Decentralization and Resource Capacity for Sustainable Sanitation Services Delivery in Ghana

Lack of or inadequate access to water, sanitation and hygiene (WASH) facilities has been cited as a major cause of morbidity and mortality in most developing countries. Meanwhile, Ghana provides a good example of the potential for decentralization to facilitate the delivery of municipal services (including sanitation), given that the country has implemented decentralization for the past three decades, with relatively well-established principles of popular participation in constitutional and other legal provisions. The country today has policies, institutions, and agencies for sanitation and waste management at all levels; from the central government to the various district authorities. In spite of this, Ghana is still ranked among the poorest in terms of access to improved sanitation, which raises worrying questions regarding the well touted positive credentials of the decentralization system in improving municipal service delivery. This chapter, therefore, unpacks this seeming paradox by examining the country’s past experiences, present situation and the future expectations on how the process of decentralization can be improved to ensure sustainable sanitation services delivery in the country. Employing a rapid review approach, the chapter acknowledges the marginal improvement chalked by the decentralization process in the delivery of sanitation services, but advocates political, legislative, institutional and attitudinal re-engineering in order to reap the full benefits of decentralization in the country.