Summary

Deteriorating quality of service provision and disease outbreaks (such as cholera) led to the institution of water supply and sanitation (WSS) sector reforms in Eastern and Southern Africa region in the 1990s. The realization of the urgent need to improve the performance of the sector, especially as related to health impacts, resulted in the formulation of new policy and legal and institutional frameworks to reorganize the sector and establish regulators who could address networked and nonnetworked WSS systems.

Regulators as policy implementers have the delicate role of balancing the interests of government, service providers, and consumers. Decision- makers continue to design, implement, and evaluate the outcomes associated with new frameworks. Regional regulatory cooperation can accelerate improvements in service provision to meet the United Nations Sustainable Development Goals through development of common frameworks and approaches for WSS that can be adapted to unique country situations.