In India, the approach of the Total Sanitation Campaign (a nationwide programme to boost sanitation coverage, particularly in rural areas) was revised in 2004 to make the payment of the subsidy to below-poverty line (BPL) households dependent on the entire village reaching Open Defecation Free (ODF) status.14 OBA mechanisms have also been considered by bilateral donors, such as the AFD in Morocco and South Africa,15 but they are yet to apply those principles on a significant scale. This mechanism works as follows: a fixed subsidy amount is paid to a private operator for each new water connection installed in a poor neighbourhood. A significant risk with such approach, however, is that the newly connected users might not receive adequate service from the operator after the connection has been installed. To enhance the sustainability of the schemes, a portion of the output-based payment can be withheld until several months of service delivery have been made.