[11] The reforms also aim at increasing cost recovery and a modernization of the urban utility Ghana Water Company Limited (GWCL).

[19] In the main Northern Region of Ghana alone, 32% of the 2.5 million residents lack access to improved water sources and must often resort to contaminated drinking-water.

[20] This table presents the classifications of improved and unimproved water sources in Ghana since the end of the Millennium Development Goals, according to the WHO and UNICEF.

[30] Contaminated drinking water, along with poor sanitation, are linked to transmission of water-related diseases such as cholera, diarrhoea, dysentery, hepatitis A, typhoid and polio.

[34] The main traditional sources of water in many parts of rural Ghana are small ponds and unprotected wells, both of which are really easily polluted, causing diseases to the people who drink it (Oxfam).

Inadequate management of urban, industrial and agricultural wastewater often means that the drinking-water of millions of people is either dangerously contaminated or chemically polluted.

[41] In 1817, Thomas Edward Bowdich documented upon the sanitation methods in the Ashanti Empire including the prevalence of latrines across the houses of Kumasi.

According to scholar Donna Maier, a Public Works Department existed in the Ashanti Empire under the stool called Akwammofo Akonnwa.

The Water Supply Division of the Public Works Department was responsible for the service provision in rural and urban areas of Ghana.

In the mid-1990s, under the Presidency of Jerry Rawlings and after the passing of a new democratic Constitution in 1992, the government of Ghana enacted five key laws that affected the responsibility for water supply and sanitation: In 1999, the responsibility to support communities in the provision of water supply and sanitation in more than 110 small towns and in rural areas was transferred to the District Assemblies.

In 2000, a lease contract between GWCL and the US company Azurix failed due to public opposition and accusations of corruption which led to the formation of the Coalition against Water Privatization.

The main objectives of the 5-year management contract were: In rural areas, the powers and resources of District Assemblies were strengthened through the Local Government Service Act 656 of 2003.

[54] The Ministry of Local Government and Rural Development shares responsibility for setting sanitation policies and coordinating funding for the sub-sector with MWRWH.

[62] Communities and in rural areas and small towns elect gender-balanced water and sanitation boards consisting of volunteers, including one or two village-based caretakers who received special training in repair and maintenance.

[58] Maintenance units of CWSA have been privatized and the regional companies created through this process now perform major repairs on behalf of District Assemblies.

IPA recruits researchers and decision-makers to measure the impacts of interventions in the areas of agriculture, education, health, financial inclusion, governance, peace & recovery, small & medium enterprises, and social protection among 18 country programs.

[68] This study assesses the willingness of households in Northern Ghana to purchase the Kosim filter that is sold by Pure Home Water (PHW), a Ghana-based NGO.

The study also aims to measure the health effects of household-level water treatment in areas whose populations have a high risk of waterborne disease.

[70] Founded in 2005, PHW was designed to be a manufacturer of ceramic pot water filters located in the northern city of Tamale, Ghana.

Its two goals include delivering aid to the people most in need of safe drinking water, sanitation and hygiene (WASH) in Northern Ghana, and to become financially and locally self-sustaining.

Saha Global works to empower the women of rural Ghanaian communities to provide access to clean water and electricity through the provision of business opportunities.

Through its efforts in making water and sanitation safe, accessible and cost-effective, Water.org has continued to deliver aid to more than four million lives around the world for over 25 years.

[80] As part of the efforts to reduce system losses, in February 2008 the Accra East Region of AVRL-GWCL has caused the arrest of ten illegal connection syndicates in the Adenta community.

A study conducted in five community-managed piped systems in the Ashanti Region found an average tariff of about US$0.60 per m³ in 2003, which actually covers between 57 and 77% of the full supply cost.

[85] Since economic efficiency as well as cost recovery in the sector are extremely low, financing water and sanitation investments in Ghana relies heavily on external funding.

[52] Despite the strong engagement of international donors, funding remains insufficient to achieve the Millennium Development Goals for water and sanitation, aiming at halving the share of the population without access to these services by 2015 compared to 1990.

[88] The International Finance Corporation (IFC) supports the Asutsuare Water Treatment Plant, a 500 million Euro Build, Own, Operate and Transfer (BOOT) project with GWCL developed by the Belgian contractor Denys.

[95] A large-scale decentralization approach in the planning, implementation, and management of water supply and sanitation in Ghana was one of the main characteristics of the second program.

Gender-balanced water and sanitation committees were set up to actively engage and include NGOs, private sector actors, and District Assemblies.

Therefore, the project supports the planning, construction, and rehabilitation of water and sanitation systems in small towns and provides hygiene promotion, training, and technical assistance.