Improving health at schools through franchising of water and sanitation services

Abstract

Some areas of the developing world have seen an increasingly poor and often unacceptable quality of water and sanitation service. The reason for this is invariably inadequate arrangements and incentives for operation and maintenance (O&M) -- including not just skills shortfalls, budget shortfalls and sometimes inadequate design and/or construction, but weak institutional arrangements, and unwillingness, or inability, to change. Improved institutional and financial mechanisms, where corporate, social and ethical responsibilities are given due attention, are needed. An important aspect would be how to increase positive incentives -- part of this must be the measurement of performance, and a system for rewarding on the basis of that performance.