Project no. 290732 RurbanAfrica African Rural‐City Connections 2012 ‐2016 SP1‐Cooperation FP7‐SSH‐2011‐2 Deliverable No. 4.1 Mapping of Service Provision in low‐ income areas Volume 1: Main Report Work Package 4: Access to services in low‐ income city communities Author s: WEDC and other WP4 team members Work Pa ckage: 4 Due date, month: 31 ‐0 3‐2014 Date of first draft, month: 31 ‐0 3‐2014 Final version, month: Volume 1: Main Report Mapping of Service Provision in low-income areas – Sub-Saharan Africa Volume 2: Country Reports 1. Access to services in low-income city communities – Cameroon 2. Access to services in low-income city communities– Ghana 3. Access to Services in Rwanda 4. Urban poverty dynamics and rural – urban linkages: access to services in low income communities in Tanzania Main Report Contents List of Tables ............................................................................................................................... 6 List of Figures .............................................................................................................................. 6 1. Introduction ........................................................................................................................ 9 1.1 Case study countries ................................................................................................... 9 1.2 Data analysis method ................................................................................................ 11 2. State of the Art Overview of Sanitation in Sub-Saharan Africa ........................................ 14 2.1 Patterns of access to sanitation ................................................................................ 14 2.2 Barriers to improved urban sanitation services ........................................................ 17 2.3 Innovative approaches in urban sanitation .............................................................. 18 2.4 Case study countries ................................................................................................. 20 2.4.1 Cameroon .............................................................................................................. 20 2.4.2 Ghana .................................................................................................................... 24 2.4.3 Rwanda.................................................................................................................. 28 2.4.4 Tanzania ................................................................................................................ 31 2.5 Sanitation references ................................................................................................ 35 3. State of the Art Overview for Water Supply in Sub-Saharan Africa ................................. 36 3.1 Patterns of access to rural water .............................................................................. 36 3.2 Rural water challenges and barriers ......................................................................... 37 3.3 Patterns of access urban water................................................................................. 37 3.4 Barriers to improved water services ......................................................................... 39 3.5 Successful and innovative urban water approaches ................................................ 40 3.6 Case study countries ................................................................................................ 42 3.6.1 Cameroon .............................................................................................................. 42 3.6.2 Ghana .................................................................................................................... 46 3.6.3 Rwanda.................................................................................................................. 50 3.6.4 Tanzania ............................................................................................................... 53 3.7 Water sector references ........................................................................................... 56 4. State of the Art Overview for Electricity in Sub-Saharan Africa ....................................... 59 4.1 Patterns of access ..................................................................................................... 59 4.2 Financing access to electricity ................................................................................... 60 4.3 Barriers to improved electricity access ..................................................................... 61 4.4 Use of electricity in urban low income communities ............................................... 62 4.5 Effects of intermittent or no electricity .................................................................... 63 4.6 Increasing electricity access ...................................................................................... 63 4.7 Case Study Countries ................................................................................................ 64 4.7.1 Cameroon .............................................................................................................. 64 4.7.2 Ghana .................................................................................................................... 67 4.7.3 Rwanda.................................................................................................................. 70 4.7.4 Tanzania ................................................................................................................ 72 4.8 Electricity References ................................................................................................ 74 5. State of the Art Overview for Primary and Secondary Education in Sub-Saharan Africa . 77 5.1 Patterns of access ..................................................................................................... 77 5.3 Increasing access: innovative approaches ................................................................ 79 5.4 Case Study Countries ............................................................................................... 81 5.4.1 Cameroon .............................................................................................................. 81 5.4.2 Ghana .................................................................................................................... 83 5.4.3 Rwanda.................................................................................................................. 83 5.4.4 Tanzania ................................................................................................................ 84 5.5 Education References............................................................................................... 85 6. State of the Art Overview for Health in Sub-Saharan Africa ............................................. 86 6.1 Patterns of access .................................................................................................... 86 6.2 Challenges and barriers to access ............................................................................ 86 6.3 Increasing access ...................................................................................................... 89 6.4 Case Study Countries ................................................................................................ 89 6.4.1 Cameroon .............................................................................................................. 89 6.4.2 Ghana .................................................................................................................... 90 6.4.3 Rwanda.................................................................................................................. 92 6.4.4 Tanzania ................................................................................................................ 93 6.5 References ................................................................................................................ 94 7. State of the Art Overview for Mobile Phones in Sub-Saharan Africa ............................... 95 7.1 Patterns of access ..................................................................................................... 95 7.2 Barriers to mobile phone access .............................................................................. 95 7.3 Innovative uses to enhance livelihoods .................................................................... 96 7.4 Case Study Countries ................................................................................................ 97 7.4.1 Cameroon .............................................................................................................. 97 7.4.2 Ghana .................................................................................................................... 99 7.4.3 Rwanda................................................................................................................ 101 7.4.4 Tanzania .............................................................................................................. 103 7.5 Mobile references ................................................................................................... 105 8. State of the Art Overview for Urban Transport in Sub-Saharan Africa ........................... 106 8.1 Key problems .........................................................................................................