Pakistan has made progress towards improving services through the adoption of MDGs. The document discusses the shift from MDGs to SDGs, focusing on goals for access to drinking water. While MDG 7 targeted halving the proportion of people without access to water, SDG 6 aims for universal access to safe drinking water by 2030. This represents a shift from access alone to ensuring water quality. However, achieving higher quality faces barriers including difficulties monitoring quality, lack of technical skills, inadequate cost recovery systems, and insufficient research capacity. The document advocates for addressing psychological, infrastructural, political/managerial, and economic barriers to improve quality of life in poor communities.

1. Pakistan and SDGs

2. MDGs Impact
• The adoption of the MDGs has catalyzed a major thrust towards the
improvement of services.

4. A Taxonomy of Goals
Sustainable
Development
Human
Development
Infrastructure
Centered
Physical
Infrastructure
Social
Infrastructure
Non-
Infrastructure
Economic
Growth
Environment

5. The Turn to Quality
MDG 7, Target 10,
Indicator 30
SDG 6, Target 6.1,
Indicator 6.1.1
Target Halve, by 2015, the
proportion of people
without sustainable
access to safe drinking
water
By 2030, achieve
universal and equitable
access to safe and
affordable drinking
water for all
Indicator Proportion of
population with
sustainable access to an
improved water source
Percentage of
population using safely
managed drinking water
services

6. Reasons for Quality Gaps
• Monitoring: progress cannot be measured without attention to the qualitative dimension.
The current service delivery systems lack the capacity to define and measure quality.
• Technical Skills: While the operation of basic infrastructure services can be handled by less-
trained or lower-educated staff, the quality-relevant components need to be handled by
better trained and educated personnel.
• Management: management systems designed for simpler operations find it difficult to
adapt themselves to higher level targets and goals.
• Cost Recovery: most service institutions are not equipped to recover the cost of their
operations from users; the result is an exclusive reliance on government budgets, and in
lean times, the discontinuation of quality-relevant services.
• Networking: High quality institutions possess a higher capacity for mobilizing support from
other entities at affordable cost: other government agencies, other segments of a stratified
industry (e.g., other tiers of the health system, primary, secondary, tertiary), universities
and research institutions, and the private sector. In contrast, simpler institutions are far
more reliant on internal resources, often to the detriment of the quality of their programs.
• Research: The quality of services depends on a continuous loop of information collection,
research and analysis, and adaptation of methods, policies, practices, procedures, and
investment to cater to changing situations.

7. The Four Barriers
• Psychological: The belief that they do not have the capacity to solve their
problems themselves. This can also be seen as a kind of fatalism that accepts
misery as divine-ordained. Dr. Khan advocated a program of social
mobilization to create awareness both of the problems and of the
community's capacity to address them.
• Infrastructural/Technological: Poor communities do not have the necessary
infrastructure for the delivery of services. The solution was to develop or
harness infrastructure and technology for the community's needs.
• Political/ Managerial: Poor communities lack the managerial capacity to
manage public activities efficiently, as well as the political capacity to
harness publicly available resources while protecting their own common
resources from exploitation or hijacking. This challenge required capacity
building investment.
• Economic: Finally, the poor communities lacked both the economic capacity
to afford municipal services, and the political capacity to obtain subsidies
from the public exchequer. The solution was, on the one hand to lower the
cost of services, and on the other hand to enhance their ability to pay.

8. Physical
Capital
Financial Capital
Human Capital
Social Capital
Human Capital
Financial Capital
Physical
Capital