What is the evidence on top-down and bottom-up approaches in improving access to water, sanitation and electricity services in low-income or informal settlements?

What do we want to know?

This systematic review examines the evidence on the effectiveness of different urban-planning approaches in providing access to water, sanitation and electricity services in low-income or informal settlements in low- and middle-income countries (LMICs). The study was funded by the Department for International Development (DFID) of the UK government and conducted by the Indian Institute of Technology Madras.

What did we find?

This review found that top-down efforts are ineffective for connecting populations to centralised water, sanitation or electricity services. Bottom up, participatory approaches are effective for local sanitation solutions, but not for water supply or connectivity to other services.

Services provided by public or private agencies through centralised planning and implementation (top-down) appeared effective in individual studies for connecting populations to water, sanitation and electricity. However, where studies were sufficiently similar to justify pooling findings in a statistical meta-analysis, this conclusion was not confirmed. Qualitative synthesis of contextual factors suggest a need for the customisation of solutions to meet local needs, and better delivery of services by alternative/non-government service providers.

Participatory (bottom-up) approaches adopted by NGOs and CBOs suit the construction and maintenance of toilets, which can be standalone, and statistical meta-analysis confirms their effectiveness for individual but not community toilets. Although studies of bottom-up approaches to improving water access appeared positive more often than studies of top down approaches, this difference was not statistically significant in a meta-analysis. Moreover, bottom-up approaches suffer from problems of scaling-up. Replication of successful models may not always be possible, since the same conditions may not be present in different locations.

Neighbourhoods without security of tenure are rarely served well top-down. Bottom-up approaches are also limited in this context, and also in Africa, where efforts may be hampered by particularly modest levels of economic development. Public-private partnerships show promise for top-down approaches to improving water supply. Bottom-up, NGO led initiatives for improving water supply need the co-operation and support of the public sector.

What are the implications?

Political commitment should be backed by appropriate institutional arrangements for a top-down approach to work.
A bottom-up approach is more effective in achieving an all-round improvement in access.
As policy shifts from community to personal household facilities, a bottom-up approach will have a greater relevance.
Addressing tenure-security issues plays an important role in effecting access.
Programmes that aim to improve basic services should incorporate components of inclusivity right from the project-conception stage.

How did we get these results?

The steps followed for the review were:

Formulating exclusion and inclusion criteria to determine the studies to be included in the review.
Deciding on the sources and the search methods (search phrases) to be used to identify the studies.
Managing the shortlisted and identified studies using EPPI-Reviewer.
Quality appraisal of the studies identified for inclusion in the review.
Synthesising the evidence in the included studies. Given the heterogeneity of the studies, multiple methods were used in the synthesis: numerical summary, meta-analysis and textual narration.

This report should be cited as: Annamalai TR, Devkar G, Mahalingam A, Benjamin S, Rajan SC, Deep A (2016) What is the evidence on top-down and bottom-up approaches in improving access to water, sanitation and electricity services in low-income or informal settlements? London: EPPI Centre, Social Science Research Unit, UCL Institute of Education, University College London.