Policy expertise

The political economy of sanitation: How to increase investment and improve services for the poor?

Policy Area
World Bank
2008 - 2010
OPM contact

This work helps inform the design and implementation of pro-poor sanitation projects by improving understanding around the complex institutional relationships in the sanitation sector. Worldwide, over two billion people live without access to adequate toilet facilities, with the poorest members of society often the worst affected. We used a political economy analysis (PEA) approach to investigate why sanitation investments and service provision are not given sufficient priority and why, when efforts are undertaken, they are not targeted towards improving sanitation for the poor. The team conducted a secondary literature desk review and mixed-methods research in four case study countries: Brazil, India, Indonesia, and Senegal. Findings from each case study were used to develop an Action Framework with recommendations for improving the design and implementation of sanitation programmes within different contexts. More broadly, the study identified the value of effective PEA for the sector, highlighting how it may lead to improvements in the timing, tailoring and location of investments, the strengthening of accountability mechanisms and the promotion of long-term engagement with different stakeholders.

The 2006 Human Development Report outlines the scale of the global sanitation problem: a third of the world’s population lack access to improved sanitation facilities. Furthermore, the majority of those lacking access live in low- and middle- income countries that are already failing to achieve key public health and social development goals.

The problem is further compounded by a lack of political incentives to invest in sanitation resources as well as over-reliance on mainstream technologies (e.g. sewerage) that are often inaccessible for the poorest and most vulnerable members of society.

There is an urgent need to improve understanding around the myriad social, political and economic factors that together determine the success or failure of investments within the sanitation sector. This project was established to address this need by providing evidence that can inform the design, development and implementation of effective pro-poor sanitation programmes.

Our team conducted a combination of primary and secondary research including a literature review on the political economy of sanitation and fieldwork research in four case study countries: Brazil, India, Indonesia and Senegal. The case study countries were selected to represent a range of sanitation contexts from which useful operational lessons could be drawn, and covered a variety of WSP and World Bank projects.

During the review stage of the project, key research questions and hypotheses were identified and used as a basis for the design of fieldwork strategies in each case study country. Field research was led by a multidisciplinary team of national and international consultants and sanitation experts and included interviews and focus group discussions with members of national and local governments, private and public service providers, civil society, international organisations, and project teams. In each country, processes, institutional arrangements, actors, risks and opportunities were mapped and assessed to draw out key examples and lessons learnt within the different contexts:

  • The Brazil case study analysed the national-level political economy dynamics of urban sanitation investment over the lifetime of the Water and Sanitation Sector Modernization Project . It also assessed the Bahil Azul Program implemented by the Bahia state utility in the Salvador Metropolitan Region of the country;
  • In India, the team looked at the political drivers for the success of the Total Sanitation Campaign in rural Maharashtra;
  • The Indonesia case study focused on the reasons behind the recent increase in government interest in urban sanitation provision; and
  • The Senegal case study analysed sector reforms at the end of the 1990s and explored political economy factors that explained the increased investment in urban sanitation in Dakar.

Case study findings were used to develop diagnostics frameworks for each country which, in turn, informed the development of an Action Framework – a set of operational implications and practical advice for sanitation practitioners. The Action Framework includes advice on the timing, tailoring and location of investments and operations, and the use of PEA to support pro-poor sanitation investments. Specific activities undertaken by our team included:

  • Conducting a secondary literature desk review on the political economy of sanitation
  • Designing fieldwork strategies for four case study countries: Brazil, India, Indonesia and Senegal
  • Conducting primary fieldwork including semi-structured key informant interviews and focus group discussions with public and private sector stakeholders and civil society organisations
  • Completing stakeholder analysis and organisational mapping for each case study context and developing diagnostics frameworks
  • Developing an Action Framework outlining operational guidance for sanitation practitioners

This study has helped improve understanding of the complex institutional relationships and processes inherent in the sanitation sector. In turn, by identifying the barriers and opportunities within different contexts and providing practical operational guidance, it is supporting improved design and implementation of effective pro-poor sanitation programmes.

More broadly, the study provides a blueprint for conducting political economy analysis of sanitation investments. The importance of PEA as an assessment approach in the sector is likely to increase as greater evidence of the positive relationship between improved sanitation and economic, educational and health outcomes results in greater awareness of, and political incentives for, investment in sanitation.

Associate Consultant
Leader, Social Development