From 1994–2011, USAID’s Financial Institutions Reform and Expansion–Debt and Infrastructure (FIRE-D) activity partnered with India’s central, state, and municipal governments to provide technical assistance to 16 Indian states. USAID published an independent ex-post evaluation that followed up on six states and cities, seven years after FIRE-D ended to look at the project's long-term impact, to understand how urban water and sanitation services have changed, and to what extent policies, practices, and financing mechanisms introduced through FIRE-D have been sustained. This is the fourth in a series of ex-post evaluations of past USAID water and sanitation projects.