private divide. This is especially true where there simply isn’t going to be the public or private financing to provide adequate water and sanitation services to individual households. In this case, community organization is likely to be critical, thereby involving another dimension of urban governance. The same economics that is used to justify government intervention often justifies more localized community action. The low-income residents of informal settlements, most of whom do not even have secure tenure rights, are not really in very a good position to organize their own water and sanitation provision (Spronk, 2009). Nevertheless, some of the more successful efforts to improve water and sanitation provision in deprived settlements have indeed come from the bottom up (McGranahan, 2009), as illustrated in Box 8 (see Annex). Despite the similarities among these successful endeavours, in every case, a closer look demonstrates that success depended on adapting to local conditions: political, economic, cultural, social, geographical and so on.
It is worth noting that despite the relevance for public health, inequalities in access to essential sanitation – in particular sewerage services (Hall & Lobina, 2009). – continue to be neglected in comparison to the supply of water. Sanitation is considered a public good, but it is highly unlikely that the MDG sanitation targets will be met (UNICEF and WHO, 2008, p8). In essence, the challenge to ensure sustainable, efficient and equitable provision of water and sanitation in urban (and rural) settings is a matter of multi-level governance (UNESCO, 2006), and the imperative to address the often ignored or neglected structural socio-economic and political processes or the systemic conditions that constrain the implementation of effective water and sanitation policies is critical (Castro, 2009, p. 5). Who participates? Who decides about how these services are to be organized, financed and governed, by whom, on what principles, based upon what interests, etc. (Castro, 2009, p. 6)? The constraints on decision-making and implementation processes are often defined by the participation and the power of a variety of actors (Sanz, 2009).
Participation, according to Stiglitz (2002), is considered critical to the social transformation necessary for development, since, among other factors, it would contribute to building ownership and commitment, to shaping avenues for involvement in decision-making processes, and to supporting sustainability of development processes, outcomes and decisions. Although the relevance of participation has been recognized by many agencies, in practice