Water supply and sanitation in low and middle income cities : comparing Accra, Jakarta and Sao Paulo

This paper is based on comparable cross-sectional studies of household environmental problems in three cities with differing proportions of poor households: Accra (majority are poor), Jakarta (fair share) and Sao Paulo (minority). It examines access to water, water sources, bacteriological water quality, excreta and sullage disposal systems, and price inequalities. In Accra, the absence of public infrastructure leads to higher levels of sharing of water points and latrines, whereas in Jakarta this absence is partly compensated by more private solutions. In Sao Paulo, the responsibility for providing water supply and sewerage is being shouldered by the government, or at least has been displaced from the individual households. Limited public resources available for water and sanitation systems tend to be invested in standard systems typically accessible only for the rich, while the poorest segments often struggle with the indirect access to the public systems. Whereas public water and sanitation services commonly are supplied below cost price, those without access to these services often pay a higher unit price, per bucket of water or for toilet use. The paper argues that policies should concentrate on extending the sanitary systems through differentiated and flexible services in low-income areas as well as emphasizing the importance of good management and participation at the lowest level, especially where the technology is less sophisticated.