Reducing Inequalities in Water Supply, Sanitation, and Hygiene in the Era of the Sustainable Development Goals

The Sustainable Development Goals (SDGs) and the World Bank’s corporate goals of ending extreme poverty and boosting shared prosperity call for specific attention to the poor and vulnerable. The overarching objective of the SDGs is to end poverty in all its forms, but their key difference from the earlier Millennium Development Goals (MDGs) is the integration of social, economic, and environmental goals (UN 2015). This has significant implications for reforms aimed at improving service delivery. With this understanding as its guiding compass, the Water Supply, Sanitation, and Hygiene (WASH) Poverty Diagnostic Initiative focuses on what it will take to reduce existing inequalities in WASH services worldwide. This report, a synthesis of that global initiative, offers new insights on how data can be used to inform allocation decisions to reduce inequalities and prioritize investment in WASH to boost human capital. It also offers a fresh perspective on service delivery that considers how institutional arrangements1 affect the incentives of a range of actors. When it comes to improving services, politics matters as much today as it did in the London of the mid-19th century. Importantly, as will be discussed below, the report does not offer prescriptive global solutions for service delivery challenges. Instead, it seeks to encourage a dialogue on ways to think and work differently, using a problem-driven approach and engaging with the constraints imposed by the broader governance environment. Built on in-depth country-level analysis, the WASH Poverty Diagnostic Initiative aims to provide data-driven recommendations to help policy makers, stakeholders, and donors plan more strategically and equitably. The present report synthesizes multisectoral research from 17 low and middle-income countries and the West Bank and Gaza, undertaken since 2015. It presents new evidence on inequalities in access to WASH services, examines the impact of unequal services on the poor, and explores context-specific constraints that go beyond technical issues to understand why service delivery continues to be inadequate and inefficient. It highlights findings from individual countries, involves substantial reanalysis of existing data sets in new and innovative ways, brings new evidence on spatial inequalities at the subnational level, and shares insights on SDG parameters that were previously invisible. The work confirms some prior findings, even as it challenges water sector practitioners and decision makers to do business differently.