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 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? 2016.

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Authors: Annamalai TR, Devkar G, Mahalingam A, Benjamin S, Rajan SC, Deep A. EPPI-Centre, Social Science Research Unit, UCL Institute of Education, University College London. 

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 cooperation and support of the public sector.