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Citywide Inclusive Sanitation (CWIS) Initiative

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    The Global Sanitation Crisis

    Urban population growth dramatically outpaces gains in access to safe sanitation. As the world continues to urbanize, the challenges of sanitation will only grow. Not surprisingly, sanitation was an off-track Millennium Development Goal – the target was missed by almost 700 million people. The World Bank helps countries address sanitation challenges: ending open defecation, improving service delivery, and closing the loop from access to sanitation facilities to sustainable management of wastewater and sludge. Learn more in this INFOGRAPHIC 

    Moving from the MDGs to the SDGs 

    The Sustainable Development Goal 6 has drastically changed the focus from access to a household sanitation facility (as was prioritized under the MDGs) to consideration of the full sanitation service chain. Despite 2.1 billion people gaining access to improved toilets or latrines since 1990, we have a long way to go to meet the new SDG target of safely managed sanitation for all.

    Learn more about the Sanitation Service Chain in this infographic

    The World Bank’s Water Global Practice, in partnership with sector development partners (including The Bill & Melinda Gates Foundation, Emory University, The University of Leeds, WaterAid and Plan International), have jointly developed and advanced an approach to tackling urban sanitation challenges, termed Citywide Inclusive Sanitation (CWIS)

    CWIS: promoting Business as Unusual

    Business as usual in urban sanitation—where conventional sewerage and wastewater treatment are considered as the only solution—will not get us to universal safely managed sanitation. Citywide Inclusive Sanitation (CWIS) looks to shift the urban sanitation paradigm, aiming to ensure everyone has access to safely managed sanitation by promoting a range of solutions—both onsite and sewered, centralized or decentralized—tailored to the realities of the world's burgeoning cities. CWIS means focusing on service provision and its enabling environment, rather than on building infrastructure.

    This shift in paradigm to CWIS requires a shift in mindsets. Governments and development agencies increasingly recognize that historic approaches to urban sanitation have not always worked and new approaches are required. Consulting firms need to think differently, and not simply replicate approaches found in high-income countries. Engineering curricula should include the design and management of non-conventional systems and should explore opportunities for leapfrogging to solutions that take full account of the public health and environmental imperatives of urban sanitation. We should rethink the way sanitation infrastructure is funded and challenge approaches that subsidize sewers but not onsite sanitation, that do not embrace innovation and do not consider running costs. CWIS, or business as unusual, requires awareness raising and capacity building, capturing best practices, working in coordination with complementary city services, and the development and use of tools that help better design and implement sustainable urban sanitation services for all.

    At the World Bank, we see an important emerging global movement to engage on CWIS by governments and development partners, which provides an unprecedented opportunity to shift the urban sanitation paradigm in the pursuit of universal safely managed sanitation. Learn more about the World Bank’s approach to business as unusual in urban sanitation through our vision of Citywide Inclusive Sanitation and our approach to implementing it in our Frontiers in Environmental Science article.

    A CWIS project is where…

    • Everybody benefits from adequate sanitation service delivery outcomes that meet user aspirations and that protect the health of users.
    • Human waste is safely managed along the whole sanitation service chain ensuring protection of the environment and of human health.
    • diversity of appropriate technical solutions is embracedcombining both on-site and sewered solutions, in either centralized or decentralized systems, with consideration of resource recovery and re-use.
    • Cities demonstrate political will, technical and managerial leadership, and identify new and creative long-term funding options for sanitation.
    • Institutional arrangements and regulations, with well-aligned incentives, are in place for the operation and maintenance of the full sanitation service chain.
    • Funding is allocated for non-infrastructure aspects of service delivery, such as capacity building, household engagement and outreach, and sanitation marketing.
    • Complementary urban services, including water supply, drainage, greywater management and solid waste management, are incorporated into sanitation planning.
    • Activities are included to target specific unserved and underserved groups, such as women, ethnic minorities, the urban poor and people with disabilities.

    Good Examples of CWIS

    Watch the videos below to learn more about business as unusual in urban sanitation service provision


     Cochabamba, Bolivia – Decentralized Wastewater Collection, Treatment and Reuse

    English | Spanish | French


     Manila, Philippines – Mixed Wastewater and Fecal Sludge Responses

    English | Spanish | French


     El Alto, Bolivia – Dry Sanitation Services and Reuse

    English | Spanish | French


     Durban, South Africa – Services for All

    English | Spanish | French


     Kenya & Haiti – Container-Based Sanitation

    English | Spanish | French


     Brasilia, Brazil – Condominial Sewers and Appropriate Wastewater Treatment

    English | Spanish | French


     Brazil & Colombia – Connecting the Unconnected to Existing Sewers

    English | Spanish | French

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    The World Bank’s Citywide Inclusive Sanitation (CWIS) team is working with Bank task teams, their government counterparts and other development partners to help initiate and advance CWIS approaches, and to influence the design and implementation of urban sanitation investment projects and components, in a large range of countries across the world. The CWIS team is doing this through four major pillars of support: (1) direct Operational Support to Bank investment projects; (2) developing and disseminating Tools & Resources to assist project design and implementation; (3) undertaking Knowledge & Learning events; and (4) Building Partnerships with external stakeholders.

