A policy review  of Dutch aid during 1990 to 2011 to improve drinking water and sanitation services in developing countries found that while millions of peole have gained access, the impact on health and sustainability was limited.
The main focus of the review is on the period from 2004 when aid was directed at supporting the Millennium Development Goal of halving the world’s population without sustainable access to safe drinking water and basic sanitation by 2015.
The review is primarily based on:
- a study of Dutch policy and its execution;
- impact evaluation studies of drinking water and sanitation programmes in Benin , Egypt, Yemen, Mozambique  and Tanzania .
The policy review was supported by a reference group which included Dr. Christine Sijbesma of IRC International Water and Sanitation Centre.
Following an introduction, chapter 2 covers the problem analysis and international context. Chapter 3 describes the Dutch policy that lies at the basis of the targets for drinking water and sanitation, the responsibilities, instruments and policy execution, the budgets, monitoring and evaluation and the available information about the realisation of the contribution to the MDG target for drinking water and sanitation. Chapter 4 analyses the impact of the Netherlands-supported programmes and sustainability of results. The final chapter discusses findings that concern policy efficiency.
The main findings were:
- Dutch aid helped millions of people gain access to improved drinking water supply and sanitation
- the substantial increase in the use of improved water sources did not a guarantee the safety of the drinking water or the necessary water consumption
- effects of training and education on the building of toilets and their use and on hygiene was often limited and sanitary facilities were often too expensive for the poor
- improved access to drinking water supply significantly reduced women’s burden and increased their participation in programmes, and gave girls more time for school, but had a limited impact on income
- positive health impacts were generally modest or non-existent
- water supplies benefitted many poor communities but to a lesser extent the poorest segment while sanitation increased mainly in better off villages and households
- capacity of local communities, governments and NGOs for the maintenance of the facilities remained insufficient, there was limited involvement of the private sector, and partial subsidies remain necessary
- costs of communal water supplies and of privately owned toilets made with local materials were low, but benefits were often limited
- internal policy processes still fell short
 Tesselaar, R. et al., 2012. From infrastructure to sustainable impact : policy review of the Dutch contribution to drinking water and sanitation (1990-2011). (IOB evaluation ; no. 366). The Hague, The Netherlands: Ministry of Foreign Affairs of the Netherlands. 132 p. : 9 fig., 12 tab. 54 ref.
Available at: <http://bit.ly/OU0cOO> [PDF 4.6 MB]
 Tesselaar, R. et al., 2011. The risk of vanishing effects : impact evaluation of drinking water supply and sanitation programmes in rural Benin. (IOB evaluation ; no. 357). The Hague, The Netherlands: Ministry of Foreign Affairs of the Netherlands. Available at: <http://bit.ly/OTZe53>
 Tesselaar, R. et al., 2011. More than water, impact of drinking water supply and sanitation interventions in rural Mozambique. (IOB evaluation ; no. 360). The Hague, The Netherlands: Ministry of Foreign Affairs of the Netherlands. Available at: <http://bit.ly/OTZzow>
 Tesselaar, R. et al., 2007. Water supply and Sanitation programmes Shinyanga region, Tanzania 1990-2006. (IOB evaluation ; no. 305). The Hague, The Netherlands: Ministry of Foreign Affairs of the Netherlands. Available at: <http://bit.ly/OTZRMa>