 1.80)

1.11 (0.41, 3.04)

1.09 (0.94, 1.26)

0.56 (0.35, 0.90)

0.79 (0.31, 2.00)

ES (95% CI)

0.75 (0.64, 0.87)

0.88 (0.69, 1.12)

1.15 (0.86, 1.54)

0.23 (0.22, 0.23)

2.43 (2.31, 2.56)

1.19 (0.48, 2.96)

0.97 (0.54, 1.75)

1.73 (1.57, 1.91)

0.94 (0.76, 1.17)

1.15 (1.00, 1.34)

0.34 (0.34, 0.34)

2.89 (2.76, 3.02)

0.41 (0.15, 1.06)

3.01 (0.95, 9.57)

1.05 (0.73, 1.52)

1.36 (0.84, 2.20)

0.66 (0.50, 0.87)

0.99 (0.61, 1.59)

2.32 (2.21, 2.44)

0.55 (0.21, 1.44)

1.04 (0.71, 1.52)

3.46 (2.19, 5.48)

1.02 (0.81, 1.30)

0.33 (0.15, 0.68)

1.93 (1.40, 2.65)

1.24 (1.01, 1.52)

1.03 (0.88, 1.21)

5.28 (4.00, 6.97)

2.07 (0.47, 9.18)

0.91 (0.23, 3.60)

2.46 (0.94, 6.45)

0.85 (0.70, 1.03)

1.11 (0.19, 6.43)

1.11 (0.59, 2.08)

1.76 (1.33, 2.33)

0.00 (0.00, 0.00)

2.40 (2.28, 2.53)

1.42 (1.12, 1.81)

2.12 (2.12, 2.13)

3.63 (1.68, 7.83)

0.31 (0.30, 0.31)

9.54 (8.14, 11.18)

2.56 (2.45, 2.68)

1.33 (1.01, 1.74)

0.41 (0.19, 0.91)

1.11 (0.68, 1.80)

1.11 (0.41, 3.04)

1.09 (0.94, 1.26)

0.56 (0.35, 0.90)

0.79 (0.31, 2.00)

ES (95% CI)

0.75 (0.64, 0.87)

0.88 (0.69, 1.12)

1.15 (0.86, 1.54)

0.23 (0.22, 0.23)

2.43 (2.31, 2.56)

1.19 (0.48, 2.96)

0.97 (0.54, 1.75)

1.73 (1.57, 1.91)

0.94 (0.76, 1.17)

1.15 (1.00, 1.34)

0.34 (0.34, 0.34)

2.89 (2.76, 3.02)

0.41 (0.15, 1.06)

3.01 (0.95, 9.57)

1.00081 1 1232

Ratio favours Intervention

444

Figure A4.14: Forest plots for proportion of households who found the services

affordable, by type of slum, when service was delivered by alternative providers

NOTE: Weights are from random effects analysis

Overall (I-squared = 73.1%, p = 0.000)

Hailu,D.,Osorio,R.G.,Tsukada,R.(2012)

Mustafa,D.,Reeder,P.(2009)

Zaki,S.,Nurul,A.A.T.M.(2009)

Low income household

Hailu,D.,Osorio,R.G.,Tsukada,R.(2012)

Zaki,S.,Nurul,A.A.T.M.(2009)

Subtotal (I-squared = 0.0%, p = 0.535)

Hailu,D.,Osorio,R.G.,Tsukada,R.(2012)

Zaki,S.,Nurul,A.A.T.M.(2009)

Slum - formal

Zaki,S.,Nurul,A.A.T.M.(2009)

Kayaga,S.,Kadimba-Mwanamwambwa,C.(2006)

Slum - informal

Subtotal (I-squared = .%, p = .)

Subtotal (I-squared = 81.1%, p = 0.000)

Evidence

1.11 (0.67, 1.83)

1.11 (0.45, 2.72)

0.20 (0.10, 0.38)

2.66 (0.76, 9.28)

2.11 (0.78, 5.68)

1.28 (0.27, 6.08)

0.97 (0.44, 2.10)

1.50 (0.99, 2.26)

0.87 (0.43, 1.79)

1.60 (0.84, 3.06)

1.75 (0.70, 4.38)

1.28 (0.74, 2.24)

0.82 (0.33, 2.06)

ES (95% CI)

1.11 (0.67, 1.83)

1.11 (0.45, 2.72)