    Operational Support to Bank projects: At the World Bank we find that there is appetite for moving towards the principles of Citywide Inclusive Sanitation in our existing and our new urban sanitation investment projects and components, in low- and middle-income countries alike – and, increasingly, we see government and service provider counterparts interested in adopting CWIS approaches. We currently have engagements in a diversity of countries around the world in which we are advancing CWIS principles, at both large and small scale, be it in single or multiple cities in a given country. The World Bank’s CWIS team provides expertise in support of Bank and government project teams in operationalizing and embedding CWIS principles within their urban sanitation investments (see a list of the type of Bank staff and consultant expertise that we provide HERE).

    The Bank’s CWIS team is currently supporting urban sanitation engagements in over 30 countries. The list below provides a flavor of the differing degrees our engagement and work to advance the CWIS agenda in a selection of these countries.

    Access more details of the engagement HERE








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    The Bank’s CWIS team has developed the following operational tools, reference material and support documentation designed to assist task teams and their government counterparts in better designing and implementing urban sanitation projects and components that doesn’t involve the reinventing of the wheel for every new operation and which encourages the building on, or leapfrogging to, good global practice. This support material is organized below into the following groups: (1) Assessment tools and related materials (2) Guidance notes and manuals; (3) Generic and example terms of reference; and (4) Other complementary resources.

    Assessments & Related Materials

    The CWIS Costing & Planning Tool:

    This free-to-use, open-database online tool allows planners to compare the capital and running costs of different types of sanitation solutions along the whole sanitation service chain at the component, system, and city levels – for both sewered and onsite interventions.

    Fecal Sludge Flow Diagrams (SFDs):

    The SFDs depict the movement of fecal sludge/septage and wastewater across a city with the objective of providing impactful visualizations of the status of sanitation in a city, in order to assist planners, decision-makers and other stakeholders in better understanding the bottlenecks, gaps and ‘leakage’ of waste in the city.

    Urban Sanitation Rapid Assessments:

    The Urban Sanitation Rapid Assessment tool is designed to guide task teams and their government counterparts to understand the sanitation context of the city and to recommend short-term priority interventions that are in line with the project’s development objective as well as the Sustainable Development Goals.

    Strategic Sanitation Planning:

    The City-level Strategic Planning for Urban Sanitation Guidance Note is intended for use by World Bank task teams and their government counterparts, as well as other teams/organizations who are in the early stages of designing a new sanitation intervention or a new approach to providing sanitation services within a city.

    Countywide Inclusive Sanitation Planning Guide:

    The Government of Kenya’s ‘Countywide Inclusive Sanitation’ initiative was initiated with the support of World Bank Technical Assistance to better understand sanitation challenges along the rural/small town/peri-urban/urban continuum. A methodology was developed in collaboration with Nakuru County and relevant national government representatives to address sanitation challenges in a county-wide manner in Nakuru. This note summarizes the methodology used in order to encourage its application in other counties in Kenya and similar decentralized administrative boundaries in other countries.

    Urban Sanitation Implementation Indicators:

    These indicators have been developed to guide Bank teams and their government counterparts in the development of results frameworks for urban sanitation projects and programs.

    Nakuru Countywide Strategic Sanitation Plan:

    This Strategy lays down solutions to move to achieve the Nakuru County Vision 2030.


    Guidance Notes and Manuals

    *NEW: CONNECTING THE UNCONNECTED: Approaches for Getting Households to Connect to Sewerage Networks (launched on Nov.19, 2020)

    This guide looks at the reasons why so many households still get left behind and remain unconnected to existing or new sewer networks. The report also provides an overview and lessons from global experiences in order to identify the elements that can help maximize connections to sewers, including for low-income households, while drawing on the principles of CWIS.

    Health, Safety and Dignity of Sanitation Workers: An Initial Assessment

    The World Bank, World Health Organization (WHO), International Labour Organization (ILO) and WaterAid have joined forces to shed light on the neglected issue of sanitation workers. This report, the most extensive global exploration of the topic to date, analyzes the problems, explores good practices, and sets out actions to improve the health, safety and dignity of sanitation workers.

     Shared and Public Sanitation: Championing Delivery Models That Work

    A guide to the design and implementation of shared, community and public sanitation facilities, with a focus on operation and management models that support long-term service provision. The document draws on good experiences from across the globe and provides guidance for service providers (whether private or public sector entities) and service authorities, as well as consideration of the user perspective, including special needs for people with disabilities, women, the elderly, etc.

