To address the complex challenge of sustaining basic water and sanitation services in low income settings, international organizations and local and national government entities are beginning to design and implement interventions explicitly aimed at addressing system weaknesses. Often referred to as “systems approaches,” these interventions seek to understand, engage with, and positively influence the network of actors and the interacting factors that deliver services.
As WASH sector assistance and support activities shift toward systems approaches, many associated intermediate results and desired outcomes become less quantifiable than those of more traditional WASH activities. This paper reviews systems approaches, evaluation methodologies, and several applications in East Africa, at varying geographic scales. Early findings from the application of outcome mapping and system-wide assessments within the USAID-funded Sustainable WASH Systems Learning Partnership (SWS) indicate the importance of including both within an overall monitoring approach to support systems strengthening of water and sanitation services.