Water Supply and Sanitation in Low and Middle Income Cities: Comparing Accra, Jakarta and Sao Paulo

THE FOLLOW-UP to a paper prepared for the Fifth Stockholm Water Symposium in 1995, this is the first publication of the new Urban Environment Series. The paper draws on the three-city study of three very different cities – Jakarta, Accra and Sao Paulo – to examine households' access to water and sanitation facilities and the disadvantages faced by the poorest households. The questionnaires that form the basis of the study were carried out in 1991 and 1992. In each city, approximately 1,000 households were surveyed on a range of environmental topics, including water supply and sanitation. Each major problem was assessed in terms of the physical processes and severity, the health risks involved, and the priorities and willingness to pay of the residents.

The diversity between the cities is reflected in the poor residents' access to water and sanitation in each of them. In Accra, the majority of the population are denied the benefits of this infrastructure, whereas in Jakarta the percentage is lower and, in Sao Paulo, a minority suffer from the lack of service.

The paper concentrates on the household perspective of water and sanitation. That is to say, the environmental aspects of water on its way from tap to mouth and the hazards related to poor sanitation. Less central to the argument are issues of environmental management at municipal level. In its examination of the topic, the paper considers access to water in the three cities, sources of water, water quality, excreta disposal, sullage disposal and price inequalities. Conclusions and recommendations are presented at the end.