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Water and Sanitation

Water for People’s Well-Being. (2013). Human Development in South Asia 2013: Water for Human Development. MahbubulHaq Human Development Centre.
The second chapter in the report emphasizes on the importance of clean water and sanitation for human development, with the arguments that they reduce income poverty and child mortality, break life-cycle disadvantages, enhance female education and free girls’ and women’s time from collecting water from long distances. While in the rural areas, poor human health is due to lack of necessary sanitation facilities and sometimes access to water at all, in urban areas population growth and urbanization contributes to poor human health, more so because of increasing water demand and water pollution. Furthermore, women feel the impact of these impediments more. Thus, using an integrated gender-sensitive approach to development, especially in line with the human development paradigm, can have a positive impact on the sustainability and effectiveness of water interventions in addition to water conservation. The chapter also points out that the actual financial and technical resources budgeted and utilized have varied substantially. The deficit in financing in the water and sanitation sector has resulted in lower coverage. Thus, it recommends that there should be provision for water as a human right in the legislation. There is also need for regulation and equity through pricing and subsidies so that the poor have access to this basic right.

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The economic impacts of inadequate sanitation in Pakistan.(2011). Water and Sanitation Program. World Bank.
The study empirically estimates the economic impacts of current poor sanitationconditions in Pakistan as well as the economic benefits of options for improved conditions. It provides policy makersat both national and local levels with evidence to justify larger investments
in improving the sanitation conditions in the country. According to the report, the current status of sanitation and poor hygiene practices has led to significant public costs, such as premature deaths and economic and financial costs due to diseases attributable to poor sanitation. Furthermore, national figures hide rural-urban disparities. Furthermore, health impacts accounted for the vast majority of total economic costs. They occur due to premature mortality, loss of productivity due to illness or costs of treatment. Therefore, priority treatment needs to be given to the issue of poor sanitation at all administrative levels—local, provincial, and national—and investments should be made to build moderately improved and hygienic latrines in both urban and rural areas. Special treatment and attention are needed in the areas where the poor population lives and in rural areas, where children are more at risk from diarrhea and malnutrition. Furthermore, education and awareness campaigns are needed at all levels, particularly in schools, to promote personal hygiene.

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Gupta, Anjali Sen. (2010).Water and sewerage services in Karachi: Citizen Report Card – sustainable service delivery improvements. Water and Sanitation Program, World Bank.
This report discusses the key findings and recommendations emerging from a pilot Citizen Report Card (CRC) on water, sanitation, and sewerage services in Karachi. This initiative comes, on one hand, in the wake of deteriorating services and dysfunctional governance structures and, on the other, an emergent consensus to bring in far-reaching institutional reforms that should move beyond financial and technical imperatives. However, what distinguishes a CRC from a regular survey is the post-survey strategy to build upon the ‘symptoms’ provided by the CRC, and design effective and focused responses. The findings of the CRC shows that Karachi W&SB’s services were found to be satisfactory and above average by 6.5 percent of the users and that both users and utility staff want improvement in systems and services. Thus, by assembling a set of credible and objective benchmarks, the CRC has provided a forum for different stakeholders to converge around issues and explore solutions and reforms. Furthermore, CRC studies are also a means for testing out different options that citizens wish to exercise, individually or collectively, to tackle current problems. Thus, CRC can be used for other services as well.

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Nanan, D., White, F., Azam, I., Afsar, H., &Hozhabri, S. (2003).Evaluation of a water, sanitation, and hygiene education intervention on diarrhoea in northern Pakistan.Bulletin of the World Health Organization, 81(3), 160-165.
This study examines the Water and Sanitation Extension Programme (WASEP) of the Aga Khan Development Network (AKDN), which it undertook in selected villages in Northern Areas and Chitral in northern Pakistan. The aim was to improve potable water supply at village and household levels, sanitation facilities and their use, and awareness and practices about hygiene behaviour. The WASEP intervention seemed to account for an estimated 25% reduction in the incidence of diarrhoea in children. In addition, younger children, girls, and children of younger mothers were associated with a higher likelihood of diarrhoea. These findings are important in terms of refining the approach to future water, sanitation, and hygiene initiatives in northern Pakistan. The integrated approach adopted by WASEP, which incorporates engineering solutions with appropriate education to maximize facility usage and improve hygiene practices, is a useful example of how desired health benefits can be obtained from projects of this type. Although the evaluation was made at an interim point of a scheduled five-year implementation plan, some sites had not completed the programme, and unexpected funding difficulties were experienced, the findings indicate that WASEP positively influenced the health status of villages served by the project, by reducing the incidence of diarrhoeal disease.

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