0.20 (0.10, 0.38)

2.66 (0.76, 9.28)

2.11 (0.78, 5.68)

1.28 (0.27, 6.08)

0.97 (0.44, 2.10)

1.50 (0.99, 2.26)

0.87 (0.43, 1.79)

1.60 (0.84, 3.06)

1.75 (0.70, 4.38)

1.28 (0.74, 2.24)

0.82 (0.33, 2.06)

ES (95% CI)

1.105 1 9.53

Ratio favours Intervention

445

LIST OF ABBREVIATIONS

AAA Sociedad de Aceueducto, Alcantarillado y Aseo de Barranquilla S.A

ADB Asian Development Bank

AEC Ahmedabad Electricity Company

AMA Accra Metropolitan Assembly

AMC Ahmedabad Municipal Corporation

APSA Association for Promoting Social Action

BADI Basic Amenities Deprivation Index

BMC Mumbai Municipal Corporation

BSUP Basic services for the urban poor

BWSL Belize Water Supply Limited

BWSSB Bangalore Water Supply and Sewerage Board

CBO Community-Based Organization

CLIFF Community-led Infrastructure Facility

CMC Community Management Committee

CODI Community Organizations Development Institute

CSA Central Statistical Authority

DAEP Depressed Area Electrification Program

DEWATS Decentralized wastewater treatment systems

DFID UK Department of International Development

DFID SARH UK Department for International Development South Asia Research Hub

DSK Dusthya Shasthya Kendra

DTF Devolution Trust Fund

DWASA Dhaka Water Supply and Sewerage Authority

EDF Électricité de France

EEPCO Ethiopian Electric and Power Company

EngKAR Engineering Knowledge Research Programme

446

EPPI-Centre Evidence for Policy and Practice Information and Co-ordinating Centre

ESKOM South African Utility

FGD Focus Group Discussion

GDP Gross domestic product

GNESD Global Network on Energy for Sustainable Development

IDA International Development Association

IDP Integrated Development Plan

IDPAA Institute for Developmental Policy Analysis and Advocacy

ISJ Institute Social Jakarta

JBIC Japanese Bank for International Co-operation

JMC Jabalpur Municipal Corporation

JNNURM Jawaharlal Nehru National Urban Renewal Mission

KIEB Kolkata Environment Improvement Programme

KMA Kumasi Metropolitan Assembly

KMC Kolkata Municipal Corporation

KUSP Kampala Urban Sanitation Project

KWSB Karachi Water and Sewerage Board

LGEB Local Government Engineering Bureau

LGED Local Government and Engineering Department

LMIC Low- and Middle-Income Country

LPG Liquefied petroleum gas

MDG Millennium Development Goal

MEA Metropolitan Electricity Authority

MERALCO Manila Electric Company

MPUSP Madhya Pradesh urban services for the poor programme

NEA National Electrification Agency

NESDB National Economic and Social Development Board

NGO Non-Governmental Organization

447

NSO National Statistical Office

NSS National Sample Survey

OCWD Olongapo City Water District

ODA Overseas development assistance

OPP Orangi Pilot Project

OPP-RTI Orangi Pilot Project-Research and Training Institute

PAC Public Affairs Centre

PCUP Presidents Commission on Urban Poor

PHCN Power Holding Company of Nigeria

PHED Public Health and Engineering Department

PMGP Prime Minister’s Grant Project

PMU Program Management Unit

PP Poverty Pocket

PPN Popular privatization narrative

PRONAI Program for Normalisation of Informal Areas

PSTC Population Services and Training Center

RERC Rajasthan Electricity Regulatory Commission

RWSSMB Rajasthan Water Supply and Sewerage Management Board

SBMA Subic Metropolitan Area

SBMC Sanitation Block Management Committees

SDI Service Deprivation Index

SHAHAR Supporting Household Activities for Health, Assets and Revenue project

SIDA Swedish Development Cooperation Agency

SIP Slum Improvement Project

SKAA Sindh Katchi Abadi Authority

SMD Standardised Mean Difference

SPARC Society for Promotion of Area Resource Centres

ULB Urban local bodies

448

VAMBAY Valmiki Ambedkar Awas Yojana

WASA Water Supply and Sewerage Authority

WASH Water, Sanitation and Hygiene

WSP Water and Sanitation Programme

WSS Water supply and sanitation

WSSA Water and sanitation service in Africa

WVI World Vision International