Decentralization has been proposed for a decade, but implementation was very slow and in mid-2007 was reversed when the national water company took over two municipal systems.

Additionally, ENACAL, the national utility responsible for water provision in Managua, has been labelled as "one of the most notorious overbillers in the country".

[4] Bacteriological urban drinking water quality was considered acceptable by the WHO based on samples analyzed by the national utility.

The 2005 Census reported that 63% of households have toilet systems which discharge into sewers in Managua, with 30% of the population using pit latrines in settlements, and the remainder using septic tanks managed by five private companies.

[8] Nicaragua is a water-rich country with a water availability of 35,000 cubic meter/capita/year, corresponding to more than five times the average for Central America and the Caribbean.

[5] After the revolution a centralized public national water company, the Instituto Nicaragüense de Acueductos y Alcantarillados (INAA), was created.

After the electoral defeat of Daniel Ortega's first administration (1979–1990) the subsequent governments tried to decentralize service provision without much success.

[11] Subsequently, tariffs were frozen during the administration of Enrique Bolaños (2002–2007), leading to a gradual deterioration of the utility's financial situation.

This project included provisions for decentralization, with private and local water management in the municipalities of León and Chinandega.

[6] The contract has been criticized by a consumer advocacy group which argues the agreement will make access to public water more costly to most Nicaraguans.

[15] A new Water Law was passed in November 2007 which gives ENACAL responsibility for supervision and control of service provision in rural areas.

The regulatory agency, the National Water and Sewerage Institute - Instituto Nicaragüense de Acueductos y Alcantarillados, INAA - is in charge of sector regulation.

Some of these departments have received greater autonomy, such as in the case of Granada, under what is called the "Modelo de Gestion Descontentrado".

ETAP plays a crucial role in enhancing rural capacity and addressing water distribution inequalities in Nicaragua.

Through a structured two-year curriculum, ETAP offers full-ride scholarships leading to a diploma as a "Specialist Technician in Design and Management of Rural Water Supply and Sanitation Systems," recognized by the Nicaraguan Technical Institute (INATEC).

Approximately 85% of Agua Para La Vida's field staff are ETAP alumni, demonstrating the program's efficacy in equipping rural citizens with expertise in water and sanitation skills while fostering self-sufficiency in infrastructure projects.

By emphasizing active participation and empowering individuals through financial autonomy and political engagement, Agua Para La Vida aims to create sustainable solutions that alleviate water inequity and promote inclusive development.

In Ecuador, Buen Vivir principles have been integrated into watershed management programs, such as the New Governance Model implemented in Tungurahua province.

This model emphasizes participatory governance and indigenous norms, which have led to innovative approaches in water resource management.

Local communities have been actively involved in decision-making processes, ensuring that water access and distribution are equitable and sustainable.

Buen Vivir initiatives promote infrastructure development to improve water access in rural areas.

Similar to initiatives such as ETAP, capacity building and education are also integral components of Buen Vivir strategies.

ENACAL has taken recent steps to improve efficiency, however and labor productivity has increased from 7.5 employees per 1000 water connections in 2006 to 7.04 in 2007.

This led to its near bankruptcy and required the National Government to make transfers of an average of US$20 million per year to compensate net losses as of 2005.

In July 2007 there was a modification in sewerage tariffs for the City of Managua which allows sewage treatment costs to be partially covered.

Between 2002 and 2007 ENACAL invested US$162 million in the sector, of which 2% was self-financed by the utility, 5% was financed by the national government with its own resources, and the remaining 93% came from external grants and loans.

ICO has approved a $5 million loan to support the building of a sanitary sewerage and wastewater treatment system in Telica, Nicaragua.

[33] The main donors in the water and sanitation sector in Nicaragua are the Spanish development cooperation (AECID) which supports the sector program VIDA, the Inter-American Development Bank (IDB) that implements the Spanish Water Fund FECASALC, the World Bank with its program to reduce water losses in Managua (PRASMA), a rural program called PRASNICA, a project for adaptation to climate change, Germany through GIZ and KfW, as well as the Swiss Development Cooperation (COSUDE) in rural areas.