     Fecal Sludge and Septage Treatment: A Guide for Low- and Middle-Income Countries 

    Available in English | French

    This engineering design manual responds to the urgent need to provide guidance to engineers on how to design treatment works to appropriately handle the increasing volumes of faecal sludge and septage collected in the rapidly expanding towns and cities of the world. It discusses the urban contexts that influence treatment requirements and the different septage/fecal sludge treatment processes available. 

     Evaluating the Potential of Container-Based Sanitation:

    Over the past decade, container-based sanitation (CBS) approaches have emerged as an alternative service delivery modality for the urban poor without access to other onsite or sewered solutions. Existing CBS approaches focus on delivering a sanitation service along the whole sanitation service chain – from containment through to treatment and reuse – rather than only providing a traditional infrastructure intervention. 

    Generic and Example TORs

    We have developed generic terms of reference (TORs) for assisting task teams and their government counterparts in the design and implementation of key urban sanitation interventions, as well as having example terms of reference from some Bank operations, including:

    The Design of Fecal Sludge Management Interventions – considering their technical, institutional, social, financial and business dimensions.

    Also Available in French 

    Example TOR for Consulting Services for the Preparation of Participatory Sanitation Master Plans and Technical Specifications for Bidding Documents (Angola)

    Nakuru Countywide Inclusive Sanitation Terms of Reference for Preparation of a Strategic Sanitation Investment Plan for Nakuru County 


    Other Complementary Resources

    The CWIS team has curated a selection of relevant urban sanitation resources grouped into the following areas of interest. Access the full list of resources HERE.

    • More About Urban Sanitation
    • Onsite Sanitation/Fecal Sludge Management
    • Sewerage
    • Wastewater Treatment
    • Sludge and Greywater Management and Reuse
    • Wastewater Reuse
    • Financing and Subsidies
    • Monitoring and Evaluation
    • Policies, Intuitions and Regulation
    • Inclusion
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    The Bank’s CWIS team undertakes awareness raising, knowledge exchange and capacity building work through the design and delivery of CWIS Knowledge & Learning (K&L) events for Bank task teams, their government counterparts and development partners, with a view to promoting peer-to-peer learning on good practice urban sanitation service delivery. These tailored events and workshops can be national, regional or global in nature.

    The following events/workshops have already been carried out.

    Africa Regional K&L event, Durban, South Africa, December 2016

    Kenya National CWIS K&L event, Nairobi, Kenya, Februrary 2018

    LAC Regional K&L event, Brasília, Brazil, March 2018

    Ethiopia National CWIS K&L events

    MENA Regional workshop on sanitation/CWIS, Lebanon, May 2018

    West Africa Regional Anglophone K&L CWIS event, Accra, Ghana, May 2018

    Indonesia national workshop on sanitation/CWIS, Jakarta, Indonesia, November 2019

    Bangladesh national workshop on CWIS, Dhaka, Bangladesh, February 2019

    India National Workshop on CWIS, New Delhi, India, February 2019


    Anglophone & Lusophone Africa Event, Kampala, Uganda, November 2019


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    Partnerships between governments and the World Bank are at the heart of our work and of our modus operandi during both project preparation and implementation. In addition to our investment project work, the Bank’s CWIS team is also working across the world with several other key partners in the sector to advance the concepts of Citywide Inclusive Sanitation, including with other multilateral development banks, bilateral donors and various other development partners.

    We are partnering with the Bill & Melinda Gates Foundation under the Urban Sanitation Innovation Partnership which leverages the comparative advantages of both organizations in support of our country counterparts in working towards ‘proof of scale’ for innovative sanitation delivery services for all, with a focus on sustainable services for the poor. We are also working with bilateral organizations: in Angola, for example, we are co-financing a project with the Agence Française de Développement (AFD) that will support strategic sanitation planning in nine secondary cities and will pilot sanitation service provision for 35,000 people.

    We are collaborating with WaterAid, WHO, ILO and SNV on the challenges and realities facing sanitation workers; with GIZ, WaterAid and other development partners on the shared, community and public sanitation agenda; with pS-Eau, the University of Leeds, UCL and WSUP on rethinking approaches to designing and implementing sewers; with Eawag-Sandec and the Gates Foundation on training material for a new generation of urban sanitation sector professionals; and with other non-governmental organizations, think tanks and research entities on various CWIS-related initiatives.




The Citywide Inclusive Sanitation (CWIS) initiative is funded by the Global Water Security and Sanitation Partnership (GWSP).




Citywide Inclusive Sanitation Team, World Bank

Team members of the CWIS Initiative

Contact the CWIS Team