The push to ensure that water supply, sanitation and hygiene promotion were always integrated within a project began in the 1990s. This has effectively ensured that more sanitation and hygiene work has been undertaken than would have otherwise been the case. Sanitation and hygiene have piggy backed on the political and community demand for improved water supplies. This piggy backing of sanitation and hygiene on political and community demand for improved water supplies has also highlighted some significant differences between the sectors. The result then of an integrated approach has worked to the disadvantage of sanitation. These can be summarised as:

• Different time horizons - A new water supply can be installed and completed in a matter of weeks; both sanitation and hygiene involve more complex forms of behaviour change which can require decades to achieve.

• Different decision-making processes - Water supply decision-making is based at community level; sanitation decisions are at household level and most hygiene behaviour change decisions at individual level. The promotion techniques needed are different for each level.

• Time to create demand - Demand for a water supply usually already exists and often it is difficult for an organisation to meet the high levels of demand. Demand for sanitation is hidden, weak, and needs to be created and vocalised before systems can be designed and constructed.

• Different skill sets required - The water sector has been dominated by engineers who feel comfortable with technical problems and tend to lean towards technical solutions. Sanitation requires softer, people-based skills and takes engineers into areas where they feel uncomfortable and with which they are unfamiliar. As a result, project staff in integrated projects naturally prefer water supply provision and tend to neglect sanitation.