Eau et développement

Despite recent progress extending access to drinking water supplies globally, ensuring long-term functionality of rural water infrastructure remains challenging. Past research on rural water project outcomes has used two principal approaches: large-N statistical studies estimating average effect sizes, or case studies providing causal description. Notably lacking is a rigorous comparative analysis of conditions determining sustained service delivery. We use fuzzy-set qualitative comparative analysis (fsQCA) to identify causal conditions ("pathways") leading to sustained functionality of rural water supplies across diverse geographies. Twenty cases were selected through a review of the literature. We identified and coded five conditions to examine their influence on project outcomes for each case. Results reveal three distinct pathways sufficient for achieving sustained functionality: Pathway 1 features piped networks with professionalized, service-oriented management and post-construction support. Pathway 2 features a self-supply approach (e.g., private wells and small piped schemes) delivering water services on premises. Pathway 3 describes community-managed water points (e.g., deep boreholes with hand-pumps) in the context of freshwater scarcity. Two conditions were common across all pathways: good financial management and user participation in project decisions. Strong management, combined with sufficient financial and technical resources, moderates the influence of physical water availability on service sustainability.

Water and sanitation represents a key battlefront in combating the spread of antimicrobial resistance (AMR). Basic water sanitation infrastructure is an essential first step to protecting public health, thereby limiting the spread of pathogens and the need for antibiotics. AMR presents unique human health risks, meriting new risk assessment frameworks specifically adapted to water and sanitation-borne AMR. There are numerous exposure routes to AMR originating from human waste, each of which must be quantified for its relative risk to human health. Wastewater treatment plants (WWTPs) play a vital role in centralized collection and treatment of human sewage, but there are numerous unresolved questions in terms of the microbial ecological processes occurring within and the extent to which they attenuate or amplify AMR. Research is needed to advance understanding of the fate of resistant bacteria and antibiotic resistance genes (ARGs) in various waste management systems, depending on the local constraints and intended re-use applications. WHO and national AMR action plans would benefit from a more holistic 'One Water' understanding. Here we provide a framework for research, policy, practice, and public engagement aimed at limiting the spread of AMR from water and sanitation in both low-, medium- and high-income countries, alike.

Today's rapid global urbanization highlights the need for long-term transformations of basic service sectors in developing cities in order to improve the livelihoods of the urban poor. Sustainability transitions frameworks have proven fruitful for addressing these sort of challenges. However, they have been at pains so far in accounting for the heterogeneity and complexities that typically characterize informal settlements in the Global South. We therefore propose a conceptual framework that extends the conventional analysis of socio-technical regimes by distinguishing the two levels of sectoral regime and service regime. Challenges for sustainability transitions may then be identified by missing alignments within and among the two regime levels. The framework is applied to the sanitation sector of Nairobi, Kenya, a city experiencing rapid population growth and a highly uneven provision of basic services. Drawing on a set of 152 in-depth interviews, observations, and five focus group discussions, the paper reconstructs the prevailing service regimes and shows how they suffer from misalignments and dysfunctionalities creating all sorts of problems at a sectoral level. We conclude that Nairobi's sanitation sector can best be characterized as representing a splintered regime. The paper concludes with a discussion of how the new conceptualization of socio-technical regimes suggests some new sustainable transition pathways and how this framework might also be instructive for transition challenges in cities of the Global North.

Ensuring universal access to safe drinking water is a global challenge, especially in rural areas. This research aimed to assess the effectiveness of a risk-based strategy to improve drinking water safety for five gravity-fed piped schemes in rural communities of the Mid-Western Region of Nepal. The strategy was based on establishing community-led monitoring of the microbial water quality and the sanitary status of the schemes. The interventions examined included field-robust laboratories, centralized data management, targeted infrastructure improvements, household hygiene and filter promotion, and community training. The results indicate a statistically significant improvement in the microbial water quality eight months after intervention implementation, with the share of taps and household stored water containers meeting the international guidelines increasing from 7% to 50% and from 17% to 53%, respectively. At the study endline, all taps had a concentration of <10 CFU Escherichia coli/100 mL. These water quality improvements were driven by scheme-level chlorination, improved hygiene behavior, and the universal uptake of household water treatment. Sanitary inspection tools did not predict microbial water quality and, alone, are not sufficient for decision making. Implementation of this risk-based water safety strategy in remote rural communities can support efforts towards achieving universal water safety.